In the face of constantly changing environments,the central nervous system(CNS)rapidly and accurately calculates the body's needs,regulates feeding behavior,and maintains energy homeostasis.The arcuate nucleus of ...In the face of constantly changing environments,the central nervous system(CNS)rapidly and accurately calculates the body's needs,regulates feeding behavior,and maintains energy homeostasis.The arcuate nucleus of the hypothalamus(ARC)plays a key role in this process,serv-ing as a critical brain region for detecting nutrition-related hormones and regulating appetite and energy homeostasis.Agouti-related protein(AgRP)/neuropeptide Y(NPY)neu-rons in the ARC are core elements that interact with other brain regions through a complex appetite-regulating network to comprehensively control energy homeostasis.In this review,we explore the discovery and research progress of AgRP neurons in regulating feeding and energy metabolism.In addition,recent advances in terms of feeding behavior and energy homeostasis,along with the redundant neural mecha-nisms involved in energy metabolism,are discussed.Finally,the challenges and opportunities in the field of neural regula-tion of feeding and energy metabolism are briefly discussed.展开更多
This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessmen...This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.展开更多
For decades,researchers have known that when neurons lose their activating inputs,they can atrophy and even die.For example,removing sensory nerve inputs from the arm to the spinal cord after amputation or cutting the...For decades,researchers have known that when neurons lose their activating inputs,they can atrophy and even die.For example,removing sensory nerve inputs from the arm to the spinal cord after amputation or cutting the spinal nerves can shrink the post-synaptic target zones(e.g.,Woods et al.,2000).From touch receptors for the hand and arm,primary nerve afferents enter the spinal cord,and axons travel in the dorsal columns to target the cuneate nucleus(Cu)of the brainstem on the same side of the body(Figure 1).When sensory loss is unilateral,the overwhelming result is for the associated primary target zone to shrink in total size(cross-sectional area),as compared to the size of the opposite side.展开更多
Objective To observe the impacts of acupuncture on brainstem evoked potentials in the patients with primary depression. Methods Forty cases of primary depression were treated by acupuncture at Baihui （百会 GV 20）, Y...Objective To observe the impacts of acupuncture on brainstem evoked potentials in the patients with primary depression. Methods Forty cases of primary depression were treated by acupuncture at Baihui （百会 GV 20）, Yinatng （印堂 GV 29）, DazhuT （大椎 GV 14）, bilateral Shenmen （神门 HT 7）, bilateral Taichong （太冲 LR 3）, bilateral Neiguan （内关 PC 6） and SanyTnjiao （三阴交 SP 6）. The needles were retained for 30 min. Acupuncture treatment was given once every two days, three treatments a week. The brainstem auditory evoked potential （BAEP） and visual evoked potential （VEP） were observed in 6 weeks of treatment. The change in Hamilton depression scale （HAMD） score was observed before and after treatment in the depression group. Results After treatment, VEP wave latency was shortened significantly in patients of depression （P〈0.05）, BAEPIII wave latency was shortened significantly （P〈0.05）. The score of HAMD was decreased apparently in the depression group （P〈0.05）. Conclusions The stressability of visual and auditory stimuli in the central nervous system was decreased in the patients of depression. Acupuncture shortens remarkably the brainstem evoked potentials latency in the patients of depression and achieves the effective results in the treatment of primary depression.展开更多
Objective To explore the effect of acupuncture at ＂Jing Jiaji＂ （颈夹背） on sudden hearing loss by observing the changes of the threshold of auditory brainstem response （ABR） of deaf guinea pigs. Methods Sixty he...Objective To explore the effect of acupuncture at ＂Jing Jiaji＂ （颈夹背） on sudden hearing loss by observing the changes of the threshold of auditory brainstem response （ABR） of deaf guinea pigs. Methods Sixty healthy guinea pigs were selected, with computer randomization, 20 were randomly divided into a normal control group （group A）, while the rest were randomly and equally divided into a model group （group B） and an acupuncture group （group C） when turned deaf after gentamycin sulfate and furosemide were administered. No treatment was administered for either the group A or the group B, while acupuncture at ＂Jing Jiaji＂ was given for the group C for 30 days. The ABR thresholds of each group were observed and recorded separately after the treatment for 15 days and 30 days. Results The ABR threshold in the group C was lower than that in the group B after the treatment of 15 days （P〈O.05）. After the treatment of 30 days, the ABR threshold in the group C was obviously lower than that in the group B （P〈0.01）, and was obviously lower than that before acupuncture （P〈0.01）. Conclusion Acupuncture at ＂Jing Jiaji＂ has definite effect on improving the hearing of deaf guinea pigs.展开更多
Purpose:Misophonia is not investigated much from an audiological perspective.Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia.Methods:A cross-sectional st...Purpose:Misophonia is not investigated much from an audiological perspective.Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia.Methods:A cross-sectional study was conducted among university students who had misophonia.The revised Amsterdam Misophonia Scale was used to determine the severity of misophonia.Participants were divided into mild and moderate-severe misophonia and compared with the healthy control group.Auditory Brainstem Response testing was recorded from all the individuals with misophonia.The absolute latency,amplitude,inter-peak latency difference,and inter-rate latency difference were compared between the groups.Results:One-way ANOVA result showed no significant difference in all the parameters of auditory brainstem response between the groups.These results are suggestive of normal brainstem processing in individuals with misophonia.Conclusions:The study concludes that the auditory pathway up to brainstem areas is intact in individuals with misophonia.Further studies are essential on a larger population for generalizing the results.展开更多
