As a new type of nerve regulation technology, Vagus Nerve Stimulation is currently used in the treatment of nervous system diseases. Auricular Vagus Nerve Stimulation has become one of the research hotspots in this fi...As a new type of nerve regulation technology, Vagus Nerve Stimulation is currently used in the treatment of nervous system diseases. Auricular Vagus Nerve Stimulation has become one of the research hotspots in this field, because there is no implantation risk. However, there is no unified standard for the treatment parameters of aVNS for nervous system diseases. In this paper, the research progress of the anatomical structure and parameters of the vagus nerve and its role in nervous system diseases are reviewed to provide basis for further research.展开更多
Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from dam...Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.展开更多
Neurodegenerative diseases are often misdiagnosed,especially when the diagnosis is based solely on clinical symptoms.The p75 neurotrophic receptor(p75^(NTR))has been studied as an index of sensory and motor nerve deve...Neurodegenerative diseases are often misdiagnosed,especially when the diagnosis is based solely on clinical symptoms.The p75 neurotrophic receptor(p75^(NTR))has been studied as an index of sensory and motor nerve development and maturation.Its cleavable extracellular domain(ECD)is readily detectable in various biological fluids including plasma,serum and urine.There is evidence for increased p75NTR ECD levels in neurodegenerative diseases such as Alzheimer’s disease,amyotrophic lateral sclerosis,age-related dementia,schizophrenia,and diabetic neuropathy.Whether p75^(NTR) ECD could be used as a biomarker for diagnosis and/or prognosis in these disorders,and whether it could potentially lead to the development of targeted therapies,remains an open question.In this review,we present and discuss published studies that have evaluated the relevance of this emerging biomarker in the context of various neurodegenerative diseases.We also highlight areas that require further investigation to better understand the role of p75^(NTR) ECD in the clinical diagnosis and management of neurodegenerative disorders.展开更多
Retinal and optic nerve diseases are degenerative ocular pathologies which lead to irreversible visual loss. Since the advanced therapies availability, cell-based therapies offer a new all-encompassing approach. Advan...Retinal and optic nerve diseases are degenerative ocular pathologies which lead to irreversible visual loss. Since the advanced therapies availability, cell-based therapies offer a new all-encompassing approach. Advances in the knowledge of neuroprotection, immunomodulation and regenerative properties of mesenchymal stem cells(MSCs) have been obtained by several preclinical studies of various neurodegenerative diseases. It has provided the opportunity to perform the translation of this knowledge to prospective treatment approaches for clinical practice. Since 2008, several first steps projecting new treatment approaches, have been taken regarding the use of cell therapy in patients with neurodegenerative pathologies of optic nerve and retina. Most of the clinical trials using MSCs are in Ⅰ/Ⅱ phase, recruiting patients or ongoing, and they have as main objective the safety assessment of MSCs using various routes of administration. However, it is important to recognize that, there is still a long way to go to reach clinical trials phase Ⅲ-Ⅳ. Hence, it is necessary to continue preclinical and clinical studies to improve this new therapeutic tool. This paper reviews the latest progress of MSCs in human clinical trials for retinal and optic nerve diseases.展开更多
OBJECTIVE:China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine.More than 10 years ago,in 2003,nerve growth factor injection was listed as a national drug.The goal ...OBJECTIVE:China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine.More than 10 years ago,in 2003,nerve growth factor injection was listed as a national drug.The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases.DATA RETRIEVAL:A computer-based retrieval was performed from six databases,including the Cochrane Library,Pub Med,EMBASE,Sino Med,CNKI,and the VIP database,searching from the clinical establishment of nerve growth factor for treatment until December 31,2013.The key words for the searches were "nerve growth factor,randomized controlled trials" in Chinese and in English.DATA SELECTION:Inclusion criteria:any study published in English or Chinese referring to randomized controlled trials of nerve growth factor;patients with neurological diseases such as peripheral nerve injury,central nerve injury,cranial