Effects of acute and chronic trauma on degree centrality of brain functional images in patients with post-traumatic stress disorder who lost their only child / 中华行为医学与脑科学杂志

Objective:To investigate the effects and significance of acute and chronic trauma on brain degree centrality (DC) in patients with post-traumatic stress disorder (PTSD) who lost their only child at resting state.Methods:Retrospectively, the study enrolled a total of 51 parents with PTSD, including 35 PTSD parents whose children was lost in emergencies (acute bereaved PTSD group) and 16 PTSD parents whose children was lost of chronic causes such as diseases (chronic bereaved PTSD group). Fifty local adults were also included as healthy controls (HC group). The clinical administered PTSD scale(CAPS) was used to evaluate the severity of the subjects' clinical symptoms.Resting-state functional magnetic resonance imaging(fMRI) data of all subjects were collected and DC values were calculated.SPSS 22.0 software was used for statistical analysis.Covariance analysis was performed among three groups, while post hoc was performed between any two groups.What's more, correlation analyses were utilized between abnormal brain regions and the scores of CAPS.Results:Significant group effects were found in multiple regions, including the right inferior temporal gyrus (MNI: x, y, z=66, -27, -21), right temporal pole (MNI: x, y, z=54, 15, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15), bilateral medial superior frontal gyri (MNI: right x, y, z=6, 63, 12; left x, y, z=-3, 60, 18), left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with HC group, the DC of two patient groups increased in the right inferior temporal gyrus (MNI: acute x, y, z=63, -27, -21; chronic x, y, z=63, -21, -27); the DC of acute bereaved PTSD group decreased in the right temporal pole (MNI: x, y, z=45, 21, -15) and the right orbital inferior frontal gyrus (MNI: x, y, z=48, 24, -12), while the DC of chronic bereaved PTSD group decreased in the left inferior parietal angular gyrus (MNI: x, y, z=-45, -36, 51) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51). Compared with chronic bereaved PTSD group, the DC of acute bereaved PTSD group increased in the left inferior parietal angular gyrus (MNI: x, y, z=-33, -39, 42) and left postcentral gyrus (MNI: x, y, z=-45, -33, 51), while decreased in the right temporal pole (MNI: x, y, z=51, 12, -9), right orbital inferior frontal gyrus (MNI: x, y, z=42, 21, -15) and bilateral medial superior frontal gyri (MNI: left x, y, z=0, 57, 15; right x, y, z=3, 57, 15). In chronic bereaved PTSD group, the DC of the left postcentral gyrus was negatively correlated with C1 (avoid trauma-related thoughts, feelings) score in CAPS ( r=-0.606, P=0.028). In acute bereaved PTSD group, the DC of the left medial superior frontal gyrus was negatively correlated with D4 (high vigilance) score ( r=-0.416, P=0.020). Conclusion:There exist functional abnormalities of multiple brain regions in acute and chronic bereaved parents with PTSD.The high arousal symptoms of the former may be related with the abnormalities of prefrontal-amygdala neural circuit, while the latter show higher avoidance which may be associated with the dysfunction of somatosensory brain regions such as postcentral gyrus.

The evaluating value of hippocampal subfield's T2 signal intensity before and after the treatment for mild cognitive impairment / 实用放射学杂志

Objective To investigate the value of the hippocampal subfield's MRI T2 signal intensity in evaluating the effect of the hydrochloric donepezil for mild cognitive impairment(MCI).Methods 20 MCI patients with hydrochloric donepezil (treatment group) and 20 patients with placebo (control group) were scanned by MRI using FSE-T2 sequence.The margin of hippocampal subfields was outlined manually for each side to measure the MRI T2 signal intensity.The relationship between hippocampal MRI T2 signal intensity and MMSE scores was analyzed in the treatment group.Results Before the treatment, there was no significant difference of the MRI T2 signal intensity between groups.After the treatment, the MRI T2 signal intensity in the bilateral head of the treatment group was significantly decreased compared with the control group(P<0.05).There was an inverse relationship between the MRI T2 signal intensity of the bilateral hippocampal head and MMSE scores in the treatment group(P<0.05).Conclusion The MRI T2 signal intensity in the bilateral hippocampal head could be regarded as a valuable marker in making clinical diagnosis and evaluating the effect of the treatment for MCI in its early stage.