To characterize the patterns of ABR waves in tree shrews, we must understand the hearing sensitivity and auditory function of healthy adult tree shrews. Fifteen tree shrews(30 ears) were stimulated with clicks and ton...To characterize the patterns of ABR waves in tree shrews, we must understand the hearing sensitivity and auditory function of healthy adult tree shrews. Fifteen tree shrews(30 ears) were stimulated with clicks and tone-pips at 11 different frequencies from 1 to 60 kHz. The ABR waves were recorded and analyzed. The ABR consisted of five to seven positive waves in the first 10 ms after a click stimulus, and the average hearing threshold of component III was 27.86 ± 3.78 dB SPL. Wave III was the largest and most clear. The ABR threshold was related to the tone-pip sitmulus by a "U" shaped curve. The sensitive frequency was approximately 8 kHz in tree shrews. The latencies systematically decreased with increasing stimulus frequencies. The ABR amplitudes of wave III increased as the sound pressure level increased. All of these results provide an empirical basis for future studies of hearing diseases in tree shrews.展开更多
AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to a...AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane.METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model.Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve.RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage.Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure.CONCLUSION: Brainstem hemorrhage could causeintracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.展开更多
Lesions of the brainstem have been reported in the clinical scenarios of hypoxic-ischemic encephalopathy(HIE), although the prevalence of these lesions is probably underestimated. Neuropathologic studies have demonstr...Lesions of the brainstem have been reported in the clinical scenarios of hypoxic-ischemic encephalopathy(HIE), although the prevalence of these lesions is probably underestimated. Neuropathologic studies have demonstrated brainstem involvement in severely asphyxiated infants as an indicator of poor outcome. Among survivors to HIE, the most frequent clinical complaints that may be predicted by brainstem lesions include feeding problems, speech, language and communication problems and visual impairments. Clinical series, including vascular and metabolic etiologies, have found selective involvement of the brainstem with the demonstration of symmetric bilateral columnar lesions of the tegmentum. The role of brainstem lesions in HIE is currently a matter of debate, especially when tegmental lesions are present in the absence of supratentorial lesions. Differential diagnosis of tegmental lesions in neonates and infants include congenital metabolic syndromes and drug-related processes. Brainstem injury with the presence of supratentorial lesions is a predictor of poor outcome and high rates of mortality and morbidity. Further investigation will be conducted to identify specific sites of the brainstem that are vulnerable to hypoxic-ischemic and toxic-metabolic insults.展开更多
Inoperable brainstem gliomas (BSG) are among the most difficult to treat malignancies. In the intent-to-treat (ITT) population of the BT-11 study for BSG, forty patients (median age 11.2 years old) were enrolled. Anti...Inoperable brainstem gliomas (BSG) are among the most difficult to treat malignancies. In the intent-to-treat (ITT) population of the BT-11 study for BSG, forty patients (median age 11.2 years old) were enrolled. Antineoplastons A10 and AS2-1 (ANP) were administered intravenously daily. The median daily dose of A10 was 8.70 g/kg/day and AS2-1 was 0.32 g/kg/day. Efficacy analyses were conducted in two subgroups: recurrent pediatric diffuse intrinsic pontine glioma (RPDIPG, N?= 17) and non-diffuse intrinsic pontine glioma (NDIPG, N?= 11). This paper reports the results of the study of the efficacy and safety of ANP in patients with NDIPG. The results in the RPDIPG group were reported before;complete response (CR) was 6%, partial response (PR) 23.5%, and stable disease (SD) 17.6%. One year overall survival (OS) was 29.4%, 2 years 11.8%, and 5, 10, and 15 years 6%. In the NDIPG group, there were 36% CR and 27.5% SD. OS at 1, 5, 10, and 15 years was 82%, 73%, 62%, and 50% correspondingly. There was only one serious adverse event (9%) reported in NDIPG represented by hypokalemia, Grade 4. The results suggest that ANP shows efficacy and an acceptable tolerability profile in patients with RPDIPG and NDIPG.展开更多
Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencepha...Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencephalography （EEG）, magnetic resonance imaging （MRI） and cerebrospinal fluid （CSF） examination were studied to clarify the characteristics of this syndrome. Results： A 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MR1 demonstrated high-intensity abnormalities on T2-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered. Conclusion： BBE, fisher syndrome （FS） and Guillain-Barre syndrome （GBS） are similar clinically; BBE and FS were proposed to be the variant of GBS.展开更多
Objective:To evaluate the changes of brainstem auditory evoked potential (BAEP) in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods: BAEPs were performed in 32 controls and 40 patien...Objective:To evaluate the changes of brainstem auditory evoked potential (BAEP) in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods: BAEPs were performed in 32 controls and 40 patients. Wave Ⅰ , Ⅱ , Ⅲ ,Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies were measured, respectively. Results: Abnormalities of BAEPs in 13 patients (13/40, 32 ％). Among the13 abnormal BAEPs, 3 displayed prolongation of latency to waves in one side, no potential in another side; 5 displayed a similar abnormality which was bilateral prolongation of latency to waves ;and another 5 displayed unilateral latency delay. Compared wave Ⅰ , Ⅱ , Ⅲ , Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies in the patients and the controls, there were no significant differences (P＞0.05). Conclusion: BAEPs can be used for evaluating the diagnostic and prognostic values in the cases of delayed encephalopathy after acute carbon monoxide poisoning.展开更多
