BACKGROUND Cardiogenic embolism caused by patent foramen ovale(PFO)is a common etiology of cryptogenic stroke(CS),particularly in young and middle-aged patients.Studies about right-to-left shunt(RLS)detection using co...BACKGROUND Cardiogenic embolism caused by patent foramen ovale(PFO)is a common etiology of cryptogenic stroke(CS),particularly in young and middle-aged patients.Studies about right-to-left shunt(RLS)detection using contrast-enhanced transcranial Doppler(c-TCD)are numerous.According to the time phase and number of microbubbles detected on c-TCD,RLS can be classified and graded.We hypothesized that the characteristics of an infarction lesion on diffusion-weighted imaging differs when combining the type and grade of RLS on c-TCD in patients with PFO-related CS.AIM To explore the characteristics of infarction lesions on diffusion-weighted imaging when combining the RLS type and grade determined by c-TCD.METHODS We retrospectively evaluated CS patients from August 2015 to December 2019 at a tertiary hospital.In total,111 PFO-related CS patients were divided according to whether RLS was permanent(microbubbles detected both at resting state and after the Valsalva maneuver)or latent(microbubbles detected only after the Valsalva maneuver)on c-TCD.Each group was subdivided into small,mild and large RLS according to the grade of shunt on c-TCD.A normal control group was composed of 33 patients who suffered from simple dizziness.Intragroup and intergroup differences were analyzed in terms of clinical,laboratory and diffusion-weighted imaging lesion characteristics.The correlation between RLS grade evaluated by c-TCD and size of PFO determined by transesophageal echocardiography were also analyzed.RESULTS In 111 patients with PFO-related CS,68 had permanent RLS and 43 had latent RLS.Clinical characteristics and laboratory tests were not significantly different among the permanent RLS,latent RLS and normal control groups.The proportion of patients with multiple territory lesions in the permanent RLS group(50%)was larger than that in the latent RLS group(27.91%;P=0.021).Posterior circulation was more likely to be affected in the latent RLS group than in the permanent RLS group(30.23%vs 8.82%,P=0.004).Permanent-large and latent-large RLS were both more likely to be related to multiple(P_(trend)=0.017 and 0.009,respectively),small(P_(trend)=0.035 and 0.006,respectively)and cortical(P_(trend)=0.031 and 0.033,respectively)lesions.The grade of RLS evaluated by c-TCD was correlated to the size of PFO determined by transesophageal echocardiography(r=0.758,P<0.001).CONCLUSION Distribution of the infarct suggested the possible type of RLS.Multiple,small and cortical infarcts suggest large RLS induced by a large PFO.展开更多
BACKGROUND: If changes of hemodynamics in internal or external cranial artery and stenosis of atherosclerosis are found early, patients with transient ischemic attack (TIA) may be treated at an early phase so as to pr...BACKGROUND: If changes of hemodynamics in internal or external cranial artery and stenosis of atherosclerosis are found early, patients with transient ischemic attack (TIA) may be treated at an early phase so as to prevent and decrease the onset of cerebral infarction. Carotid Doppler can analyze carotid canal wall, hemodynamic properties and stenosis, and changes of plaque morphology; however, transcranial Doppler (TCD) can evaluate vascular stenosis and occlusion and judge collateral circulation in cranium through detecting velocity and direction of blood flow. Can the association of them increase the diagnostic rate of TIA? OBJECTIVE: To evaluate the effect of the association of carotid Doppler and TCD on TIA in internal carotid artery. DESIGN: Contrast observational study. SETTING: Department of Neuroelectrophysiology, Central People’s Hospital of Huizhou. PARTICIPANTS: A total of 54 patients with TIA in internal carotid artery were selected from the Department of Neurology of Huizhou Central People’s Hospital from May 2004 to June 2005. There were 35 males and 24 females aged 46-81 years. The clinical situation was asthenia of single limb, hemiplegia, anaesthesia of single upper or lower limb, hemianesthesia, sensory disorder and aphasia. The symptoms lasted for less than 2 hours. All cases were diagnosed with CT, and those who had pathological changes of acute cerebral infarction and history of cardiac disease were excluded. Additionally, 50 healthy subjects who were regarded as control group were selected from the Department of Neurology of Huizhou Central People’s Hospital. There were 30 males and 20 females aged 45-80 years. All subjects were consent. METHODS: HD15000 color Doppler ultrasound (Philips Company, USA) and Muliti-DopX2 TCD (DWL Company, Germany) were used to detect hemodynamics, stenosis and distribution of atherosclerosis in carotid artery and internal carotid artery. Evaluation of marker: Stenosis was calculated by the ratio between the minimal cavity and vascular sectional area at the maximal site of plaque (mild: stenosis < 50%; moderate and severe: stenosis ≥ 50%). With TCD, the following results were regarded as stenosis: blood velocity of average envelope > 120 cm/s (diagnostic criteria of vascular stenosis of basilar artery: blood velocity of average envelope > 80 cm/s), increase and segmental property of blood flow, and murmu of turbulent flow and vessel. MAIN OUTCOME MEASURES: Positive rate of atherosclerosis and incidence of stenosis with carotid Doppler and TCD. RESULTS: All 54 TIA patients and 50 healthy subjects were involved in the final analysis. ① Results of carotid Doppler: Atherosclerosis and stenosis were obvious in experimental group. Positive rate of atherosclerosis was 85% (46/54) and incidence of stenosis of carotid artery was 41% (22/54), which were higher than those in control group [52% (26/54), 41% (22/54), χ2 = 13.42, 10.90, P < 0.01]. ② Results of TCD: In experimental group, positive rate of atherosclerosis at base of skull was 89% (48/54) and incidence of stenosis of internal cranial artery was 48% (26/54), which were higher than those in control group [62% (31/50), 0, χ2 = 10.28, 32.00, P < 0.01]. Stenosis of artery was mainly involved in middle cerebral artery, initial segment and crotch of carotid artery. CONCLUSION: The association of carotid Doppler and TCD can increase clinically diagnostic rate of TIA and provide bases for apposition and intensity of TIA lesion.展开更多
BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to ...BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to severe hypoxic-ischemic encephalopathy (HIE).OBJECTIVE: To observe the abnormal results of HIE at different degrees detected with BEAM and TCD in infant patients, and compare the detection results at the same time point between BEAM, TCD and computer tomography (CT) examinations.DESIGN: Contrast observation.SETTING: Departments of Neuro-electrophysiology and Pediatrics, Second Affiliated Hospital of Qiqihar Medical College.PARTICIPANTS: Totally 416 infant patients with HIE who received treatment in the Department of Newborn Infants, Second Affiliated Hospital of Qiqihar Medical College during January 2001 and December 2005. The infant patients, 278 male and 138 female, were at embryonic 37 to 42 weeks and weighing 2.0 to 4.1 kg, and they were diagnosed with CT and met the diagnostic criteria of HIE of newborn infants compiled by Department of Neonatology, Pediatric Academy, Chinese Medical Association. According to diagnostic criteria, 130 patients were mild abnormal, 196 moderate abnormal and 90 severe abnormal. The relatives of all the infant patients were informed of the experiment. METHODS: BEAM and TCD examinations were performed in the involved 416 infant patients with HIE at different