neuropathy,and nervous system infections;patients older than 7 years;similar research methods and outcomes assessing symptoms;and measurement of nerve conduction velocities.The meta-analysis was conducted using Review Manager 5.2.3 software.MAIN OUTCOME MEASURES:The total effective rate,the incidence of adverse effects,and the nerve conduction velocity were recorded for each study.RESULTS:Sixty-four studies involving 6,297 patients with neurological diseases were included.The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group(P < 0.0001,RR:1.35,95%CI:1.30–1.40).The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group(P < 0.00001,MD:4.59 m/s,95%CI:4.12–5.06).The incidence of pain or scleroma at the injection site in the nerve growth factor group was also higher than that in the control group(P < 0.00001,RR:6.30,95%CI:3.53–11.27),but such adverse effects were mild.CONCLUSION:Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective.展开更多
This critical review of the literature shows that there is a close link between the microbiome,the gut,and the brain in Parkinson's disease.The vagus nerve,the main component of the parasympathetic nervous system,...This critical review of the literature shows that there is a close link between the microbiome,the gut,and the brain in Parkinson's disease.The vagus nerve,the main component of the parasympathetic nervous system,is involved in the regulation of immune response,digestion,heart rate,and control of mood.It can detect microbiota metabolites through its afferents,transferring this gut information to the central nervous system.Preclinical and clinical studies have shown the important role played by the gut microbiome and gut-related factors in disease development and progression,as well as treatment responses.These findings suggest that the gut microbiome may be a valuable target for new therapeutic strategies for Parkinson's disease.More studies are needed to better understand the underlying biology and how this axis can be modulated for the patient's benefit.展开更多
We describe a rare case of an arteriovenous malformation(AVM) embedded in the vestibulocochlear nerve presenting with subarachnoid hemorrhage(SAH) treated by microsurgical elimination of the main feeding artery and pa...We describe a rare case of an arteriovenous malformation(AVM) embedded in the vestibulocochlear nerve presenting with subarachnoid hemorrhage(SAH) treated by microsurgical elimination of the main feeding artery and partial nidus volume reduction with no permanent deficits. This 70-year-old woman was incidentally diagnosed 4 years previously with two small unruptured tandem aneurysms(ANs) on the right anterior inferior cerebral artery feeding a small right cerebellopontine angle AVM. The patient was followed conservatively until she developed sudden headache, nausea and vomiting and presented to our outpatient clinic after several days. Magnetic resonance imaging demonstrated findings suggestive of early subacute SAH in the quadrigeminal cistern. A microsurgical flow reduction technique via clipping between the two ANs and partial electrocoagulation of the nidus buried within the eighth cranial nerve provided radiographical devascularization of the ANs with residual AVM shunt flow and no major deficits during the 2.5 year follow-up. This is only the second report of an auditory nerve AVM. In the event of recurrence, reoperation or application of alternative therapies may be considered.展开更多
AIM: To observe the changes in the thickness of peripapillary retinal nerve fiber layer(p RNFL) and peripapillary vessel density(pVD) in patients with different stages of Parkinson's disease(PD).METHODS: Totally 4...AIM: To observe the changes in the thickness of peripapillary retinal nerve fiber layer(p RNFL) and peripapillary vessel density(pVD) in patients with different stages of Parkinson's disease(PD).METHODS: Totally 47 patients(47 eyes) with primary PD were divided into the mild group and the moderateto-severe group according to Hoehn & Yahr(H&Y) stage. Among them, there were 27 cases(27 eyes) in mild group and 20 cases(20 eyes) in moderate-to-severe group. And 20 cases(20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography(OCTA) examinations. The pRNFL thickness, total vessel density(tVD) and capillary vessel density(cVD) of the optic disc in average, superior half, inferior half, superior nasal(SN), nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior temporal(IT), temporal inferior(TI), temporal superior(TS), and superior temporal(ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-Ⅲ score in patients with PD, respectively.RESULTS: There were significant differences in p RNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups(P<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-Ⅲ score, respectively(P<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups(P<0.05). In PD group, the tVD of whole image and the c VD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively(P<0.05);the cVD of TS quadrant was negatively correlated with UPDRS-Ⅲ score(P<0.05).CONCLUSION: The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-Ⅲ score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-Ⅲ score.展开更多