BACKGROUND： Previous experiments have demonstrated that brainstem auditory evoked potential is affected by exercise, exercise duration, and frequency. OBJECTIVE： Comparing the brainstem auditory evoked potential of ...BACKGROUND： Previous experiments have demonstrated that brainstem auditory evoked potential is affected by exercise, exercise duration, and frequency. OBJECTIVE： Comparing the brainstem auditory evoked potential of students studying folk dance to students studying other subjects. DESIGN： Observational contrast study. SETTING： Physical Education College, Shandong Normal University PARTICIPANTS： Fifty-five female students were enrolled at Shandong Normal University between September and December in 2005, including 21 students that studied folk dance and 34 students that studied other subjects. The age of the folk dance students averaged （19 ± 1） years and dance training length was （6.0 ± 1.5） years. The students that studied other subjects had never taken part in dance training or other physical training, and their age averaged （22 ± 1） years, body height averaged （162 ± 5） cm, body mass averaged （51 ± 6） kg. All subjects had no prior ear disease or history of other neurological disorders. All students provided informed consent for the experimental project. METHODS： The neural electricity tester, NDI-200 （Shanghai Poseidon Medical Electronic Instrument Factory） was used to examine and record Brainstem Auditory Evoked Potential values of the subjects during silence, as well as to transversally analyze the Brainstem Auditory Evoked Potential values. The electrode positions were cleaned and degreased with soapy water, followed by ethanol. The selected bipolar electrodes were situated on the head： recording electrodes were placed at the Baihui acupoint, and the reference electrode was placed at the mastoid of the measured ear, with grounding electrodes in the center of the forehead. Brainstem Auditory Evoked Potential values were elicited by monaural stimulation of a ＂click＂ though an earphone; the other ear was sheltered by the white noise. The click intensity was 102 db, the stimulation frequency was 30 Hz, the bandpass filters were 1 000-3 000 Hz, the sensitivity was 5 ta V, and a total of 2 000 sweeps were averaged. Waveform identification and analysis： various components of the Brainstem Auditory Evoked Potential values were identified, and the peak latencies and peak-peak values were analyzed. MAIN OUTCOME MEASURES： Latency of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ and Peak-Peak Value of Ⅰ, Ⅲ, Ⅴwere measured. RESULTS： Fifty-five subjects were enrolled in the final analysis, without any loss. Compared to the students who studied other subjects ① Ⅰ -Ⅴ peak latencies （PL）： Ⅳ PL of the right ear of the folk dance students was obviously longer （P 〈 0.05）; ② Ⅰ, Ⅲ, V peak-peak values：Ⅰ peak-peak values of the right ear were obviously higher （P 〈 0.05）. CONCUSION： ① PL of the right ear of the folk dance students was obviously longer, which indicates that dancing results in a stronger sensibility to auditory stimuli. ②. Peak-peak values were obviously higher, which indicates that long-term exercise enhances the music senses and synchrony of auditory nerve impulses.展开更多
BACKGROUND Convulsive-like movements are rare in basilar artery occlusive cerebral infarction(BAOCI).These manifestations may easily be mistaken for epileptic seizures caused by compromised anterior circulation or by ...BACKGROUND Convulsive-like movements are rare in basilar artery occlusive cerebral infarction(BAOCI).These manifestations may easily be mistaken for epileptic seizures caused by compromised anterior circulation or by cortical lesions.Delayed diagnosis of this condition affects its subsequent treatment and prognosis.Therefore,it is critical to recognize this type of phenomenon in the early stage.CASE SUMMARY A 55-year-old male patient presented with unconsciousness,rigidity,and a paroxysmal twitch in both lower limbs.These conditions lasted for nearly 2 h and resembled status epilepticus.After the initial conditions subsided,hemiplegia occurred and then subsided rapidly.The family refused thrombolytic therapy because the symptoms were similar to Todd paralysis after epilepsy.However,magnetic resonance imaging showed left pontine infarction.No abnormality was observed in a video electroencephalogram during the interictal period.Digital subtraction angiography revealed that the basilar artery was occluded and that the posterior communicating arteries were patent.Fortunately,the patient received a good prognosis after antiplatelet therapy,lipid regulation,balloon dilatation of the basilar artery,and rehabilitation.CONCLUSION Convulsive-like movements may be an early sign of basilar artery occlusive brainstem infarction.It is important to identify this phenomenon in a timely manner.展开更多
Differential diagnosis of brainstem lesions,either isolated or in association with cerebellar and supra-tentorial lesions,can be challenging. Knowledge of the structural organization is crucial for the differential di...Differential diagnosis of brainstem lesions,either isolated or in association with cerebellar and supra-tentorial lesions,can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential,especially in the pediatric population. Magnetic resonance imaging(MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and,particularly,the brainstem. High magnetic static field MRI allows detailed visualization of the morphology,signal intensity and metabolic content of the brainstem nuclei,together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular,toxico-metabolic,infectiveinflammatory,degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions,the brainstem vascularization territories,gray and white matter distribution and tissue selective vulnerability.展开更多
BACKGROUND The auditory brainstem implant(ABI)is a significant treatment to restore hearing sensations for neurofibromatosis type 2(NF2)patients.However,there is no ideal method in assisting the placement of ABIs.In t...BACKGROUND The auditory brainstem implant(ABI)is a significant treatment to restore hearing sensations for neurofibromatosis type 2(NF2)patients.However,there is no ideal method in assisting the placement of ABIs.In this case series,intraoperative cochlear nucleus mapping was performed in awake craniotomy to help guide the placement of the electrode array.CASE SUMMARY We applied the asleep-awake-asleep technique for awake craniotomy and hearing test via the retrosigmoid approach for acoustic neuroma resections and ABIs,using mechanical ventilation with a laryngeal mask during the asleep phases,utilizing a ropivacaine-based regional anesthesia,and sevoflurane combined with propofol/remifentanil as the sedative/analgesic agents in four NF2 patients.ABI electrode arrays were placed in the awake phase with successful intraoperative hearing tests in three patients.There was one uncooperative patient whose awake hearing test needed to be aborted.In all cases,tumor resection and ABI were performed safely.Satisfactory electrode effectiveness was achieved in awake ABI placement.CONCLUSION This case series suggests that awake craniotomy with an intraoperative hearing test for ABI placement is safe and well tolerated.Awake craniotomy is beneficial for improving the accuracy of ABI electrode placement and meanwhile reduces non-auditory side effects.展开更多
