Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved ...Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external展开更多
Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging. Excited areas of ankle activ...Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging. Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum. Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum. Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.展开更多
Totally three articles focusing on functional magnetic resonance imaging features of brain function in the activated brain regions of stroke patients undergoing acupuncture on the healthy limbs and healthy controls un...Totally three articles focusing on functional magnetic resonance imaging features of brain function in the activated brain regions of stroke patients undergoing acupuncture on the healthy limbs and healthy controls undergoing acupuncture on the lower extremities are published in three issues. We hope that our readers find these papers useful to their research.展开更多
In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan （TE5）. In ischemic stroke subjects, functional MRI showed enhance...In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan （TE5）. In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.展开更多
Most studies addressing the specificity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effect...Most studies addressing the specificity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effects of acupuncture on brain function in a pathological context. Sixteen patients with ischemic stroke were randomly assigned to true point group （true acupuncture at right Waiguan （SJ5）） and sham point group （sham acupuncture）. Results of functional magnetic resonance imaging revealed activation in right parietal lobe （Brodmann areas 7 and 19）, the right temporal lobe （Brodmann area 39）, the right limbic lobe （Brodmann area 23） and bilateral oc-cipital lobes （Brodmann area 18）. Furthermore, inhibition of bilateral frontal lobes （Brodmann area 4, 6, and 45）, right parietal lobe （Brodmann areas 1 and 5） and left temporal lobe （Brodmann area 21 ） were observed in the true point group. Activation in the precuneus of right parietal lobe （Brodmann area 7） and inhibition of the left superior frontal gyrus （Brodmann area 10） was observed in the sham group. Compared with sham acupuncture, acupuncture at Waiguan in stroke patients inhibited Brodmann area 5 on the healthy side. Results indicated that the altered specificity of sensation-associated cortex （Brodmann area 5） is possibly associated with a central mechanism of acupuncture at Waiguan for stroke patients.展开更多
Ten Chinese patients with brain tumors involving language regions were selected. Preoperative functional MRI was performed to locate Broca＇s or Wernicke＇s area, and the cortex that was essential for language functio...Ten Chinese patients with brain tumors involving language regions were selected. Preoperative functional MRI was performed to locate Broca＇s or Wernicke＇s area, and the cortex that was essential for language function was determined by electrocortical mapping. A site-by-site comparison between functional MRI and electrocortical mapping was performed with the aid of a neuronavigation device. Results showed that the sensitivity and specificity of preoperative functional MRI were 80.0% and 85.0% in Broca＇s area and 66.6% and 85.2% in Wemicke＇s area, respectively. These experimental findings indicate that functional MRI is an accurate, reliable technique with which to identify the location of Wernicke＇s area or Broca＇s area in patients with brain tumors.展开更多
Studies have shown that functional network connection models can be used to study brain net- work changes in patients with schizophrenia. In this study, we inferred that these models could also be used to explore func...Studies have shown that functional network connection models can be used to study brain net- work changes in patients with schizophrenia. In this study, we inferred that these models could also be used to explore functional network connectivity changes in stroke patients. We used independent component analysis to find the motor areas of stroke patients, which is a novel way to determine these areas. In this study, we collected functional magnetic resonance imaging datasets from healthy controls and right-handed stroke patients following their first ever stroke. Using