Frontotemporal lobar degeneration(FTLD)is a form of progressive dementia characterized by degeneration of the frontal and temporal lobes of the brain.This pathology involves a series of cognitive,behavioral,and neurol...Frontotemporal lobar degeneration(FTLD)is a form of progressive dementia characterized by degeneration of the frontal and temporal lobes of the brain.This pathology involves a series of cognitive,behavioral,and neurological symptoms that influence personality,decision-making ability,and language.展开更多
Alzheimer’s disease(AD)is a neurodegenerative disease with long preclinical phase,typically followed by a slow decline in memory,thinking and reasoning abilities.The underlying pathological processes are not yet full...Alzheimer’s disease(AD)is a neurodegenerative disease with long preclinical phase,typically followed by a slow decline in memory,thinking and reasoning abilities.The underlying pathological processes are not yet fully elucidated,although two main disease hallmarks have been associated with AD pathology:amyloid beta species and neurofibrillary tangles.The plaques are deposits of a protein fragment called beta-amyloid(Aβ),which accumulates in the spaces between neurons.Tangles are twisted fibers of the tau protein,which accumulates inside the cells.展开更多
We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students ...We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.展开更多
Background: Controversial research has indicated potential neuroprotective qualities of lithium in the prevention of dementia, but it did not lead to a definite conclusion. Aim: We seek to examine whether lithium has ...Background: Controversial research has indicated potential neuroprotective qualities of lithium in the prevention of dementia, but it did not lead to a definite conclusion. Aim: We seek to examine whether lithium has a protective effect in an elderly population suffering from bipolar disorder. Patients and Methods: Of a retrospective cohort including 433 patient files that met inclusion criteria (age over 65 years and bipolar disease coded by ICD), 147 files contained enough relevant data. The patients’ files were divided into lithium users (LU) for those who used lithium for at least a minimum of 3 months and non-users (LNU) for those who did not use lithium at all or used it for a period of less than 3 months. We searched for dementia incidence in these two groups. Results: 433 files were collected initially through a computerized search using ICD10 code for bipolar affective disorder. One hundred twenty three files were excluded due to age (younger than 65 years), 7 were excluded due to neurological background, and 49 were excluded due to either a secondary or a not strictly bipolar psychiatric diagnosis. One hundred and seven were excluded due to insufficient/uncertain data. The remainders of 147 files were included in the final analysis. Twenty five of the 147 bipolar patients were diagnosed with dementia (17%). Amongst the 92 LNU patients, 16 developed dementia (17.4%) and of the 55 LU patients, 9 developed dementia (16.4%);Pearson’s χ<sup>2</sup>(1) = 0.026, p Conclusions: No cognitive protective qualities of lithium treatment in elderly bipolar patients were demonstrated by our study.展开更多
Objective: To investigate the effects of atorvastatin combined with clopidogrel on inflammatory factors, coagulation and platelet activation in patients with acute cerebral infarction. Methods: A total of 140 cases pa...Objective: To investigate the effects of atorvastatin combined with clopidogrel on inflammatory factors, coagulation and platelet activation in patients with acute cerebral infarction. Methods: A total of 140 cases patients with acute cerebral infarction who were confirmed by clinical and imaging diagnoses were randomly divided into treatment group (70 cases) and control group (70 cases). Both groups were treated routinely before treatment. The observation group was treated with clopidogrel and atorvastatin, while the control group was treated with aspirin and atorvastatin. The changes of inflammatory factors, coagulation function and platelet activation index before and after treatment were compared between the two groups. Result: Before treatment, the levels of serum soluble intercellular adhesion molecule-1 (sICAM-1), transforming growth factor-β (TGF-β), coagulation parameters prothrombin time(PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), coagulation index of platelets platelet -membrane glycoprotein (CD62p), lysosomal granular membrane glycoprotein (CD63), platelet-monocyte aggregates (PMA), coagulation parameters were not statistically significant. After treatment, the levels of sICAM-1, CD62p, CD63, PMA and FIB in both groups decreased and the levels of TGF-β, PT and APTT increased. The levels of sICAM-1, FIB, CD62p, CD63 and PMA in the observation group were (370.32±37.13) ng/mL, (1.97±0.21) g/L, (1.38±0.14)%, (0.22±0.02)%, and (18.47+1.85)% respectively, which were lower than those in the control group ((410.47±42.32) ng/mL, (2.58±0.26) s, (2.67±0.27)%, (0.35±0.03)% and (22.87±2.91)%)While the levels of TGF-β, PT and APPT were (231.53±23.52) ng/mL, (15.42±1.53) s, (37.31±3.54) s were higher than the control group ((218.56±22.17) ng/mL, (12.32±1.27) s and (29.89±3.01)s)And the differences were significant. Conclusion: Atorvastatin combined with clopidogrel treatment can effectively relieve the inflammatory response, reduce the release of inflammatory cytokines, improve blood coagulation and inhibit platelet aggregation in patients with acute cerebral infarction. So it deserves further clinical promotion.展开更多
The volume of the amygdala is reduced in advanced Alzheimer’s disease (AD). However, there is controversy whether amygdala atrophy is present in mild AD and in the transitional phase between health and the onset of d...The volume of the amygdala is reduced in advanced Alzheimer’s disease (AD). However, there is controversy whether amygdala atrophy is present in mild AD and in the transitional phase between health and the onset of dementia. The aim of this prospective longitudinal study was to investigate whether amygdala atrophy is present in subjects with questionable dementia and mild dementia and whether amygdala volume is associated with the future rate of cognitive change, that is the annual change in the Mini Mental State Examination (MMSE). At baseline, volum es of the amygdala were measured in 97 participants aged 70-87 years (40 contro ls, 33 patients with questionable dementia, 24 patients with mild AD) using magn etic resonance imaging. Eighty-six participants were clinically re-examined af ter 2.3 years on average. At baseline, significant differences in mean amygdala volume were found between controls and participants with mild AD. There was no s ignificant correlation between the longitudinal annual change in MMSE and the ba seline amygdala volume in any of the three groups.展开更多
Alzheimer’s disease (AD) is a neurodegenerative disease characterized by senile plaques and neurofibrillary tangles. Senile plaques are deposits of amyloid ?-peptide (A?) produced by the cleavage of a transmembrane p...Alzheimer’s disease (AD) is a neurodegenerative disease characterized by senile plaques and neurofibrillary tangles. Senile plaques are deposits of amyloid ?-peptide (A?) produced by the cleavage of a transmembrane protein termed Amyloid Precursor Protein (APP). The amyloidogenic cleavage of APP is performed by γ-secretase complex and ?-site APP cleaving enzyme 1 (BACE1), a key enzyme in AD that can be activated by different noxious stimuli. Interestingly, some viruses could activate double-stranded RNA-activated protein kinase (PKR), which phosphorylates Eukaryotic Initiation Factor 2 alpha (eIF2α). This phosphorylation stops global translation to avoid any synthesis of viral infective proteins, but paradoxically up-regulates BACE1 translation. One of the viral mechanisms to circumvent eIF2α phosphorylation is the recruitment of protein phosphatase 1 (PP1), to fully dephosphorylate eIF2α and allow viral protein synthesis. Due to the functional relationship between BACE1, PKR, PP1 and AD we have performed a large (1122 cases and 1191 control individuals) case-control genetic analysis using two biallelic polymorphisms rs2254958 and rs7480390, located within the genes coding for PKR and the catalytic unit A of PP1, respectively. Although a trend to association of the rs2254958 TT genotype with AD risk was found, our results show that neither rs7480390 nor rs2254958 are associated with AD susceptibility.展开更多
