Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been rep...Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been reported in immunocompetent individuals. This involvement can result in epilepsy, meningoencephalitis, myelitis or encephalopathy. The standard treatment is albendazole at a dosage of 10 to 15 mg/kg/day. The duration of treatment varies greatly depending on the clinical cases reported, ranging from 5 days to several weeks in the case of severe forms. We report a case of myelitis due to Toxocara canis in a 14-year-old patient admitted for gait disorders. The laboratory assessment shows isolated hypereosinophilia at 8000 elements per mm3. Medullary magnetic resonance imaging (MRI) showed an intradural process of inflammatory and infectious appearance extended between T10 and L1 levels, hypointense in T1, hyperintense in T2, and homogeneous. Parasitological analysis of the stools noted the presence of high concentrations of Toxocara canis. Serology by ELISA (enzyme-linked immunosorbent assay) is strongly positive for toxocariasis, and western blot confirms the presence of antibodies directed against Toxocara larvae. Treatment with albendazole 400 mg × 2/day for 10 days associated with corticosteroid therapy (prednisone 50 mg/day for 5 days) allowed the disappearance of pain in 8 days, normalization of eosinophilia and improvement of walking.展开更多
Objective: to analyze the clinical application effect of nursing intervention in the fall nursing of elderly patients in the Department of Neurology. Methods: in this study, 72 patients with the risk of falling admitt...Objective: to analyze the clinical application effect of nursing intervention in the fall nursing of elderly patients in the Department of Neurology. Methods: in this study, 72 patients with the risk of falling admitted to the Department of Neurology in our hospital from April 2018 to April 2020 were taken as the research objects. According to the random number method, they were randomly divided into the control group and the research group, with 36 cases in the former group (routine care) and 36 cases in the latter group (comprehensive care). Two kinds of nursing application and clinical fall event prevention and nursing satisfaction to carry out a comparative analysis. Results: the incidence of decline in the study group (2.7%) was lower than that in the control group (22.2%). Nursing satisfaction in the study group (100%) was higher than that in the control group (83.3%), P < 0.05. Conclusion: reasonable nursing intervention in the neurology department of elderly patients fall nursing can play a good preventive effect, and can improve nursing satisfaction.展开更多
Objective: to explore the effect of humanized nursing in intensive care of neurology department. Methods: 58 severe patients who were admitted to the Department of Neurology in our hospital from February to October 20...Objective: to explore the effect of humanized nursing in intensive care of neurology department. Methods: 58 severe patients who were admitted to the Department of Neurology in our hospital from February to October 2019 were selected as the research subjects, and they were equally divided into the experimental group and the control group. The effects and effectiveness of humanized nursing care in two groups were compared. Results: in terms of clinical nursing care, the effective rates of patient care in the experimental group and the control group were 95.55% and 82.76%, respectively. The effective rate in the experimental group was higher than that in the control group, and the two groups' data were statistically significant (P < 0.05). In terms of comfort and neurological care, the difference in scores between the two groups was obviously insufficient before treatment, and both groups had improvements after treatment. The neurological score and comfort score in the experimental group were (11.09±2.17) and (11.09±2.17), respectively. In the control group, the neurological scores were (15.36±3.43) and comfort scores were (5.03±2.24). The experimental group was better than the control group, and the data between the two groups had statistical significance (P < 0.05). Conclusion: humanistic nursing care for severe patients in neurology department is worthy of learning, because it can promote neurological recovery, improve comfort and prognosis.展开更多
Objective: with the increasing awareness of national health care and rights protection, the requirements for achieving high-quality prognosis and complete medical care skills are increasing. This is thought-provoking....Objective: with the increasing awareness of national health care and rights protection, the requirements for achieving high-quality prognosis and complete medical care skills are increasing. This is thought-provoking. In recent years, closed-loop management has been widely discussed and applied in the field of health care. Methods: 780 patients hospitalized in hospitals from April 2016 to March 2017 were selected as the control group, and 820 patients hospitalized in hospitals from April 2017 to March 2018 were selected as the observation group. Patients in control group were given routine nursing management. The observation group applied the closed-loop nursing management mode, which took the time of nurses nursing patients as the main line. The content of nursing work runs through the whole nursing work flow of nurses from the beginning of nursing, the implementation of nursing process, the end of nursing and the handover, forming a closed-loop process chain, which refines and streamlines nursing work and emphasizes the whole process quality control. Results: the difference between the two nursing management modes was evaluated by comparing the nurses' awareness rate of illness, mastery rate of safety knowledge of patients or accompanying nurses, satisfaction of patients or accompanying nurses, nursing quality and incidence rate of nursing risk events. Conclusion: the application effect of closed-loop management in neurology department is better than that of routine management, which can effectively improve the nursing effect and reduce the incidence of adverse risk events, and is worthy of clinical application.展开更多
Intraventricular haemorrhage (IVH) is an extremely rare and poorly described complication of central nervous system Tuberculosis (CNS-TB). In this study, we report the case of a 42-year-old man who presented with a we...Intraventricular haemorrhage (IVH) is an extremely rare and poorly described complication of central nervous system Tuberculosis (CNS-TB). In this study, we report the case of a 42-year-old man who presented with a weakness of the left hemibody with diffuse headache, altered consciousness associated with fever. No notion of contagion was noted. Brain computed tomography (CT) showed a hematoma in the occipital horns of the lateral ventricles with peri-lesional oedema of the right hemisphere;after injection of contrast product (CP), there were ring-shaped contrasts in the occipital horn of the lateral ventricle and the right thalamus. Angioscan showed no aneurysms or vascular anomalies. Chest X-ray showed micronodular opacities less than 1.5 cm in size in relation to miliary. Xpert MTB/RIF of sputum and cerebrospinal fluid (CSF) showed Mycobacterium tuberculosis (MT). The patient’s course was favourable under antihypertensive and antitubercular treatment. Conclusion: This case illustrates the diagnostic difficulties of CNS-TB due to the polymorphism of the clinical and radiological presentation of CNS-TB.展开更多