Tinnitus has often been studied using salicylate in animal models as they are capable of inducing tempo-rary hearing loss and tinnitus. Studies have recently observed enhancement of auditory evoked responses of the au...Tinnitus has often been studied using salicylate in animal models as they are capable of inducing tempo-rary hearing loss and tinnitus. Studies have recently observed enhancement of auditory evoked responses of the auditory cortex (AC) post salicylate treatment which is also shown to be related to tinnitus like behavior in rats. The aim of this study was to observe if enhancements of the AC post salicylate treatment are also present at structures in the brainstem. Four male Sprague Dawley rats with AC implanted electrodes were tested for both AC and auditory brainstem response (ABR) recordings pre and post 250 mg/kg intraperitone-al injections of salicylate. The responses were recorded as the peak to trough amplitudes of P1-N1 (AC), ABR wave V, and ABR waveⅡ. AC responses resulted in statistically significant enhancement of ampli-tude at 2 hours post salicylate with 90 dB stimuli tone bursts of 4, 8, 12, and 20 kHz. Wave V of ABR re-sponses at 90 dB resulted in a statistically significant reduction of amplitude 2 hours post salicylate and a mean decrease of amplitude of 31%for 16 kHz. WaveⅡamplitudes at 2 hours post treatment were signifi-cantly reduced for 4, 12, and 20 kHz stimuli at 90 dB SPL. Our results suggest that the enhancement chang-es of the AC related to salicylate induced tinnitus are generated superior to the level of the inferior colliculus and may originate in the AC.展开更多
BACKGROUNDIntracranial Listeria infections are common in newborns and immunocompromisedindividuals, but brainstem abscesses are rare.CASE SUMMARYWe report a rare case of brainstem abscesses caused by Listeria monocyto...BACKGROUNDIntracranial Listeria infections are common in newborns and immunocompromisedindividuals, but brainstem abscesses are rare.CASE SUMMARYWe report a rare case of brainstem abscesses caused by Listeria monocytogenes in apreviously healthy adult patient. The patient’s magnetic resonance imagingexamination showed multiple brain abscesses, and his second cerebrospinal fluidculture test indicated the presence of Listeria monocytogenes. Despite earlyempirical therapy, the patient’s condition progressively deteriorated. Because thepatient's abscesses were located in the brainstem and multiple lobes, surgery wasnot possible. The patient died 40 d after admission.CONCLUSIONThis case highlights the importance of rational clinical use of drugs to avoidpotentially serious infectious complications.展开更多
According to clinical statistics,the mortality of patients with early brainstem hemorrhage is high.In this study,we established rat models of brainstem hemorrhage by injecting type Ⅶ collagenase into the right basote...According to clinical statistics,the mortality of patients with early brainstem hemorrhage is high.In this study,we established rat models of brainstem hemorrhage by injecting type Ⅶ collagenase into the right basotegmental pontine and investigated the pathological changes of early brainstem hemorrhage using multi-sequence magnetic resonance imaging and histopathological methods.We found that brainstem hematoma gradually formed in the injured rats over the first 3 days and then reduced after 7 days.The edema that occurred was mainly of the vasogenic type.No complete myelin sheath structure was found around the focus of the brainstem hemorrhage.The integrity and continuity of nerve fibers gradually deteriorated over the first 7 days.Neuronal degeneration was mild in the first 3 days and then obviously aggravated on the 7^(th)day.Inflammatory cytokines,interleukin-1β,and tumor necrosis factorαappeared on the 1st day after intracerebral hemorrhage,reached peak levels on the 3^(rd)day,and decreased from the 7^(th)day.Our findings show the characteristics of the progression of early brainstem hemorrhage.展开更多
The human brain is known to have six cholinergic nudei （Selden et al., 1998; Nieuwenhuys et al., 2008）. The cerebral cortex obtains cholinergic innervation mainly from the basalis nucleus of Meynert （Ch 4） in the ...The human brain is known to have six cholinergic nudei （Selden et al., 1998; Nieuwenhuys et al., 2008）. The cerebral cortex obtains cholinergic innervation mainly from the basalis nucleus of Meynert （Ch 4） in the bas- al forebrain through the medial and lateral cholinergic pathways （Selden et al., 1998; Mesulam et al., 1983）. The cingulum, the neural fiber bundle connecting the basal forebrain and the medial temporal lobe, contains the medial cholinergic pathway （Selden et al., 1998; Hong and Jang, 2010）.展开更多
基金supported by Grants from the Research Funds of the Center for Advanced Interdisciplinary Science and Biomedicine of IHM(QYPY20220018)the National Natural Science Foundation of China(31822026,32271063,31500860,and 32100821)the National Science and Technology Innovation 2030 Major Project of China(2021ZD0203900).
文摘In the face of constantly changing environments,the central nervous system(CNS)rapidly and accurately calculates the body's needs,regulates feeding behavior,and maintains energy homeostasis.The arcuate nucleus of the hypothalamus(ARC)plays a key role in this process,serv-ing as a critical brain region for detecting nutrition-related hormones and regulating appetite and energy homeostasis.Agouti-related protein(AgRP)/neuropeptide Y(NPY)neu-rons in the ARC are core elements that interact with other brain regions through a complex appetite-regulating network to comprehensively control energy homeostasis.In this review,we explore the discovery and research progress of AgRP neurons in regulating feeding and energy metabolism.In addition,recent advances in terms of feeding behavior and energy homeostasis,along with the redundant neural mecha-nisms involved in energy metabolism,are discussed.Finally,the challenges and opportunities in the field of neural regula-tion of feeding and energy metabolism are briefly discussed.