The contactin-associated protein(Caspr) family participates in nerve excitation and conduction, and neurotransmitter release in myelinated axons. We analyzed the structures and functions of the Caspr family–CNTNAP1(C...The contactin-associated protein(Caspr) family participates in nerve excitation and conduction, and neurotransmitter release in myelinated axons. We analyzed the structures and functions of the Caspr family–CNTNAP1(Caspr1), CNTNAP2(Caspr2), CNTNAP3(Caspr3), CNTNAP4(Caspr4) and CNTNAP5(Caspr5), Caspr1–5 is not only involved in the formation of myelinated axons, but also participates in maintaining the stability of adjacent connections. Caspr1 participates in the formation, differentiation, and proliferation of neurons and astrocytes, and in motor control and cognitive function. We also analyzed the relationship between the Caspr family and neurodegenerative diseases, multiple sclerosis, and autoimmune encephalitis. However, the effects of Caspr on disease course and prognosis remain poorly understood. The effects of Caspr on disease diagnosis and treatment need further investigation.展开更多
Lamotrigine(LTG)is a widely used drug for the treatment of epilepsy.Emerging clinical evidence suggests that LTG may improve cognitive function in patients with Alzheimer’s disease.However,the underlying molecular me...Lamotrigine(LTG)is a widely used drug for the treatment of epilepsy.Emerging clinical evidence suggests that LTG may improve cognitive function in patients with Alzheimer’s disease.However,the underlying molecular mechanisms remain unclear.In this study,amyloid precursor protein/presenilin 1(APP/PS1)double transgenic mice were used as a model of Alzheimer’s disease.Five-month-old APP/PS1 mice were intragastrically administered 30 mg/kg LTG or vehicle once per day for 3 successive months.The cognitive functions of animals were assessed using Morris water maze.Hyperphosphorylated tau and markers of synapse and glial cells were detected by western blot assay.The cell damage in the brain was investigated using hematoxylin and eosin staining.The levels of amyloid-βand the concentrations of interleukin-1β,interleukin-6 and tumor necrosis factor-αin the brain were measured using enzyme-linked immunosorbent assay.Differentially expressed genes in the brain after LTG treatment were analyzed by high-throughput RNA sequencing and real-time polymerase chain reaction.We found that LTG substantially improved spatial cognitive deficits of APP/PS1 mice;alleviated damage to synapses and nerve cells in the brain;and reduced amyloid-βlevels,tau protein hyperphosphorylation,and inflammatory responses.High-throughput RNA sequencing revealed that the beneficial effects of LTG on Alzheimer’s disease-related neuropathologies may have been mediated by the regulation of Ptgds,Cd74,Map3k1,Fosb,and Spp1 expression in the brain.These findings revealed potential molecular mechanisms by which LTG treatment improved Alzheimer’s disease.Furthermore,these data indicate that LTG may be a promising therapeutic drug for Alzheimer’s disease.展开更多
The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disord...The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disorders but also in systemic diseases.Systemic diseases can trigger the inflammatory responses in the central nervous system,occasionally leading to sustained inflammation and functional disturbance of the central nervous system.This review summarizes the current knowledge on the association between glymphatic dysfunction and central nervous system inflammation.In addition,we discuss the hypothesis that disease conditions initially associated with peripheral inflammation ove rwhelm the performance of the glymphatic system,thereby triggering central nervous system dysfun ction,chronic neuroinflammation,and neurodegeneration.Future research investigating the role of the glymphatic system in neuroinflammation may offer innovative therapeutic approaches for central nervous system disorders.展开更多