degrees with DYD2000 16-channel BEAM instrument and EME-2000 ultrasonograph before preliminary diagnosis treatment (within 1 month after birth) and 1,3,6,12 and 24 months after birth, and detected results were compared between BEAM, TCD and CT examinations. MAIN OUTCOME MEASURES: Comparison of detection results of HIE at different time points in infant patients between BEAM, TCD and CT examinations.RESULTS: All the 416 infant patients with HIE participated in the result analysis. ① Comparison of the detected results in infant patients with mild HIE at different time points after birth between BEAM, TCD and CT examinations: BEAM examination showed that the recovery was delayed, and the abnormal rate of BEAM examination was significantly higher than that of CT examination 1 and 3 months after birth [55.4%(72/130)vs. 17.0%(22/130),χ2=41.66;29.2%(38/130) vs. 6.2%(8/130),χ2=23.77,P < 0.01], exceptional patients had mild abnormality and reached the normal level in about 6 months. TCD examination showed that the disease condition significantly improved and infant patients with HIE basically recovered 1 or 2 months after birth, while CT examination showed that infant patients recovered 3 or 4 months after birth. ② Comparison of detection results of infant patients with moderate HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination 1,3,6 and 12 months after birth [90.8%(178/196),78.6%(154/196),χ2=4.32,P < 0.05;64.3%(126/196),43.9%(86/196),χ2=16.44;44.9%(88/196),22.4%(44/196),χ2=22.11;21.4%(42/196),10.2%(20/196),χ2=9.27,P < 0.01]. BEAM examination showed that there was still one patient who did not completely recovered in the 24th month due to the relatives of infant patients did not combine the treatment,. TCD examination showed that the abnormal rate was 23.1%(30/196)in the 1st month after birth, and all the patients recovered to the normal in the 3rd month after birth, while CT examination showed that mild abnormality still existed in the 24th month after birth(1.0%,2/196). ③ Comparison of detection results of infant patients with severe HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination in the 1st, 3rd, 6th and 12th months after birth[86.7%(78/90),44.4%(40/90),χ2=35.53;62.2%(56/90),31.1%(28/90),χ2=17.51;37.8%(34/90),6.7%(6/90),χ2=27.14,P < 0.01]. BEAM examination showed that mild abnormality still existed in 4 infant patients in the 24th month after birth. TCD examination showed that the abnormal rate was 11.1% (10/90) in the 3rd month after birth, and all the infant patients recovered in the 6th month after birth. CT examination showed that the abnormal rate was 6.7%(6/90) in the 12th month after birth, and all of infant patients recovered to the normal in the 24th month after birth.CONCLUSION: BEAM is the direct index to detect brain function of infant patients with HIE, and positive reaction is still very sensitive in the tracking detection of convalescent period. The positive rate of morphological reaction in CT examination is superior to that in TCD examination, and the positive rate is very high in the acute period of HIE in examination.展开更多
Objective:For patients with early acute cerebral infarction(ACI),transcranial Doppler ultrasound was used in the clinical examination,and its application effect was observed and analyzed.Methods:This study was carried...Objective:For patients with early acute cerebral infarction(ACI),transcranial Doppler ultrasound was used in the clinical examination,and its application effect was observed and analyzed.Methods:This study was carried out between October 2018 and October 2019.50 patients with ACI included as the research object was evaluated by transcranial Doppler and CT examination,and the application of the two examination methods was compared.Results:The results of transcranial Doppler examination showed that the abnormal rate of blood flow velocity and the ratio of both sides(VACA)in patients with early ACI was higher than that of CT examination.Conclusion:With the impact on the location and area of vascular occlusion in patients,VACA can effectively reflect the status and effectiveness of the collateral circulation function of the patient’s pia vessels during cerebral infarction.展开更多
Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) tr...Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.展开更多
Objective To explore the effect of locally using dexamethasone on the blood flow velocity in the middle cerebral artery(FVmca) and cerebral edema after brain injury. Methods 20 rabbits were classified to 2 groups, gro...Objective To explore the effect of locally using dexamethasone on the blood flow velocity in the middle cerebral artery(FVmca) and cerebral edema after brain injury. Methods 20 rabbits were classified to 2 groups, group A( the control group) and B (the treated group). An experimental rabbit model was conducted to contusion by bone window plasty with extradural hitting. Group B was treated by locally infiltrating of dexamethasone at equidistance to lesions. Group A was given normal saline the same way as Group B. The changes of FVmca using trans－cranial Doppler and moisture in brain tissues were observed. Results The normal value of FVmca was (31.8± 4.5)cm/s, while the value of FVmca in group A and B were (15.4± 3.9)cm/s and (22.1± 3.5)cm/s separately.Water content in damaged hemisphere in Group A and B were (81.54± 0.55)％ and (79.35± 0.50)％ respectively. There was a significant difference between the 2 groups (P<0.05). The levels of FVmca in group A and B were lower than that of control and there was also a significant difference between group A and B (P<0.05).Conclusions FVmca decreased and the brain moisture increased after brain injury while FVmca increased and the brain moisture reduced after treatment with dexamethasone. It demonstreated that local treatment of dexamethasone had an obvious therapeutical effect on brain injury.展开更多
Sickle-cell disease (SCD) is the most common cause of ischemic stroke in children and it happens in about 11% of patients between the age of 2 and 20 years old. About 7% of the world population is affected by hemoglob...Sickle-cell disease (SCD) is the most common cause of ischemic stroke in children and it happens in about 11% of patients between the age of 2 and 20 years old. About 7% of the world population is affected by hemoglobin disorders, mostly sickle cell anemia. SCD has a high prevalence in the population of African offspring and it is a public health problem in Brazil that affects more than 30,000 million people. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. Transcranial Doppler Ultrasonography (TCD) to SCD patients can be a valuable service that results in a significant decrease of first stroke rates. In this work, we present a review about TCD as an effective strategy to detect children with SCD who are at risk for stroke.展开更多
Transcranial Doppler(TCD) is useful for investigation of intracranial arterial blood flow and can be used to detect a real-time embolic signal. Unfortunately, artefacts can mimic the embolic signal, complicating inter...Transcranial Doppler(TCD) is useful for investigation of intracranial arterial blood flow and can be used to detect a real-time embolic signal. Unfortunately, artefacts can mimic the embolic signal, complicating interpretation and necessitating expert-level opinion to distinguish the two. Resolving this situation is critical to achieve improved accuracy and utility of TCD for patients with disrupted intracranial arterial blood flow, such as stroke victims. A common type of stroke encountered in the clinic is cryptogenic stroke(or stroke with undetermined etiology), and patent foramen ovale(PFO) has been associated with the condition. An early clinical trial of PFO closure effect on secondary stroke prevention failed to demonstrate any benefit for the therapy, and research into the PFO therapy generally diminished. However, the recent publication of large randomized control trials with demonstrated benefit of PFO closure for recurrent stroke prevention has rekindled the interest in PFO in patients with cryptogenic stroke. To confirm that emboli across the PFO can reach the brain, TCD should be applied to detect the air embolic signal after injection of agitated saline bubbles at the antecubital vein. In addition, the automated embolic signal detection method should further facilitate use of TCD for air embolic signal detection after the agitated saline bubbles injection in patients with cryptogenic stroke and PFO.展开更多
