Studies have confirmed that iron induces epilepsy onset, and iron ion-induced epilepsy in anima models closely resembles the clinical situation. Models of post-traumatic epilepsy （PTE） were established by intracorti...Studies have confirmed that iron induces epilepsy onset, and iron ion-induced epilepsy in anima models closely resembles the clinical situation. Models of post-traumatic epilepsy （PTE） were established by intracortical injection of FeCl2 using stereotactic techniques. Electron microscopy revealed neuronal degeneration, with shrinkage of the neuronal soma, hyperplasia of rough endoplasmic reticulum, ribosomal detachment from the endoplasmic reticulum, and vacuolar degeneration of glial cells in the right frontal lobe of FeCl2-induced PTE rats. With prolonged time injuries became more severe and neuronal apoptosis was observed. Synapses in the hippocampal neuropil significantly increased （primarily type I/excitatory synapses） at day 14 following injury. Type II synapses （inhibitory synapse） were observed in the rat hippocampus at day 30. Cortical neuronal degeneration, apoptosis, glial cell proliferation, and ultrastructural hippocampal changes, in particular changes in type of neuronal synapse, play an important role in PTE onset.展开更多
Postsynaptic density protein-95 and synaptophysin participate in synaptic reorganization in the forebrain of epilepsy models. However, the time-effect relationship between dynamic synapsin expression in hippocampus an...Postsynaptic density protein-95 and synaptophysin participate in synaptic reorganization in the forebrain of epilepsy models. However, the time-effect relationship between dynamic synapsin expression in hippocampus and synaptic reorganization in the post-traumatic epilepsy model remains unclear. FeCI2 was injected into the hippocampal CA3 region of the right forebrain in rats to induce post-traumatic epilepsy. Postsynaptic density protein-95 and synaptophysin expression was detected using immunohistochemistry. Epileptiform discharge induced by FeCI2 injection was determined in rat forebrain neurons, revealing decreased postsynaptic density protein-95 expression at 24 hours and lowest levels at 7 days. Synaptophysin expression was markedly reduced at 24 hours, but increased at 7 days. Postsynaptic density protein-95 and synaptophysin expression was consistent with abnormal mossy fiber sprouting and synaptic reorganization following neuronal injury in the hippocampal CA3 region of FeCI2-induced epilepsy models.展开更多
BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neu...BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.展开更多
Post-traumatic epilepsy(PTE)is a serious complication of traumatic brain injury.It is also the most common type of symptomatic epilepsy.This might be associated with the typical pathological changes of brain injury,in...Post-traumatic epilepsy(PTE)is a serious complication of traumatic brain injury.It is also the most common type of symptomatic epilepsy.This might be associated with the typical pathological changes of brain injury,including reactive glial hyperplasia,axonal retraction ball,Wallerian degeneration,microglial scar formation,and white matter cystic lesions.The prophylactic use of antiepileptic drugs could effectively reduce the risk of early epileptic seizures in patients with severe traumatic brain injury.In this article,we review the epidemiology,pathophysiology,clinical characteristics,and treatment of PTE based on the latest clinical and laboratory research results.展开更多
Objective： To observe the quality of life in patients with post-traumatic epilepsy and discuss the infuencing factors. Methods： We assessed 105 patients with post-traumatic epilepsy and 100 healthy people as contro...Objective： To observe the quality of life in patients with post-traumatic epilepsy and discuss the infuencing factors. Methods： We assessed 105 patients with post-traumatic epilepsy and 100 healthy people as control using Quality of Life Scale-31 （QOL-31）, Self-rating Depressing Scale （SDS） and Self-rating Anxiety Scale （SAS）, and conducted retrospective analysis on the depression, anxiety, site of trauma, control of seizure, EEG and therapeutic compliance. Results： Patients with post-traumatic epilepsy scored much lower than the control group on QOL-31 （P〈0.01）, but higher than the control group on SDS and SAS （P〈0.01）. Multiple regression analysis indicated that major influencing factors on the quality of life were anxiety, therapeutic compliance, depression, poor control of epileptic seizure and site of trauma. Conclusions： The quality of life in patients with posttraumatic epilepsy has significantly declined. Doctors should pay attention to psychological and mental problems of patients with epilepsy, such as depression and anxiety, enhancing therapeutic compliance and controlling epileptic seizure, which are the keys to improving prognosis.展开更多
Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with...Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.展开更多
Objectives:This study examines the effectiveness of an eight-week game-based physical activity program designed to reduce post-traumatic stress levels in children affected by the Kahramanmaraş-centered earthquakes tha...Objectives:This study examines the effectiveness of an eight-week game-based physical activity program designed to reduce post-traumatic stress levels in children affected by the Kahramanmaraş-centered earthquakes that occurred in Turkey on 06 February 2023.Following the earthquake,millions of children experienced significant changes in their education and living conditions,adversely affecting their psychological health.Methods:The therapeutic effects of physical activity on post-traumatic stress disorder(PTSD)are frequently emphasized in the literature,and this study specifically focuses on the impact of game-based exercises.The research employed an experimental design,involving 80 earthquake-affected children aged 10 to 13,who were randomly assigned to either an experimental group(n=40)or a control group(n=40).The experimental group participated in game-based physical activities three times per week for eight weeks,with each session lasting 60 min.Data were collected using the Child Post-Traumatic Stress Reaction Index(CPTS-RI),and pre-test and post-test comparisons were conducted.Results:Children in the experimental group showed a marked reduction in PTSD symptoms,with mean CPTS-RI scores decreasing from 2.60 at pre-test to 1.91 at post-test.In contrast,the control group’s scores remained virtually unchanged(2.59 at pre-test vs.2.57 at post-test).Two-way ANOVA demonstrated significant main effects of group and time,as well as a significant group×time interaction(F=114.88,p<0.001,η^(2)=0.42),indicating that the reduction was attributable to participation in the game-based physical activity program.These findings highlight not only the statistical significance but also the practical relevance of structured,culturally adapted physical activity interventions for trauma-exposed children.Conclusion:These findings suggest that regular,structured game-based physical activities can support the mental health of children following traumatic events such as earthquakes and reduce their stress levels.The study recommends integrating physical activity into post-disaster psychosocial support programs and highlights it as an effective,accessible,and enjoyable method to enhance children’s trauma coping skills.Accordingly,it advocates for the wider implementation of physical activity-based interventions in similar crisis situations.展开更多