In this study, the performance of Sevcik’s algorithm that calculates the fractal dimension and permutation entropy as discriminants to detect calming and insight meditation in electroencephalo-graphic (EEG) signals w...In this study, the performance of Sevcik’s algorithm that calculates the fractal dimension and permutation entropy as discriminants to detect calming and insight meditation in electroencephalo-graphic (EEG) signals was assessed. The proposed methods were applied to EEG recordings from meditators practicing insight meditation and calming meditation before as well as during both types of meditation. Analysis was conducted using statistical hypothesis testing to determine the validity of the proposed meditation-identifying techniques. For both types of meditation, there was a statistically significant reduction in the permutation entropy. This result can be explained by the increased EEG synchronization, which is repeatedly observed in the course of meditation. In contrast, the fractal dimension (FD) was significantly increased during calming meditation, but during insight meditation, no statistically significant change was detected. Increased FD during meditation can be interpreted as an increase in self-similarity of EEG signals during self-organisation of hierarchical structure oscillators in the brain. Our results indicate that fractal dimension and permutation entropy could be used as parameters to detect both types of meditation. The permutation entropy is advantageous compared with the fractal dimension because it does not require a stationary signal.展开更多
Background Primary progressive aphasia(PPA)is a neurodegenerative disorder characterized by a gradual,insidious and progressive loss of language abilities,with naming difficulties being an early and persistent impairm...Background Primary progressive aphasia(PPA)is a neurodegenerative disorder characterized by a gradual,insidious and progressive loss of language abilities,with naming difficulties being an early and persistent impairment common to all three variants.In the absence of effective pharmacological treatments and given the progressive nature of the disorder,in the past few decades,many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life.Main body We review language treatments most commonly used in clinical practice among patients with different variants of PPA,with a focus on the enhancement of spoken and written naming abilities.Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed.Forty-eight studies were included in this literature review,identifying four main types of language treatment:a)lexical retrieval treatment,b)phonological and/or orthographic treatment,c)semantic treatment,and d)a multimodality approach treatment.Overall,language training is able to induce immediate improvements of naming abilities in all variants of PPA.Moreover,despite the large variability among results,generalization and long-term effects can be recorded after the training.The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system.Conclusion The majority of studies have demonstrated improvements of naming abilities following language treatments.Given the progressive nature of PPA,it is essential to apply language treatment in the early stages of the disease.展开更多
引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impair...引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impairment of Cognition Classification Consensus Study,VICCCS）,旨在就VCI的诊断原则（VICCCS-1）和诊断方案（VICCCS-2）达成一致意见.本文提供了VICCCS-2的相关内容.方法使用VICCCS-1达成的原则和已发表的诊断指南作为在线德尔菲（Delphi）调查的参考基点,以期对VCI的临床诊断达成共识.结果共进行了6轮调查,每轮有65～79名专家参与,他们就VICCCS修订的轻度和重度VCI的诊断指南达成共识,并肯定了美国国立神经疾病与卒中研究所-加拿大卒中网（National Institute of Neurological Disorders and Stroke–Canadian Stroke Network,NINDS-CSN）发布的神经心理学评估方案和对影像学检查的推荐意见.讨论VICCCS-2建议规范化应用NINDS-CSN推荐的神经心理学和影像学评估方案诊断VCI,以促进研究协作.展开更多