BACKGROUND: Latest researches at home and abroad indicate that glycerol trinitrate plays its function because it can metabolize into nitrogen monoxide (NO) in vivo. OBJECTIVE: To study the therapeutic effects of NO ve...BACKGROUND: Latest researches at home and abroad indicate that glycerol trinitrate plays its function because it can metabolize into nitrogen monoxide (NO) in vivo. OBJECTIVE: To study the therapeutic effects of NO vector of ultrasonic atomizing inhalation on vertebro-basilar artery insufficiency (VBI) through transcranial Doppler (TCD) detection and serum NO content and indirect effect of TCD on cerebral blood flow changes. DESIGN: Randomized grouping and controlled clinical study. SETTING: Department of Neurology, the Fourth People's Hospital of Jinan. PARTICIPANTS: A total of 130 patients who were diagnosed as VBI were selected from Department of Neurology, the Fourth People's Hospital of Jinan from December 2001 to December 2005. The involved inpatients were checked by CT and MRI, and met the VBI diagnostic standard enacted by the Fourth National Academic Meeting of Cerebrovascular Disease in 1995. All patients and their relatives provided the confirmed consent. They were randomly divided into low-dose treatment group (n =60), high-lose treatment group (n =30) and control group (n =40). METHODS: Patients in the low-dose and high-dose treatment groups were given ultrasonic atomizing inhalation of 3 mg and 5 mg glycerol trinitrate, respectively, for 20 minutes, once a day. In addition, ligustrazine and energy mixture were used once a day for three days in a course. Cases in the control group were only given ligustrazine and energy mixture. All selected cases accepted TCD, blood NO content was checked at the time of beginning, after the first time and after a period of treatment. According to the TCD test, VBI patients were divided into two groups (high-low flow velocity). The vertebral artery (VA) and basal artery (BA) of left or right sides were detected by 2 Hz detector via occipital window. MAIN OUTCOME MEASURES: ① Blood flow velocity of systolic phase, blood flow velocity of diastole phase and vascular resistance in left and right VA and BA detected by using TCD before treatment, after treatment for one course; ② content of serum NO indirectly measured by using nitric acid disoxidation technique. RESULTS: All 130 VBI patients were involved in the final analysis. ① Changes of hemodynamic indexes: Systolic phase of VA and diastole phase of BA were higher in low-dose treatment group than that in the control group after first treatment, and there was significant difference (P < 0.05); meanwhile, systolic phase and diastole phase of VA and systolic phase of BA were also higher in treatment group than that in the control group after one course (P < 0.05). However, both systolic phase and diastole phase of VA and BA were lower in high-dose treatment group than that in the control group after first treatment and one course, and there was significant difference (P < 0.05). ② Content of serum NO: After first treatment, there was no significant difference between low-dose treatment group and high-dose treatment group (P > 0.05); but both groups were higher than control group, and there was significant difference (P < 0.05, 0.01). CONCLUSION: NO vector of ultrasonic atomizing inhalation can improve VBI so as to improve cerebral blood-supply state.展开更多
AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic res...AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic resonance angiogram(MRA) in patients with sickle cell disease. METHODS: A retrospective evaluation was performed of the outcomes in all patients with a Transcranial Doppler examination at our institution since the implementation of the hospital picture archiving and communication system(PACS) system in January 2003 through December 2012. All ultrasound imaging exams were performed by the same technologist with a 3 MHz transducer. Inclusion criteria was based upon the Transcranial Doppler procedure code in our PACS which had an indication of sickle cell disease in the history. The patient's age and gender along with the vessel with the highest time averaged mean velocity as well as the highest peak systolic velocity was recorded for analysis. A subset of the study cohort also had subsequent MR imaging and Angiograms performed within 6 mo of the TCD examination. MRI results were categorized as having a disease related abnormality(vessel narrowing, collateral formation/moya-moya, or abnormal fluid attenuation inversion recovery signal in parenchyma indicative of prior stroke) or normal. The MRI results formed the comparison standards for TCD exams in evaluating intracranial injury. Sensitivity and specificity for the two TCD criteria(TAMV and PSV) were calculated to determine which could be a better predictor for intracranial vasculopathy /clinically occult strokes.RESULTS: The study cohort for our institution was 110patients with a total of 291 TCD examinations. These patients had a mean age of 7.6 years with a range from 2-18 years of age. Sixty-two of the 110 patients(56%) had two or more TCD exams. Thirty-seven patients(34%) had at least one MRI following a TCD examination. Of the 291 TCD examinations, 46(16%) were conditional or abnormal by TAMV criteria. One hundred and sixteen(40%) were conditional or abnormal by PSV criteria. All studies that were abnormal by TAMV were also abnormal by PSV criteria. Seventy of the 116(60%) studies which were conditional or abnormal by peak systolic criteria would not have been identified by time averaged mean maximum velocity criteria. The most frequent location of highest velocity measurement was noted to be in the middle cerebral artery regardless of whether it was measured by PSV or TAMV. From the 37 patients having one or more MRIs, 43 MRI exams were performed within 6 mo of a TCD examination. Twenty two(51%) MRIs had a disease related abnormality reported. When evaluating conditional or abnormal exams by PSV criteria against follow-up MRI/MRA, the sensitivity was 73% [16/(16 + 6)] and specificity was 81% [17/(4 + 17)]. When evaluating conditional or abnormal exams by TAMV criteria by follow-up MRI/MRA as the gold standard, the sensitivity was 41% [9/(9 + 13)] and the specificity was 100% [21/(21 + 0)]. In using conditional or abnormal criteria from PSV and TAMV to predict abnormalities on followup MRI/MR Angiogram, PSV was more sensitive(73% vs 41%) while TAMV was more specific(100% vs 81%). CONCLUSION: Based on the data obtained at our institution and using the assumption that the best screening test is the one with the highest sensitivity, the peak systolic velocity could be the measurement of choice for TCD screening.展开更多
Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuro...Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuropsychiatric and neurological disorders,albeit with varying success.The rationale behind the use of NIBS has historically been that stim ulation techniques modulate neuronal activity in the targeted region and consequently induce plasticity which can lead to therapeutic outcomes.展开更多