BACKGROUND Postoperative anxiety,depression,irritability,and even fear in patients with intertrochanteric femoral fractures may hinder recovery,compromise treatment efficacy,and impede rehabilitation.AIM To investigat...BACKGROUND Postoperative anxiety,depression,irritability,and even fear in patients with intertrochanteric femoral fractures may hinder recovery,compromise treatment efficacy,and impede rehabilitation.AIM To investigate the correlations among anxiety,depression,sense of coherence(SOC),and post-traumatic growth(PTG)in patients who underwent intertrochanteric femoral fracture surgery to improve clinical management strategies and outcomes.METHODS This study carefully selected 211 patients who received surgical treatment for intertrochanteric femoral fractures and were admitted to Dongying People’s Hospital from March 2022 to March 2024.Anxiety and depression in these patients were assessed with the anxiety and depression subscales of the Hospital Anxiety and Depression Scale(HADS),respectively.SOC was evaluated using the 13-item SOC scale(SOC-13),which encompasses three key dimensions:Comprehensibility,manageability,and meaningfulness.PTG was assessed with the Chinese version of PTG Inventory(CPTGI),covering five distinct dimensions:Personal strength,appreciation of life,relating to others,new possibilities,and spiritual change.The Pearson correlation coefficient was used to meticulously analyze the associations among HADS-Anxiety,HADS-Depression,SOC-13,and CPTGI.Further,univariate and multivariate analyses were conducted to identify factors that affect PTG in patients who underwent intertrochanteric femoral fracture surgery.RESULTS The collected data demonstrated that 67.30%and 60.66%of the 211 patients experienced anxiety and depression,respectively,with overall anxiety levels ranging from mild to moderate and depression levels being mild.The mean SOC-13 score was 55.73±8.81 points,indicating a generally low SOC level.The average CPTGI score was 54.93±9.92 points,demonstrating a relatively low PTG level.Notably,both HADS-Anxiety and HADS-Depression scores were significantly negatively correlated with CPTGI,whereas SOC-13 scores were significantly positively correlated with CPTGI.Univariate and multivariate analyses identified the presence of comorbidities[odds ratio(OR)=2.747,P=0.003],monthly household income(OR=3.292,P<0.001),and exercise habits(OR=4.651,P<0.001)as independent predictors of PTG in patients.CONCLUSION The results of this study indicate a significant negative correlation of anxiety and depression with PTG in patients after intertrochanteric femoral fracture surgery,whereas a significant positive association exists between SOC and PTG.This study helps more comprehensively understand the psychological status and recovery processes of such patients,thereby potentially providing valuable information for clinical practice and psychological interventions.展开更多
BACKGROUND Although exposure therapy is a proven treatment for post-traumatic stress disorder(PTSD),empirical research is difficult due to ethical issues.Recently,virtual reality-based content that can provide space a...BACKGROUND Although exposure therapy is a proven treatment for post-traumatic stress disorder(PTSD),empirical research is difficult due to ethical issues.Recently,virtual reality-based content that can provide space and time similar to reality for exposure therapy techniques is increasing.AIM To examine exposure therapy using driving simulations in patients with PTSD due to traffic accidents with PTSD symptoms.METHODS The intervention was provided to two individuals who experienced PTSD symptoms after a traffic accident using a driving simulator.Among the singlesubject experimental designs,the ABA(baseline-intervention-baseline)design was used,and the PTSD checklist and brain wave frequency were used to measure the results.RESULTS In all participants,the standard category departure time of the electroencephalogram decreased from baseline,and PTSD symptoms decreased after the intervention.CONCLUSION These results suggest the potential use of a driving simulator as an exposure treatment tool for PTSD.展开更多
Dear Editor,Post-traumatic stress disorder(PTSD)is a major issue for military personnel,with prevalence rates between 1%and 35%in veterans^([1]),significantly higher than in the general population^([2]).Psychological ...Dear Editor,Post-traumatic stress disorder(PTSD)is a major issue for military personnel,with prevalence rates between 1%and 35%in veterans^([1]),significantly higher than in the general population^([2]).Psychological resources,particularly hope,can protect against PTSD and promote post-traumatic growth^([3]).Hope,conceptualized as both a trait and a state,contributes to well-being and resilience and is negatively associated with PTSD symptoms,representing a psychological factor while mitigating the impact of trauma by fostering resilience and adaptive coping mechanisms.展开更多
AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these...AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.展开更多
BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these pati...BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these patients often endure psychological burdens that may adversely affect postoperative recovery.The potential benefits of targeted perioperative psychological interventions have not been fully elucidated in this special population.This study hypothesized that a structured perioperative psychological program would improve recovery outcomes,including postoperative pain,functional outcomes,and mental well-being.AIM To evaluate the impact of perioperative psychological intervention on postoperative outcomes among elderly patients with PTSD undergoing hip fracture surgery.METHODS Between January 1,2022,and December 31,2024,medical records of 50 elderly hip fracture patients(age≥65)with PTSD who underwent surgical fixation at our center were retrospectively reviewed.Patients were divided into an intervention(n=25;standardized psychological care)and control(n=25;usual care)groups.Data collected included demographics,fracture type,PTSD severity,and anesthesia details.The intervention comprised preoperative counseling,relaxation training,and postoperative coping sessions.Postoperative outcomes compared included pain,PTSD severity,activities of daily living scores,complications,length of stay,mental health,and functional recovery.RESULTS The groups had comparable demographic and clinical characteristics.The intervention group demonstrated significantly lower pain scores on postoperative days 3 and 7(P<0.01),fewer moderate-to-severe depressive symptoms(P<0.05),and a greater reduction in PTSD severity(P<0.01)compared with the control group.Furthermore,the intervention group exhibited improved activities of daily living scores at 4 weeks post-surgery and a lower postoperative complication rate(16%vs 32%,P=0.14).The average length of hospital stay was shorter in the intervention group(11.5±2.0 days vs 13.1±2.6 days,P<0.05).CONCLUSION In elderly hip fractures patients with comorbid PTSD,perioperative psychological interventions improved pain control,functional recovery,and PTSD symptoms,supporting its value in holistic perioperative management and outcome enhancement.展开更多