背景:眩晕与临床神经科疾病密切相关。当神经元受损或死亡时,可能导致前庭系统的异常,引发眩晕症状,因此有必要探讨并分析临床神经科常见的眩晕相关热点问题。目的:采用文献计量学方法分析临床神经科常见的眩晕相关国内外的研究热点。方...背景:眩晕与临床神经科疾病密切相关。当神经元受损或死亡时,可能导致前庭系统的异常,引发眩晕症状,因此有必要探讨并分析临床神经科常见的眩晕相关热点问题。目的:采用文献计量学方法分析临床神经科常见的眩晕相关国内外的研究热点。方法:由第一作者检索2014-2023年万方数据库和Web of Science核心集数据库,检索临床神经科常见的眩晕治疗的研究相关文献,采用VOSviewer_1.6.19软件对文献的发文量、国家/地区、机构、关键词、共被引文献及高被引文献进行计量学分析,剖析总结该研究领域的研究热点。结果与结论:(1)Web of Science核心集数据库2022年该领域文献发文量174篇最高,万方数据库2020年该领域文献发文量最高133篇;发文量最高的国家前3位分别是美国、德国、中国;国际机构中发文量最高的是德国慕尼黑大学,中国机构中发文量最高的是成都中医药大学。(2)关键词分析结果显示,中国该领域的研究热点疾病主要为梅尼埃病、颈性眩晕、老年性眩晕、良性阵发性位置性眩晕、孤立性眩晕和高血压眩晕,治疗方法包括针刺、康复、药物(天麻素、半夏白术天麻汤)和手法复位。国际上该领域的研究热点疾病主要包括良性阵发性位置性眩晕、新冠病毒病例的前庭性疾病、梅尼埃病、前庭神经鞘瘤、听神经瘤和前庭性偏头痛等,热点治疗方法为传统抗眩晕药物、抗抑郁、抗焦虑治疗和显微手术等。(3)文献共被引分析结果显示,对于以持续性眩晕为主要症状的急性前庭综合征而言,三步骤床边眼动检查(HINTS:头部-冲击-眼球震颤-斜视测试)在急性前庭综合征患者合并脑卒中的诊断方面比早期MRI更敏感,此观点是最被同行认可的前庭综合征脑卒中检测方法;对以阵发性眩晕为主要症状的前庭神经炎患者而言,使用激素治疗更有效。(4)高被引文献分析结果显示,在万方数据库中近10年热点文献中,针刺风池穴、“小醒脑开窍”针刺法改善后循环缺血性眩晕均取得了一定成效,近3年文献发现银杏叶提取物+天麻素、针刺+半夏白术汤、倍他司汀+天麻素、前庭康复训练+Epley耳石复位法,都可以不同程度地改善眩晕症状。而近10年Web of Science核心集数据中的文献并无特色性抗眩晕药物受到关注,大部分以传统抗眩晕药物和显微手术为主,但近3年国际文献中有少数病例报告发现COVID-19感染后可能导致前庭神经炎并出现眩晕症状。(5)眩晕的发生和发展可能与神经元的损伤和再生密切相关,例如,病毒感染、炎症刺激或其他病理因素可能导致神经元损伤或死亡,从而影响前庭系统的功能。目前国内外都发布了眩晕相关的诊治规范指南,国际指南较为推荐前庭康复和物理康复联合治疗眩晕症状,中国指南较为推荐中西医药物、复位及针刺联合治疗,但研究证据级别并不高,因此未来还需要大量的大样本、多中心关于抗眩晕治疗的随机对照试验来验证。展开更多
Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative...Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative diseases. Proper regulation of mitophagy is crucial for maintaining homeostasis; conversely, inadequate removal of mitochondria through mitophagy leads to the generation of oxidative species, including reactive oxygen species and reactive nitrogen species, resulting in various neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These diseases are most prevalent in older adults whose bodies fail to maintain proper mitophagic functions to combat oxidative species. As mitophagy is essential for normal body function, by targeting mitophagic pathways we can improve these disease conditions. The search for effective remedies to treat these disease conditions is an ongoing process, which is why more studies are needed. Additionally, more relevant studies could help establish therapeutic conditions, which are currently in high demand. In this review, we discuss how mitophagy plays a significant role in homeostasis and how its dysregulation causes neurodegeneration. We also discuss how combating oxidative species and targeting mitophagy can help treat these neurodegenerative diseases.展开更多
文摘As a new type of nerve regulation technology, Vagus Nerve Stimulation is currently used in the treatment of nervous system diseases. Auricular Vagus Nerve Stimulation has become one of the research hotspots in this field, because there is no implantation risk. However, there is no unified standard for the treatment parameters of aVNS for nervous system diseases. In this paper, the research progress of the anatomical structure and parameters of the vagus nerve and its role in nervous system diseases are reviewed to provide basis for further research.
文摘Corneal neuromas,also termed microneuromas,refer to microscopic,irregula rly-shaped enlargements of terminal subbasal nerve endings at sites of nerve damage or injury.The formation of corneal neuromas results from damage to corneal nerves,such as following corneal pathology or corneal or intraocular surge ries.Initially,denervated areas of sensory nerve fibers become invaded by sprouts of intact sensory nerve fibers,and later injured axons regenerate and new sprouts called neuromas develop.In recent years,analysis of corneal nerve abnormalities including corneal neuromas which can be identified using in vivo confocal microscopy,a non-invasive imaging technique with microscopic resolution,has been used to evaluate corneal neuropathy and ocular surface dysfunction.Corneal neuromas have been shown to be associated with clinical symptoms of discomfort and dryness of eyes,and are a promising surrogate biomarker for ocular surface diseases,such as neuropathic corneal pain,dry eye disease,diabetic corneal neuropathy,neurotrophic keratopathy,Sjogren's syndrome,bullous keratopathy,post-refra ctive surgery,and others.In this review,we have summarized the current literature on the association between these ocular surface diseases and the presentation of corneal microneuromas,as well as elaborated on their pathogenesis,visualization via in vivo confocal microscopy,and utility in monitoring treatment efficacy.As current quantitative analysis on neuromas mainly relies on manual annotation and quantification,which is user-dependent and labor-intensive,future direction includes the development of artificial intelligence software to identify and quantify these potential imaging biomarkers in a more automated and sensitive manner,allowing it to be applied in clinical settings more efficiently.Combining imaging and molecular biomarkers may also help elucidate the associations between corneal neuromas and ocular surface diseases.