To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,es...To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,especially transcranial magnetic stimulation(TMS)and transcranial electrical stimulation,have been increasingly used for the treatment of brain diseases,including insomnia disorder.展开更多
INTRODUCTION Repetitive transcranial magnetic stimulation(rTMS)is a neuroplasticity-enhancing technique that modifies brain responsiveness to various therapeutic modalities in clinical psychiatric and neurological app...INTRODUCTION Repetitive transcranial magnetic stimulation(rTMS)is a neuroplasticity-enhancing technique that modifies brain responsiveness to various therapeutic modalities in clinical psychiatric and neurological applications. Furthermore,its effect can be attributed to long-term potentiation(LTP)or longterm depression(LTD)-like neuroplasticity.However,responsiveness to rTMS is largely variable in healthy and pathological brains and is mediated by complex biological mechanisms.Metaplasticity refers to a higher-order plasticity mechanism in which the direction and magnitude of synaptic plasticity are modified by prior neuronal activity and is believed to be a significant factor leading to the response variability of rTMs.展开更多
In this paper we present a new experimental observation using a conventional reflectometry technique,poloidal correlation reflectometry(PCR),in the Experimental Advanced Superconducting Tokamak(EAST).The turbulence sp...In this paper we present a new experimental observation using a conventional reflectometry technique,poloidal correlation reflectometry(PCR),in the Experimental Advanced Superconducting Tokamak(EAST).The turbulence spectrum detected by the PCR system exhibits an asymmetry and induced Doppler shift f_(D)during the internal kink mode(IKM)rotation phase.This Doppler shift f_(D)is the target measurement of Doppler reflectometry,but captured by conventional reflectometry.Results show that the Doppler shift f_(D)is modulated by the periodic changes in the effective angle between the probing wave and cutoff layer normal,but not by plasma turbulence.The fishbone mode and saturated long-lived mode are typical IKMs,and this modulation phenomenon is observed in both cases.Moreover,the value of the Doppler shift f_(D)is positively correlated with the amplitude of the IKM,even when the latter is small.However,the positive and negative frequency components of the Doppler shift f_(D)can be asymmetric,which is related to the plasma configuration.A simulated analysis is performed by ray tracing to verify these observations.These results establish a clear link between f_(D)and IKM rotation,and are helpful for studying the characteristics of IKM and related physical phenomena.展开更多
An innovative complex lidar system deployed on an airborne rotorcraft platform for remote sensing of atmospheric pollution is proposed and demonstrated.The system incorporates integrated-path differential absorption l...An innovative complex lidar system deployed on an airborne rotorcraft platform for remote sensing of atmospheric pollution is proposed and demonstrated.The system incorporates integrated-path differential absorption lidar(DIAL) and coherent-doppler lidar(CDL) techniques using a dual tunable TEA CO_(2)laser in the 9—11 μm band and a 1.55 μm fiber laser.By combining the principles of differential absorption detection and pulsed coherent detection,the system enables agile and remote sensing of atmospheric pollution.Extensive static tests validate the system’s real-time detection capabilities,including the measurement of concentration-path-length product(CL),front distance,and path wind speed of air pollution plumes over long distances exceeding 4 km.Flight experiments is conducted with the helicopter.Scanning of the pollutant concentration and the wind field is carried out in an approximately 1 km slant range over scanning angle ranges from 45°to 65°,with a radial resolution of 30 m and10 s.The test results demonstrate the system’s ability to spatially map atmospheric pollution plumes and predict their motion and dispersion patterns,thereby ensuring the protection of public safety.展开更多
Pulse echo accumulation is commonly employed in coherent Doppler wind LiDAR(light detection and ranging)under the assumption of steady wind.Here,the measured spectral data are analyzed in the time dimension and freque...Pulse echo accumulation is commonly employed in coherent Doppler wind LiDAR(light detection and ranging)under the assumption of steady wind.Here,the measured spectral data are analyzed in the time dimension and frequency dimension to cope with the temporal wind shear and achieve the optimal accumulation time.A hardware-efficient algorithm combining the interpolation and cross-correlation is used to enhance the wind retrieval accuracy by reducing the frequency sampling interval and then reduce the spectral width calculation error.Moreover,the temporal broadening effect and spatial broadening effect are decoupled according to the strategy we developed.展开更多
Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility ...Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.展开更多
BACKGROUND Speech disorders have a substantial impact on communication abilities and quality of life.Traditional treatments such as speech and psychological therapies frequently demonstrate limited effectiveness and p...BACKGROUND Speech disorders have a substantial impact on communication abilities and quality of life.Traditional treatments such as speech and psychological therapies frequently demonstrate limited effectiveness and patient compliance.Transcranial electrical stimulation(TES)has emerged as a promising non-invasive treatment to improve neurological functions.However,its effectiveness in enhancing language functions and serum neurofactor levels in individuals with speech disorders requires further investigation.AIM To investigate the impact of TES in conjunction with standard therapies on serum neurotrophic factor levels and language function in patients with speech disorders.METHODS In a controlled study spanning from March 2019 to November 2021,81 patients with speech disorders were divided into a control group(n=40)receiving standard speech stimulation and psychological intervention,and an observation group(n=41)receiving additional TES.The study assessed serum levels of ciliary neurotrophic factor(CNTF),glial cell-derived neurotrophic factor(GDNF),brainderived neurotrophic factor(BDNF),and nerve growth factor(NGF),as well as evaluations of motor function,language function,and development quotient scores.RESULTS After 3 wk of intervention,the observation group exhibited significantly higher serum levels of CNTF,GDNF,BDNF,and NGF compared to the control group.Moreover,improvements were noted in motor function,cognitive function,language skills,physical abilities,and overall development quotient scores.It is worth mentioning that the observation group also displayed superior perfor CONCLUSION This retrospective study concluded that TES combined with traditional speech and psychotherapy can effectively increase the levels of neurokines in the blood and enhance language function in patients with speech disorders.These results provide a promising avenue for integrating TES into standard treatment methods for speech disorders.展开更多
The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted...The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.展开更多
基金People’s Livelihood Science and Technology Project(Research on Application of Key Technologies)of Suzhou(No.SS202061)Technical Cooperation Project of Soochow University(No.H211064).