Over one-third of 700,000 military personnel who served in the first Gulf War(GW)suffer from an assortment of symptoms,including cognitive and memory problems,musculoskeletal pain,gastrointestinal discomfort,fatigue,a...Over one-third of 700,000 military personnel who served in the first Gulf War(GW)suffer from an assortment of symptoms,including cognitive and memory problems,musculoskeletal pain,gastrointestinal discomfort,fatigue,and respiratory issues[1,2].The precise etiology of Gulf War illness(GWI)is unclear.However,epidemiological and preclinical studies imply that exposures to the prophylactic drug pyridostigmine bromide,insecticides,pesticides,smoke from oil well fires,and interaction between these exposures and war-related stress underlie this illness[2].As per the Kansas case definition,GWI is a chronic multi-symptom illness displaying one moderately severe and/or multiple symptoms of any severity in at least 3 of 6 symptom domains(fatigue,pain,neurological/cognitive/mood,skin,gastrointestinal,respiratory)[1,2].While the exact pathophysiological changes underlying GWI have not been identified,alterations in immune regulation and dysregulation of the redox balance have been observed in GWI,resulting in chronic systemic inflammation and neuroinflammation[2].展开更多
Epilepsy is a leading cause of disability and mortality worldwide. However, despite the availability of more than 20 antiseizure medications, more than one-third of patients continue to experience seizures. Given the ...Epilepsy is a leading cause of disability and mortality worldwide. However, despite the availability of more than 20 antiseizure medications, more than one-third of patients continue to experience seizures. Given the urgent need to explore new treatment strategies for epilepsy, recent research has highlighted the potential of targeting gliosis, metabolic disturbances, and neural circuit abnormalities as therapeutic strategies. Astrocytes, the largest group of nonneuronal cells in the central nervous system, play several crucial roles in maintaining ionic and energy metabolic homeostasis in neurons, regulating neurotransmitter levels, and modulating synaptic plasticity. This article briefly reviews the critical role of astrocytes in maintaining balance within the central nervous system. Building on previous research, we discuss how astrocyte dysfunction contributes to the onset and progression of epilepsy through four key aspects: the imbalance between excitatory and inhibitory neuronal signaling, dysregulation of metabolic homeostasis in the neuronal microenvironment, neuroinflammation, and the formation of abnormal neural circuits. We summarize relevant basic research conducted over the past 5 years that has focused on modulating astrocytes as a therapeutic approach for epilepsy. We categorize the therapeutic targets proposed by these studies into four areas: restoration of the excitation–inhibition balance, reestablishment of metabolic homeostasis, modulation of immune and inflammatory responses, and reconstruction of abnormal neural circuits. These targets correspond to the pathophysiological mechanisms by which astrocytes contribute to epilepsy. Additionally, we need to consider the potential challenges and limitations of translating these identified therapeutic targets into clinical treatments. These limitations arise from interspecies differences between humans and animal models, as well as the complex comorbidities associated with epilepsy in humans. We also highlight valuable future research directions worth exploring in the treatment of epilepsy and the regulation of astrocytes, such as gene therapy and imaging strategies. The findings presented in this review may help open new therapeutic avenues for patients with drugresistant epilepsy and for those suffering from other central nervous system disorders associated with astrocytic dysfunction.展开更多
Complex genetic architecture is the major cause of heterogeneity in epilepsy,which poses challenges for accurate diagnosis and precise treatment.A large number of epilepsy candidate genes have been identified from cli...Complex genetic architecture is the major cause of heterogeneity in epilepsy,which poses challenges for accurate diagnosis and precise treatment.A large number of epilepsy candidate genes have been identified from clinical studies,particularly with the widespread use of next-generation sequencing.Validating these candidate genes is emerging as a valuable yet challenging task.Drosophila serves as an ideal animal model for validating candidate genes associated with neurogenetic disorders such as epilepsy,due to its rapid reproduction rate,powerful genetic tools,and efficient use of ethological and electrophysiological assays.Here,we systematically summarize the advantageous techniques of the Drosophila model used to investigate epilepsy genes,including genetic tools for manipulating target gene expression,ethological assays for seizure-like behaviors,electrophysiological techniques,and functional imaging for recording neural activity.We then introduce several typical strategies for identifying epilepsy genes and provide new insights into gene-gene interactions in epilepsy with polygenic causes.We summarize well-established precision medicine strategies for epilepsy and discuss prospective treatment options,including drug therapy and gene therapy for genetic epilepsy based on the Drosophila model.Finally,we also address genetic counseling and assisted reproductive technology as potential approaches for the prevention of genetic epilepsy.展开更多
Epilepsy is a serious neurological disorder;however,the effectiveness of current medications is often suboptimal.Recently,stem cell technology has demonstrated remarkable therapeutic potential in addressing various ne...Epilepsy is a serious neurological disorder;however,the effectiveness of current medications is often suboptimal.Recently,stem cell technology has demonstrated remarkable therapeutic potential in addressing various neurological diseases,igniting interest in its applicability for epilepsy treatment.This comprehensive review summarizes different therapeutic approaches utilizing various types of stem cells.Preclinical experiments have explored the use and potential therapeutic effects of mesenchymal stem cells,including genetically modified variants.Clinical trials involving patientderived mesenchymal stem cells have shown promising results,with reductions in the frequency of epileptic seizures and improvements in neurological,cognitive,and motor functions reported.Another promising therapeutic strategy involves neural stem cells.These cells can be cultured outside the body and directed to differentiate into specific cell types.The transplant of neural stem cells has the potential to replace lost inhibitory interneurons,providing a novel treatment avenue for epilepsy.Embryonic stem cells are characterized by their significant capacity for self-renewal and their ability to differentiate into any type of somatic cell.In epilepsy treatment,embryonic stem cells can serve three primary functions:neuron regeneration,the maintenance of cellular homeostasis,and restorative activity.One notable strategy involves differentiating embryonic stem cells intoγ-aminobutyric acidergic neurons for transplantation into lesion sites.This approach is currently undergoing clinical trials and could be a breakthrough in the treatment of refractory epilepsy.Induced pluripotent stem cells share the same genetic background as the donor,thereby reducing the risk of immune rejection and addressing ethical concerns.However,research on induced pluripotent stem cell therapy remains in the preclinical stage.Despite the promise of stem cell therapies for epilepsy,several limitations must be addressed.Safety concerns persist,including issues such as tumor formation,and the low survival rate of transplanted cells remains a significant challenge.Additionally,the high cost of these treatments may be prohibitive for some patients.In summary,stem cell therapy shows considerable promise in managing epilepsy,but further research is needed to overcome its existing limitations and enhance its clinical applicability.展开更多