文摘Neurodegenerative diseases are often misdiagnosed,especially when the diagnosis is based solely on clinical symptoms.The p75 neurotrophic receptor(p75^(NTR))has been studied as an index of sensory and motor nerve development and maturation.Its cleavable extracellular domain(ECD)is readily detectable in various biological fluids including plasma,serum and urine.There is evidence for increased p75NTR ECD levels in neurodegenerative diseases such as Alzheimer’s disease,amyotrophic lateral sclerosis,age-related dementia,schizophrenia,and diabetic neuropathy.Whether p75^(NTR) ECD could be used as a biomarker for diagnosis and/or prognosis in these disorders,and whether it could potentially lead to the development of targeted therapies,remains an open question.In this review,we present and discuss published studies that have evaluated the relevance of this emerging biomarker in the context of various neurodegenerative diseases.We also highlight areas that require further investigation to better understand the role of p75^(NTR) ECD in the clinical diagnosis and management of neurodegenerative disorders.
基金Supported by A grants from the Consejería de Educación de la Junta de Castilla y León,No.VA118U14the Centro en Red de Medicina Regenerativa y Terapia Celular de la Junta de Castilla y León,47011 Valladolid
文摘Retinal and optic nerve diseases are degenerative ocular pathologies which lead to irreversible visual loss. Since the advanced therapies availability, cell-based therapies offer a new all-encompassing approach. Advances in the knowledge of neuroprotection, immunomodulation and regenerative properties of mesenchymal stem cells(MSCs) have been obtained by several preclinical studies of various neurodegenerative diseases. It has provided the opportunity to perform the translation of this knowledge to prospective treatment approaches for clinical practice. Since 2008, several first steps projecting new treatment approaches, have been taken regarding the use of cell therapy in patients with neurodegenerative pathologies of optic nerve and retina. Most of the clinical trials using MSCs are in Ⅰ/Ⅱ phase, recruiting patients or ongoing, and they have as main objective the safety assessment of MSCs using various routes of administration. However, it is important to recognize that, there is still a long way to go to reach clinical trials phase Ⅲ-Ⅳ. Hence, it is necessary to continue preclinical and clinical studies to improve this new therapeutic tool. This paper reviews the latest progress of MSCs in human clinical trials for retinal and optic nerve diseases.
基金supported by the National Science and Technology Major Projects for "Major New Drugs Innovation and Development",No.2012ZX09201-301-005
文摘OBJECTIVE:China is the only country where nerve growth factor is approved for large-scale use as a clinical medicine.More than 10 years ago,in 2003,nerve growth factor injection was listed as a national drug.The goal of this article is to evaluate comprehensively the efficacy and safety of nerve growth factor for the treatment of neurological diseases.DATA RETRIEVAL:A computer-based retrieval was performed from six databases,including the Cochrane Library,Pub Med,EMBASE,Sino Med,CNKI,and the VIP database,searching from the clinical establishment of nerve growth factor for treatment until December 31,2013.The key words for the searches were "nerve growth factor,randomized controlled trials" in Chinese and in English.DATA SELECTION:Inclusion criteria:any study published in English or Chinese referring to randomized controlled trials of nerve growth factor;patients with neurological diseases such as peripheral nerve injury,central nerve injury,cranial neuropathy,and nervous system infections;patients older than 7 years;similar research methods and outcomes assessing symptoms;and measurement of nerve conduction velocities.The meta-analysis was conducted using Review Manager 5.2.3 software.MAIN OUTCOME MEASURES:The total effective rate,the incidence of adverse effects,and the nerve conduction velocity were recorded for each study.RESULTS:Sixty-four studies involving 6,297 patients with neurological diseases were included.The total effective rate in the group treated with nerve growth factor was significantly higher than that in the control group(P < 0.0001,RR:1.35,95%CI:1.30–1.40).The average nerve conduction velocity in the nerve growth factor group was significantly higher than that in the control group(P < 0.00001,MD:4.59 m/s,95%CI:4.12–5.06).The incidence of pain or scleroma at the injection site in the nerve growth factor group was also higher than that in the control group(P < 0.00001,RR:6.30,95%CI:3.53–11.27),but such adverse effects were mild.CONCLUSION:Nerve growth factor can significantly improve nerve function in patients with nervous system disease and is safe and effective.