文摘BACKGROUND Cardiogenic embolism caused by patent foramen ovale(PFO)is a common etiology of cryptogenic stroke(CS),particularly in young and middle-aged patients.Studies about right-to-left shunt(RLS)detection using contrast-enhanced transcranial Doppler(c-TCD)are numerous.According to the time phase and number of microbubbles detected on c-TCD,RLS can be classified and graded.We hypothesized that the characteristics of an infarction lesion on diffusion-weighted imaging differs when combining the type and grade of RLS on c-TCD in patients with PFO-related CS.AIM To explore the characteristics of infarction lesions on diffusion-weighted imaging when combining the RLS type and grade determined by c-TCD.METHODS We retrospectively evaluated CS patients from August 2015 to December 2019 at a tertiary hospital.In total,111 PFO-related CS patients were divided according to whether RLS was permanent(microbubbles detected both at resting state and after the Valsalva maneuver)or latent(microbubbles detected only after the Valsalva maneuver)on c-TCD.Each group was subdivided into small,mild and large RLS according to the grade of shunt on c-TCD.A normal control group was composed of 33 patients who suffered from simple dizziness.Intragroup and intergroup differences were analyzed in terms of clinical,laboratory and diffusion-weighted imaging lesion characteristics.The correlation between RLS grade evaluated by c-TCD and size of PFO determined by transesophageal echocardiography were also analyzed.RESULTS In 111 patients with PFO-related CS,68 had permanent RLS and 43 had latent RLS.Clinical characteristics and laboratory tests were not significantly different among the permanent RLS,latent RLS and normal control groups.The proportion of patients with multiple territory lesions in the permanent RLS group(50%)was larger than that in the latent RLS group(27.91%;P=0.021).Posterior circulation was more likely to be affected in the latent RLS group than in the permanent RLS group(30.23%vs 8.82%,P=0.004).Permanent-large and latent-large RLS were both more likely to be related to multiple(P_(trend)=0.017 and 0.009,respectively),small(P_(trend)=0.035 and 0.006,respectively)and cortical(P_(trend)=0.031 and 0.033,respectively)lesions.The grade of RLS evaluated by c-TCD was correlated to the size of PFO determined by transesophageal echocardiography(r=0.758,P<0.001).CONCLUSION Distribution of the infarct suggested the possible type of RLS.Multiple,small and cortical infarcts suggest large RLS induced by a large PFO.
文摘BACKGROUND: If changes of hemodynamics in internal or external cranial artery and stenosis of atherosclerosis are found early, patients with transient ischemic attack (TIA) may be treated at an early phase so as to prevent and decrease the onset of cerebral infarction. Carotid Doppler can analyze carotid canal wall, hemodynamic properties and stenosis, and changes of plaque morphology; however, transcranial Doppler (TCD) can evaluate vascular stenosis and occlusion and judge collateral circulation in cranium through detecting velocity and direction of blood flow. Can the association of them increase the diagnostic rate of TIA? OBJECTIVE: To evaluate the effect of the association of carotid Doppler and TCD on TIA in internal carotid artery. DESIGN: Contrast observational study. SETTING: Department of Neuroelectrophysiology, Central People’s Hospital of Huizhou. PARTICIPANTS: A total of 54 patients with TIA in internal carotid artery were selected from the Department of Neurology of Huizhou Central People’s Hospital from May 2004 to June 2005. There were 35 males and 24 females aged 46-81 years. The clinical situation was asthenia of single limb, hemiplegia, anaesthesia of single upper or lower limb, hemianesthesia, sensory disorder and aphasia. The symptoms lasted for less than 2 hours. All cases were diagnosed with CT, and those who had pathological changes of acute cerebral infarction and history of cardiac disease were excluded. Additionally, 50 healthy subjects who were regarded as control group were selected from the Department of Neurology of Huizhou Central People’s Hospital. There were 30 males and 20 females aged 45-80 years. All subjects were consent. METHODS: HD15000 color Doppler ultrasound (Philips Company, USA) and Muliti-DopX2 TCD (DWL Company, Germany) were used to detect hemodynamics, stenosis and distribution of atherosclerosis in carotid artery and internal carotid artery. Evaluation of marker: Stenosis was calculated by the ratio between the minimal cavity and vascular sectional area at the maximal site of plaque (mild: stenosis < 50%; moderate and severe: stenosis ≥ 50%). With TCD, the following results were regarded as stenosis: blood velocity of average envelope > 120 cm/s (diagnostic criteria of vascular stenosis of basilar artery: blood velocity of average envelope > 80 cm/s), increase and segmental property of blood flow, and murmu of turbulent flow and vessel. MAIN OUTCOME MEASURES: Positive rate of atherosclerosis and incidence of stenosis with carotid Doppler and TCD. RESULTS: All 54 TIA patients and 50 healthy subjects were involved in the final analysis. ① Results of carotid Doppler: Atherosclerosis and stenosis were obvious in experimental group. Positive rate of atherosclerosis was 85% (46/54) and incidence of stenosis of carotid artery was 41% (22/54), which were higher than those in control group [52% (26/54), 41% (22/54), χ2 = 13.42, 10.90, P < 0.01]. ② Results of TCD: In experimental group, positive rate of atherosclerosis at base of skull was 89% (48/54) and incidence of stenosis of internal cranial artery was 48% (26/54), which were higher than those in control group [62% (31/50), 0, χ2 = 10.28, 32.00, P < 0.01]. Stenosis of artery was mainly involved in middle cerebral artery, initial segment and crotch of carotid artery. CONCLUSION: The association of carotid Doppler and TCD can increase clinically diagnostic rate of TIA and provide bases for apposition and intensity of TIA lesion.