Objective Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder （PTSD）. Comparison of the resting-state patterns of intrinsic functional synchronization, as measu...Objective Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder （PTSD）. Comparison of the resting-state patterns of intrinsic functional synchronization, as measured by functional magnetic resonance imaging （fMRI）, between groups with and without PTSD following a traumatic event can help identify the neural mechanisms of the disorder and targets for intervention. Methods Fifty-four PTSD patients and 72 matched traumatized subjects who experienced the 2008 Sichuan earthquake were imaged with blood oxygen level-dependent （BOLD） fMRI and analyzed using the measure of regional homogeneity （ReHo） during the resting state. Results PTSD patients presented enhanced ReHo in the left inferior parietal lobule and right superior frontal gyrus, and reduced ReHo in the right middle temporal gyrus and lingual gyrus, relative to traumatized individuals without PTSD. Conclusion Our findings showed that abnormal brain activity exists under resting conditions in PTSD patients who had been exposed to a major earthquake. Alterations in the local functional connectivity of cortical regions are likely to contribute to the neural mechanisms underlying PTSD.展开更多
Brain-derived neurotrophic factor(BDNF), which regulates neuronal survival, growth differentiation, and synapse formation, is known to be associated with depression and post-traumatic stress disorder(PTSD). However, t...Brain-derived neurotrophic factor(BDNF), which regulates neuronal survival, growth differentiation, and synapse formation, is known to be associated with depression and post-traumatic stress disorder(PTSD). However, the molecular mechanism for those mental disorders remains unknown. Studies have shown that BDNF is associated with PTSD risk and exaggerated startle reaction(a major arousal manifestation of PTSD) in United States military service members who were deployed during the wars in Iraq and Afghanistan. The frequency of the Met/Met in BDNF gene was greater among those with PTSD than those without PTSD. Among individuals who experienced fewer lifetime stressful events, the Met carriers have significantly higher total and startle scores on the PTSD Checklist than the Val/Val carriers. In addition, subjects with PTSD showed higher levels of BDNF in their peripheral blood plasma than the non-probable-PTSD controls. Increased BDNF levels and startle response were observed in both blood plasma and brain hippocampus by inescapable tail shock in rats. In this paper, we reviewed these data to discuss BDNF as a potential biomarker for PTSD risk and its possible roles in the onset of PTSD.展开更多
AIM:To demonstrate prognostic factors for poor visual outcome in patients with post-traumatic endophthalmitis(PTE)following open globe injury.METHODS:A retrospective study was conducted on 66 patients(66 eyes)with PTE...AIM:To demonstrate prognostic factors for poor visual outcome in patients with post-traumatic endophthalmitis(PTE)following open globe injury.METHODS:A retrospective study was conducted on 66 patients(66 eyes)with PTE following open globe injury from 2005 to 2015.Potential factors accounting for good and poor visual outcome were statistically analyzed by Chisquare test and Logistic regression model.RESULTS:In 66 cases,39 cases(59%)had a poor visual outcome.Univariate and multivariate Logistic regression analysis identified retained intraocular foreign body(IOFB)as the only factor significantly associated with poor visual outcome[adjusted odds ratio,4.62;95%confidence interval(1.04-20.53);P=0.04].The most common causative agents were gram-positive organisms(83%),of which Bacillus cereus(33%),was the most common pathogen.All cases received intravitreal antibiotic injections.Oral ciprofloxacin was the most used systemic antibiotic(33%).Pars plana vitrectomy was performed in 83%(55/66)of cases.At 6 mo follow-up,mean BCVA was 1.74±0.72 log MAR units.CONCLUSION:In patients with PTE following open globe injury,the only predictor of poor visual outcome is the presence of IOFB.Bacillus cereus is the most isolated microorganism.展开更多
AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review acco...AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.展开更多
基金the Science and Technology Project of Fujian Province of China,No.2007F5045the New Century Talent Support Project of Higher Learning School of Fujian Province,No.NCETFJ-0702
文摘Studies have confirmed that iron induces epilepsy onset, and iron ion-induced epilepsy in anima models closely resembles the clinical situation. Models of post-traumatic epilepsy （PTE） were established by intracortical injection of FeCl2 using stereotactic techniques. Electron microscopy revealed neuronal degeneration, with shrinkage of the neuronal soma, hyperplasia of rough endoplasmic reticulum, ribosomal detachment from the endoplasmic reticulum, and vacuolar degeneration of glial cells in the right frontal lobe of FeCl2-induced PTE rats. With prolonged time injuries became more severe and neuronal apoptosis was observed. Synapses in the hippocampal neuropil significantly increased （primarily type I/excitatory synapses） at day 14 following injury. Type II synapses （inhibitory synapse） were observed in the rat hippocampus at day 30. Cortical neuronal degeneration, apoptosis, glial cell proliferation, and ultrastructural hippocampal changes, in particular changes in type of neuronal synapse, play an important role in PTE onset.
基金the General Program of Department of Education of Guangxi Zhuang Autonomous Region,No.Guijiaokeyan[2007]34
文摘Postsynaptic density protein-95 and synaptophysin participate in synaptic reorganization in the forebrain of epilepsy models. However, the time-effect relationship between dynamic synapsin expression in hippocampus and synaptic reorganization in the post-traumatic epilepsy model remains unclear. FeCI2 was injected into the hippocampal CA3 region of the right forebrain in rats to induce post-traumatic epilepsy. Postsynaptic density protein-95 and synaptophysin expression was detected using immunohistochemistry. Epileptiform discharge induced by FeCI2 injection was determined in rat forebrain neurons, revealing decreased postsynaptic density protein-95 expression at 24 hours and lowest levels at 7 days. Synaptophysin expression was markedly reduced at 24 hours, but increased at 7 days. Postsynaptic density protein-95 and synaptophysin expression was consistent with abnormal mossy fiber sprouting and synaptic reorganization following neuronal injury in the hippocampal CA3 region of FeCI2-induced epilepsy models.
基金Supported by the Central Guided Local Science and Technology Development Fund Project for Science and Technology Innovation Base Construction,No.Guike ZY24212046National Natural Science Foundation of China,No.U22A2092+3 种基金Guangxi Education Science“the 14th Five-Year Plan”2024 Special Project“Research on Steam Education Practice in Rehabilitation Engineering”,No.2024ZJY304the Research Basic Ability Enhancement Program for Young and Middle-aged Teachers of Guangxi,No.2025KY2255the Innovation Project of GUET Graduate Education,No.2025YCXB010Natural Science Research Project of Guilin Life and Health Career Technical College,No.2025GKKY04.
文摘BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.