Application of Hippocampal Subfield Magnetic Resonance Imaging T2 Signal Intensity for Amnestic Mild Cognitive Impairment / 中国康复理论与实践

@#Objective To apply the MRI T2 signal intensity of hippocampal subfield in patients with amnestic mild cognitive impairment (aMCI) as early imageology. Methods From October, 2014 to August, 2015, 20 aMCI patients accepted cognitive training (training group), 20 aMCI patients accepted speech communication (speech group), and 20 age-and gender-matched healthy old people (control group) were scanned with MRI using FSE-T2 sequence. The margin of hippocampal subfields were outlined manually for each side to measure the T2 sig-nal intensity. The correlation between hippocampal T2 signal intensity and the scores of Mini-Mental State Examinatlon (MMSE) was ana-lyzed in the training group. Results Before treatment, T2 signal intensity in the bilateral hippocampal head was significantly high in the aM-CI patients compared with that in the control group (P<0.05). After treatment, T2 signal intensity in left hippocampal head decreased in the training group compared with that in the speech group (P<0.05), similar to the control group (P>0.05). There was negative correlation be-tween left hippocampal head's T2 signal intensity and the scores of MMSE in the training group before and after treatment (r=-0.61, r=-0.54, P<0.05). Conclusion The T2 signal intensity in left hippocampal head may respond to the cognitive function in patients with aMCI in the early stage, that could be used for diagnosis and evaluation in clinic.

Establishment of a middle cerebral artery occlusion model with intraluminal suture in rabbits and its assessment by the amplitude-integrated electroencephalogram / 国际脑血管病杂志

Objective To establish a standardized middle cerebral artery occlusion (MCAO) model with suture method in rabbits and to investigate the value of the assessment for cerebral ischemia with amplitudeintegrated electroencephalogram (aEEG).Methods A total of 34 male New Zealand white rabbits were randomly assigned to either an MCAO group (n =29) or a sham operation goup (n =5).A model of MCAO was induced with intraluminal suture method and the cerebral function monitor was performed.According to 2,3,5-triphenyltetrazolium chloride staining,the MCAO group was further divided into cortex + basal ganglia infarction,basal ganglia infarction,subarachnoid hemorrhage,and non-lesion subgroups.The differences among the physiological indicators,weight,thread end diameter,and insertion length were compared before and after modeling in all subgroups.Results The success rate of MCAO modeling with suture method in rabbits was 62.07％ (18/29),in which 37.93％ (11/29) involved in the cortex and basal ganglia,24.38％ (7/29) only involved in the basal ganglia,17.24％ (5/29) complicated by subarachnoid hemorrhage,and 20.69％ (6/29) had no infarction.There were no significant differences in the body temperature,heart rate,mean arterial pressure and arterial blood pH,oxygen partial pressure,and CO2 partial pressure among all the subgroups before and after modeling.The weight in the non-lesion subgroup was 2.36 ± 0.10 kg,it was significantly lower than 2.55 ± 0.09 kg in the cortex + basal ganglia infarction subgroup (P =0.001) and 2.50 ± 0.12 kg in the basal ganglia infarction subgroup (P =0.017).The length of suture placement in the cortex+basal ganglia infarction subgroup was 5.59 ± 0.24 cm,and it was significantly less than 6.00 ± 0.50 cm in the subarachnoid hemorrhage subgroup (P =0.036).However,it was significantly longer than 5.20 ± 0.50 cm in the non-lesion subgroup (P =0.033).After modeling there were significant differences in aEEG among all subgroups (F =14.059,P =0.000).Compared to before modeling,aEEG decreased 50.02％ (t =9.573,P ＜ 0.001) and 14.20％ respectively after modeling in the cortex + basal ganglia infarction subgroup and the ganglia infarction subgroup (t =2.908,P =0.027).Conclusions A standardized MCAO model in rabbits may be successfully established with suture method.The significantly decreased aEEG indicates that the MCAO model is successful and the lesions involve in the cortex.

