Objective To identify the most consistent and replicable characteristics of altered spontaneous brain activity in mesial temporal lobe epilepsy patients with unilateral hippocampal sclerosis (MTLE-HS). Methods A systematic literature search was performed in PubMed, Embase, The Cochrane Library, China National Knowledge Infrastructure, Wanfang, and CQVIP databases, to identify eligible whole-brain resting state functional magnetic resonance imaging studies that had measured differences in amplitude of low-frequency fluctuations or fractional amplitude of low-frequency fluctuations between patients with MTLE-HS and healthy controls from January 2000 to January 2019. After literature screening and data extraction, Anisotropic Effect-Size Signed Differential Mapping software was used for voxel based pooled meta-analysis. Results Nine datasets from six studies were finally included, which contained 207 MTLE-HS patients and 239 healthy controls. The results demonstrated that, compared with the healthy controls, the MTLE-HS patients showed increased spontaneous brain activity in right hippocampus and parahippocampal gyrus, right superior temporal gyrus, left cingulate gyrus, right fusiform gyrus, and right inferior temporal gyrus; while decreased spontaneous brain activity in left superior frontal gyrus, right angular gyrus, right middle frontal gyrus, left inferior parietal lobule, left precuneus, and right cerebellum (P<0.005, cluster extent≥10). Conclusion The current meta-analysis demonstrates that patients with MTLE-HS show increased spontaneous brain activity in lateral and mesial temporal regions and decreased spontaneous brain activity in default mode network, which preliminarily clarifies the characteristics of altered spontaneous brain activity in patients with MTLE-HS.
【摘要】目的了解青光眼小梁切除術后眼脈動振幅的變化。方法2008年3月2009年6月確診的青光眼患者32例,使用瑞士(Microtechnology AG公司)動態輪廓眼壓計測量小梁切除術前后眼壓及眼脈動振幅(OPA)的變化,進行統計分析。結果術前、術后眼壓分別為(1941±506)、(1186±352) mm Hg(Plt;005);術前、術后OPA分別為(392±176)、(204±138) mm Hg(Plt;005)。術前眼壓與OPA、術后眼壓與OPA均有相關性。結論青光眼小梁切除術后OPA會隨眼壓變化出現相應的變化,在青光眼的診斷及治療中有一定的意義。
ObjectiveSeizure-related respiratory or cardiac dysfunction was once thought to be the direct cause of sudden unexpected death in epilepsy (SUDEP), but both may be secondary to postictal cerebral inhibition. An important issue that has not been explored to date is the neural network basis of cerebral inhibition. Our aim was to investigate the features of neural networks in patients at high risk for SUDEP using a blood oxygen level-dependent (BOLD) resting-state functional MRI (Rs-fMRI) technique. MethodsRs-fMRI data were recorded from 13 patients at high risk for SUDEP and 12 patients at low risk for SUDEP. The amplitude of low-frequency fluctuations (ALFF) values were compared between the two groups to decipt the regional brain activities. ResultsCompared with patients at low risk for SUDEP, patients at high risk exhibited significant ALFF reductions in the right superior frontal gyrus, the left superior orbital frontal gyrus, the left insula and the left thalamus; and ALFF increase in the right middle cigulum gyrus, the right supplementary motor area and the left thalamus. ConclusionsThese findings highlight the need to understand the fundamental neural network dysfunction in SUDEP, which may fill the missing link between seizure-related cardiorespiratory dysfunction and SUDEP, and provide a promising neuroimaging biomarker for risk prediction of SUDEP.