文摘Post-traumatic epilepsy(PTE)is a serious complication of traumatic brain injury.It is also the most common type of symptomatic epilepsy.This might be associated with the typical pathological changes of brain injury,including reactive glial hyperplasia,axonal retraction ball,Wallerian degeneration,microglial scar formation,and white matter cystic lesions.The prophylactic use of antiepileptic drugs could effectively reduce the risk of early epileptic seizures in patients with severe traumatic brain injury.In this article,we review the epidemiology,pathophysiology,clinical characteristics,and treatment of PTE based on the latest clinical and laboratory research results.
文摘Objective： To observe the quality of life in patients with post-traumatic epilepsy and discuss the infuencing factors. Methods： We assessed 105 patients with post-traumatic epilepsy and 100 healthy people as control using Quality of Life Scale-31 （QOL-31）, Self-rating Depressing Scale （SDS） and Self-rating Anxiety Scale （SAS）, and conducted retrospective analysis on the depression, anxiety, site of trauma, control of seizure, EEG and therapeutic compliance. Results： Patients with post-traumatic epilepsy scored much lower than the control group on QOL-31 （P〈0.01）, but higher than the control group on SDS and SAS （P〈0.01）. Multiple regression analysis indicated that major influencing factors on the quality of life were anxiety, therapeutic compliance, depression, poor control of epileptic seizure and site of trauma. Conclusions： The quality of life in patients with posttraumatic epilepsy has significantly declined. Doctors should pay attention to psychological and mental problems of patients with epilepsy, such as depression and anxiety, enhancing therapeutic compliance and controlling epileptic seizure, which are the keys to improving prognosis.
文摘Post-traumatic stress disorder is a mental disorder caused by exposure to severe traumatic life events.Currently,there are no validated biomarkers or laboratory tests that can distinguish between trauma survivors with and without post-traumatic stress disorder.In addition,the heterogeneity of clinical presentations of post-traumatic stress disorder and the overlap of symptoms with other conditions can lead to misdiagnosis and inappropriate treatment.Evidence suggests that this condition is a multisystem disorder that affects many biological systems,raising the possibility that peripheral markers of disease may be used to diagnose post-traumatic stress disorder.We performed a PubMed search for microRNAs(miRNAs)in post-traumatic stress disorder(PTSD)that could serve as diagnostic biomarkers and found 18 original research articles on studies performed with human patients and published January 2012 to December 2023.These included four studies with whole blood,seven with peripheral blood mononuclear cells,four with plasma extracellular vesicles/exosomes,and one with serum exosomes.One of these studies had also used whole plasma.Two studies were excluded as they did not involve microRNA biomarkers.Most of the studies had collected samples from adult male Veterans who had returned from deployment and been exposed to combat,and only two were from recently traumatized adult subjects.In measuring miRNA expression levels,many of the studies had used microarray miRNA analysis,miRNA Seq analysis,or NanoString panels.Only six studies had used real time polymerase chain reaction assay to determine/validate miRNA expression in PTSD subjects compared to controls.The miRNAs that were found/validated in these studies may be considered as potential candidate biomarkers for PTSD and include miR-3130-5p in whole blood;miR-193a-5p,-7113-5p,-125a,-181c,and-671-5p in peripheral blood mononuclear cells;miR-10b-5p,-203a-3p,-4488,-502-3p,-874-3p,-5100,and-7641 in plasma extracellular vesicles/exosomes;and miR-18a-3p and-7-1-5p in blood plasma.Several important limitations identified in the studies need to be taken into account in future studies.Further studies are warranted with war veterans and recently traumatized children,adolescents,and adults having PTSD and use of animal models subjected to various stressors and the effects of suppressing or overexpressing specific microRNAs.
基金funded by the Scientific Research Projects Unit(BAP)ofİnönüUniversity under project number SBA-2024-3449.
文摘Objectives:This study examines the effectiveness of an eight-week game-based physical activity program designed to reduce post-traumatic stress levels in children affected by the Kahramanmaraş-centered earthquakes that occurred in Turkey on 06 February 2023.Following the earthquake,millions of children experienced significant changes in their education and living conditions,adversely affecting their psychological health.Methods:The therapeutic effects of physical activity on post-traumatic stress disorder(PTSD)are frequently emphasized in the literature,and this study specifically focuses on the impact of game-based exercises.The research employed an experimental design,involving 80 earthquake-affected children aged 10 to 13,who were randomly assigned to either an experimental group(n=40)or a control group(n=40).The experimental group participated in game-based physical activities three times per week for eight weeks,with each session lasting 60 min.Data were collected using the Child Post-Traumatic Stress Reaction Index(CPTS-RI),and pre-test and post-test comparisons were conducted.Results:Children in the experimental group showed a marked reduction in PTSD symptoms,with mean CPTS-RI scores decreasing from 2.60 at pre-test to 1.91 at post-test.In contrast,the control group’s scores remained virtually unchanged(2.59 at pre-test vs.2.57 at post-test).Two-way ANOVA demonstrated significant main effects of group and time,as well as a significant group×time interaction(F=114.88,p<0.001,η^(2)=0.42),indicating that the reduction was attributable to participation in the game-based physical activity program.These findings highlight not only the statistical significance but also the practical relevance of structured,culturally adapted physical activity interventions for trauma-exposed children.Conclusion:These findings suggest that regular,structured game-based physical activities can support the mental health of children following traumatic events such as earthquakes and reduce their stress levels.The study recommends integrating physical activity into post-disaster psychosocial support programs and highlights it as an effective,accessible,and enjoyable method to enhance children’s trauma coping skills.Accordingly,it advocates for the wider implementation of physical activity-based interventions in similar crisis situations.