Objective: to analyze the application effect of safety management in nursing management of neurology department. Methods: 78 patients with neurological diseases in our hospital from January 2019 to January 2020 were s...Objective: to analyze the application effect of safety management in nursing management of neurology department. Methods: 78 patients with neurological diseases in our hospital from January 2019 to January 2020 were selected as the research objects and randomly divided into the control group and the observation group, with 39 patients in each group. The control group was given routine nursing management, while the observation group was given additional safety management on the basis of routine nursing management. The incidence of risk and patient satisfaction under two different nursing management modes were compared. Results: the observation group using safety management had 1 case of adverse events, the risk incidence rate was (2.56%);while the control group using routine nursing management had 5 cases of adverse events, the risk incidence rate was (12.82%), the risk incidence rate of the observation group was lower than that of the control group (P < 0.05).Secondly, the satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05).Conclusion: the safety measures in nerve nursing management can effectively reduce the risk, and play an important role in helping patients recover.展开更多
Objective: to explore the utility value of safety management in nursing management of neurology department. Methods: 130 patients were randomly selected in the department of neurology in the hospital for a comparative...Objective: to explore the utility value of safety management in nursing management of neurology department. Methods: 130 patients were randomly selected in the department of neurology in the hospital for a comparative study, and divided into two groups. There were 65 cases in the control group and 65 cases in the observation group. They were adopted routine nursing management and safety management on this basis respectively. The incidence of adverse events and nursing satisfaction were compared. Results: the data showed that the data of the observation group implementing safety management were excellent, and the difference was significant (P < 0.05). Conclusion: in the clinical nursing of patients in neurology department, safety management can effectively avoid various risk factors, reduce the occurrence of accidents, and provide them with high-quality nursing and good rehabilitation environment.展开更多
Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It ...Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.展开更多
Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue dam...Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It has been recognized as a feature of Parkinson’s disease (PD) since the first descriptions of the disease. Material and Methods: This was a prospective descriptive study lasting six (06) months from November 1, 2023 to April 30, 2024. We included all patients diagnosed with PD and who had pain. Sociodemographic, clinical, paraclinical and therapeutic data were evaluated for each patient. Results: We identified a sample of 62 Parkinson’s patients, of whom 52 patients or 85.2% had associated pain. We noted a male predominance (38M/14F) and a sex ratio of 2.71. Musculoskeletal pain was common in 80% of our respondents. WHO level I, antidepressants and background treatment for KD were the most prescribed molecules. Conclusion: Our study shows a frequency of pain in PD. However, musculoskeletal pain is the most frequently encountered type of pain in PD patients. WHO step I analgesics, antidepressants and background treatment of KD were the main prescriptions in our study.展开更多
Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological me...Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.展开更多
Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an in...Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an invasive surgical treatment that modulates abnormal neural activity by implanting electrodes into specific brain areas followed by electrical stimulation.As an emerging therapeutic approach,deep brain stimulation shows significant promise as a potential new therapy for Alzheimer's disease.Here,we review the potential mechanisms and therapeutic effects of deep brain stimulation in the treatment of Alzheimer's disease based on existing clinical and basic research.In clinical studies,the most commonly targeted sites include the fornix,the nucleus basalis of Meynert,and the ventral capsule/ventral striatum.Basic research has found that the most frequently targeted areas include the fornix,nucleus basalis of Meynert,hippocampus,entorhinal cortex,and rostral intralaminar thalamic nucleus.All of these individual targets exhibit therapeutic potential for patients with Alzheimer's disease and associated mechanisms of action have been investigated.Deep brain stimulation may exert therapeutic effects on Alzheimer's disease through various mechanisms,including reducing the deposition of amyloid-β,activation of the cholinergic system,increasing the levels of neurotrophic factors,enhancing synaptic activity and plasticity,promoting neurogenesis,and improving glucose metabolism.Currently,clinical trials investigating deep brain stimulation for Alzheimer's disease remain insufficient.In the future,it is essential to focus on translating preclinical mechanisms into clinical trials.Furthermore,consecutive follow-up studies are needed to evaluate the long-term safety and efficacy of deep brain stimulation for Alzheimer's disease,including cognitive function,neuropsychiatric symptoms,quality of life and changes in Alzheimer's disease biomarkers.Researchers must also prioritize the initiation of multi-center clinical trials of deep brain stimulation with large sample sizes and target earlier therapeutic windows,such as the prodromal and even the preclinical stages of Alzheimer's disease.Adopting these approaches will permit the efficient exploration of more effective and safer deep brain stimulation therapies for patients with Alzheimer's disease.展开更多
Recombinant tissue plasminogen activator is commonly used for hematoma evacuation in minimally invasive surgery following intracerebral hemorrhage.However,during minimally invasive surgery,recombinant tissue plasminog...Recombinant tissue plasminogen activator is commonly used for hematoma evacuation in minimally invasive surgery following intracerebral hemorrhage.However,during minimally invasive surgery,recombinant tissue plasminogen activator may come into contact with brain tissue.Therefore,a thorough assessment of its safety is required.In this study,we established a mouse model of intracerebral hemorrhage induced by type VII collagenase.We observed that the administration of recombinant tissue plasminogen activator without hematoma aspiration significantly improved the neurological function of mice with intracerebral hemorrhage,reduced pathological damage,and lowered the levels of apoptosis and autophagy in the tissue surrounding the hematoma.In an in vitro model of intracerebral hemorrhage using primary cortical neurons induced by hemin,the administration of recombinant tissue plasminogen activator suppressed neuronal apoptosis,autophagy,and endoplasmic reticulum stress.Transcriptome sequencing analysis revealed that recombinant tissue plasminogen activator upregulated the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway in neurons.Moreover,the phosphoinositide 3-kinase inhibitor LY294002 abrogated the neuroprotective effects of recombinant tissue plasminogen activator in inhibiting excessive apoptosis,autophagy,and endoplasmic reticulum stress.Furthermore,to specify the domain of recombinant tissue plasminogen activator responsible for its neuroprotective effects,various inhibitors were used to target distinct domains.It has been revealed that the epidermal growth factor receptor inhibitor AG-1478 reversed the effect of recombinant tissue plasminogen activator on the phosphoinositide 3-kinase/RAC-alpha serine/threonineprotein kinase/mammalian target of rapamycin pathway.These findings suggest that recombinant tissue plasminogen activator exerts a direct neuroprotective effect on neurons following intracerebral hemorrhage,possibly through activation of the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway.展开更多
Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impair...Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impairment in Parkinson's disease is essential for early diagnosis,prognostic assessments,and the development of targeted therapies.This review aims to summarize recent advancements in biofluid biomarkers for cognitive impairment in Parkinson's disease,focusing on the detection of specific proteins,metabolites,and other biomarkers in blood,cerebrospinal fluid,and saliva.These biomarkers can shed light on the multifaceted etiology of cognitive impairment in Parkinson's disease,which includes protein misfolding,neurodegeneration,inflammation,and oxidative stress.The integration of biofluid biomarkers with neuroimaging and clinical data can facilitate the development of predictive models to enhance early diagnosis and monitor the progression of cognitive impairment in patients with Parkinson's disease.This comprehensive approach can improve the existing understanding of the mechanisms driving cognitive decline and support the development of targeted therapeutic strategies aimed at modifying the course of cognitive impairment in Parkinson's disease.Despite the promise of these biomarkers in characterizing the mechanisms underlying cognitive decline in Parkinson's disease,further research is necessary to validate their clinical utility and establish a standardized framework for early detection and monitoring of cognitive impairment in Parkinson's disease.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
Research into lactylation modifications across various target organs in both health and disease has gained significant attention.Many essential life processes and the onset of diseases are not only related to protein ...Research into lactylation modifications across various target organs in both health and disease has gained significant attention.Many essential life processes and the onset of diseases are not only related to protein abundance but are also primarily regulated by various post-translational protein modifications.Lactate,once considered merely a byproduct of anaerobic metabolism,has emerged as a crucial energy substrate and signaling molecule involved in both physiological and pathological processes within the nervous system.Furthermore,recent studies have emphasized the significant role of lactate in numerous neurological diseases,including Alzheimer's disease,Parkinson's disease,acute cerebral ischemic stroke,multiple sclerosis,Huntington's disease,and myasthenia gravis.The purpose of this review is to synthesize the current research on lactate and lactylation modifications in neurological diseases,aiming to clarify their mechanisms of action and identify potential therapeutic targets.As such,this work provides an overview of the metabolic regulatory roles of lactate in various disorders,emphasizing its involvement in the regulation of brain function.Additionally,the specific mechanisms of brain lactate metabolism are discussed,suggesting the unique roles of lactate in modulating brain function.As a critical aspect of lactate function,lactylation modifications,including both histone and non-histone lactylation,are explored,with an emphasis on recent advancements in identifying the key regulatory enzymes of such modifications,such as lactylation writers and erasers.The effects and specific mechanisms of abnormal lactate metabolism in diverse neurological diseases are summarized,revealing that lactate acts as a signaling molecule in the regulation of brain functions and that abnormal lactate metabolism is implicated in the progression of various neurological disorders.Future research should focus on further elucidating the molecular mechanisms underlying lactate and lactylation modifications and exploring their potential as therapeutic targets for neurological diseases.展开更多
Recent studies have shown that fibrotic scar formation following cerebral ischemic injury has varying effects depending on the microenvironment.However,little is known about how fibrosis is induced and regulated after...Recent studies have shown that fibrotic scar formation following cerebral ischemic injury has varying effects depending on the microenvironment.However,little is known about how fibrosis is induced and regulated after cerebral ischemic injury.Sonic hedgehog signaling participates in fibrosis in the heart,liver,lung,and kidney.Whether Shh signaling modulates fibrotic scar formation after cerebral ischemic stroke and the underlying mechanisms are unclear.In this study,we found that Sonic Hedgehog expression was upregulated in patients with acute ischemic stroke and in a middle cerebral artery occlusion/reperfusion injury rat model.Both Sonic hedgehog and Mitofusin 2 showed increased expression in the middle cerebral artery occlusion rat model and in vitro fibrosis cell model induced by transforming growth factor-beta 1.Activation of the Sonic hedgehog signaling pathway enhanced the expression of phosphorylated Smad 3 and Mitofusin 2 proteins,promoted the formation of fibrotic scars,protected synapses or promoted synaptogenesis,alleviated neurological deficits following middle cerebral artery occlusion/reperfusion injury,reduced cell apoptosis,facilitated the transformation of meninges fibroblasts into myofibroblasts,and enhanced the proliferation and migration of meninges fibroblasts.The Smad3 phosphorylation inhibitor SIS3 reversed the effects induced by Sonic hedgehog signaling pathway activation.Bioinformatics analysis revealed significant correlations between Sonic hedgehog and Smad3,between Sonic hedgehog and Mitofusin 2,and between Smad3 and Mitofusin 2.These findings suggest that Sonic hedgehog signaling may influence Mitofusin 2 expression by regulating Smad3 phosphorylation,thereby modulating the formation of early fibrotic scars following cerebral ischemic stroke and affecting prognosis.The Sonic Hedgehog signaling pathway may serve as a new therapeutic target for stroke treatment.展开更多
