AIM To define regional grey-matter abnormalities in schizophrenia patients with poor insight(Insight-),relative to patients with preserved clinical insight(Insight+),and healthy controls.METHODS Forty stable schizophr...AIM To define regional grey-matter abnormalities in schizophrenia patients with poor insight(Insight-),relative to patients with preserved clinical insight(Insight+),and healthy controls.METHODS Forty stable schizophrenia outpatients(20 Insight-and 20 Insight+) and 20 healthy controls underwent whole brain magnetic resonance imaging(MRI).Insight in all patients was assessed using the Birchwood Insight Scale(BIS;a self-report measure).The two patient groups were preselected to match on most clinical and demographic parameters but,by design,they had markedly distinct BIS scores.Voxel-based morphometry employed in SPM8 was used to examine group differences in grey matter volumes across the whole brain.RESULTS The three participant groups were comparable in age [F(2,57) = 0.34,P = 0.71] and the patient groups did not differ in age at illness onset [t(38) = 0.87,P = 0.39].Insight-and Insight+ patient groups also did not differ in symptoms on the Positive and Negative Syndromes scale(PANSS):Positive symptoms [t(38) = 0.58,P = 0.57],negative symptoms [t(38) = 0.61,P = 0.55],general psychopathology [t(38) = 1.30,P = 0.20] and total PANSS scores [t(38) = 0.21,P = 0.84].The two patient groups,as expected,varied significantly in the level of BIS-assessed insight [t(38) = 12.11,P < 0.001].MRI results revealed lower fronto-temporal,parahippocampal,occipital and cerebellar grey matter volumes in Insightpatients,relative to Insight+ patients and healthy controls(for all clusters,family-wise error corrected P < 0.05).Insight+ patient and healthy controls did not differ significantly(P > 0.20) from each other.CONCLUSION Our findings demonstrate a clear association between poor clinical insight and smaller fronto-temporal,occipital and cerebellar grey matter volumes in stable long-term schizophrenia patients.展开更多
Processing emotional and social information are two closely related and evolutionarily conserved fundamental domains that promote survival and health across species[1].However,extensive human neuroimaging studies have...Processing emotional and social information are two closely related and evolutionarily conserved fundamental domains that promote survival and health across species[1].However,extensive human neuroimaging studies have yielded inconsistent findings.For instance,the amygdala,a key brain region engaged in social-affective cognition,often lacks differential“activation”during the“emotional vs.neutral faces”contrast[2],[3].展开更多
Intracranial arterial dissection is an important cause of stroke in young and middle-aged adults,but there are no domestic or globally-accepted criteria for the diagnosis and classification of intracranial arterial di...Intracranial arterial dissection is an important cause of stroke in young and middle-aged adults,but there are no domestic or globally-accepted criteria for the diagnosis and classification of intracranial arterial dissections.The evidence base for the benefits of diagnostic and interventional angiography techniques is lacking,and the imaging features of intracranial arterial dissections are not yet universally recognized or understood by clinicians.These issues influence the diagnosis and treatment of intracranial arterial dissection.Therefore,a consensus conference was convened by Neurointerventional Expert Committee of Chinese Congress of Neurological Surgeons,Chinese Interventional Neuroradiology Society of Chinese Stroke Association and Young Physicians Committee of Chinese Congress of Neurological Surgeons.The aim of this document is to report an expert consensus on the imaging diagnosis of intracranial arterial dissection.The participating clinical experts utilized their judgment and experience.Every effort was made to achieve consensus among the committee members.The expert consensus was intended to provide guidance,but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.展开更多
Continuous drug delivery(CDD)is used in moderately advanced and late-stage Parkinson’s disease(PD)to control motor and non-motor fluctuations(‘OFF’periods).Transdermal rotigotine is indicated for early fluctuations...Continuous drug delivery(CDD)is used in moderately advanced and late-stage Parkinson’s disease(PD)to control motor and non-motor fluctuations(‘OFF’periods).Transdermal rotigotine is indicated for early fluctuations,while subcutaneous apomorphine infusion and levodopa-carbidopa intestinal gel are utilised in advanced PD.All three strategies are considered examples of continuous dopaminergic stimulation achieved through CDD.A central premise of the CDD is to achieve stable control of the parkinsonian motor and non-motor states and avoid emergence of‘OFF’periods.However,data suggest that despite their efficacy in reducing the number and duration of‘OFF’periods,these strategies still do not prevent‘OFF’periods in the middle to late stages of PD,thus contradicting the widely held concepts of continuous drug delivery and continuous dopaminergic stimulation.Why these emergent‘OFF’periods still occur is unknown.In this review,we analyse the potential reasons for their persistence.The contribution of drug-and device-related involvement,and the problems related to site-specific drug delivery are analysed.We propose that changes in dopaminergic and non-dopaminergic mechanisms in the basal ganglia might render these persistent‘OFF’periods unresponsive to dopaminergic therapy delivered via CDD.展开更多
Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in t...Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. Methods Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items： initial tumor location, final location and the growth tendency. Results In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. Conclusions Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.展开更多
Objective The purpose of this study was to correlate T2 signal intensity values in nucleus pulposus of lumbar discs with patient age,gender and stage of nucleus pulposus degeneration.Methods Lumbar imaging findings of...Objective The purpose of this study was to correlate T2 signal intensity values in nucleus pulposus of lumbar discs with patient age,gender and stage of nucleus pulposus degeneration.Methods Lumbar imaging findings of 422 cases subjects were retrospectively reviewed through T2 signal intensity values of nucleus pulposus evaluated based on the signal intensity values of MR T2-weighted mid-sagittal images of the lumbar spine,the t2 signal intensity values at all five lumbar levels (from L5-S1 to L1-L2) between male and female were used independent sample t-test and the Spearman correlation analysis.The age and grade of nucleus pulposus of disc degeneration and T2 signal intensity values were estimated by calculating and Chi-square test and the Spearman correlation analysis.The t-test was used to correlate the different anatomic levels of disc degeneration;T2 signal intensity values among the five different anatomic levels using non-parametric correlation analysis.Results There were significantly differences in T2 signal intensity values of nucleus pulposus at the same grade and anatomic level between male and female.Advanced with age,T2 signal intensity values of nucleus pulposus decreased and stage of disc degeneration increased accordingly.T2 signal intensity values may represent the nucleus pulposus degeneration of interverterbral disc.L4-L5 was the highest incidence among the nucleus pulposus degeneration of intervertebral disc.Conclusions The T2 signal intensity values based approach may be a feasible and practical tool to determine nucleus pulposus degeneration.T2 signal intensity values of nucleus pulposus of lumbar intervertebral disc are correlated with grade of degeneration and patient age.展开更多
基金Supported by The Wellcome Trust,United Kingdom and was carried out as part of the first author’s PhD research under Professor Veena Kumari and Dr Dominic ffytche’s supervision,Nos.067427 and 072298Professor Kumari is part funded by the Biomedical Research Centre for Mental Health at the Institute of Psychiatry,Psychology and Neuroscience King’s College London,and the South London and Maudsley NHS Foundation Trust,United Kingdom(to Kumari V)
文摘AIM To define regional grey-matter abnormalities in schizophrenia patients with poor insight(Insight-),relative to patients with preserved clinical insight(Insight+),and healthy controls.METHODS Forty stable schizophrenia outpatients(20 Insight-and 20 Insight+) and 20 healthy controls underwent whole brain magnetic resonance imaging(MRI).Insight in all patients was assessed using the Birchwood Insight Scale(BIS;a self-report measure).The two patient groups were preselected to match on most clinical and demographic parameters but,by design,they had markedly distinct BIS scores.Voxel-based morphometry employed in SPM8 was used to examine group differences in grey matter volumes across the whole brain.RESULTS The three participant groups were comparable in age [F(2,57) = 0.34,P = 0.71] and the patient groups did not differ in age at illness onset [t(38) = 0.87,P = 0.39].Insight-and Insight+ patient groups also did not differ in symptoms on the Positive and Negative Syndromes scale(PANSS):Positive symptoms [t(38) = 0.58,P = 0.57],negative symptoms [t(38) = 0.61,P = 0.55],general psychopathology [t(38) = 1.30,P = 0.20] and total PANSS scores [t(38) = 0.21,P = 0.84].The two patient groups,as expected,varied significantly in the level of BIS-assessed insight [t(38) = 12.11,P < 0.001].MRI results revealed lower fronto-temporal,parahippocampal,occipital and cerebellar grey matter volumes in Insightpatients,relative to Insight+ patients and healthy controls(for all clusters,family-wise error corrected P < 0.05).Insight+ patient and healthy controls did not differ significantly(P > 0.20) from each other.CONCLUSION Our findings demonstrate a clear association between poor clinical insight and smaller fronto-temporal,occipital and cerebellar grey matter volumes in stable long-term schizophrenia patients.