文摘BACKGROUND Postoperative anxiety,depression,irritability,and even fear in patients with intertrochanteric femoral fractures may hinder recovery,compromise treatment efficacy,and impede rehabilitation.AIM To investigate the correlations among anxiety,depression,sense of coherence(SOC),and post-traumatic growth(PTG)in patients who underwent intertrochanteric femoral fracture surgery to improve clinical management strategies and outcomes.METHODS This study carefully selected 211 patients who received surgical treatment for intertrochanteric femoral fractures and were admitted to Dongying People’s Hospital from March 2022 to March 2024.Anxiety and depression in these patients were assessed with the anxiety and depression subscales of the Hospital Anxiety and Depression Scale(HADS),respectively.SOC was evaluated using the 13-item SOC scale(SOC-13),which encompasses three key dimensions:Comprehensibility,manageability,and meaningfulness.PTG was assessed with the Chinese version of PTG Inventory(CPTGI),covering five distinct dimensions:Personal strength,appreciation of life,relating to others,new possibilities,and spiritual change.The Pearson correlation coefficient was used to meticulously analyze the associations among HADS-Anxiety,HADS-Depression,SOC-13,and CPTGI.Further,univariate and multivariate analyses were conducted to identify factors that affect PTG in patients who underwent intertrochanteric femoral fracture surgery.RESULTS The collected data demonstrated that 67.30%and 60.66%of the 211 patients experienced anxiety and depression,respectively,with overall anxiety levels ranging from mild to moderate and depression levels being mild.The mean SOC-13 score was 55.73±8.81 points,indicating a generally low SOC level.The average CPTGI score was 54.93±9.92 points,demonstrating a relatively low PTG level.Notably,both HADS-Anxiety and HADS-Depression scores were significantly negatively correlated with CPTGI,whereas SOC-13 scores were significantly positively correlated with CPTGI.Univariate and multivariate analyses identified the presence of comorbidities[odds ratio(OR)=2.747,P=0.003],monthly household income(OR=3.292,P<0.001),and exercise habits(OR=4.651,P<0.001)as independent predictors of PTG in patients.CONCLUSION The results of this study indicate a significant negative correlation of anxiety and depression with PTG in patients after intertrochanteric femoral fracture surgery,whereas a significant positive association exists between SOC and PTG.This study helps more comprehensively understand the psychological status and recovery processes of such patients,thereby potentially providing valuable information for clinical practice and psychological interventions.
文摘BACKGROUND Although exposure therapy is a proven treatment for post-traumatic stress disorder(PTSD),empirical research is difficult due to ethical issues.Recently,virtual reality-based content that can provide space and time similar to reality for exposure therapy techniques is increasing.AIM To examine exposure therapy using driving simulations in patients with PTSD due to traffic accidents with PTSD symptoms.METHODS The intervention was provided to two individuals who experienced PTSD symptoms after a traffic accident using a driving simulator.Among the singlesubject experimental designs,the ABA(baseline-intervention-baseline)design was used,and the PTSD checklist and brain wave frequency were used to measure the results.RESULTS In all participants,the standard category departure time of the electroencephalogram decreased from baseline,and PTSD symptoms decreased after the intervention.CONCLUSION These results suggest the potential use of a driving simulator as an exposure treatment tool for PTSD.
基金supported by the Institut de Recherche Biomédicale des Armées(Brétigny-sur-Orge,France).
文摘Dear Editor,Post-traumatic stress disorder(PTSD)is a major issue for military personnel,with prevalence rates between 1%and 35%in veterans^([1]),significantly higher than in the general population^([2]).Psychological resources,particularly hope,can protect against PTSD and promote post-traumatic growth^([3]).Hope,conceptualized as both a trait and a state,contributes to well-being and resilience and is negatively associated with PTSD symptoms,representing a psychological factor while mitigating the impact of trauma by fostering resilience and adaptive coping mechanisms.
文摘AIM:To evaluate the prevalence of early post-traumatic stress disorder(PTSD)among young and middle-aged patients who have suffered open globe injuries,and to identify the psychosocial factors influencing PTSD in these patients.METHODS:A total of 280 patients who underwent ocular trauma surgery between January 2023 and January 2024 were selected through convenience sampling.Data were collected using a custom-designed demographic questionnaire,the Connor-Davidson Resilience Scale(CDRISC),the Cognitive Emotion Regulation Questionnaire(C-ERRI),and the PTSD Checklist-Civilian Version(PCL-C).Univariate analysis and stepwise multiple linear regression analysis were performed to determine the factors affecting PTSD in these patients.RESULTS:The average PTSD score for the patients was 33.22±13.48.The scores for individual PTSD dimensions,ranked from highest to lowest,were recurrent traumatic experiences,heightened arousal,avoidance reactions,and social dysfunction.Positive PTSD symptoms were observed in 85 patients(30.36%).Univariate analysis indicated that gender,postoperative vision,marital status,psychological resilience,and rumination were significant factors affecting PTSD symptoms(χ^(2)/t=6.53,17.88,8.83,2.17,and 14.1,respectively;all P<0.05).Pearson correlation analysis showed a positive correlation between rumination and PTSD symptoms(r=0.73,P<0.01)and a negative correlation between psychological resilience and PTSD symptoms(r=-0.14,P<0.05).Stepwise multiple linear regression analysis identified postoperative vision(notably eye removal),rumination levels,and psychological resilience(optimism)as major factors influencing PTSD in these patients(R^(2)=0.57,P<0.001).CONCLUSION:Young and middle-aged patients with open globe injuries have a high incidence of PTSD.Significant risk factors for early PTSD include primary enucleation,high levels of rumination,and low psychological resilience(optimism).Conversely,patients with good postoperative vision recovery,low rumination levels,and high levels of optimism are less likely to develop PTSD.Healthcare providers should pay special attention to patients who undergo primary enucleation,strive to reduce their rumination levels,and enhance their psychological resilience,thereby promoting a positive and optimistic attitude towards their condition and reducing the incidence of PTSD.
基金Supported by the Shandong Province Medical and Health Science and Technology Development Program Project,No.202204070354.
文摘BACKGROUND Hip fracture in elderly patients,particularly those with comorbid post-traumatic stress disorder(PTSD),presents a significant clinical challenge.In addition to the physiological stress of surgery,these patients often endure psychological burdens that may adversely affect postoperative recovery.The potential benefits of targeted perioperative psychological interventions have not been fully elucidated in this special population.This study hypothesized that a structured perioperative psychological program would improve recovery outcomes,including postoperative pain,functional outcomes,and mental well-being.AIM To evaluate the impact of perioperative psychological intervention on postoperative outcomes among elderly patients with PTSD undergoing hip fracture surgery.METHODS Between January 1,2022,and December 31,2024,medical records of 50 elderly hip fracture patients(age≥65)with PTSD who underwent surgical fixation at our center were retrospectively reviewed.Patients were divided into an intervention(n=25;standardized psychological care)and control(n=25;usual care)groups.Data collected included demographics,fracture type,PTSD severity,and anesthesia details.The intervention comprised preoperative counseling,relaxation training,and postoperative coping sessions.Postoperative outcomes compared included pain,PTSD severity,activities of daily living scores,complications,length of stay,mental health,and functional recovery.RESULTS The groups had comparable demographic and clinical characteristics.The intervention group demonstrated significantly lower pain scores on postoperative days 3 and 7(P<0.01),fewer moderate-to-severe depressive symptoms(P<0.05),and a greater reduction in PTSD severity(P<0.01)compared with the control group.Furthermore,the intervention group exhibited improved activities of daily living scores at 4 weeks post-surgery and a lower postoperative complication rate(16%vs 32%,P=0.14).The average length of hospital stay was shorter in the intervention group(11.5±2.0 days vs 13.1±2.6 days,P<0.05).CONCLUSION In elderly hip fractures patients with comorbid PTSD,perioperative psychological interventions improved pain control,functional recovery,and PTSD symptoms,supporting its value in holistic perioperative management and outcome enhancement.