independent component analysis, six spatially independent components highly correlat- ed to the experimental paradigm were extracted. Then, the functional network connectivity of both patients and controls was established to observe the differences between them. The results showed that there were 11 connections in the model in the stroke patients, while there were only four connections in the healthy controls. Further analysis found that some damaged connections may be compensated for by new indirect connections or circuits produced after stroke. These connections may have a direct correlation with the degree of stroke rehabilitation. Our findings suggest that functional network connectivity in stroke patients is more complex than that in hea- lthy controls, and that there is a compensation loop in the functional network following stroke. This implies that functional network reorganization plays a very important role in the process of rehabilitation after stroke.展开更多
Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury（SCI）. The correlation between brain anatomical changes and fun...Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury（SCI）. The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI（mean age 40.94 ± 14.10 years old; male：female, 7：11） and 18 healthy subjects（37.33 ± 11.79 years old; male：female, 7：11） were studied by resting state functional magnetic resonance imaging. Gray matter volume（GMV） and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex（BA1） and left primary motor cortex（BA4）, and left BA1 and left somatosensory association cortex（BA5） was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry（registration number： Chi CTR-ROC-17013566）.展开更多
Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance...Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging （MR-DTI） and fluorescein sodium dyeing （FLS） guiding technique for surgery of glioma located in brain motor functional areas. Methods Totally 83 patients were enrolled according to our inclusion and exclusion criteria （56 patients in experimental group, 27 patients in control group）. In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6-24 months. Neurological deficits and Karnofsky scoring （KPS） were evaluated. Results There were no significant differences in balance test indexes of preoperative data （sex, age, lesion location and volume, and neurological deficits before operation） and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection （80.4% vs. 40.7%）, and the paralysis rate caused by surgery was lower in experimental （25.0%） vs. control （66.7%） groups （P 〈0.05）. The 6-month KPS in the low-grade and high-grade gliomas was 91＋11 and 73＋26, respectively, in the experimental group vs. 82＋9 and 43＋27, respectively, in the control group （P 〈0.05 for both）. Conclusions MR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.展开更多
目的探讨右美托咪定对丙泊酚合并瑞芬太尼麻醉下脑功能区手术术中唤醒效果的影响。方法选择择期行大脑功能区手术的患者32例,美国麻醉师协会(American Association of anesthetists,ASA)I^II级,随机分为右美托咪定组(D组)和生理盐水对照...目的探讨右美托咪定对丙泊酚合并瑞芬太尼麻醉下脑功能区手术术中唤醒效果的影响。方法选择择期行大脑功能区手术的患者32例,美国麻醉师协会(American Association of anesthetists,ASA)I^II级,随机分为右美托咪定组(D组)和生理盐水对照组(C组),两组均采用全凭静脉麻醉,静脉注射芬太尼、依托咪酯、顺阿曲库铵行麻醉诱导,1%丁卡因行喉头及气管内粘膜表面麻醉后气管插管。分别在麻醉诱导前给予1μg/kg右美托咪定和等量生理盐水在10 min内静脉注入,术中D组持续泵入右美托咪定0.2μg/(kg·h),C组泵入等量的生理盐水。唤醒试验开始时两组停用麻醉维持药物(除右美托咪定和生理盐水外),观察并记录麻醉诱导前10 min(T1)、诱导后即刻(T2)、停药即刻(T3)、唤醒即刻(T4)、加深麻醉5 min后(T5)的平均动脉压(Mean arterial pressure,MAP)、心率(heart rate,HR);记录唤醒时间、唤醒成功率、每分钟呛咳次数和体动次数。结果两组的唤醒成功率相同,D组唤醒时间比C组长但无统计学意义(P>0.05),D组的呛咳次数和体动次数明显少于C组(P<0.05),T1、T5时两组HR、MAP比较差异无统计学意义(P>0.05);两组间HR、MAP在T3、T4时比较有统计学意义(P<0.05),对照C组明显高于试验D组。结论右美托咪定有助于脑功能区手术患者全麻诱导及术中唤醒时血流动力学的稳定,并不延长唤醒时间,能减轻患者应激反应,提高唤醒质量,减少了不良事件的发生。展开更多
文摘Objective To evaluate the feasibility and safety of the self developed sound outside the ventilation device-esophageal nasopharynx catheter in brain functional areas surgery applications. Methods 13 patients involved functional areas of brain surgery were chosed. After induction of general anesthesia,the catheters were placed in the esophagus,then connected to anesthesia machines to an external
基金supported by the Science and Technology Innovation Nursery Foundation of Chinese PLA General Hospital, No. 09KMM41
文摘Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging. Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum. Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum. Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.