文摘Processing emotional and social information are two closely related and evolutionarily conserved fundamental domains that promote survival and health across species[1].However,extensive human neuroimaging studies have yielded inconsistent findings.For instance,the amygdala,a key brain region engaged in social-affective cognition,often lacks differential“activation”during the“emotional vs.neutral faces”contrast[2],[3].
基金National Natural Science Foundation of China,Special Research Project for Capital Health Development
文摘Intracranial arterial dissection is an important cause of stroke in young and middle-aged adults,but there are no domestic or globally-accepted criteria for the diagnosis and classification of intracranial arterial dissections.The evidence base for the benefits of diagnostic and interventional angiography techniques is lacking,and the imaging features of intracranial arterial dissections are not yet universally recognized or understood by clinicians.These issues influence the diagnosis and treatment of intracranial arterial dissection.Therefore,a consensus conference was convened by Neurointerventional Expert Committee of Chinese Congress of Neurological Surgeons,Chinese Interventional Neuroradiology Society of Chinese Stroke Association and Young Physicians Committee of Chinese Congress of Neurological Surgeons.The aim of this document is to report an expert consensus on the imaging diagnosis of intracranial arterial dissection.The participating clinical experts utilized their judgment and experience.Every effort was made to achieve consensus among the committee members.The expert consensus was intended to provide guidance,but they are not to be considered prescriptive for any individual patient and cannot replace the judgment of a clinician.
文摘Continuous drug delivery(CDD)is used in moderately advanced and late-stage Parkinson’s disease(PD)to control motor and non-motor fluctuations(‘OFF’periods).Transdermal rotigotine is indicated for early fluctuations,while subcutaneous apomorphine infusion and levodopa-carbidopa intestinal gel are utilised in advanced PD.All three strategies are considered examples of continuous dopaminergic stimulation achieved through CDD.A central premise of the CDD is to achieve stable control of the parkinsonian motor and non-motor states and avoid emergence of‘OFF’periods.However,data suggest that despite their efficacy in reducing the number and duration of‘OFF’periods,these strategies still do not prevent‘OFF’periods in the middle to late stages of PD,thus contradicting the widely held concepts of continuous drug delivery and continuous dopaminergic stimulation.Why these emergent‘OFF’periods still occur is unknown.In this review,we analyse the potential reasons for their persistence.The contribution of drug-and device-related involvement,and the problems related to site-specific drug delivery are analysed.We propose that changes in dopaminergic and non-dopaminergic mechanisms in the basal ganglia might render these persistent‘OFF’periods unresponsive to dopaminergic therapy delivered via CDD.
基金This study was supported by the funds from the National Key Project of Science and Technology Supporting Programs of China （No. 2007BAI05B08） and the National Natural Science Foundation of China （No. 30770617）
文摘Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. Methods Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items： initial tumor location, final location and the growth tendency. Results In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. Conclusions Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.
文摘Objective The purpose of this study was to correlate T2 signal intensity values in nucleus pulposus of lumbar discs with patient age,gender and stage of nucleus pulposus degeneration.Methods Lumbar imaging findings of 422 cases subjects were retrospectively reviewed through T2 signal intensity values of nucleus pulposus evaluated based on the signal intensity values of MR T2-weighted mid-sagittal images of the lumbar spine,the t2 signal intensity values at all five lumbar levels (from L5-S1 to L1-L2) between male and female were used independent sample t-test and the Spearman correlation analysis.The age and grade of nucleus pulposus of disc degeneration and T2 signal intensity values were estimated by calculating and Chi-square test and the Spearman correlation analysis.The t-test was used to correlate the different anatomic levels of disc degeneration;T2 signal intensity values among the five different anatomic levels using non-parametric correlation analysis.Results There were significantly differences in T2 signal intensity values of nucleus pulposus at the same grade and anatomic level between male and female.Advanced with age,T2 signal intensity values of nucleus pulposus decreased and stage of disc degeneration increased accordingly.T2 signal intensity values may represent the nucleus pulposus degeneration of interverterbral disc.L4-L5 was the highest incidence among the nucleus pulposus degeneration of intervertebral disc.Conclusions The T2 signal intensity values based approach may be a feasible and practical tool to determine nucleus pulposus degeneration.T2 signal intensity values of nucleus pulposus of lumbar intervertebral disc are correlated with grade of degeneration and patient age.