基金Department of Defense(W81XWH-17-1-0447 and W81XWH1910548 to AKS)Texas A&M University School of Medicine。
文摘Over one-third of 700,000 military personnel who served in the first Gulf War(GW)suffer from an assortment of symptoms,including cognitive and memory problems,musculoskeletal pain,gastrointestinal discomfort,fatigue,and respiratory issues[1,2].The precise etiology of Gulf War illness(GWI)is unclear.However,epidemiological and preclinical studies imply that exposures to the prophylactic drug pyridostigmine bromide,insecticides,pesticides,smoke from oil well fires,and interaction between these exposures and war-related stress underlie this illness[2].As per the Kansas case definition,GWI is a chronic multi-symptom illness displaying one moderately severe and/or multiple symptoms of any severity in at least 3 of 6 symptom domains(fatigue,pain,neurological/cognitive/mood,skin,gastrointestinal,respiratory)[1,2].While the exact pathophysiological changes underlying GWI have not been identified,alterations in immune regulation and dysregulation of the redox balance have been observed in GWI,resulting in chronic systemic inflammation and neuroinflammation[2].
基金supported by the National Key Research and Development Program of China,No. 2023YFF0714200 (to CW)the National Natural Science Foundation of China,Nos. 82472038 and 82202224 (both to CW)+3 种基金the Shanghai Rising-Star Program,No. 23QA1407700 (to CW)the Construction Project of Shanghai Key Laboratory of Molecular Imaging,No. 18DZ2260400 (to CW)the National Science Foundation for Distinguished Young Scholars,No. 82025019 (to CL)the Greater Bay Area Institute of Precision Medicine (Guangzhou)(to CW)。
文摘Epilepsy is a leading cause of disability and mortality worldwide. However, despite the availability of more than 20 antiseizure medications, more than one-third of patients continue to experience seizures. Given the urgent need to explore new treatment strategies for epilepsy, recent research has highlighted the potential of targeting gliosis, metabolic disturbances, and neural circuit abnormalities as therapeutic strategies. Astrocytes, the largest group of nonneuronal cells in the central nervous system, play several crucial roles in maintaining ionic and energy metabolic homeostasis in neurons, regulating neurotransmitter levels, and modulating synaptic plasticity. This article briefly reviews the critical role of astrocytes in maintaining balance within the central nervous system. Building on previous research, we discuss how astrocyte dysfunction contributes to the onset and progression of epilepsy through four key aspects: the imbalance between excitatory and inhibitory neuronal signaling, dysregulation of metabolic homeostasis in the neuronal microenvironment, neuroinflammation, and the formation of abnormal neural circuits. We summarize relevant basic research conducted over the past 5 years that has focused on modulating astrocytes as a therapeutic approach for epilepsy. We categorize the therapeutic targets proposed by these studies into four areas: restoration of the excitation–inhibition balance, reestablishment of metabolic homeostasis, modulation of immune and inflammatory responses, and reconstruction of abnormal neural circuits. These targets correspond to the pathophysiological mechanisms by which astrocytes contribute to epilepsy. Additionally, we need to consider the potential challenges and limitations of translating these identified therapeutic targets into clinical treatments. These limitations arise from interspecies differences between humans and animal models, as well as the complex comorbidities associated with epilepsy in humans. We also highlight valuable future research directions worth exploring in the treatment of epilepsy and the regulation of astrocytes, such as gene therapy and imaging strategies. The findings presented in this review may help open new therapeutic avenues for patients with drugresistant epilepsy and for those suffering from other central nervous system disorders associated with astrocytic dysfunction.
基金supported by the Guangdong Basic and Applied Basic Research Foundation,No.2022A1515111123(to JQ)。
文摘Complex genetic architecture is the major cause of heterogeneity in epilepsy,which poses challenges for accurate diagnosis and precise treatment.A large number of epilepsy candidate genes have been identified from clinical studies,particularly with the widespread use of next-generation sequencing.Validating these candidate genes is emerging as a valuable yet challenging task.Drosophila serves as an ideal animal model for validating candidate genes associated with neurogenetic disorders such as epilepsy,due to its rapid reproduction rate,powerful genetic tools,and efficient use of ethological and electrophysiological assays.Here,we systematically summarize the advantageous techniques of the Drosophila model used to investigate epilepsy genes,including genetic tools for manipulating target gene expression,ethological assays for seizure-like behaviors,electrophysiological techniques,and functional imaging for recording neural activity.We then introduce several typical strategies for identifying epilepsy genes and provide new insights into gene-gene interactions in epilepsy with polygenic causes.We summarize well-established precision medicine strategies for epilepsy and discuss prospective treatment options,including drug therapy and gene therapy for genetic epilepsy based on the Drosophila model.Finally,we also address genetic counseling and assisted reproductive technology as potential approaches for the prevention of genetic epilepsy.