The misfolding,aggregation,and deposition of alpha-synuclein into Lewy bodies are pivotal events that trigger pathological changes in Parkinson's disease.Extracellular vesicles are nanosized lipidbilayer vesicles ...The misfolding,aggregation,and deposition of alpha-synuclein into Lewy bodies are pivotal events that trigger pathological changes in Parkinson's disease.Extracellular vesicles are nanosized lipidbilayer vesicles secreted by cells that play a crucial role in intercellular communication due to their diverse cargo.Among these,brain-derived extracellular vesicles,which are secreted by various brain cells such as neurons,glial cells,and Schwann cells,have garnered increasing attention.They serve as a promising tool for elucidating Parkinson's disease pathogenesis and for advancing diagnostic and therapeutic strategies.This review highlights the recent advancements in our understanding of brain-derived extracellular vesicles released into the blood and their role in the pathogenesis of Parkinson's disease,with specific emphasis on their involvement in the aggregation and spread of alpha-synuclein.Brain-derived extracellular vesicles contribute to disease progression through multiple mechanisms,including autophagy-lysosome dysfunction,neuroinflammation,and oxidative stress,collectively driving neurodegeneration in Parkinson's disease.Their application in Parkinson's disease diagnosis is a primary focus of this review.Recent studies have demonstrated that brainderived extracellular vesicles can be isolated from peripheral blood samples,as they carryα-synuclein and other key biomarkers such as DJ-1 and various micro RNAs.These findings highlight the potential of brain-derived extracellular vesicles,not only for the early diagnosis of Parkinson's disease but also for disease progression monitoring and differential diagnosis.Additionally,an overview of explorations into the potential therapeutic applications of brain-derived extracellular vesicles for Parkinson's disease is provided.Therapeutic strategies targeting brain-derived extracellular vesicles involve modulating the release and uptake of pathological alpha-synuclein-containing brain-derived extracellular vesicles to inhibit the spread of the protein.Moreover,brain-derived extracellular vesicles show immense promise as therapeutic delivery vehicles capable of transporting drugs into the central nervous system.Importantly,brain-derived extracellular vesicles also play a crucial role in neural regeneration by promoting neuronal protection,supporting axonal regeneration,and facilitating myelin repair,further enhancing their therapeutic potential in Parkinson's disease and other neurological disorders.Further clarification is needed of the methods for identifying and extracting brain-derived extracellular vesicles,and large-scale cohort studies are necessary to validate the accuracy and specificity of these biomarkers.Future research should focus on systematically elucidating the unique mechanistic roles of brain-derived extracellular vesicles,as well as their distinct advantages in the clinical translation of methods for early detection and therapeutic development.展开更多
Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the...Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.展开更多
With the gradual advancement of research methods and technologies,various biological processes have been identified as playing roles in the pathogenesis of neurodegenerative diseases.However,current descriptions of th...With the gradual advancement of research methods and technologies,various biological processes have been identified as playing roles in the pathogenesis of neurodegenerative diseases.However,current descriptions of these biological processes do not fully explain the onset,progression,and development of these conditions.Therefore,exploration of the pathogenesis of neurodegenerative diseases remains a valuable area of research.This review summarizes the potential common pathogeneses of Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,Huntington’s disease,frontotemporal lobar dementia,and Lewy body disease.Research findings have indicated that several common biological processes,including aging,genetic factors,progressive neuronal dysfunction,neuronal death and apoptosis,protein misfolding and aggregation,neuroinflammation,mitochondrial dysfunction,axonal transport defects,and gut microbiota dysbiosis,are involved in the pathogenesis of these six neurodegenerative diseases.Based on current information derived from diverse areas of research,these biological processes may form complex pathogenic networks that lead to distinctive types of neuronal death in neurodegenerative diseases.Furthermore,promoting the regeneration of damaged neurons may be achievable through the repair of affected neural cells if the underlying pathogenesis can be prevented or reversed.Hence,these potential common biological processes may represent only very small,limited elements within numerous intricate pathogenic networks associated with neurodegenerative diseases.In clinical treatment,interfering with any single biological process has proven insufficient to completely halt the progression of neurodegenerative diseases.Therefore,future research on the pathogenesis of neurodegenerative diseases should focus on uncovering the complex pathogenic networks,rather than isolating individual biological processes.Based on this,therapies that aim to block or reverse various targets involved in the potential pathogenic mechanisms of neurodegenerative diseases may be promising directions,as current treatment methods that focus on halting a single pathogenic factor have not achieved satisfactory efficacy.展开更多
Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory v...Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory versus degenerative dichotomy.This was based on a broad misconception regarding essentially all neurodegenerative conditions,depicting the degenerative process as passive and immune-independent occurring as a late byproduct of active inflammation in the central nervous system(CNS),which is(solely)systemically driven.展开更多
文摘Toxocariasis is a helminthic zoonosis due to the presence in the human body of larvae of Toxocara sp., roundworms of the Ascaridae family. Less than 50 cases of central involvement related to toxocarasis have been reported in immunocompetent individuals. This involvement can result in epilepsy, meningoencephalitis, myelitis or encephalopathy. The standard treatment is albendazole at a dosage of 10 to 15 mg/kg/day. The duration of treatment varies greatly depending on the clinical cases reported, ranging from 5 days to several weeks in the case of severe forms. We report a case of myelitis due to Toxocara canis in a 14-year-old patient admitted for gait disorders. The laboratory assessment shows isolated hypereosinophilia at 8000 elements per mm3. Medullary magnetic resonance imaging (MRI) showed an intradural process of inflammatory and infectious appearance extended between T10 and L1 levels, hypointense in T1, hyperintense in T2, and homogeneous. Parasitological analysis of the stools noted the presence of high concentrations of Toxocara canis. Serology by ELISA (enzyme-linked immunosorbent assay) is strongly positive for toxocariasis, and western blot confirms the presence of antibodies directed against Toxocara larvae. Treatment with albendazole 400 mg × 2/day for 10 days associated with corticosteroid therapy (prednisone 50 mg/day for 5 days) allowed the disappearance of pain in 8 days, normalization of eosinophilia and improvement of walking.
文摘Objective: to analyze the clinical application effect of nursing intervention in the fall nursing of elderly patients in the Department of Neurology. Methods: in this study, 72 patients with the risk of falling admitted to the Department of Neurology in our hospital from April 2018 to April 2020 were taken as the research objects. According to the random number method, they were randomly divided into the control group and the research group, with 36 cases in the former group (routine care) and 36 cases in the latter group (comprehensive care). Two kinds of nursing application and clinical fall event prevention and nursing satisfaction to carry out a comparative analysis. Results: the incidence of decline in the study group (2.7%) was lower than that in the control group (22.2%). Nursing satisfaction in the study group (100%) was higher than that in the control group (83.3%), P < 0.05. Conclusion: reasonable nursing intervention in the neurology department of elderly patients fall nursing can play a good preventive effect, and can improve nursing satisfaction.