Background:The aggregation of amyloidβ(Aβ)is central in the pathogenesis of Alzheimer’s disease(AD).Recently it has been shown that specifically,larger,Thioflavin T-binding Aβaggregates are associated with increas...Background:The aggregation of amyloidβ(Aβ)is central in the pathogenesis of Alzheimer’s disease(AD).Recently it has been shown that specifically,larger,Thioflavin T-binding Aβaggregates are associated with increased neuroinflammation and cytokine release.This study was aimed to quantify fibrillary amyloid aggregates,so-called nanoplaques,and investigate their relationship with cytokines in the cerebrospinal fluid(CSF).Methods:CSF was collected from 111 patients assessed for cognitive complaints at the Oslo University Hospital Memory Clinic.The patients were grouped based on their amyloid status.The CSF nanoplaque concentration was quantified with the Thioflavin T-fluorescence correlation spectroscopy(ThT-FCS)assay.The levels of nine cytokines(eotaxin-1,granulocyte stimulating factor,interleukin[IL]-6,IL-7,IL-8,monocyte chemoattractant protein-1,gammainduced protein 10,macrophage inflammatory protein[MIP]-1α,and MIP-1β)were quantified with a magnetic bead-based multiplex assay and read on a Luminex IS 200 instrument.Results:There were 49 amyloid-negative and 62 amyloid-positive patients in the cohort;none of the cytokines differed significantly between the amyloid groups.The increased nanoplaque levels were associated with levels of MIP-1βbelow the lower limit of quantification,and with decreased levels of MIP-1αand IL-8.The associations remained significant when adjusted for age,sex,cognitive function,apolipoproteinε4 status and CSF core biomarker levels.Conclusion:The cytokine levels were not associated with amyloid status in this cohort.The nanoplaque levels were negatively associated with MIP-1β,MIP-1αand IL-8,which is in line with recent findings suggesting that the upregulation of some cytokine markers has a protective role and is negatively associated with AD progression.展开更多
基金funded by the project National Institute for Neurological Research(Programme EXCELES,ID Project No.LX22NPO5107)TEAMING:857560(EU)CZ.02.1.01/0.0/0.0/17_043/0009632(CZ)(to FA and JH)。
文摘Frontotemporal lobar degeneration(FTLD)is a form of progressive dementia characterized by degeneration of the frontal and temporal lobes of the brain.This pathology involves a series of cognitive,behavioral,and neurological symptoms that influence personality,decision-making ability,and language.
基金supported by the Project No.LQ1605 from the National Program of Sustainability II(MEYS CRthe European Regional Development Fund-Project ENOCH(CZ.02.1.01/0.0/0.0/16_019/0000868)+4 种基金the Institutional Support of Excellence 2.LF UK(699012)by the Grant Agency of Charles University(Project no.176317)partially supported by the grants from the Ministry of Education,Youth and Sports of the Czech Republic(PROGRES Q40)from the Ministry of Health of the Czech Republic(RVO–FN HK 00179906)supported by the project IT4Neuro(-degeneration),reg.nr.CZ.02.1.01/0.0/0.0/18_069/0010054
文摘Alzheimer’s disease(AD)is a neurodegenerative disease with long preclinical phase,typically followed by a slow decline in memory,thinking and reasoning abilities.The underlying pathological processes are not yet fully elucidated,although two main disease hallmarks have been associated with AD pathology:amyloid beta species and neurofibrillary tangles.The plaques are deposits of a protein fragment called beta-amyloid(Aβ),which accumulates in the spaces between neurons.Tangles are twisted fibers of the tau protein,which accumulates inside the cells.
文摘We studied the influence of doctor-patient communication skills training on brain functional architecture using resting-state functional MRI（rs-fMRI） with a regional homogeneity（ReHo） method. Ten medical students participated in the study. A 1-year long doctor-patient communication skills training program was conducted. RsfMRI data were collected at baseline, one month and one year after training. There was a significant increase in the communication skills test average scores between baseline and 1-month duration of training（P〈0.001）. After one month of communication skills training, medical students had decreased ReHo in the right superior temporal gyrus compared with the baseline. After one year of communication skills training, students had increased ReHo in multiple regions and decreased ReHo in several regions（P 〈0.05, Alphasim corrected）. The change of ReHo values in the superior temporal gyrus negatively correlated with the change of communication skills scale score between one month after communication skills training and baseline（r=-0.734, P= 0.036）. The training program we used can be an effective approach of improving doctor-patient communication skills, and the training resulted in functional plasticity of the brain’s architecture toward optimizing locally functional organization.