基金supported by the National Natural Science Foundation of China,Nos.82471471(to WJ),82471485(to FY)Shaanxi Province Special Support Program for Leading Talents in Scientific and Technological Innovation,No.tzjhjw(to WJ)+1 种基金Shaanxi Key Research and Development Plan Project,No.2023-YBSF-353(to XW)the Joint Fund Project of Innovation Research Institute of Xijing Hospital,No.LHJJ24JH13(to ZS)。
文摘Epilepsy is a serious neurological disorder;however,the effectiveness of current medications is often suboptimal.Recently,stem cell technology has demonstrated remarkable therapeutic potential in addressing various neurological diseases,igniting interest in its applicability for epilepsy treatment.This comprehensive review summarizes different therapeutic approaches utilizing various types of stem cells.Preclinical experiments have explored the use and potential therapeutic effects of mesenchymal stem cells,including genetically modified variants.Clinical trials involving patientderived mesenchymal stem cells have shown promising results,with reductions in the frequency of epileptic seizures and improvements in neurological,cognitive,and motor functions reported.Another promising therapeutic strategy involves neural stem cells.These cells can be cultured outside the body and directed to differentiate into specific cell types.The transplant of neural stem cells has the potential to replace lost inhibitory interneurons,providing a novel treatment avenue for epilepsy.Embryonic stem cells are characterized by their significant capacity for self-renewal and their ability to differentiate into any type of somatic cell.In epilepsy treatment,embryonic stem cells can serve three primary functions:neuron regeneration,the maintenance of cellular homeostasis,and restorative activity.One notable strategy involves differentiating embryonic stem cells intoγ-aminobutyric acidergic neurons for transplantation into lesion sites.This approach is currently undergoing clinical trials and could be a breakthrough in the treatment of refractory epilepsy.Induced pluripotent stem cells share the same genetic background as the donor,thereby reducing the risk of immune rejection and addressing ethical concerns.However,research on induced pluripotent stem cell therapy remains in the preclinical stage.Despite the promise of stem cell therapies for epilepsy,several limitations must be addressed.Safety concerns persist,including issues such as tumor formation,and the low survival rate of transplanted cells remains a significant challenge.Additionally,the high cost of these treatments may be prohibitive for some patients.In summary,stem cell therapy shows considerable promise in managing epilepsy,but further research is needed to overcome its existing limitations and enhance its clinical applicability.
基金supported by the National Natural Science Foundation of China (30830046,30625024, 81171286)the National Science and Technology Program of China (2007BAI17B02)+2 种基金the National Basic Research Development Program (973 Program) of China(2009CB918303)the Science and Technology Program of the Ministry of Education, China (20090162110011)the National High-Tech Research and Development Program of China (863 program:2008AA02Z408)
文摘Objective Little is known about the brain systems that contribute to vulnerability to post-traumatic stress disorder （PTSD）. Comparison of the resting-state patterns of intrinsic functional synchronization, as measured by functional magnetic resonance imaging （fMRI）, between groups with and without PTSD following a traumatic event can help identify the neural mechanisms of the disorder and targets for intervention. Methods Fifty-four PTSD patients and 72 matched traumatized subjects who experienced the 2008 Sichuan earthquake were imaged with blood oxygen level-dependent （BOLD） fMRI and analyzed using the measure of regional homogeneity （ReHo） during the resting state. Results PTSD patients presented enhanced ReHo in the left inferior parietal lobule and right superior frontal gyrus, and reduced ReHo in the right middle temporal gyrus and lingual gyrus, relative to traumatized individuals without PTSD. Conclusion Our findings showed that abnormal brain activity exists under resting conditions in PTSD patients who had been exposed to a major earthquake. Alterations in the local functional connectivity of cortical regions are likely to contribute to the neural mechanisms underlying PTSD.
基金Supported by Center for the Study of Traumatic Stress,Department of Psychiatry,Uniformed Services University of the Health Sciences
文摘Brain-derived neurotrophic factor(BDNF), which regulates neuronal survival, growth differentiation, and synapse formation, is known to be associated with depression and post-traumatic stress disorder(PTSD). However, the molecular mechanism for those mental disorders remains unknown. Studies have shown that BDNF is associated with PTSD risk and exaggerated startle reaction(a major arousal manifestation of PTSD) in United States military service members who were deployed during the wars in Iraq and Afghanistan. The frequency of the Met/Met in BDNF gene was greater among those with PTSD than those without PTSD. Among individuals who experienced fewer lifetime stressful events, the Met carriers have significantly higher total and startle scores on the PTSD Checklist than the Val/Val carriers. In addition, subjects with PTSD showed higher levels of BDNF in their peripheral blood plasma than the non-probable-PTSD controls. Increased BDNF levels and startle response were observed in both blood plasma and brain hippocampus by inescapable tail shock in rats. In this paper, we reviewed these data to discuss BDNF as a potential biomarker for PTSD risk and its possible roles in the onset of PTSD.
文摘AIM:To demonstrate prognostic factors for poor visual outcome in patients with post-traumatic endophthalmitis(PTE)following open globe injury.METHODS:A retrospective study was conducted on 66 patients(66 eyes)with PTE following open globe injury from 2005 to 2015.Potential factors accounting for good and poor visual outcome were statistically analyzed by Chisquare test and Logistic regression model.RESULTS:In 66 cases,39 cases(59%)had a poor visual outcome.Univariate and multivariate Logistic regression analysis identified retained intraocular foreign body(IOFB)as the only factor significantly associated with poor visual outcome[adjusted odds ratio,4.62;95%confidence interval(1.04-20.53);P=0.04].The most common causative agents were gram-positive organisms(83%),of which Bacillus cereus(33%),was the most common pathogen.All cases received intravitreal antibiotic injections.Oral ciprofloxacin was the most used systemic antibiotic(33%).Pars plana vitrectomy was performed in 83%(55/66)of cases.At 6 mo follow-up,mean BCVA was 1.74±0.72 log MAR units.CONCLUSION:In patients with PTE following open globe injury,the only predictor of poor visual outcome is the presence of IOFB.Bacillus cereus is the most isolated microorganism.
文摘AIM To review and report functional outcomes, complications,and survivorship associated with total knee arthroplasty(TKA) in the treatment of post-traumatic arthritis(PTA).METHODS We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for Englishlanguage clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full. The manual search included references of retrieved articles.We extracted data on patients' demographics and clinical outcomes, including preoperative diagnosis and pre- and post-operative functional scores. We summarized the data and reported the results in tables and text.RESULTS Sixteen studies, four prospective and ten retrospective,examined patients who underwent TKA for PTA due to fractures of the proximal tibia, patella, and/or distal femur. Eleven studies utilized the Knee Society Scores criteria to assess functional outcomes. All studies utilizing these criteria reported an improvement in functional and knee scores of patients following TKA. Further, studies reported an increased range of motion(ROM) and reduction of pain following surgery. The most commonly reported complications with TKA included infection, stiffness, wound complications, intraoperative rupture of tendons, and osteolysis/polyethylene wear. The overwhelming majority of these complications occurred within the first two years following surgery. Six studies examined the survivorship of TKA with subsequent revision for any reason as an endpoint. Compared to patients with osteoarthritis, patients with PTA required more revisions, the majority for polyethylene wear.CONCLUSION Although associated with higher complication rates,TKA is an effective treatment for PTA, as it improves ROM, pain and functional outcomes.