基金Teaching and Research Project of Anhui Urban Management Vocational College(Project No.:2024kfkc001)。
文摘This paper reports a case of cerebral stem infarction with quadriplegia and complete dependence on daily life.The course of the disease lasted more than 7 months.Frenchay's improved articulation Disorder Assessment Form has been assessed as severe articulation disorder.The patient has significantly improved his speech function and quality of life after systematic head control training,respiratory function training,articulation motor training,and articulation training.In the course of treatment,emphasis was placed on head postural control training and respiratory function training,and emphasis was placed on the strength and coordination training of articulatory organs,and the results were remarkable.After the patient was discharged from the hospital,the follow-up of basic daily life communication was not limited.
基金supported by National Institute of Health Grant NINDS NS16446 to JHK and NS067017 to HXQsupported by NIH NINDS NS129982 and NIH NEI EY002686 to JHK
文摘For decades,researchers have known that when neurons lose their activating inputs,they can atrophy and even die.For example,removing sensory nerve inputs from the arm to the spinal cord after amputation or cutting the spinal nerves can shrink the post-synaptic target zones(e.g.,Woods et al.,2000).From touch receptors for the hand and arm,primary nerve afferents enter the spinal cord,and axons travel in the dorsal columns to target the cuneate nucleus(Cu)of the brainstem on the same side of the body(Figure 1).When sensory loss is unilateral,the overwhelming result is for the associated primary target zone to shrink in total size(cross-sectional area),as compared to the size of the opposite side.
文摘Objective To observe the impacts of acupuncture on brainstem evoked potentials in the patients with primary depression. Methods Forty cases of primary depression were treated by acupuncture at Baihui （百会 GV 20）, Yinatng （印堂 GV 29）, DazhuT （大椎 GV 14）, bilateral Shenmen （神门 HT 7）, bilateral Taichong （太冲 LR 3）, bilateral Neiguan （内关 PC 6） and SanyTnjiao （三阴交 SP 6）. The needles were retained for 30 min. Acupuncture treatment was given once every two days, three treatments a week. The brainstem auditory evoked potential （BAEP） and visual evoked potential （VEP） were observed in 6 weeks of treatment. The change in Hamilton depression scale （HAMD） score was observed before and after treatment in the depression group. Results After treatment, VEP wave latency was shortened significantly in patients of depression （P〈0.05）, BAEPIII wave latency was shortened significantly （P〈0.05）. The score of HAMD was decreased apparently in the depression group （P〈0.05）. Conclusions The stressability of visual and auditory stimuli in the central nervous system was decreased in the patients of depression. Acupuncture shortens remarkably the brainstem evoked potentials latency in the patients of depression and achieves the effective results in the treatment of primary depression.
基金Supported by Yanbian University on Scientific Development and Application:No.36,yanda kehe zi[2013]
文摘Objective To explore the effect of acupuncture at ＂Jing Jiaji＂ （颈夹背） on sudden hearing loss by observing the changes of the threshold of auditory brainstem response （ABR） of deaf guinea pigs. Methods Sixty healthy guinea pigs were selected, with computer randomization, 20 were randomly divided into a normal control group （group A）, while the rest were randomly and equally divided into a model group （group B） and an acupuncture group （group C） when turned deaf after gentamycin sulfate and furosemide were administered. No treatment was administered for either the group A or the group B, while acupuncture at ＂Jing Jiaji＂ was given for the group C for 30 days. The ABR thresholds of each group were observed and recorded separately after the treatment for 15 days and 30 days. Results The ABR threshold in the group C was lower than that in the group B after the treatment of 15 days （P〈O.05）. After the treatment of 30 days, the ABR threshold in the group C was obviously lower than that in the group B （P〈0.01）, and was obviously lower than that before acupuncture （P〈0.01）. Conclusion Acupuncture at ＂Jing Jiaji＂ has definite effect on improving the hearing of deaf guinea pigs.
文摘Purpose:Misophonia is not investigated much from an audiological perspective.Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia.Methods:A cross-sectional study was conducted among university students who had misophonia.The revised Amsterdam Misophonia Scale was used to determine the severity of misophonia.Participants were divided into mild and moderate-severe misophonia and compared with the healthy control group.Auditory Brainstem Response testing was recorded from all the individuals with misophonia.The absolute latency,amplitude,inter-peak latency difference,and inter-rate latency difference were compared between the groups.Results:One-way ANOVA result showed no significant difference in all the parameters of auditory brainstem response between the groups.These results are suggestive of normal brainstem processing in individuals with misophonia.Conclusions:The study concludes that the auditory pathway up to brainstem areas is intact in individuals with misophonia.Further studies are essential on a larger population for generalizing the results.
基金supported by Natural Science Foundation of China[grant numbers 81760188]Scientific Research Fund of Guangxi Provincial Education Department [grant numbers 2017KY0103 (02601217023C)]
文摘To characterize the patterns of ABR waves in tree shrews, we must understand the hearing sensitivity and auditory function of healthy adult tree shrews. Fifteen tree shrews(30 ears) were stimulated with clicks and tone-pips at 11 different frequencies from 1 to 60 kHz. The ABR waves were recorded and analyzed. The ABR consisted of five to seven positive waves in the first 10 ms after a click stimulus, and the average hearing threshold of component III was 27.86 ± 3.78 dB SPL. Wave III was the largest and most clear. The ABR threshold was related to the tone-pip sitmulus by a "U" shaped curve. The sensitive frequency was approximately 8 kHz in tree shrews. The latencies systematically decreased with increasing stimulus frequencies. The ABR amplitudes of wave III increased as the sound pressure level increased. All of these results provide an empirical basis for future studies of hearing diseases in tree shrews.