基金Medical School of the Christus University Center(UNICHRISTUS)Federal University of Ceará(UFC)Fundacao de AmparoàPesquisa do Estado de S?o Paulo(FAPESP,grants 2021/06473-4)(to JCCS)。
文摘This critical review of the literature shows that there is a close link between the microbiome,the gut,and the brain in Parkinson's disease.The vagus nerve,the main component of the parasympathetic nervous system,is involved in the regulation of immune response,digestion,heart rate,and control of mood.It can detect microbiota metabolites through its afferents,transferring this gut information to the central nervous system.Preclinical and clinical studies have shown the important role played by the gut microbiome and gut-related factors in disease development and progression,as well as treatment responses.These findings suggest that the gut microbiome may be a valuable target for new therapeutic strategies for Parkinson's disease.More studies are needed to better understand the underlying biology and how this axis can be modulated for the patient's benefit.
文摘We describe a rare case of an arteriovenous malformation(AVM) embedded in the vestibulocochlear nerve presenting with subarachnoid hemorrhage(SAH) treated by microsurgical elimination of the main feeding artery and partial nidus volume reduction with no permanent deficits. This 70-year-old woman was incidentally diagnosed 4 years previously with two small unruptured tandem aneurysms(ANs) on the right anterior inferior cerebral artery feeding a small right cerebellopontine angle AVM. The patient was followed conservatively until she developed sudden headache, nausea and vomiting and presented to our outpatient clinic after several days. Magnetic resonance imaging demonstrated findings suggestive of early subacute SAH in the quadrigeminal cistern. A microsurgical flow reduction technique via clipping between the two ANs and partial electrocoagulation of the nidus buried within the eighth cranial nerve provided radiographical devascularization of the ANs with residual AVM shunt flow and no major deficits during the 2.5 year follow-up. This is only the second report of an auditory nerve AVM. In the event of recurrence, reoperation or application of alternative therapies may be considered.
文摘AIM: To observe the changes in the thickness of peripapillary retinal nerve fiber layer(p RNFL) and peripapillary vessel density(pVD) in patients with different stages of Parkinson's disease(PD).METHODS: Totally 47 patients(47 eyes) with primary PD were divided into the mild group and the moderateto-severe group according to Hoehn & Yahr(H&Y) stage. Among them, there were 27 cases(27 eyes) in mild group and 20 cases(20 eyes) in moderate-to-severe group. And 20 cases(20 eyes) who were included in the control group were healthy people who came to our hospital for health screening at the same time. All participants underwent optical coherence tomography angiography(OCTA) examinations. The pRNFL thickness, total vessel density(tVD) and capillary vessel density(cVD) of the optic disc in average, superior half, inferior half, superior nasal(SN), nasal superior(NS), nasal inferior(NI), inferior nasal(IN), inferior temporal(IT), temporal inferior(TI), temporal superior(TS), and superior temporal(ST) were measured. One-way ANOVA was used to compare the differences of optic disc parameters among the three groups, and Pearson and Spearman correlations were used to analyze the correlation between pRNFL, pVD and the disease duration, H&Y stage and UPDRS-Ⅲ score in patients with PD, respectively.RESULTS: There were significant differences in p RNFL thickness in average, superior half, inferior half, SN, NS, IN, IT and ST quadrants among the three groups(P<0.05). In PD group, the pRNFL thickness in average, superior half, inferior half, NS and IT quadrants were negatively correlated with H&Y stage and UPDRS-Ⅲ score, respectively(P<0.05). There were statistically significant differences in the cVD of whole image, inferior half, NI and TS quadrants, the tVD of the whole image, inferior half, and peripapillary among the three groups(P<0.05). In PD group, the tVD of whole image and the c VD of NI and TS quadrants were negatively correlated with the H&Y stage, respectively(P<0.05);the cVD of TS quadrant was negatively correlated with UPDRS-Ⅲ score(P<0.05).CONCLUSION: The thickness of pRNFL in PD patients is significantly decreased, and it is negatively correlated with H&Y stage and UPDRS-Ⅲ score. With the increase of the severity of the disease, the pVD parameters in PD patients increase at first in the mild group, and then decrease in the moderate-to-severe group, and negatively correlate with H&Y stage and UPDRS-Ⅲ score.