The study of magnetic resonance spectrum about sensitive brain structure of the first episode depression / 中华行为医学与脑科学杂志

Objective To explore the brain's metabolism about the hippocampus, anterior cingulate and thalamus of first episode depressive patients. Methods Using proton magnetic resonance spectroscopy and 1 HMRS analyzing technology to detect multiple metabolic indices of the hippocampus, anterior cingulate and thalamus of 20 patients and 20 healthy persons, including N-acetylaspartate ( NAA), choline ( Cho ), myoinositol ( MI ), creatine(Cr). Results The ratios of MI/Cr of the bilateral thalamus of the depressive patients group decreased ( Left (0.23 ±0.13) ,(0.25 ±0.09), t=2.25, P=0.03,Right(0.33 ±0.15,0.34 ±0.04), t=2.42, P=0.02).The ratios of NAA/Cr and Cho/Cr of the bilateral hippocampus of the depressive patients group were both lower (NAA/Cr: Left t=3.06, P=0.004,Right t=3.54, P=0.001. Cho/Cr: Left t=2.94, P=0.006,Right t=4.02,P=0.001 ). The ratios of Cho/Cr and MI/Cr of the anterior cingulate of the depressive patients group were both significantly higher (NAA/Cr: t=3.12, P=0. 003;Cho/Cr: t=2.62, P=0.01). Conclusion The metabolic abnormalities of hippocampus, anterior cingulate and thalamus maybe constitute the nervous biochemical basis of first episode depression.

Morphometric and functional alterations of amygdale and hippocampus in patients with depression: a MRI study / 中华放射学杂志

Objective To explore the morphometric and functional alterations of amygdale and hippocampus in patients with depression by anatomical and functional MRI, and try to reveal the pattern and pathogenesis of the changes in depression. Methods Sixty patients (divided equally into mild, moderate and major groups according to patient′s scores of HAMD) and 20 healthy control groups were scanned using T1WI and fMRI. The outlines of hippocampus and amygdale were drawn manually by observer and the volumes were calculated and normalized subsequently. Functional MRI was processed using SPM5 and individual activation map was got subsequently. Dunnett-t test and Pearson correlation analysis were separately used to analyze the morphometric and functional changes and the correlations between cerebral changes and clinical severity. Results The hippocampal volumes of control groups were 2296±202 left for left side and 2283±199 for right side. The hippocampal volumes of depressive patients were smaller than those of control groups, especially for the major group (left 1978±176,Dunnett-t=-10.0,P0.05,right 2210±191,Dunnett-t=-1.6,P>0.05). The amygdale′s volumes of control groups was 1762±185,the right was 1749±182, while those in patient group reduced along with the patient′s condition, i.e., the mild groups (left 1992±200,Dunnett-t=4.8,P<0.01,right 1989±191, Dunnett-t=5.0,P<0.001), the moderate groups (left 1889±192, Dunnett-t=2.8,P<0.05,right 1896±195,Dunnett-t=2.8,P<0.05), and the major groups (left 1539±178,Dunnett-t=-6.8,P<0.01,right 1543±180,Dunnett-t=-7.0,P<0.01).For fMRI study, patient group demonstrated more activation of the amygdale and hippocampus under the stimulations of negative images than controls. Furthermore, the strengthens of activation decreased along with the patient′s condition, i.e., the major ones showed the weakest activation among the patients, though it was higher than that of control group. In patient group, both the volumes and activations of hippocampus and amygdale showed significant negative correlations with HAMD scores(r=-0.80--0.90,P＜0.05). Conclusion The hippocampal volumes of depressive patients reduced, which may be due to the change of the amygdale, and the amygdale′s volumes were changed along with the patient′s condition. There were more activation in the amygdale and hippocampus of depressive patients under the stimulations of negative images.

MRI enhancement scanning features and pathology of the orthotropic transplantation nude mouse model with human pancreatic cancer / 中华胰腺病杂志