ObjectiveTo explore the predictive value of the maximum amplitude (MA) in the thromboelastogram (TEG) in the occurrence of venous thromboembolism (VTE) in patients with lung cancer after surgery.MethodsForty-one lung cancer patients with postoperative VTE in our hospital from September 2018 to August 2020 were enrolled into a thrombosis group, including 25 males and 16 females, aged 72.17±10.08 years. The 87 lung cancer patients who underwent surgery during the same period but did not suffer postoperative VTE were enrolled into a control group, including 51 males and 36 females, aged 71.06±9.49 years. The MA of thrombus in the TEG before and after the operation was compared between the two groups, and logistic regression analysis was used to test the value of the MA of thrombus at each time point in the TEG to predict the occurrence of VTE in patients with lung cancer surgery. The receiver operating characteristic curve was drawn to test the effectiveness of the MA of thrombus at each time point in the TEG to predict the occurrence of VTE in patients with lung cancer.ResultsThe MA of thrombus in the two groups after operation was greater than that before operation, and the MA of thrombus in the TEG on the day 3 after operation in the two groups> day 1> day 5 (P<0.05). The logistic regression analysis showed that the MA of thrombus in the TEG increased, which had predictive value for the occurrence of VTE in patients with lung cancer after surgery; the MA of thrombus in the TEG at each postoperative point was used as the test variable. Taking the occurrence of VTE as a state variable, the area under the curve (AUC) of MA of thrombus in the TEG on the 1st postoperative day was 0.82, and its optimal threshold was 75.15 mm; on the 3rd postoperative day, AUC was 0.88, and its optimal threshold was 80.05 mm; on the 5th day afterwards, AUC was 0.78, and its optimal threshold was 66.30 mm.ConclusionThe MA of TEG has a high predictive power for the occurrence of VTE in lung cancer patients after surgery, which suggests that TEG dynamic monitoring should be performed before surgery for lung cancer patients, and a reasonable anticoagulation plan should be formulated accordingly to reduce the occurrence of VTE.
Amblyopia is a visual development deficit caused by abnormal visual experience in early life, mainly manifesting as defected visual acuity and binocular visual impairment, which is considered to reflect abnormal development of the brain rather than organic lesions of the eye. Previous studies have reported abnormal spontaneous brain activity in patients with amblyopia. However, the location of abnormal spontaneous activity in patients with amblyopia and the association between abnormal brain function activity and clinical deficits remain unclear. The purpose of this study is to analyze spontaneous brain functional activity abnormalities in patients with amblyopia and their associations with clinical defects using resting-state functional magnetic resonance imaging (fMRI) data. In this study, 31 patients with amblyopia and 31 healthy controls were enrolled for resting-state fMRI scanning. The results showed that spontaneous activity in the right angular gyrus, left posterior cerebellum, and left cingulate gyrus were significantly lower in patients with amblyopia than in controls, and spontaneous activity in the right middle temporal gyrus was significantly higher in patients with amblyopia. In addition, the spontaneous activity of the left cerebellum in patients with amblyopia was negatively associated with the best-corrected visual acuity of the amblyopic eye, and the spontaneous activity of the right middle temporal gyrus was positively associated with the stereoacuity. This study found that adult patients with amblyopia showed abnormal spontaneous activity in the angular gyrus, cerebellum, middle temporal gyrus, and cingulate gyrus. Furthermore, the functional abnormalities in the cerebellum and middle temporal gyrus may be associated with visual acuity defects and stereopsis deficiency in patients with amblyopia. These findings help explain the neural mechanism of amblyopia, thus promoting the improvement of the treatment strategy for amblyopia.
ObjectiveTo use flash electroretinogram (F-ERG) and optical coherence tomography (OCT) to examine patients with primary retinitis pigmentosa (RP), and analyze the specificity of the disease on F-ERG and OCT. MethodsThirty-seven patients (74 eyes) diagnosed with primary retinitis pigmentosa in the Department of Ophthalmology, West China Hospital between September 2013 to October 2014 and 38 normal volunteers (76 eyes) were included in this study. F-ERG and OCT examinations were performed on all the patients. Then, we analyzed the differences between the two groups of subjects. ResultsFor RP patients undergoing P-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (73.24±6.42) ms and the amplitude of b wave was (22.87±22.48) μV; when dark adaptation of 3.0 ERG was adopted, the latency of a wave was (24.57±6.30) ms, the amplitude of a wave was (35.45±25.54) μV, the latency of b wave was (48.19±8.18) ms, and the amplitude of b wave was (119.47±50.89) μV; with the light adaptation of 3.0 ERG, the latency of a wave was (21.01±4.86) ms, the amplitude of a wave was (12.59±13.43) μV, the latency of b wave was (38.43±5.00) ms, and the amplitude of b wave was (27.19±38.12) μV. For normal volunteers undergoing F-ERG examination with the dark adaptation of 0.01 ERG, the latency of b wave was (72.63±3.49) ms and the amplitude of b wave was (86.36±21.57) μV; when the dark adaptation was 3.0 ERG, the latency of a wave was (22.88±1.62) ms, the amplitude of a wave was (210.74±43.57) μV, the latency of b wave was (42.59±2.60) ms, and the amplitude of b wave was (398.29±62.42) μV; when the light adaptation of 3.0 ERG was adopted, the latency of a wave was (16.61±0.87) ms, the amplitude of a wave was (54.26±19.64) μV, the latency of b wave was (33.29±1.11) ms, and the amplitude of b wave was (176.98±63.44) μV. There were no significant differences between the two groups when dark adaptation ERG was 0.01 (P=0.48), but for other adaptations, there were significant differences in the latency and amplitude of a and b wave between the two groups (P<0.05). The results of OCT showed that the retinal thickness of the RP patients with a range of 1 mm diameter centered on macular center concave was (218.66±74.14) mm, 3 mm diameter was (275.03±47.85) mm, and 6 mm diameter was (247.37±46.44) mm. For normal volunteers, OCT showed that the retinal thickness with a 1 mm range centered on macular center concave was (250.38±15.79) mm, 3 mm was (323.64±17.26) mm, and 6 mm was (283.44±12.50) mm. The differences between the two groups were statistically significant for each range (P<0.01). ConclusionFor patients with RP, F-ERG shows latency delay and amplitude decrease for each response, while OCT displays a thinning thickness of macular fovea. Therefore, F-ERG and OCT can not only effectively evaluate the functions of macular and the surrounding retina, but can also be used as an effective method for the diagnosis of RP.