文摘BACKGROUND: It has been proved that brain electrical activity mapping (BEAM) and transcranial Doppler (TCD) detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to severe hypoxic-ischemic encephalopathy (HIE).OBJECTIVE: To observe the abnormal results of HIE at different degrees detected with BEAM and TCD in infant patients, and compare the detection results at the same time point between BEAM, TCD and computer tomography (CT) examinations.DESIGN: Contrast observation.SETTING: Departments of Neuro-electrophysiology and Pediatrics, Second Affiliated Hospital of Qiqihar Medical College.PARTICIPANTS: Totally 416 infant patients with HIE who received treatment in the Department of Newborn Infants, Second Affiliated Hospital of Qiqihar Medical College during January 2001 and December 2005. The infant patients, 278 male and 138 female, were at embryonic 37 to 42 weeks and weighing 2.0 to 4.1 kg, and they were diagnosed with CT and met the diagnostic criteria of HIE of newborn infants compiled by Department of Neonatology, Pediatric Academy, Chinese Medical Association. According to diagnostic criteria, 130 patients were mild abnormal, 196 moderate abnormal and 90 severe abnormal. The relatives of all the infant patients were informed of the experiment. METHODS: BEAM and TCD examinations were performed in the involved 416 infant patients with HIE at different degrees with DYD2000 16-channel BEAM instrument and EME-2000 ultrasonograph before preliminary diagnosis treatment (within 1 month after birth) and 1,3,6,12 and 24 months after birth, and detected results were compared between BEAM, TCD and CT examinations. MAIN OUTCOME MEASURES: Comparison of detection results of HIE at different time points in infant patients between BEAM, TCD and CT examinations.RESULTS: All the 416 infant patients with HIE participated in the result analysis. ① Comparison of the detected results in infant patients with mild HIE at different time points after birth between BEAM, TCD and CT examinations: BEAM examination showed that the recovery was delayed, and the abnormal rate of BEAM examination was significantly higher than that of CT examination 1 and 3 months after birth [55.4%(72/130)vs. 17.0%(22/130),χ2=41.66;29.2%(38/130) vs. 6.2%(8/130),χ2=23.77,P < 0.01], exceptional patients had mild abnormality and reached the normal level in about 6 months. TCD examination showed that the disease condition significantly improved and infant patients with HIE basically recovered 1 or 2 months after birth, while CT examination showed that infant patients recovered 3 or 4 months after birth. ② Comparison of detection results of infant patients with moderate HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination 1,3,6 and 12 months after birth [90.8%(178/196),78.6%(154/196),χ2=4.32,P < 0.05;64.3%(126/196),43.9%(86/196),χ2=16.44;44.9%(88/196),22.4%(44/196),χ2=22.11;21.4%(42/196),10.2%(20/196),χ2=9.27,P < 0.01]. BEAM examination showed that there was still one patient who did not completely recovered in the 24th month due to the relatives of infant patients did not combine the treatment,. TCD examination showed that the abnormal rate was 23.1%(30/196)in the 1st month after birth, and all the patients recovered to the normal in the 3rd month after birth, while CT examination showed that mild abnormality still existed in the 24th month after birth(1.0%,2/196). ③ Comparison of detection results of infant patients with severe HIE at different time points between BEAM, TCD and CT examinations: The abnormal rate of BEAM examination was significantly higher than that of CT examination in the 1st, 3rd, 6th and 12th months after birth[86.7%(78/90),44.4%(40/90),χ2=35.53;62.2%(56/90),31.1%(28/90),χ2=17.51;37.8%(34/90),6.7%(6/90),χ2=27.14,P < 0.01]. BEAM examination showed that mild abnormality still existed in 4 infant patients in the 24th month after birth. TCD examination showed that the abnormal rate was 11.1% (10/90) in the 3rd month after birth, and all the infant patients recovered in the 6th month after birth. CT examination showed that the abnormal rate was 6.7%(6/90) in the 12th month after birth, and all of infant patients recovered to the normal in the 24th month after birth.CONCLUSION: BEAM is the direct index to detect brain function of infant patients with HIE, and positive reaction is still very sensitive in the tracking detection of convalescent period. The positive rate of morphological reaction in CT examination is superior to that in TCD examination, and the positive rate is very high in the acute period of HIE in examination.
文摘Objective:For patients with early acute cerebral infarction(ACI),transcranial Doppler ultrasound was used in the clinical examination,and its application effect was observed and analyzed.Methods:This study was carried out between October 2018 and October 2019.50 patients with ACI included as the research object was evaluated by transcranial Doppler and CT examination,and the application of the two examination methods was compared.Results:The results of transcranial Doppler examination showed that the abnormal rate of blood flow velocity and the ratio of both sides(VACA)in patients with early ACI was higher than that of CT examination.Conclusion:With the impact on the location and area of vascular occlusion in patients,VACA can effectively reflect the status and effectiveness of the collateral circulation function of the patient’s pia vessels during cerebral infarction.
文摘Non-invasive Doppler ultrasonographic study of cerebral arteries [transcranial Doppler(TCD)] has been extensively applied on both outpatient and inpatient settings. It is performed placing a low-frequency(≤ 2 MHz) transducer on the scalp of the patient over specific acoustic windows, in order to visualize the intracranial arterial vessels and to evaluate the cerebral blood flow velocity and its alteration in many different conditions. Nowadays the most widespread indication for TCD in outpatient setting is the research of right to left shunting, responsable of so called "paradoxical embolism", most often due to patency of foramen ovale which is responsable of the majority of cryptogenic strokes occuring in patients younger than 55 years old. TCD also allows to classify the grade of severity of such shunts using the so called "microembolic signal grading score". In addition TCD has found many useful applications in neurocritical care practice. It is useful on both adults and children for day-to-day bedside assessment of critical conditions including vasospasm in subarachnoidal haemorrhage(caused by aneurysm rupture or traumatic injury), traumatic brain injury, brain stem death. It is used also to evaluate cerebral hemodynamic changes after stroke. It also allows to investigate cerebral pressure autoregulation and for the clinical evaluation of cerebral autoregulatory reserve.
文摘Objective To explore the effect of locally using dexamethasone on the blood flow velocity in the middle cerebral artery(FVmca) and cerebral edema after brain injury. Methods 20 rabbits were classified to 2 groups, group A( the control group) and B (the treated group). An experimental rabbit model was conducted to contusion by bone window plasty with extradural hitting. Group B was treated by locally infiltrating of dexamethasone at equidistance to lesions. Group A was given normal saline the same way as Group B. The changes of FVmca using trans－cranial Doppler and moisture in brain tissues were observed. Results The normal value of FVmca was (31.8± 4.5)cm/s, while the value of FVmca in group A and B were (15.4± 3.9)cm/s and (22.1± 3.5)cm/s separately.Water content in damaged hemisphere in Group A and B were (81.54± 0.55)％ and (79.35± 0.50)％ respectively. There was a significant difference between the 2 groups (P<0.05). The levels of FVmca in group A and B were lower than that of control and there was also a significant difference between group A and B (P<0.05).Conclusions FVmca decreased and the brain moisture increased after brain injury while FVmca increased and the brain moisture reduced after treatment with dexamethasone. It demonstreated that local treatment of dexamethasone had an obvious therapeutical effect on brain injury.
文摘Sickle-cell disease (SCD) is the most common cause of ischemic stroke in children and it happens in about 11% of patients between the age of 2 and 20 years old. About 7% of the world population is affected by hemoglobin disorders, mostly sickle cell anemia. SCD has a high prevalence in the population of African offspring and it is a public health problem in Brazil that affects more than 30,000 million people. Prevention of primary stroke might be feasible with a way to identify children at greatest risk. Transcranial Doppler Ultrasonography (TCD) to SCD patients can be a valuable service that results in a significant decrease of first stroke rates. In this work, we present a review about TCD as an effective strategy to detect children with SCD who are at risk for stroke.
文摘Transcranial Doppler(TCD) is useful for investigation of intracranial arterial blood flow and can be used to detect a real-time embolic signal. Unfortunately, artefacts can mimic the embolic signal, complicating interpretation and necessitating expert-level opinion to distinguish the two. Resolving this situation is critical to achieve improved accuracy and utility of TCD for patients with disrupted intracranial arterial blood flow, such as stroke victims. A common type of stroke encountered in the clinic is cryptogenic stroke(or stroke with undetermined etiology), and patent foramen ovale(PFO) has been associated with the condition. An early clinical trial of PFO closure effect on secondary stroke prevention failed to demonstrate any benefit for the therapy, and research into the PFO therapy generally diminished. However, the recent publication of large randomized control trials with demonstrated benefit of PFO closure for recurrent stroke prevention has rekindled the interest in PFO in patients with cryptogenic stroke. To confirm that emboli across the PFO can reach the brain, TCD should be applied to detect the air embolic signal after injection of agitated saline bubbles at the antecubital vein. In addition, the automated embolic signal detection method should further facilitate use of TCD for air embolic signal detection after the agitated saline bubbles injection in patients with cryptogenic stroke and PFO.