Objective To investigate the MRI imaging features, and pathologic basis of the orthotropic transplantation nude mouse model with human pancreatic cancer. Methods Adopting Siemens Magnetom Trio Tim 3.0 Tesla superconductive MRI and breast coil was used to examine 30 orthotropic transplantation nude mouse models of the human pancreatic cancer, these mouse were sampled to acquire TSE-T1 -weighted and T2-weighted transverse axial images. Intraperitoneal injection of Gd DTP A was used to perform continuous dynamic enhancement scanning. Signal intensities of tumors were measured in plain scanning and each phase' s enhancement scanning images, respectively. Intensification rates of tumors were calculated. Pathologic examination of tumors was performed to be compared with the findings of MRI scanning. Results The successful rate of inoculation of 30 nude mice was 100%. The histological findings were comparable with poorly differentiated adenocarcinoma. Compared with signal of adjacent tissues, the MRI findings of the tumors were uniformly slightly hypointensity (90% , 27/30) , or unevenly (10% , 3/30) on TSE-T1WI; uniformly (20% , 6/30) or unevenly (80% , 24/30) hyperintensity with equal or more hyper signal spots on TSE-T2WI. Signal intensities on plain scanning was 228.35 ±11.71, and 1.5,3,6,9, 12 min after enhancement scanning, thesignal intensities were 258.20 ± 11.17, 301.75 ± 17.09, 358.65 ±25.13, 480.05 ± 19.01, 558.35 ± 40.49, which were significantly higher than those in plain scanning (P <0.01). The intensification rate of every phase was 0.13 ±0.04, 0.35 ±0.11, 0.56 ±0.10, 1.10 ±0.10, 1.45 ±0.18, and the difference among these phases was statistically significant (P <0.01). The significantly intensified area was the area where the tumor cells grew actively with rich capillaries; the central area without intensification was the area of necrotic tissue and/or densely packed tumor cells and few capillaries. Conclusions High resolution MRI imaging of implanted tumors can be obtained by intraperitoneal injection of contrast, and it is consistent with pathologic examinations.

Dynamic research about the change of the behavior and hippocampal volume of rat depressive model / 中华行为医学与脑科学杂志

Objective To explore the dynamic change and correlation of the behavior and hippocampal volumes by MRI of rat depressive model. Methods Based on the evaluation of ethology, thirty SD rats were randomly and equally divided into control group and model group which was exposed to chronic unpredictable mild stress for 8 weeks. The body weight, fluid consumption test and Morris water maze test were done at the beginning and per week while the bilateral hippocampal volumes of every rat were measured by high field MRI at the beginning and per two weeks. Results Based on the behavioral data,the rat depressive model was established successfully,and changed dynamically. On 4th week,the left hippocampal volumes of depressive rat were significantly reduced (model group(37.13 ±2.40)mm3 ,control group (39.05 ±2.05)mm3, t=2.36, P＜0.05) while the right ones did not. On 6th week, the right ones began to reduce significantly ( model group ( 37.85 ± 2.11 ) mm3, control group ( 39.44 ± 2.10 ) mm3, t = 2.07, P ＜ 0.05 ) while the left one still reduced, but the extent of the left's reduction was bigger than the right( left:15% ,right:8% ). And there was apparent correlation between the behavior and the reduction of hippocampal volumes. Conclusion The behavior and hippocampal volumes of rat depressive model changes dynamically,and there was a regularity of them.

Stereotactic Minimally Invasive Aspiration for Small Thalamic Hemorrhage A Clinical Study / 国际脑血管病杂志

Objective:To explore the feasibilitv of stereotactic minimally invasive aspiration of small thalamic bemorrhage.Methods:Twenty-two patients with small thalamic hemowhage(5 to 10 mL)were divided into two groups:a stereotactic group(n=10)and a control group(n= 12).The patients in the stereotactic group received stereomctic minimally invasive puncture and drainage of hematomas.According to the condition,repeated infusion of urokinase(10-20 kU) into the hematoma cavities were administered 12 hours after the procedure,and the hematomas were irrigated and drained so as to removal of them completely after retaining for 2-4 hours, The appropriate symptomatic treatment was administered in the patients in both groups.National Institutes of Health Stroke Scale(NIHSS)scores were determined 14 and 30 days before and after the treatment in all the patients.The reductiom of the NIJSS scores (as compared with those before treatment)were calculated at day 14 and 30 respectively after the treatment. Results:The reductiom of the NIHSS scores in the stereotactic group at day 14 and 30 were significantly higher than those in the control group.It was suggested that the neurological functional recovery of the patients was faster after stereotmtic minimally invasive puncture and drainage of intracranial hematorna in the stereotactic group.Concision:The stereotactic minimally invasive puncture and drainage of intracranial hematoma may significantly improve the outcome in patients with small thalamic hemorrhage.

Systematic teaching exploration of neurology / 中华医学教育探索杂志

The systematic teaching does better to help students master and use what they have learned, and it will be good for avoidance of repeated contents and shortening teaching time. It can also help students find more interest in studying neurology.