文摘Totally three articles focusing on functional magnetic resonance imaging features of brain function in the activated brain regions of stroke patients undergoing acupuncture on the healthy limbs and healthy controls undergoing acupuncture on the lower extremities are published in three issues. We hope that our readers find these papers useful to their research.
基金supported by the National Basic Research Program of China(973 Program),No.2006CB504505,2012CB518504the Third Key Construction Program of "211 Project" of Guangdong Province
文摘In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan （TE5）. In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.
基金the State Plan for Development of Basic Research in Key Areas(973 Program)in China,No.2006CB504505,2012CB518504the Key Subject Construction Project of"211 Engineering"III Stage of Guangdong Province in Chinathe Guangdong Provincial"College Students’Innovative Experiment Plan"Project in China,No.1212112038
文摘Most studies addressing the specificity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effects of acupuncture on brain function in a pathological context. Sixteen patients with ischemic stroke were randomly assigned to true point group （true acupuncture at right Waiguan （SJ5）） and sham point group （sham acupuncture）. Results of functional magnetic resonance imaging revealed activation in right parietal lobe （Brodmann areas 7 and 19）, the right temporal lobe （Brodmann area 39）, the right limbic lobe （Brodmann area 23） and bilateral oc-cipital lobes （Brodmann area 18）. Furthermore, inhibition of bilateral frontal lobes （Brodmann area 4, 6, and 45）, right parietal lobe （Brodmann areas 1 and 5） and left temporal lobe （Brodmann area 21 ） were observed in the true point group. Activation in the precuneus of right parietal lobe （Brodmann area 7） and inhibition of the left superior frontal gyrus （Brodmann area 10） was observed in the sham group. Compared with sham acupuncture, acupuncture at Waiguan in stroke patients inhibited Brodmann area 5 on the healthy side. Results indicated that the altered specificity of sensation-associated cortex （Brodmann area 5） is possibly associated with a central mechanism of acupuncture at Waiguan for stroke patients.
基金supported by the Key Technologies R&D Program of Ningxia Hui Autonomous Region in 2008,No.2008-165-17the Key Technologies R&D Program of Ningxia Hui Autonomous Region in 2011,No. 2011-89
文摘Ten Chinese patients with brain tumors involving language regions were selected. Preoperative functional MRI was performed to locate Broca＇s or Wernicke＇s area, and the cortex that was essential for language function was determined by electrocortical mapping. A site-by-site comparison between functional MRI and electrocortical mapping was performed with the aid of a neuronavigation device. Results showed that the sensitivity and specificity of preoperative functional MRI were 80.0% and 85.0% in Broca＇s area and 66.6% and 85.2% in Wemicke＇s area, respectively. These experimental findings indicate that functional MRI is an accurate, reliable technique with which to identify the location of Wernicke＇s area or Broca＇s area in patients with brain tumors.
基金supported by the National Natural Science Foundation of China,No.60905024
文摘Studies have shown that functional network connection models can be used to study brain net- work changes in patients with schizophrenia. In this study, we inferred that these models could also be used to explore functional network connectivity changes in stroke patients. We used independent component analysis to find the motor areas of stroke patients, which is a novel way to determine these areas. In this study, we collected functional magnetic resonance imaging datasets from healthy controls and right-handed stroke patients following their first ever stroke. Using independent component analysis, six spatially independent components highly correlat- ed to the experimental paradigm were extracted. Then, the functional network connectivity of both patients and controls was established to observe the differences between them. The results showed that there were 11 connections in the model in the stroke patients, while there were only four connections in the healthy controls. Further analysis found that some damaged connections may be compensated for by new indirect connections or circuits produced after stroke. These connections may have a direct correlation with the degree of stroke rehabilitation. Our findings suggest that functional network connectivity in stroke patients is more complex than that in hea- lthy controls, and that there is a compensation loop in the functional network following stroke. This implies that functional network reorganization plays a very important role in the process of rehabilitation after stroke.