基金Supported by the Natural Science Foundation of Tianjin, No.023610711and the Project Sponsored by SRF for ROCS, SEMthe Teaching Research Foundation of Tianjin Medical University
文摘AIM: To explore the dynamic changes in the pressure of the lateral ventricle during acute brainstem hemorrhage and the changes of neural discharge of vagus nerve under the load of intracranial hypertension, so as to analyze their effects on the congestive degree of intestinal mucous membrane and the morphologic changes of intestinal mucous membrane.METHODS: An operation was made to open the skull to obtain an acute brainstem hemorrhage animal model.Microcirculatory microscope photography device and video recording system were used to determine the changes continuously in the caliber of jejunal mesenteric artery during brainstem hemorrhage and the changes with time in the congestion of jejunal mucosal villi. We used HE stain morphology to analyze the changes of duodenal mucosal villi. A recording electrode was used to calculate and measure the electric discharge activities of cervical vagus nerve.RESULTS: (1) We observed that the pressure of lateral cerebral ventricle increased transiently during acute brainstem hemorrhage; (2) The caliber of the jejunal mesenteric artery increased during brainstem hemorrhage.Analysis of red color coordinate values indicated transient increase in the congestion of jejunal mucous membrane during acute brainstem hemorrhage; (3) Through the analysis of the pathologic slice, we found enlarged blood vessels, stagnant blood, and transudatory red blood cells in the duodenal submucous layer; (4) Electric discharge of vagus nerve increased and sporadic hemorrhage spots occurred in duodenal mucous and submucous layer, when the lateral ventricle was under pressure.CONCLUSION: Brainstem hemorrhage could causeintracranial hypertension, which would increase the neural discharge of vagus nerve and cause the transient congestion of jejunal mucous membrane. It could cause hyperemia and diffused hemorrhage in the duodenal submucous layer 48 h after brainstem hemorrhage.
文摘Lesions of the brainstem have been reported in the clinical scenarios of hypoxic-ischemic encephalopathy(HIE), although the prevalence of these lesions is probably underestimated. Neuropathologic studies have demonstrated brainstem involvement in severely asphyxiated infants as an indicator of poor outcome. Among survivors to HIE, the most frequent clinical complaints that may be predicted by brainstem lesions include feeding problems, speech, language and communication problems and visual impairments. Clinical series, including vascular and metabolic etiologies, have found selective involvement of the brainstem with the demonstration of symmetric bilateral columnar lesions of the tegmentum. The role of brainstem lesions in HIE is currently a matter of debate, especially when tegmental lesions are present in the absence of supratentorial lesions. Differential diagnosis of tegmental lesions in neonates and infants include congenital metabolic syndromes and drug-related processes. Brainstem injury with the presence of supratentorial lesions is a predictor of poor outcome and high rates of mortality and morbidity. Further investigation will be conducted to identify specific sites of the brainstem that are vulnerable to hypoxic-ischemic and toxic-metabolic insults.
文摘Inoperable brainstem gliomas (BSG) are among the most difficult to treat malignancies. In the intent-to-treat (ITT) population of the BT-11 study for BSG, forty patients (median age 11.2 years old) were enrolled. Antineoplastons A10 and AS2-1 (ANP) were administered intravenously daily. The median daily dose of A10 was 8.70 g/kg/day and AS2-1 was 0.32 g/kg/day. Efficacy analyses were conducted in two subgroups: recurrent pediatric diffuse intrinsic pontine glioma (RPDIPG, N?= 17) and non-diffuse intrinsic pontine glioma (NDIPG, N?= 11). This paper reports the results of the study of the efficacy and safety of ANP in patients with NDIPG. The results in the RPDIPG group were reported before;complete response (CR) was 6%, partial response (PR) 23.5%, and stable disease (SD) 17.6%. One year overall survival (OS) was 29.4%, 2 years 11.8%, and 5, 10, and 15 years 6%. In the NDIPG group, there were 36% CR and 27.5% SD. OS at 1, 5, 10, and 15 years was 82%, 73%, 62%, and 50% correspondingly. There was only one serious adverse event (9%) reported in NDIPG represented by hypokalemia, Grade 4. The results suggest that ANP shows efficacy and an acceptable tolerability profile in patients with RPDIPG and NDIPG.
文摘Objective： There is no report on Bickerstaff s brainstem encephalitis （BBE） patients in China. We here report the first case of BBE in China. Methods： Clinical features, results of electromyography, eleetroencephalography （EEG）, magnetic resonance imaging （MRI） and cerebrospinal fluid （CSF） examination were studied to clarify the characteristics of this syndrome. Results： A 44-year-old man presented himself at our inpatient department with somnolence and dizziness as his initial symptoms. He developed multiple cranial nerves paralysis especially internal and external ophthalmoplegia, ataxia and tetraparesis within 1 week. His condition rapidly deteriorated, and he experienced coma. Electromyography showed indications of peripheral nerve dysfunction, electroencephalography revealed loss of basic rhythm, MR1 demonstrated high-intensity abnormalities on T2-weighted images of medulla oblongata, and CSF albuminocytological dissociation was defined abnormally as high protein. Ten months later, he almost completely recovered. Conclusion： BBE, fisher syndrome （FS） and Guillain-Barre syndrome （GBS） are similar clinically; BBE and FS were proposed to be the variant of GBS.