基金supported by a grant from the Instructional Program of Science and Technology Bureau of Wuxi City of China,No.0302B010507130039PB
文摘The contactin-associated protein(Caspr) family participates in nerve excitation and conduction, and neurotransmitter release in myelinated axons. We analyzed the structures and functions of the Caspr family–CNTNAP1(Caspr1), CNTNAP2(Caspr2), CNTNAP3(Caspr3), CNTNAP4(Caspr4) and CNTNAP5(Caspr5), Caspr1–5 is not only involved in the formation of myelinated axons, but also participates in maintaining the stability of adjacent connections. Caspr1 participates in the formation, differentiation, and proliferation of neurons and astrocytes, and in motor control and cognitive function. We also analyzed the relationship between the Caspr family and neurodegenerative diseases, multiple sclerosis, and autoimmune encephalitis. However, the effects of Caspr on disease course and prognosis remain poorly understood. The effects of Caspr on disease diagnosis and treatment need further investigation.
基金supported by the National Natural Science Foundation of China, No. 81771140 (to YDZ)the Natural Science Foundation of Jiangsu Province of China, No. BK20201117 (to YDZ)Jiangsu “Six One Project” for Distinguished Medical Scholars of China, No. LGY2020013 (to TJ)
文摘Lamotrigine(LTG)is a widely used drug for the treatment of epilepsy.Emerging clinical evidence suggests that LTG may improve cognitive function in patients with Alzheimer’s disease.However,the underlying molecular mechanisms remain unclear.In this study,amyloid precursor protein/presenilin 1(APP/PS1)double transgenic mice were used as a model of Alzheimer’s disease.Five-month-old APP/PS1 mice were intragastrically administered 30 mg/kg LTG or vehicle once per day for 3 successive months.The cognitive functions of animals were assessed using Morris water maze.Hyperphosphorylated tau and markers of synapse and glial cells were detected by western blot assay.The cell damage in the brain was investigated using hematoxylin and eosin staining.The levels of amyloid-βand the concentrations of interleukin-1β,interleukin-6 and tumor necrosis factor-αin the brain were measured using enzyme-linked immunosorbent assay.Differentially expressed genes in the brain after LTG treatment were analyzed by high-throughput RNA sequencing and real-time polymerase chain reaction.We found that LTG substantially improved spatial cognitive deficits of APP/PS1 mice;alleviated damage to synapses and nerve cells in the brain;and reduced amyloid-βlevels,tau protein hyperphosphorylation,and inflammatory responses.High-throughput RNA sequencing revealed that the beneficial effects of LTG on Alzheimer’s disease-related neuropathologies may have been mediated by the regulation of Ptgds,Cd74,Map3k1,Fosb,and Spp1 expression in the brain.These findings revealed potential molecular mechanisms by which LTG treatment improved Alzheimer’s disease.Furthermore,these data indicate that LTG may be a promising therapeutic drug for Alzheimer’s disease.
基金supported by the National Natural Science Foundation of China,Nos.82071249 and 81771207 (both to CH)。
文摘The glymphatic system is a relatively recently identified fluid exchange and transpo rt system in the brain.Accumulating evidence indicates thatglymphatic function is impaired not only in central nervous system disorders but also in systemic diseases.Systemic diseases can trigger the inflammatory responses in the central nervous system,occasionally leading to sustained inflammation and functional disturbance of the central nervous system.This review summarizes the current knowledge on the association between glymphatic dysfunction and central nervous system inflammation.In addition,we discuss the hypothesis that disease conditions initially associated with peripheral inflammation ove rwhelm the performance of the glymphatic system,thereby triggering central nervous system dysfun ction,chronic neuroinflammation,and neurodegeneration.Future research investigating the role of the glymphatic system in neuroinflammation may offer innovative therapeutic approaches for central nervous system disorders.