文摘Background: Controversial research has indicated potential neuroprotective qualities of lithium in the prevention of dementia, but it did not lead to a definite conclusion. Aim: We seek to examine whether lithium has a protective effect in an elderly population suffering from bipolar disorder. Patients and Methods: Of a retrospective cohort including 433 patient files that met inclusion criteria (age over 65 years and bipolar disease coded by ICD), 147 files contained enough relevant data. The patients’ files were divided into lithium users (LU) for those who used lithium for at least a minimum of 3 months and non-users (LNU) for those who did not use lithium at all or used it for a period of less than 3 months. We searched for dementia incidence in these two groups. Results: 433 files were collected initially through a computerized search using ICD10 code for bipolar affective disorder. One hundred twenty three files were excluded due to age (younger than 65 years), 7 were excluded due to neurological background, and 49 were excluded due to either a secondary or a not strictly bipolar psychiatric diagnosis. One hundred and seven were excluded due to insufficient/uncertain data. The remainders of 147 files were included in the final analysis. Twenty five of the 147 bipolar patients were diagnosed with dementia (17%). Amongst the 92 LNU patients, 16 developed dementia (17.4%) and of the 55 LU patients, 9 developed dementia (16.4%);Pearson’s χ<sup>2</sup>(1) = 0.026, p Conclusions: No cognitive protective qualities of lithium treatment in elderly bipolar patients were demonstrated by our study.
文摘Objective: To investigate the effects of atorvastatin combined with clopidogrel on inflammatory factors, coagulation and platelet activation in patients with acute cerebral infarction. Methods: A total of 140 cases patients with acute cerebral infarction who were confirmed by clinical and imaging diagnoses were randomly divided into treatment group (70 cases) and control group (70 cases). Both groups were treated routinely before treatment. The observation group was treated with clopidogrel and atorvastatin, while the control group was treated with aspirin and atorvastatin. The changes of inflammatory factors, coagulation function and platelet activation index before and after treatment were compared between the two groups. Result: Before treatment, the levels of serum soluble intercellular adhesion molecule-1 (sICAM-1), transforming growth factor-β (TGF-β), coagulation parameters prothrombin time(PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), coagulation index of platelets platelet -membrane glycoprotein (CD62p), lysosomal granular membrane glycoprotein (CD63), platelet-monocyte aggregates (PMA), coagulation parameters were not statistically significant. After treatment, the levels of sICAM-1, CD62p, CD63, PMA and FIB in both groups decreased and the levels of TGF-β, PT and APTT increased. The levels of sICAM-1, FIB, CD62p, CD63 and PMA in the observation group were (370.32±37.13) ng/mL, (1.97±0.21) g/L, (1.38±0.14)%, (0.22±0.02)%, and (18.47+1.85)% respectively, which were lower than those in the control group ((410.47±42.32) ng/mL, (2.58±0.26) s, (2.67±0.27)%, (0.35±0.03)% and (22.87±2.91)%)While the levels of TGF-β, PT and APPT were (231.53±23.52) ng/mL, (15.42±1.53) s, (37.31±3.54) s were higher than the control group ((218.56±22.17) ng/mL, (12.32±1.27) s and (29.89±3.01)s)And the differences were significant. Conclusion: Atorvastatin combined with clopidogrel treatment can effectively relieve the inflammatory response, reduce the release of inflammatory cytokines, improve blood coagulation and inhibit platelet aggregation in patients with acute cerebral infarction. So it deserves further clinical promotion.
文摘The volume of the amygdala is reduced in advanced Alzheimer’s disease (AD). However, there is controversy whether amygdala atrophy is present in mild AD and in the transitional phase between health and the onset of dementia. The aim of this prospective longitudinal study was to investigate whether amygdala atrophy is present in subjects with questionable dementia and mild dementia and whether amygdala volume is associated with the future rate of cognitive change, that is the annual change in the Mini Mental State Examination (MMSE). At baseline, volum es of the amygdala were measured in 97 participants aged 70-87 years (40 contro ls, 33 patients with questionable dementia, 24 patients with mild AD) using magn etic resonance imaging. Eighty-six participants were clinically re-examined af ter 2.3 years on average. At baseline, significant differences in mean amygdala volume were found between controls and participants with mild AD. There was no s ignificant correlation between the longitudinal annual change in MMSE and the ba seline amygdala volume in any of the three groups.