文摘Objective: to explore the effect of humanized nursing in intensive care of neurology department. Methods: 58 severe patients who were admitted to the Department of Neurology in our hospital from February to October 2019 were selected as the research subjects, and they were equally divided into the experimental group and the control group. The effects and effectiveness of humanized nursing care in two groups were compared. Results: in terms of clinical nursing care, the effective rates of patient care in the experimental group and the control group were 95.55% and 82.76%, respectively. The effective rate in the experimental group was higher than that in the control group, and the two groups' data were statistically significant (P < 0.05). In terms of comfort and neurological care, the difference in scores between the two groups was obviously insufficient before treatment, and both groups had improvements after treatment. The neurological score and comfort score in the experimental group were (11.09±2.17) and (11.09±2.17), respectively. In the control group, the neurological scores were (15.36±3.43) and comfort scores were (5.03±2.24). The experimental group was better than the control group, and the data between the two groups had statistical significance (P < 0.05). Conclusion: humanistic nursing care for severe patients in neurology department is worthy of learning, because it can promote neurological recovery, improve comfort and prognosis.
文摘Objective: with the increasing awareness of national health care and rights protection, the requirements for achieving high-quality prognosis and complete medical care skills are increasing. This is thought-provoking. In recent years, closed-loop management has been widely discussed and applied in the field of health care. Methods: 780 patients hospitalized in hospitals from April 2016 to March 2017 were selected as the control group, and 820 patients hospitalized in hospitals from April 2017 to March 2018 were selected as the observation group. Patients in control group were given routine nursing management. The observation group applied the closed-loop nursing management mode, which took the time of nurses nursing patients as the main line. The content of nursing work runs through the whole nursing work flow of nurses from the beginning of nursing, the implementation of nursing process, the end of nursing and the handover, forming a closed-loop process chain, which refines and streamlines nursing work and emphasizes the whole process quality control. Results: the difference between the two nursing management modes was evaluated by comparing the nurses' awareness rate of illness, mastery rate of safety knowledge of patients or accompanying nurses, satisfaction of patients or accompanying nurses, nursing quality and incidence rate of nursing risk events. Conclusion: the application effect of closed-loop management in neurology department is better than that of routine management, which can effectively improve the nursing effect and reduce the incidence of adverse risk events, and is worthy of clinical application.
文摘Intraventricular haemorrhage (IVH) is an extremely rare and poorly described complication of central nervous system Tuberculosis (CNS-TB). In this study, we report the case of a 42-year-old man who presented with a weakness of the left hemibody with diffuse headache, altered consciousness associated with fever. No notion of contagion was noted. Brain computed tomography (CT) showed a hematoma in the occipital horns of the lateral ventricles with peri-lesional oedema of the right hemisphere;after injection of contrast product (CP), there were ring-shaped contrasts in the occipital horn of the lateral ventricle and the right thalamus. Angioscan showed no aneurysms or vascular anomalies. Chest X-ray showed micronodular opacities less than 1.5 cm in size in relation to miliary. Xpert MTB/RIF of sputum and cerebrospinal fluid (CSF) showed Mycobacterium tuberculosis (MT). The patient’s course was favourable under antihypertensive and antitubercular treatment. Conclusion: This case illustrates the diagnostic difficulties of CNS-TB due to the polymorphism of the clinical and radiological presentation of CNS-TB.
文摘Objective: to analyze the application effect of safety management in nursing management of neurology department. Methods: 78 patients with neurological diseases in our hospital from January 2019 to January 2020 were selected as the research objects and randomly divided into the control group and the observation group, with 39 patients in each group. The control group was given routine nursing management, while the observation group was given additional safety management on the basis of routine nursing management. The incidence of risk and patient satisfaction under two different nursing management modes were compared. Results: the observation group using safety management had 1 case of adverse events, the risk incidence rate was (2.56%);while the control group using routine nursing management had 5 cases of adverse events, the risk incidence rate was (12.82%), the risk incidence rate of the observation group was lower than that of the control group (P < 0.05).Secondly, the satisfaction of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05).Conclusion: the safety measures in nerve nursing management can effectively reduce the risk, and play an important role in helping patients recover.
文摘Objective: to explore the utility value of safety management in nursing management of neurology department. Methods: 130 patients were randomly selected in the department of neurology in the hospital for a comparative study, and divided into two groups. There were 65 cases in the control group and 65 cases in the observation group. They were adopted routine nursing management and safety management on this basis respectively. The incidence of adverse events and nursing satisfaction were compared. Results: the data showed that the data of the observation group implementing safety management were excellent, and the difference was significant (P < 0.05). Conclusion: in the clinical nursing of patients in neurology department, safety management can effectively avoid various risk factors, reduce the occurrence of accidents, and provide them with high-quality nursing and good rehabilitation environment.
文摘Introduction: Malignant sylvian infarction (MSI) is a type of ischemic stroke (ICS) usually affecting the entire territory of the middle cerebral artery (MCA) associated with significant cerebral edema and a mass. It represents about 10% of all AICs, with a mortality of up to 80%. The objectives of our study were to describe the sociodemographic profile and the main clinical manifestations and identify the prognostic factors of ISM. Material and Methods: We conducted a retrospective descriptive study over a 2-year period. It included patients hospitalized for cerebral infarction involving 2/3 of the ACM territory with a NIHSS score ≥ 17 and/or a Glasgow score Results: We collected 223 patients hospitalized for ischemic stroke, of whom 21 patients (9.4%) presented with ISM. The mean age was 57.43 ± 24.24 years with a male predominance (52.4%). The mean admission time was 47 ± 0.87 hours, and hemiplegia was the frequent neurological sign (85.7%). HBP was the common cardiovascular risk factor (76.2%). The mean NIHSS at admission was 18.38 ± 12.29. Respiratory distress (p-value = 0.00015), aspiration pneumonia (p-value = 0.015) and brain herniation (p-value = 0.014) were the main complications associated with mortality. Conclusion: ISM is associated with poor prognosis in the absence of surgical treatment. Respiratory distress, aspiration pneumonia and brain herniation are associated with high mortality.
文摘Introduction: Pain has been defined for more than 20 years by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. It has been recognized as a feature of Parkinson’s disease (PD) since the first descriptions of the disease. Material and Methods: This was a prospective descriptive study lasting six (06) months from November 1, 2023 to April 30, 2024. We included all patients diagnosed with PD and who had pain. Sociodemographic, clinical, paraclinical and therapeutic data were evaluated for each patient. Results: We identified a sample of 62 Parkinson’s patients, of whom 52 patients or 85.2% had associated pain. We noted a male predominance (38M/14F) and a sex ratio of 2.71. Musculoskeletal pain was common in 80% of our respondents. WHO level I, antidepressants and background treatment for KD were the most prescribed molecules. Conclusion: Our study shows a frequency of pain in PD. However, musculoskeletal pain is the most frequently encountered type of pain in PD patients. WHO step I analgesics, antidepressants and background treatment of KD were the main prescriptions in our study.