基金Supported by the Department of Education in Henan (2000320042)
文摘Objective:To evaluate the changes of brainstem auditory evoked potential (BAEP) in patients with delayed encephalopathy after acute carbon monoxide poisoning. Methods: BAEPs were performed in 32 controls and 40 patients. Wave Ⅰ , Ⅱ , Ⅲ ,Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies were measured, respectively. Results: Abnormalities of BAEPs in 13 patients (13/40, 32 ％). Among the13 abnormal BAEPs, 3 displayed prolongation of latency to waves in one side, no potential in another side; 5 displayed a similar abnormality which was bilateral prolongation of latency to waves ;and another 5 displayed unilateral latency delay. Compared wave Ⅰ , Ⅱ , Ⅲ , Ⅳ, Ⅴ latencies and Ⅰ-Ⅲ , Ⅲ-Ⅴ , Ⅰ-Ⅴ interpeak latencies in the patients and the controls, there were no significant differences (P＞0.05). Conclusion: BAEPs can be used for evaluating the diagnostic and prognostic values in the cases of delayed encephalopathy after acute carbon monoxide poisoning.
文摘BACKGROUND： Previous experiments have demonstrated that brainstem auditory evoked potential is affected by exercise, exercise duration, and frequency. OBJECTIVE： Comparing the brainstem auditory evoked potential of students studying folk dance to students studying other subjects. DESIGN： Observational contrast study. SETTING： Physical Education College, Shandong Normal University PARTICIPANTS： Fifty-five female students were enrolled at Shandong Normal University between September and December in 2005, including 21 students that studied folk dance and 34 students that studied other subjects. The age of the folk dance students averaged （19 ± 1） years and dance training length was （6.0 ± 1.5） years. The students that studied other subjects had never taken part in dance training or other physical training, and their age averaged （22 ± 1） years, body height averaged （162 ± 5） cm, body mass averaged （51 ± 6） kg. All subjects had no prior ear disease or history of other neurological disorders. All students provided informed consent for the experimental project. METHODS： The neural electricity tester, NDI-200 （Shanghai Poseidon Medical Electronic Instrument Factory） was used to examine and record Brainstem Auditory Evoked Potential values of the subjects during silence, as well as to transversally analyze the Brainstem Auditory Evoked Potential values. The electrode positions were cleaned and degreased with soapy water, followed by ethanol. The selected bipolar electrodes were situated on the head： recording electrodes were placed at the Baihui acupoint, and the reference electrode was placed at the mastoid of the measured ear, with grounding electrodes in the center of the forehead. Brainstem Auditory Evoked Potential values were elicited by monaural stimulation of a ＂click＂ though an earphone; the other ear was sheltered by the white noise. The click intensity was 102 db, the stimulation frequency was 30 Hz, the bandpass filters were 1 000-3 000 Hz, the sensitivity was 5 ta V, and a total of 2 000 sweeps were averaged. Waveform identification and analysis： various components of the Brainstem Auditory Evoked Potential values were identified, and the peak latencies and peak-peak values were analyzed. MAIN OUTCOME MEASURES： Latency of Ⅰ , Ⅱ, Ⅲ, Ⅳ, Ⅴ and Peak-Peak Value of Ⅰ, Ⅲ, Ⅴwere measured. RESULTS： Fifty-five subjects were enrolled in the final analysis, without any loss. Compared to the students who studied other subjects ① Ⅰ -Ⅴ peak latencies （PL）： Ⅳ PL of the right ear of the folk dance students was obviously longer （P 〈 0.05）; ② Ⅰ, Ⅲ, V peak-peak values：Ⅰ peak-peak values of the right ear were obviously higher （P 〈 0.05）. CONCUSION： ① PL of the right ear of the folk dance students was obviously longer, which indicates that dancing results in a stronger sensibility to auditory stimuli. ②. Peak-peak values were obviously higher, which indicates that long-term exercise enhances the music senses and synchrony of auditory nerve impulses.
基金Supported by National Natural Science Foundations of China,No.81903584.
文摘BACKGROUND Convulsive-like movements are rare in basilar artery occlusive cerebral infarction(BAOCI).These manifestations may easily be mistaken for epileptic seizures caused by compromised anterior circulation or by cortical lesions.Delayed diagnosis of this condition affects its subsequent treatment and prognosis.Therefore,it is critical to recognize this type of phenomenon in the early stage.CASE SUMMARY A 55-year-old male patient presented with unconsciousness,rigidity,and a paroxysmal twitch in both lower limbs.These conditions lasted for nearly 2 h and resembled status epilepticus.After the initial conditions subsided,hemiplegia occurred and then subsided rapidly.The family refused thrombolytic therapy because the symptoms were similar to Todd paralysis after epilepsy.However,magnetic resonance imaging showed left pontine infarction.No abnormality was observed in a video electroencephalogram during the interictal period.Digital subtraction angiography revealed that the basilar artery was occluded and that the posterior communicating arteries were patent.Fortunately,the patient received a good prognosis after antiplatelet therapy,lipid regulation,balloon dilatation of the basilar artery,and rehabilitation.CONCLUSION Convulsive-like movements may be an early sign of basilar artery occlusive brainstem infarction.It is important to identify this phenomenon in a timely manner.
文摘Differential diagnosis of brainstem lesions,either isolated or in association with cerebellar and supra-tentorial lesions,can be challenging. Knowledge of the structural organization is crucial for the differential diagnosis and establishment of prognosis of pathologies with involvement of the brainstem. Familiarity with the location of the lesions in the brainstem is essential,especially in the pediatric population. Magnetic resonance imaging(MRI) is the most sensitive and specific imaging technique for diagnosing disorders of the posterior fossa and,particularly,the brainstem. High magnetic static field MRI allows detailed visualization of the morphology,signal intensity and metabolic content of the brainstem nuclei,together with visualization of the normal development and myelination. In this pictorial essay we review the brainstem pathology in pediatric patients and consider the MR imaging patterns that may help the radiologist to differentiate among vascular,toxico-metabolic,infectiveinflammatory,degenerative and neoplastic processes. Helpful MR tips can guide the differential diagnosis: These include the location and morphology of lesions,the brainstem vascularization territories,gray and white matter distribution and tissue selective vulnerability.