基金supported by the Spanish Ministerio de Ciencia y Tecnología(FIS:PI07/0593 and PI10/00587,ISCIII-RETIC RED HERACLES RD06/0009/002-FEDER).
文摘Alzheimer’s disease (AD) is a neurodegenerative disease characterized by senile plaques and neurofibrillary tangles. Senile plaques are deposits of amyloid ?-peptide (A?) produced by the cleavage of a transmembrane protein termed Amyloid Precursor Protein (APP). The amyloidogenic cleavage of APP is performed by γ-secretase complex and ?-site APP cleaving enzyme 1 (BACE1), a key enzyme in AD that can be activated by different noxious stimuli. Interestingly, some viruses could activate double-stranded RNA-activated protein kinase (PKR), which phosphorylates Eukaryotic Initiation Factor 2 alpha (eIF2α). This phosphorylation stops global translation to avoid any synthesis of viral infective proteins, but paradoxically up-regulates BACE1 translation. One of the viral mechanisms to circumvent eIF2α phosphorylation is the recruitment of protein phosphatase 1 (PP1), to fully dephosphorylate eIF2α and allow viral protein synthesis. Due to the functional relationship between BACE1, PKR, PP1 and AD we have performed a large (1122 cases and 1191 control individuals) case-control genetic analysis using two biallelic polymorphisms rs2254958 and rs7480390, located within the genes coding for PKR and the catalytic unit A of PP1, respectively. Although a trend to association of the rs2254958 TT genotype with AD risk was found, our results show that neither rs7480390 nor rs2254958 are associated with AD susceptibility.
文摘In this study, the performance of Sevcik’s algorithm that calculates the fractal dimension and permutation entropy as discriminants to detect calming and insight meditation in electroencephalo-graphic (EEG) signals was assessed. The proposed methods were applied to EEG recordings from meditators practicing insight meditation and calming meditation before as well as during both types of meditation. Analysis was conducted using statistical hypothesis testing to determine the validity of the proposed meditation-identifying techniques. For both types of meditation, there was a statistically significant reduction in the permutation entropy. This result can be explained by the increased EEG synchronization, which is repeatedly observed in the course of meditation. In contrast, the fractal dimension (FD) was significantly increased during calming meditation, but during insight meditation, no statistically significant change was detected. Increased FD during meditation can be interpreted as an increase in self-similarity of EEG signals during self-organisation of hierarchical structure oscillators in the brain. Our results indicate that fractal dimension and permutation entropy could be used as parameters to detect both types of meditation. The permutation entropy is advantageous compared with the fractal dimension because it does not require a stationary signal.
基金This work was supported by the Italian Ministry of Health(Ricerca Corrente and Giovani Ricercatori grant GR-2018-12365105).
文摘Background Primary progressive aphasia(PPA)is a neurodegenerative disorder characterized by a gradual,insidious and progressive loss of language abilities,with naming difficulties being an early and persistent impairment common to all three variants.In the absence of effective pharmacological treatments and given the progressive nature of the disorder,in the past few decades,many studies have investigated the effectiveness of language training to minimize the functional impact of word-finding difficulties in daily life.Main body We review language treatments most commonly used in clinical practice among patients with different variants of PPA,with a focus on the enhancement of spoken and written naming abilities.Generalization of gains to the ability to name untrained stimuli or to other language abilities and the maintenance of these results over time are also discussed.Forty-eight studies were included in this literature review,identifying four main types of language treatment:a)lexical retrieval treatment,b)phonological and/or orthographic treatment,c)semantic treatment,and d)a multimodality approach treatment.Overall,language training is able to induce immediate improvements of naming abilities in all variants of PPA.Moreover,despite the large variability among results,generalization and long-term effects can be recorded after the training.The reviewed studies also suggest that one factor that determines the choice of a particular approach is the compromised components of the lexical/semantic processing system.Conclusion The majority of studies have demonstrated improvements of naming abilities following language treatments.Given the progressive nature of PPA,it is essential to apply language treatment in the early stages of the disease.