基金supported by a grant from Tsinghua University Initiative Scientific Research Program,No.2014081266,20131089382the National Natural Science Foundation of China,No.61171002,60372023
文摘Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury（SCI）. The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI（mean age 40.94 ± 14.10 years old; male：female, 7：11） and 18 healthy subjects（37.33 ± 11.79 years old; male：female, 7：11） were studied by resting state functional magnetic resonance imaging. Gray matter volume（GMV） and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex（BA1） and left primary motor cortex（BA4）, and left BA1 and left somatosensory association cortex（BA5） was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry（registration number： Chi CTR-ROC-17013566）.
文摘Background Tumor surgery in brain motor functional areas remains challenging. Novel techniques are being developed to gain maximal and safe resection for brain tumor surgery. Herein, we assessed the magnetic resonance diffusion tensor imaging （MR-DTI） and fluorescein sodium dyeing （FLS） guiding technique for surgery of glioma located in brain motor functional areas. Methods Totally 83 patients were enrolled according to our inclusion and exclusion criteria （56 patients in experimental group, 27 patients in control group）. In the experimental group, the surgical approach was designed by DTI imaging, which showed the relationship between the tumor and motor tract. The range of resection in the operation was determined using the FLS-stained area, which recognized the tumor and its infiltrated tissue. The traditional routine method was used in the control group. Postoperatively, all patients underwent enhanced brain MRI within 72 hours to ascertain the extent of resection. Patients were followed in our outpatient clinic over 6-24 months. Neurological deficits and Karnofsky scoring （KPS） were evaluated. Results There were no significant differences in balance test indexes of preoperative data （sex, age, lesion location and volume, and neurological deficits before operation） and diagnosis of histopathology between the two groups. There was a trend in the experimental group for greater rates of gross total resection （80.4% vs. 40.7%）, and the paralysis rate caused by surgery was lower in experimental （25.0%） vs. control （66.7%） groups （P 〈0.05）. The 6-month KPS in the low-grade and high-grade gliomas was 91＋11 and 73＋26, respectively, in the experimental group vs. 82＋9 and 43＋27, respectively, in the control group （P 〈0.05 for both）. Conclusions MR-DTI and FLS dye guiding for surgery of glioma located in brain motor functional areas can increase the gross total resection rate, decrease the paralysis rate caused by surgery, and improve patient quality of life compared with traditional glioma surgery.
文摘目的探讨右美托咪定对丙泊酚合并瑞芬太尼麻醉下脑功能区手术术中唤醒效果的影响。方法选择择期行大脑功能区手术的患者32例,美国麻醉师协会(American Association of anesthetists,ASA)I^II级,随机分为右美托咪定组(D组)和生理盐水对照组(C组),两组均采用全凭静脉麻醉,静脉注射芬太尼、依托咪酯、顺阿曲库铵行麻醉诱导,1%丁卡因行喉头及气管内粘膜表面麻醉后气管插管。分别在麻醉诱导前给予1μg/kg右美托咪定和等量生理盐水在10 min内静脉注入,术中D组持续泵入右美托咪定0.2μg/(kg·h),C组泵入等量的生理盐水。唤醒试验开始时两组停用麻醉维持药物(除右美托咪定和生理盐水外),观察并记录麻醉诱导前10 min(T1)、诱导后即刻(T2)、停药即刻(T3)、唤醒即刻(T4)、加深麻醉5 min后(T5)的平均动脉压(Mean arterial pressure,MAP)、心率(heart rate,HR);记录唤醒时间、唤醒成功率、每分钟呛咳次数和体动次数。结果两组的唤醒成功率相同,D组唤醒时间比C组长但无统计学意义(P>0.05),D组的呛咳次数和体动次数明显少于C组(P<0.05),T1、T5时两组HR、MAP比较差异无统计学意义(P>0.05);两组间HR、MAP在T3、T4时比较有统计学意义(P<0.05),对照C组明显高于试验D组。结论右美托咪定有助于脑功能区手术患者全麻诱导及术中唤醒时血流动力学的稳定,并不延长唤醒时间,能减轻患者应激反应,提高唤醒质量,减少了不良事件的发生。