基金Beijing Municipal Administration of Hospitals Ascent Plan,No.DFL20180502.
文摘BACKGROUND The auditory brainstem implant(ABI)is a significant treatment to restore hearing sensations for neurofibromatosis type 2(NF2)patients.However,there is no ideal method in assisting the placement of ABIs.In this case series,intraoperative cochlear nucleus mapping was performed in awake craniotomy to help guide the placement of the electrode array.CASE SUMMARY We applied the asleep-awake-asleep technique for awake craniotomy and hearing test via the retrosigmoid approach for acoustic neuroma resections and ABIs,using mechanical ventilation with a laryngeal mask during the asleep phases,utilizing a ropivacaine-based regional anesthesia,and sevoflurane combined with propofol/remifentanil as the sedative/analgesic agents in four NF2 patients.ABI electrode arrays were placed in the awake phase with successful intraoperative hearing tests in three patients.There was one uncooperative patient whose awake hearing test needed to be aborted.In all cases,tumor resection and ABI were performed safely.Satisfactory electrode effectiveness was achieved in awake ABI placement.CONCLUSION This case series suggests that awake craniotomy with an intraoperative hearing test for ABI placement is safe and well tolerated.Awake craniotomy is beneficial for improving the accuracy of ABI electrode placement and meanwhile reduces non-auditory side effects.
文摘Tinnitus has often been studied using salicylate in animal models as they are capable of inducing tempo-rary hearing loss and tinnitus. Studies have recently observed enhancement of auditory evoked responses of the auditory cortex (AC) post salicylate treatment which is also shown to be related to tinnitus like behavior in rats. The aim of this study was to observe if enhancements of the AC post salicylate treatment are also present at structures in the brainstem. Four male Sprague Dawley rats with AC implanted electrodes were tested for both AC and auditory brainstem response (ABR) recordings pre and post 250 mg/kg intraperitone-al injections of salicylate. The responses were recorded as the peak to trough amplitudes of P1-N1 (AC), ABR wave V, and ABR waveⅡ. AC responses resulted in statistically significant enhancement of ampli-tude at 2 hours post salicylate with 90 dB stimuli tone bursts of 4, 8, 12, and 20 kHz. Wave V of ABR re-sponses at 90 dB resulted in a statistically significant reduction of amplitude 2 hours post salicylate and a mean decrease of amplitude of 31%for 16 kHz. WaveⅡamplitudes at 2 hours post treatment were signifi-cantly reduced for 4, 12, and 20 kHz stimuli at 90 dB SPL. Our results suggest that the enhancement chang-es of the AC related to salicylate induced tinnitus are generated superior to the level of the inferior colliculus and may originate in the AC.
文摘BACKGROUNDIntracranial Listeria infections are common in newborns and immunocompromisedindividuals, but brainstem abscesses are rare.CASE SUMMARYWe report a rare case of brainstem abscesses caused by Listeria monocytogenes in apreviously healthy adult patient. The patient’s magnetic resonance imagingexamination showed multiple brain abscesses, and his second cerebrospinal fluidculture test indicated the presence of Listeria monocytogenes. Despite earlyempirical therapy, the patient’s condition progressively deteriorated. Because thepatient's abscesses were located in the brainstem and multiple lobes, surgery wasnot possible. The patient died 40 d after admission.CONCLUSIONThis case highlights the importance of rational clinical use of drugs to avoidpotentially serious infectious complications.
基金supported by the Natural Science Foundation of Xinjiang Uygur Autonomous Region, No. 2020D01A13 (to CWW)Chengdu Science and Technology Bureau, No. 2019-YF05-00511-SN (to MT)1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, Nos. ZY2016102 (to MT), and ZY2016203 (to CY)
文摘According to clinical statistics,the mortality of patients with early brainstem hemorrhage is high.In this study,we established rat models of brainstem hemorrhage by injecting type Ⅶ collagenase into the right basotegmental pontine and investigated the pathological changes of early brainstem hemorrhage using multi-sequence magnetic resonance imaging and histopathological methods.We found that brainstem hematoma gradually formed in the injured rats over the first 3 days and then reduced after 7 days.The edema that occurred was mainly of the vasogenic type.No complete myelin sheath structure was found around the focus of the brainstem hemorrhage.The integrity and continuity of nerve fibers gradually deteriorated over the first 7 days.Neuronal degeneration was mild in the first 3 days and then obviously aggravated on the 7^(th)day.Inflammatory cytokines,interleukin-1β,and tumor necrosis factorαappeared on the 1st day after intracerebral hemorrhage,reached peak levels on the 3^(rd)day,and decreased from the 7^(th)day.Our findings show the characteristics of the progression of early brainstem hemorrhage.
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by the Ministry of Educa-tion,Science and Technology,No.2012R1A1A4A01001873
文摘The human brain is known to have six cholinergic nudei （Selden et al., 1998; Nieuwenhuys et al., 2008）. The cerebral cortex obtains cholinergic innervation mainly from the basalis nucleus of Meynert （Ch 4） in the bas- al forebrain through the medial and lateral cholinergic pathways （Selden et al., 1998; Mesulam et al., 1983）. The cingulum, the neural fiber bundle connecting the basal forebrain and the medial temporal lobe, contains the medial cholinergic pathway （Selden et al., 1998; Hong and Jang, 2010）.