基金supported by the National Natural Science Foundation of China,No.82274304(to YH)the Major Clinical Study Projects of Shanghai Shenkang Hospital Development Center,No.SHDC2020CR2046B(to YH)Shanghai Municipal Health Commission Talent Plan,No.2022LJ010(to YH).
文摘Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels,often leading to stroke and dementia.Due to its diverse etiologies and complex pathological mechanisms,preventing and treating cerebral small vessel vasculopathy is challenging.Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis.Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease.This review begins with a comprehensive introduction to the structure,function,and driving factors of the glymphatic system,highlighting its essential role in brain waste clearance.Afterwards,cerebral small vessel disease was reviewed from the perspective of the glymphatic system,after which the mechanisms underlying their correlation were summarized.Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain,thereby exacerbating the pathological processes associated with cerebral small vessel disease.The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease:arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease.Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system.However,the effectiveness of its parameters needs to be enhanced.Among various nervous system diseases,including cerebral small vessel disease,glymphatic failure may be a common final pathway toward dementia.Overall,this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.
基金supported by the Capital Fund for Health Improvement and Research,No.2022-2-2048(to WZ)the National Natural Science Foundation of China,No.81970992(to WZ)+3 种基金Capital Clinical Characteristic Application Research,No.Z121107001012161(to WZ)the Natural Science Foundation of Beijing,No.7082032(to WZ)the Key Technology R&D Program of Beijing Municipal Education Commission,No.KZ201610025030(to WZ)Project of Scientific and Technological Development of Traditional Chinese Medicine in Beijing,No.JJ2018-48(to WZ)。
文摘Alzheimer's disease is the most common type of cognitive disorder,and there is an urgent need to develop more effective,targeted and safer therapies for patients with this condition.Deep brain stimulation is an invasive surgical treatment that modulates abnormal neural activity by implanting electrodes into specific brain areas followed by electrical stimulation.As an emerging therapeutic approach,deep brain stimulation shows significant promise as a potential new therapy for Alzheimer's disease.Here,we review the potential mechanisms and therapeutic effects of deep brain stimulation in the treatment of Alzheimer's disease based on existing clinical and basic research.In clinical studies,the most commonly targeted sites include the fornix,the nucleus basalis of Meynert,and the ventral capsule/ventral striatum.Basic research has found that the most frequently targeted areas include the fornix,nucleus basalis of Meynert,hippocampus,entorhinal cortex,and rostral intralaminar thalamic nucleus.All of these individual targets exhibit therapeutic potential for patients with Alzheimer's disease and associated mechanisms of action have been investigated.Deep brain stimulation may exert therapeutic effects on Alzheimer's disease through various mechanisms,including reducing the deposition of amyloid-β,activation of the cholinergic system,increasing the levels of neurotrophic factors,enhancing synaptic activity and plasticity,promoting neurogenesis,and improving glucose metabolism.Currently,clinical trials investigating deep brain stimulation for Alzheimer's disease remain insufficient.In the future,it is essential to focus on translating preclinical mechanisms into clinical trials.Furthermore,consecutive follow-up studies are needed to evaluate the long-term safety and efficacy of deep brain stimulation for Alzheimer's disease,including cognitive function,neuropsychiatric symptoms,quality of life and changes in Alzheimer's disease biomarkers.Researchers must also prioritize the initiation of multi-center clinical trials of deep brain stimulation with large sample sizes and target earlier therapeutic windows,such as the prodromal and even the preclinical stages of Alzheimer's disease.Adopting these approaches will permit the efficient exploration of more effective and safer deep brain stimulation therapies for patients with Alzheimer's disease.
基金supported by the National Natural Science Foundation of China,Nos.92148206,82071330(both to ZT)a grant from the Major Program of Hubei Province,No.2023BAA005(to ZT)+1 种基金a grant from the Key Research and Discovery Program of Hubei Province,No.2021BCA109(to ZT)the Research Foundation of Tongji Hospital,No.2022B37(to PZ)。
文摘Recombinant tissue plasminogen activator is commonly used for hematoma evacuation in minimally invasive surgery following intracerebral hemorrhage.However,during minimally invasive surgery,recombinant tissue plasminogen activator may come into contact with brain tissue.Therefore,a thorough assessment of its safety is required.In this study,we established a mouse model of intracerebral hemorrhage induced by type VII collagenase.We observed that the administration of recombinant tissue plasminogen activator without hematoma aspiration significantly improved the neurological function of mice with intracerebral hemorrhage,reduced pathological damage,and lowered the levels of apoptosis and autophagy in the tissue surrounding the hematoma.In an in vitro model of intracerebral hemorrhage using primary cortical neurons induced by hemin,the administration of recombinant tissue plasminogen activator suppressed neuronal apoptosis,autophagy,and endoplasmic reticulum stress.Transcriptome sequencing analysis revealed that recombinant tissue plasminogen activator upregulated the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway in neurons.Moreover,the phosphoinositide 3-kinase inhibitor LY294002 abrogated the neuroprotective effects of recombinant tissue plasminogen activator in inhibiting excessive apoptosis,autophagy,and endoplasmic reticulum stress.Furthermore,to specify the domain of recombinant tissue plasminogen activator responsible for its neuroprotective effects,various inhibitors were used to target distinct domains.It has been revealed that the epidermal growth factor receptor inhibitor AG-1478 reversed the effect of recombinant tissue plasminogen activator on the phosphoinositide 3-kinase/RAC-alpha serine/threonineprotein kinase/mammalian target of rapamycin pathway.These findings suggest that recombinant tissue plasminogen activator exerts a direct neuroprotective effect on neurons following intracerebral hemorrhage,possibly through activation of the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway.