文摘BACKGROUND: Latest researches at home and abroad indicate that glycerol trinitrate plays its function because it can metabolize into nitrogen monoxide (NO) in vivo. OBJECTIVE: To study the therapeutic effects of NO vector of ultrasonic atomizing inhalation on vertebro-basilar artery insufficiency (VBI) through transcranial Doppler (TCD) detection and serum NO content and indirect effect of TCD on cerebral blood flow changes. DESIGN: Randomized grouping and controlled clinical study. SETTING: Department of Neurology, the Fourth People's Hospital of Jinan. PARTICIPANTS: A total of 130 patients who were diagnosed as VBI were selected from Department of Neurology, the Fourth People's Hospital of Jinan from December 2001 to December 2005. The involved inpatients were checked by CT and MRI, and met the VBI diagnostic standard enacted by the Fourth National Academic Meeting of Cerebrovascular Disease in 1995. All patients and their relatives provided the confirmed consent. They were randomly divided into low-dose treatment group (n =60), high-lose treatment group (n =30) and control group (n =40). METHODS: Patients in the low-dose and high-dose treatment groups were given ultrasonic atomizing inhalation of 3 mg and 5 mg glycerol trinitrate, respectively, for 20 minutes, once a day. In addition, ligustrazine and energy mixture were used once a day for three days in a course. Cases in the control group were only given ligustrazine and energy mixture. All selected cases accepted TCD, blood NO content was checked at the time of beginning, after the first time and after a period of treatment. According to the TCD test, VBI patients were divided into two groups (high-low flow velocity). The vertebral artery (VA) and basal artery (BA) of left or right sides were detected by 2 Hz detector via occipital window. MAIN OUTCOME MEASURES: ① Blood flow velocity of systolic phase, blood flow velocity of diastole phase and vascular resistance in left and right VA and BA detected by using TCD before treatment, after treatment for one course; ② content of serum NO indirectly measured by using nitric acid disoxidation technique. RESULTS: All 130 VBI patients were involved in the final analysis. ① Changes of hemodynamic indexes: Systolic phase of VA and diastole phase of BA were higher in low-dose treatment group than that in the control group after first treatment, and there was significant difference (P < 0.05); meanwhile, systolic phase and diastole phase of VA and systolic phase of BA were also higher in treatment group than that in the control group after one course (P < 0.05). However, both systolic phase and diastole phase of VA and BA were lower in high-dose treatment group than that in the control group after first treatment and one course, and there was significant difference (P < 0.05). ② Content of serum NO: After first treatment, there was no significant difference between low-dose treatment group and high-dose treatment group (P > 0.05); but both groups were higher than control group, and there was significant difference (P < 0.05, 0.01). CONCLUSION: NO vector of ultrasonic atomizing inhalation can improve VBI so as to improve cerebral blood-supply state.
文摘AIM: To compare time average maximum mean velocity(TAMV) and peak systolic velocity(PSV) criteria of Trans Cranial Doppler(TCD) in their ability to predict abnormalities on magnetic resonance imaging(MRI)/magnetic resonance angiogram(MRA) in patients with sickle cell disease. METHODS: A retrospective evaluation was performed of the outcomes in all patients with a Transcranial Doppler examination at our institution since the implementation of the hospital picture archiving and communication system(PACS) system in January 2003 through December 2012. All ultrasound imaging exams were performed by the same technologist with a 3 MHz transducer. Inclusion criteria was based upon the Transcranial Doppler procedure code in our PACS which had an indication of sickle cell disease in the history. The patient's age and gender along with the vessel with the highest time averaged mean velocity as well as the highest peak systolic velocity was recorded for analysis. A subset of the study cohort also had subsequent MR imaging and Angiograms performed within 6 mo of the TCD examination. MRI results were categorized as having a disease related abnormality(vessel narrowing, collateral formation/moya-moya, or abnormal fluid attenuation inversion recovery signal in parenchyma indicative of prior stroke) or normal. The MRI results formed the comparison standards for TCD exams in evaluating intracranial injury. Sensitivity and specificity for the two TCD criteria(TAMV and PSV) were calculated to determine which could be a better predictor for intracranial vasculopathy /clinically occult strokes.RESULTS: The study cohort for our institution was 110patients with a total of 291 TCD examinations. These patients had a mean age of 7.6 years with a range from 2-18 years of age. Sixty-two of the 110 patients(56%) had two or more TCD exams. Thirty-seven patients(34%) had at least one MRI following a TCD examination. Of the 291 TCD examinations, 46(16%) were conditional or abnormal by TAMV criteria. One hundred and sixteen(40%) were conditional or abnormal by PSV criteria. All studies that were abnormal by TAMV were also abnormal by PSV criteria. Seventy of the 116(60%) studies which were conditional or abnormal by peak systolic criteria would not have been identified by time averaged mean maximum velocity criteria. The most frequent location of highest velocity measurement was noted to be in the middle cerebral artery regardless of whether it was measured by PSV or TAMV. From the 37 patients having one or more MRIs, 43 MRI exams were performed within 6 mo of a TCD examination. Twenty two(51%) MRIs had a disease related abnormality reported. When evaluating conditional or abnormal exams by PSV criteria against follow-up MRI/MRA, the sensitivity was 73% [16/(16 + 6)] and specificity was 81% [17/(4 + 17)]. When evaluating conditional or abnormal exams by TAMV criteria by follow-up MRI/MRA as the gold standard, the sensitivity was 41% [9/(9 + 13)] and the specificity was 100% [21/(21 + 0)]. In using conditional or abnormal criteria from PSV and TAMV to predict abnormalities on followup MRI/MR Angiogram, PSV was more sensitive(73% vs 41%) while TAMV was more specific(100% vs 81%). CONCLUSION: Based on the data obtained at our institution and using the assumption that the best screening test is the one with the highest sensitivity, the peak systolic velocity could be the measurement of choice for TCD screening.
基金supported by the Bryant Stokes Neurological Research Fund (to JM)a fellowship from Multiple Sclerosis Western Australia (MSWA)+1 种基金the Perron Institute for Neurological and Translational Sciencethe Bryant Stokes Neurological Research Fund (to JR)。
文摘Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuropsychiatric and neurological disorders,albeit with varying success.The rationale behind the use of NIBS has historically been that stim ulation techniques modulate neuronal activity in the targeted region and consequently induce plasticity which can lead to therapeutic outcomes.