ObjectiveTo study whether the pattern visual evoked potential (P-VEP) under different spatial frequency in patients with multiple sclerosis (MS) is different from normal people. MethodsP-VEP examination under high (15') and low (60') spatial frequency was performed on 18 MS patients (36 eyes) treated in our department from September 2011 to April 2012 and 20 normal volunteers (40 eyes). Then, we analyzed the difference between the two groups under the above-mentioned two kinds of spatial frequency. ResultsThe latency of P100 of P-VEP under high spatial frequency in MS patients was (120.50±13.04) ms which was significantly different from (109.21±5.38) ms of normal volunteers (P < 0.05). The latency of P100 of P-VEP under low spatial frequency in MS patients was (109.57±12.87) ms, which was also significantly different from (103.31±5.45) ms of normal volunteers (P < 0.05). The amplitude of P100 of P-VEP under high spatial frequency in MS patients was (9.17±5.69)μV and it was significantly lower than that[(15.69±8.45)μv] of normal volunteers (P < 0.05). The amplitude of P100 of P-VEP under low spatial frequency in MS patients was (11.93±16.75)μV and it was not significantly different from normal volunteers[(13.47±9.24μV)]. Based on different corrected vision, the MS patients were divided into two groups (vision≥1.0 and vision < 1.0). For patients with vision≥1.0, the latency of P100 and the amplitude of P100 of P-VEP under high spatial frequency was (113.43±8.28) ms and (12.94±5.46)μV; the latency of P100 and the amplitude of P100 of P-VEP under low spatial frequency was (111.13±11.50) ms and (11.57±5.60)μV. For patients with vision < 1.0, the latency of P100 and the amplitude of P100 of P-VEP under high spatial frequency was (126.69±13.49) ms and (5.87±3.43)μV; the latency of P100 and the amplitude of P100 of P-VEP under low spatial frequency was (108.26±14.11) ms and (12.24±5.82)μV. There was no significant difference in the latency and amplitude of P100 under low spatial frequency between the two groups with different corrected vision (P > 0.05), but the latency and amplitude of P100 under high spatial frequency were both significantly different between those two groups (P < 0.05). ConclusionsCompared with normal people, MS patients feature latency delay and amplitude reduction of the P-VEP, which was more severe under high spatial frequency. P-VEP under high spatial frequency may become an important evidence to evaluate visual function of MS patients.
We investigated the baseline brain activity level in patients with major depressive disorder (MDD) by amplitude of low-frequency fluctuation (ALFF) based on resting-state functional MRI (fMRI). We examined 13 patients in the MDD group and 14 healthy volunteers in the control group by resting-state fMRI on GE Signa 3.0T. We calculated and compared the ALFF values of the two groups. In the MDD group, ALFF values in the right medial prefrontal were higher than those in control group, with statistically significant differences (P<0.001). ALFF values in the left parietal in the MDD group were lower than those in control group with statistically significant differences (P<0.001). This resting-state fMRI study suggested that the alteration brain activity in the right medial prefrontal and left parietal ALFF contributed to the understanding of the pathophysiological mechanism of MDD patients.