基金supported by Applied Basic Research Foundation of Yunnan Province,Nos.202301AS070045,202101AY070001-115(to XY and BL)National Natural Science Foundation of China,No.81960242(to XY)。
文摘Cognitive impairment is a particularly severe non-motor symptom of Parkinson's disease that significantly diminishes the quality of life of affected individuals.Identifying reliable biomarkers for cognitive impairment in Parkinson's disease is essential for early diagnosis,prognostic assessments,and the development of targeted therapies.This review aims to summarize recent advancements in biofluid biomarkers for cognitive impairment in Parkinson's disease,focusing on the detection of specific proteins,metabolites,and other biomarkers in blood,cerebrospinal fluid,and saliva.These biomarkers can shed light on the multifaceted etiology of cognitive impairment in Parkinson's disease,which includes protein misfolding,neurodegeneration,inflammation,and oxidative stress.The integration of biofluid biomarkers with neuroimaging and clinical data can facilitate the development of predictive models to enhance early diagnosis and monitor the progression of cognitive impairment in patients with Parkinson's disease.This comprehensive approach can improve the existing understanding of the mechanisms driving cognitive decline and support the development of targeted therapeutic strategies aimed at modifying the course of cognitive impairment in Parkinson's disease.Despite the promise of these biomarkers in characterizing the mechanisms underlying cognitive decline in Parkinson's disease,further research is necessary to validate their clinical utility and establish a standardized framework for early detection and monitoring of cognitive impairment in Parkinson's disease.
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 Applied Basic Research Joint Fund Project of Yunnan Province,No.202301AY070001-200Middle-aged Academic and Technical Training Project for High-Level Talents,No.202105AC160065+1 种基金Yunnan Clinical Medical Center for Neurological and Cardiovascular Diseases,No.YWLCYXZX2023300077Key Clinical Specialty of Neurology in Yunnan Province,No.300064(all to CL)。
文摘Research into lactylation modifications across various target organs in both health and disease has gained significant attention.Many essential life processes and the onset of diseases are not only related to protein abundance but are also primarily regulated by various post-translational protein modifications.Lactate,once considered merely a byproduct of anaerobic metabolism,has emerged as a crucial energy substrate and signaling molecule involved in both physiological and pathological processes within the nervous system.Furthermore,recent studies have emphasized the significant role of lactate in numerous neurological diseases,including Alzheimer's disease,Parkinson's disease,acute cerebral ischemic stroke,multiple sclerosis,Huntington's disease,and myasthenia gravis.The purpose of this review is to synthesize the current research on lactate and lactylation modifications in neurological diseases,aiming to clarify their mechanisms of action and identify potential therapeutic targets.As such,this work provides an overview of the metabolic regulatory roles of lactate in various disorders,emphasizing its involvement in the regulation of brain function.Additionally,the specific mechanisms of brain lactate metabolism are discussed,suggesting the unique roles of lactate in modulating brain function.As a critical aspect of lactate function,lactylation modifications,including both histone and non-histone lactylation,are explored,with an emphasis on recent advancements in identifying the key regulatory enzymes of such modifications,such as lactylation writers and erasers.The effects and specific mechanisms of abnormal lactate metabolism in diverse neurological diseases are summarized,revealing that lactate acts as a signaling molecule in the regulation of brain functions and that abnormal lactate metabolism is implicated in the progression of various neurological disorders.Future research should focus on further elucidating the molecular mechanisms underlying lactate and lactylation modifications and exploring their potential as therapeutic targets for neurological diseases.
基金supported by the National Natural Science Foundation of China,Nos.82171456(to QY)and 81971229(to QY)the Natural Science Foundation of Chongqing,Nos.CSTC2021JCYJ-MSXMX0263(to QY)and CSTB2023NSCQ-MSX1015(to XL)Doctoral Innovation Project of The First Affiliated Hospital of Chongqing Medical University,Nos.CYYY-BSYJSCXXM-202318(to JW)and CYYY-BSYJSCXXM-202327(to HT).
文摘Recent studies have shown that fibrotic scar formation following cerebral ischemic injury has varying effects depending on the microenvironment.However,little is known about how fibrosis is induced and regulated after cerebral ischemic injury.Sonic hedgehog signaling participates in fibrosis in the heart,liver,lung,and kidney.Whether Shh signaling modulates fibrotic scar formation after cerebral ischemic stroke and the underlying mechanisms are unclear.In this study,we found that Sonic Hedgehog expression was upregulated in patients with acute ischemic stroke and in a middle cerebral artery occlusion/reperfusion injury rat model.Both Sonic hedgehog and Mitofusin 2 showed increased expression in the middle cerebral artery occlusion rat model and in vitro fibrosis cell model induced by transforming growth factor-beta 1.Activation of the Sonic hedgehog signaling pathway enhanced the expression of phosphorylated Smad 3 and Mitofusin 2 proteins,promoted the formation of fibrotic scars,protected synapses or promoted synaptogenesis,alleviated neurological deficits following middle cerebral artery occlusion/reperfusion injury,reduced cell apoptosis,facilitated the transformation of meninges fibroblasts into myofibroblasts,and enhanced the proliferation and migration of meninges fibroblasts.The Smad3 phosphorylation inhibitor SIS3 reversed the effects induced by Sonic hedgehog signaling pathway activation.Bioinformatics analysis revealed significant correlations between Sonic hedgehog and Smad3,between Sonic hedgehog and Mitofusin 2,and between Smad3 and Mitofusin 2.These findings suggest that Sonic hedgehog signaling may influence Mitofusin 2 expression by regulating Smad3 phosphorylation,thereby modulating the formation of early fibrotic scars following cerebral ischemic stroke and affecting prognosis.The Sonic Hedgehog signaling pathway may serve as a new therapeutic target for stroke treatment.