基金the National Natural Science Foundation of China(81871426,81871430,82260359,U22A20303)Hebei Provincial Natural Science Foundation(H2020206263,H2020206625)STI2030-Major Projects Program(2022ZD0214500).
文摘To the editor:Insomnia disorder has a serious and widespread detrimental effect on humans with comorbidity with other mental or physical health problems.In recent years,noninvasive brain stimulation(NIBS)techniques,especially transcranial magnetic stimulation(TMS)and transcranial electrical stimulation,have been increasingly used for the treatment of brain diseases,including insomnia disorder.
基金the Shanghai Municipal Health Commission Clinical ResearchProgram(20224Y0220)to ZBStart-up Fundfor RAPs under the Strategic Hiring Scheme(P0048866)and JJZ.
文摘INTRODUCTION Repetitive transcranial magnetic stimulation(rTMS)is a neuroplasticity-enhancing technique that modifies brain responsiveness to various therapeutic modalities in clinical psychiatric and neurological applications. Furthermore,its effect can be attributed to long-term potentiation(LTP)or longterm depression(LTD)-like neuroplasticity.However,responsiveness to rTMS is largely variable in healthy and pathological brains and is mediated by complex biological mechanisms.Metaplasticity refers to a higher-order plasticity mechanism in which the direction and magnitude of synaptic plasticity are modified by prior neuronal activity and is believed to be a significant factor leading to the response variability of rTMs.
基金supported by the National Key R&D Program of China(Nos.2022YFE03050003,2022YFE03020004,2019YFE03080200,2022YFE03070004)National Natural Science Foundation of China(Nos.12275315,11875289,12175277,11975271)+3 种基金partly supported by the Youth Science and Technology Talents Support Program(2020)by Anhui Association for Science and Technology(No.RCTJ202009)the Science Foundation of Institute of Plasma Physics,Chinese Academy of Sciences(No.DSJJ2021-08)the China Postdoctoral Science Foundation(No.2021M703256)the Director Funding of Hefei Institutes of Physical Science,Chinese Academy of Sciences(No.YZJJ2022QN16)。
文摘In this paper we present a new experimental observation using a conventional reflectometry technique,poloidal correlation reflectometry(PCR),in the Experimental Advanced Superconducting Tokamak(EAST).The turbulence spectrum detected by the PCR system exhibits an asymmetry and induced Doppler shift f_(D)during the internal kink mode(IKM)rotation phase.This Doppler shift f_(D)is the target measurement of Doppler reflectometry,but captured by conventional reflectometry.Results show that the Doppler shift f_(D)is modulated by the periodic changes in the effective angle between the probing wave and cutoff layer normal,but not by plasma turbulence.The fishbone mode and saturated long-lived mode are typical IKMs,and this modulation phenomenon is observed in both cases.Moreover,the value of the Doppler shift f_(D)is positively correlated with the amplitude of the IKM,even when the latter is small.However,the positive and negative frequency components of the Doppler shift f_(D)can be asymmetric,which is related to the plasma configuration.A simulated analysis is performed by ray tracing to verify these observations.These results establish a clear link between f_(D)and IKM rotation,and are helpful for studying the characteristics of IKM and related physical phenomena.
文摘An innovative complex lidar system deployed on an airborne rotorcraft platform for remote sensing of atmospheric pollution is proposed and demonstrated.The system incorporates integrated-path differential absorption lidar(DIAL) and coherent-doppler lidar(CDL) techniques using a dual tunable TEA CO_(2)laser in the 9—11 μm band and a 1.55 μm fiber laser.By combining the principles of differential absorption detection and pulsed coherent detection,the system enables agile and remote sensing of atmospheric pollution.Extensive static tests validate the system’s real-time detection capabilities,including the measurement of concentration-path-length product(CL),front distance,and path wind speed of air pollution plumes over long distances exceeding 4 km.Flight experiments is conducted with the helicopter.Scanning of the pollutant concentration and the wind field is carried out in an approximately 1 km slant range over scanning angle ranges from 45°to 65°,with a radial resolution of 30 m and10 s.The test results demonstrate the system’s ability to spatially map atmospheric pollution plumes and predict their motion and dispersion patterns,thereby ensuring the protection of public safety.
基金Project supported by the Shanghai Science and Technology Innovation Action(Grant No.22dz1208700).
文摘Pulse echo accumulation is commonly employed in coherent Doppler wind LiDAR(light detection and ranging)under the assumption of steady wind.Here,the measured spectral data are analyzed in the time dimension and frequency dimension to cope with the temporal wind shear and achieve the optimal accumulation time.A hardware-efficient algorithm combining the interpolation and cross-correlation is used to enhance the wind retrieval accuracy by reducing the frequency sampling interval and then reduce the spectral width calculation error.Moreover,the temporal broadening effect and spatial broadening effect are decoupled according to the strategy we developed.
文摘Trigeminal neuralgia is a severe,disabling pain and its deafferentation remains a challenge for health providers.Transcranial direct current stimulation is a non-invasive stimulation technique which finds new utility in managing pain.There-fore,the introduction of alternative,non-invasive,safe,and effective methods should be considered in treating patients with trigeminal neuralgia unresponsive to conventional treatment.
文摘BACKGROUND Speech disorders have a substantial impact on communication abilities and quality of life.Traditional treatments such as speech and psychological therapies frequently demonstrate limited effectiveness and patient compliance.Transcranial electrical stimulation(TES)has emerged as a promising non-invasive treatment to improve neurological functions.However,its effectiveness in enhancing language functions and serum neurofactor levels in individuals with speech disorders requires further investigation.AIM To investigate the impact of TES in conjunction with standard therapies on serum neurotrophic factor levels and language function in patients with speech disorders.METHODS In a controlled study spanning from March 2019 to November 2021,81 patients with speech disorders were divided into a control group(n=40)receiving standard speech stimulation and psychological intervention,and an observation group(n=41)receiving additional TES.The study assessed serum levels of ciliary neurotrophic factor(CNTF),glial cell-derived neurotrophic factor(GDNF),brainderived neurotrophic factor(BDNF),and nerve growth factor(NGF),as well as evaluations of motor function,language function,and development quotient scores.RESULTS After 3 wk of intervention,the observation group exhibited significantly higher serum levels of CNTF,GDNF,BDNF,and NGF compared to the control group.Moreover,improvements were noted in motor function,cognitive function,language skills,physical abilities,and overall development quotient scores.It is worth mentioning that the observation group also displayed superior perfor CONCLUSION This retrospective study concluded that TES combined with traditional speech and psychotherapy can effectively increase the levels of neurokines in the blood and enhance language function in patients with speech disorders.These results provide a promising avenue for integrating TES into standard treatment methods for speech disorders.
文摘The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.