文摘背景:眩晕与临床神经科疾病密切相关。当神经元受损或死亡时,可能导致前庭系统的异常,引发眩晕症状,因此有必要探讨并分析临床神经科常见的眩晕相关热点问题。目的:采用文献计量学方法分析临床神经科常见的眩晕相关国内外的研究热点。方法:由第一作者检索2014-2023年万方数据库和Web of Science核心集数据库,检索临床神经科常见的眩晕治疗的研究相关文献,采用VOSviewer_1.6.19软件对文献的发文量、国家/地区、机构、关键词、共被引文献及高被引文献进行计量学分析,剖析总结该研究领域的研究热点。结果与结论:(1)Web of Science核心集数据库2022年该领域文献发文量174篇最高,万方数据库2020年该领域文献发文量最高133篇;发文量最高的国家前3位分别是美国、德国、中国;国际机构中发文量最高的是德国慕尼黑大学,中国机构中发文量最高的是成都中医药大学。(2)关键词分析结果显示,中国该领域的研究热点疾病主要为梅尼埃病、颈性眩晕、老年性眩晕、良性阵发性位置性眩晕、孤立性眩晕和高血压眩晕,治疗方法包括针刺、康复、药物(天麻素、半夏白术天麻汤)和手法复位。国际上该领域的研究热点疾病主要包括良性阵发性位置性眩晕、新冠病毒病例的前庭性疾病、梅尼埃病、前庭神经鞘瘤、听神经瘤和前庭性偏头痛等,热点治疗方法为传统抗眩晕药物、抗抑郁、抗焦虑治疗和显微手术等。(3)文献共被引分析结果显示,对于以持续性眩晕为主要症状的急性前庭综合征而言,三步骤床边眼动检查(HINTS:头部-冲击-眼球震颤-斜视测试)在急性前庭综合征患者合并脑卒中的诊断方面比早期MRI更敏感,此观点是最被同行认可的前庭综合征脑卒中检测方法;对以阵发性眩晕为主要症状的前庭神经炎患者而言,使用激素治疗更有效。(4)高被引文献分析结果显示,在万方数据库中近10年热点文献中,针刺风池穴、“小醒脑开窍”针刺法改善后循环缺血性眩晕均取得了一定成效,近3年文献发现银杏叶提取物+天麻素、针刺+半夏白术汤、倍他司汀+天麻素、前庭康复训练+Epley耳石复位法,都可以不同程度地改善眩晕症状。而近10年Web of Science核心集数据中的文献并无特色性抗眩晕药物受到关注,大部分以传统抗眩晕药物和显微手术为主,但近3年国际文献中有少数病例报告发现COVID-19感染后可能导致前庭神经炎并出现眩晕症状。(5)眩晕的发生和发展可能与神经元的损伤和再生密切相关,例如,病毒感染、炎症刺激或其他病理因素可能导致神经元损伤或死亡,从而影响前庭系统的功能。目前国内外都发布了眩晕相关的诊治规范指南,国际指南较为推荐前庭康复和物理康复联合治疗眩晕症状,中国指南较为推荐中西医药物、复位及针刺联合治疗,但研究证据级别并不高,因此未来还需要大量的大样本、多中心关于抗眩晕治疗的随机对照试验来验证。
基金supported by Basic Science Research Program through the National Research Foundation of Korea(NRF) funded by the Ministry of Science,ICT and Future Planning,No.2018R1C1B5029745(to HJC),2011-0030072(to YH),2018R1D1A1B07040282(to JJ),2018R1A2B6001123(to NYJ)
文摘Mitophagy is activated by a number of stimuli, including hypoxia, energy stress, and increased oxidative phosphorylation activity. Mitophagy is associated with oxidative stress conditions and central neurodegenerative diseases. Proper regulation of mitophagy is crucial for maintaining homeostasis; conversely, inadequate removal of mitochondria through mitophagy leads to the generation of oxidative species, including reactive oxygen species and reactive nitrogen species, resulting in various neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. These diseases are most prevalent in older adults whose bodies fail to maintain proper mitophagic functions to combat oxidative species. As mitophagy is essential for normal body function, by targeting mitophagic pathways we can improve these disease conditions. The search for effective remedies to treat these disease conditions is an ongoing process, which is why more studies are needed. Additionally, more relevant studies could help establish therapeutic conditions, which are currently in high demand. In this review, we discuss how mitophagy plays a significant role in homeostasis and how its dysregulation causes neurodegeneration. We also discuss how combating oxidative species and targeting mitophagy can help treat these neurodegenerative diseases.