文摘引言血管性认知损害（vascular cognitive impairment,VCI）诊断共识的缺乏（体现为多种不同评估方案的使用）,妨碍了对其理解和治疗的推进.多个国家的大量临床医生和研究人员参与了2个阶段血管性认知损害分类共识研究（Vascular Impairment of Cognition Classification Consensus Study,VICCCS）,旨在就VCI的诊断原则（VICCCS-1）和诊断方案（VICCCS-2）达成一致意见.本文提供了VICCCS-2的相关内容.方法使用VICCCS-1达成的原则和已发表的诊断指南作为在线德尔菲（Delphi）调查的参考基点,以期对VCI的临床诊断达成共识.结果共进行了6轮调查,每轮有65～79名专家参与,他们就VICCCS修订的轻度和重度VCI的诊断指南达成共识,并肯定了美国国立神经疾病与卒中研究所-加拿大卒中网（National Institute of Neurological Disorders and Stroke–Canadian Stroke Network,NINDS-CSN）发布的神经心理学评估方案和对影像学检查的推荐意见.讨论VICCCS-2建议规范化应用NINDS-CSN推荐的神经心理学和影像学评估方案诊断VCI,以促进研究协作.
基金This work was supported by funding from the Olav Thon Foundation,The Norwegian Health Association,Swedish Foundation for Strategic Research(SBE13-0115)Swedish Research Council(VR 2018-05337)+3 种基金Olle Engkvists Foundation(199-0480)Magnus Bergvalls Foundation(2018-02642)Region Stockholm(ALF projects 20180365 and 20190561)The funding agencies had no influence on the study design,data collection,data analysis,interpretation of the data or the manuscript writing.
文摘Background:The aggregation of amyloidβ(Aβ)is central in the pathogenesis of Alzheimer’s disease(AD).Recently it has been shown that specifically,larger,Thioflavin T-binding Aβaggregates are associated with increased neuroinflammation and cytokine release.This study was aimed to quantify fibrillary amyloid aggregates,so-called nanoplaques,and investigate their relationship with cytokines in the cerebrospinal fluid(CSF).Methods:CSF was collected from 111 patients assessed for cognitive complaints at the Oslo University Hospital Memory Clinic.The patients were grouped based on their amyloid status.The CSF nanoplaque concentration was quantified with the Thioflavin T-fluorescence correlation spectroscopy(ThT-FCS)assay.The levels of nine cytokines(eotaxin-1,granulocyte stimulating factor,interleukin[IL]-6,IL-7,IL-8,monocyte chemoattractant protein-1,gammainduced protein 10,macrophage inflammatory protein[MIP]-1α,and MIP-1β)were quantified with a magnetic bead-based multiplex assay and read on a Luminex IS 200 instrument.Results:There were 49 amyloid-negative and 62 amyloid-positive patients in the cohort;none of the cytokines differed significantly between the amyloid groups.The increased nanoplaque levels were associated with levels of MIP-1βbelow the lower limit of quantification,and with decreased levels of MIP-1αand IL-8.The associations remained significant when adjusted for age,sex,cognitive function,apolipoproteinε4 status and CSF core biomarker levels.Conclusion:The cytokine levels were not associated with amyloid status in this cohort.The nanoplaque levels were negatively associated with MIP-1β,MIP-1αand IL-8,which is in line with recent findings suggesting that the upregulation of some cytokine markers has a protective role and is negatively associated with AD progression.