基金supported by the National Natural Science Foundation of China,No.822712782019 Wuhan Huanghe Talents Program+3 种基金2020 Wuhan Medical Research Project,No.20200206010123032021 Hubei Youth Top-notch Talent Training Program2022 Outstanding Youth Project of Natural Science Foundation of Hubei Province,No.2022CFA106Medical Research Program of Huatongguokang,No.2023HT036(all to NX)。
文摘The misfolding,aggregation,and deposition of alpha-synuclein into Lewy bodies are pivotal events that trigger pathological changes in Parkinson's disease.Extracellular vesicles are nanosized lipidbilayer vesicles secreted by cells that play a crucial role in intercellular communication due to their diverse cargo.Among these,brain-derived extracellular vesicles,which are secreted by various brain cells such as neurons,glial cells,and Schwann cells,have garnered increasing attention.They serve as a promising tool for elucidating Parkinson's disease pathogenesis and for advancing diagnostic and therapeutic strategies.This review highlights the recent advancements in our understanding of brain-derived extracellular vesicles released into the blood and their role in the pathogenesis of Parkinson's disease,with specific emphasis on their involvement in the aggregation and spread of alpha-synuclein.Brain-derived extracellular vesicles contribute to disease progression through multiple mechanisms,including autophagy-lysosome dysfunction,neuroinflammation,and oxidative stress,collectively driving neurodegeneration in Parkinson's disease.Their application in Parkinson's disease diagnosis is a primary focus of this review.Recent studies have demonstrated that brainderived extracellular vesicles can be isolated from peripheral blood samples,as they carryα-synuclein and other key biomarkers such as DJ-1 and various micro RNAs.These findings highlight the potential of brain-derived extracellular vesicles,not only for the early diagnosis of Parkinson's disease but also for disease progression monitoring and differential diagnosis.Additionally,an overview of explorations into the potential therapeutic applications of brain-derived extracellular vesicles for Parkinson's disease is provided.Therapeutic strategies targeting brain-derived extracellular vesicles involve modulating the release and uptake of pathological alpha-synuclein-containing brain-derived extracellular vesicles to inhibit the spread of the protein.Moreover,brain-derived extracellular vesicles show immense promise as therapeutic delivery vehicles capable of transporting drugs into the central nervous system.Importantly,brain-derived extracellular vesicles also play a crucial role in neural regeneration by promoting neuronal protection,supporting axonal regeneration,and facilitating myelin repair,further enhancing their therapeutic potential in Parkinson's disease and other neurological disorders.Further clarification is needed of the methods for identifying and extracting brain-derived extracellular vesicles,and large-scale cohort studies are necessary to validate the accuracy and specificity of these biomarkers.Future research should focus on systematically elucidating the unique mechanistic roles of brain-derived extracellular vesicles,as well as their distinct advantages in the clinical translation of methods for early detection and therapeutic development.
基金supported by the Nature Science Foundation of Liaoning Province,Nos.2022-MS-211,2021-MS-064,and 2024-MS-048(all to YC).
文摘Alzheimer’s disease,a devastating neurodegenerative disorder,is characterized by progressive cognitive decline,primarily due to amyloid-beta protein deposition and tau protein phosphorylation.Effectively reducing the cytotoxicity of amyloid-beta42 aggregates and tau oligomers may help slow the progression of Alzheimer’s disease.Conventional drugs,such as donepezil,can only alleviate symptoms and are not able to prevent the underlying pathological processes or cognitive decline.Currently,active and passive immunotherapies targeting amyloid-beta and tau have shown some efficacy in mice with asymptomatic Alzheimer’s disease and other transgenic animal models,attracting considerable attention.However,the clinical application of these immunotherapies demonstrated only limited efficacy before the discovery of lecanemab and donanemab.This review first discusses the advancements in the pathogenesis of Alzheimer’s disease and active and passive immunotherapies targeting amyloid-beta and tau proteins.Furthermore,it reviews the advantages and disadvantages of various immunotherapies and considers their future prospects.Although some antibodies have shown promise in patients with mild Alzheimer’s disease,substantial clinical data are still lacking to validate their effectiveness in individuals with moderate Alzheimer’s disease.
基金supported by the National Natural Science Foundation of China,No.82160255(to RX)the Natural Science Foundation of Jiangxi Province,No.20212BAB216026(to HL)+2 种基金Science and Technology Plan Project of Health Commission of Jiangxi Province,No.202110016(to HL)Science and Technology Plan Project of Jiangxi Provincial Administration of Traditional Chinese Medicine,No.2022B975(to HL)a grant from Jiangxi Province Key Laboratory of Neurology,No.2024SSY06081(to RX).
文摘With the gradual advancement of research methods and technologies,various biological processes have been identified as playing roles in the pathogenesis of neurodegenerative diseases.However,current descriptions of these biological processes do not fully explain the onset,progression,and development of these conditions.Therefore,exploration of the pathogenesis of neurodegenerative diseases remains a valuable area of research.This review summarizes the potential common pathogeneses of Alzheimer’s disease,Parkinson’s disease,amyotrophic lateral sclerosis,Huntington’s disease,frontotemporal lobar dementia,and Lewy body disease.Research findings have indicated that several common biological processes,including aging,genetic factors,progressive neuronal dysfunction,neuronal death and apoptosis,protein misfolding and aggregation,neuroinflammation,mitochondrial dysfunction,axonal transport defects,and gut microbiota dysbiosis,are involved in the pathogenesis of these six neurodegenerative diseases.Based on current information derived from diverse areas of research,these biological processes may form complex pathogenic networks that lead to distinctive types of neuronal death in neurodegenerative diseases.Furthermore,promoting the regeneration of damaged neurons may be achievable through the repair of affected neural cells if the underlying pathogenesis can be prevented or reversed.Hence,these potential common biological processes may represent only very small,limited elements within numerous intricate pathogenic networks associated with neurodegenerative diseases.In clinical treatment,interfering with any single biological process has proven insufficient to completely halt the progression of neurodegenerative diseases.Therefore,future research on the pathogenesis of neurodegenerative diseases should focus on uncovering the complex pathogenic networks,rather than isolating individual biological processes.Based on this,therapies that aim to block or reverse various targets involved in the potential pathogenic mechanisms of neurodegenerative diseases may be promising directions,as current treatment methods that focus on halting a single pathogenic factor have not achieved satisfactory efficacy.
文摘Active inflammation in“inactive”progressive multiple sclerosis:Traditionally,the distinction between relapsing-remitting multiple sclerosis and progressive multiple sclerosis(PMS)has been framed as an inflammatory versus degenerative dichotomy.This was based on a broad misconception regarding essentially all neurodegenerative conditions,depicting the degenerative process as passive and immune-independent occurring as a late byproduct of active inflammation in the central nervous system(CNS),which is(solely)systemically driven.
