Objective To explore the changes of serum miR-146a expression level in patients with Parkinson’s disease（PD）,and analyze its correlation with inflammatory factors.Methods A total of 108 PD patients admitted to our hospital from August 2017 to March 2021 were selected as the PD group, and 87 healthy volunteers were included as the control group.The serum miR-146a expression and the levels of interleukin-1β（IL-1β）,IL-2,IL-6,high-sensitivity C-reactive protein（hs-CRP） and tumor necrosis factor-α（TNF-α） were compared between the two groups.According to the expression of miR-146a, the patients were divided into high expression group and low expression group, and the relationship between its expression and the clinical characteristics of PD was analyzed.ROC was drawn to analyze the AUC of serum miR-146a to assess PD.The correlation between serum miR-146a expression level and inflammatory factors was analyzed by Pearson linear correlation.Results The expression of serum miR-146a in the PD group was lower than control group, and the levels of serum IL-1β,IL-2,IL-6,TNF-α,and hs-CRP were higher than those in the control group（P＜0.05）.The UPDRS score of the miR-146a low expression group was ≥50 points, H-Y grade 3 to 5,and the proportion of cognitive impairment was higher than the high expression group（P＜0.05）.Serum miR-146a expression assessed PD AUC of 0.795.Pearson linear correlation analysis showed that serum miR-146a expression was negatively correlated with IL-1β,IL-2,IL-6,TNF-α,and hs-CRP levels（P＜0.05）.Conclusion The expression level of serum miR-146a in PD patients is down-regulated and is closely related to inflammatory factors, which has a certain value in the diagnosis of PD.
Objective To explore the relationship between the characteristics of polysomnography and cognitive dysfunction in patients with Parkinson’s disease.Methods A total of 207 patients diagnosed as Parkinson’s disease in the Department of Neurology of our hospital from January 2021 to January 2022 were selected.All patients received Parkinson’s Sleep Scale（PDSS） to assess their sleep status, and the included patients were divided into two groups according to their final scores: the sleep disorder free group（n=126） and the sleep disorder group（n=81）.Clinical data of all patients were collected and monitored by polysomnography.The difference of baseline data, EEG data, polysomnography parameters and sleep-related scores between the two groups were compared to observe the cognitive function of the two groups.Scores related to anxiety and depression and scores of various dimensions of MoCA.Results Results The age and course of disease in sleep disorder group increased significantly than those in no sleep disorder group（all P＜0.05）.The amplitude, frequency, index and generalization ratio of EEG parameters in 2 groups were all P＜0.05.The sleep efficiency of patients without sleep disorder group was significantly higher than that of sleep disorder group, the proportion of NREM2 sleep in patients without sleep disorder group decreased significantly than that of sleep disorder group, and the proportion of NREM3 sleep in patients without sleep disorder group increased significantly than that of sleep disorder group（all P＜0.05）.The proportion of rapid eye movement sleep in barrier-free sleep group increased significantly than that in sleep disorder group（P＜0.05）.The comparison of UPDRS score, H-Y stage and PDSS scores in 2 groups were all P＜0.05.The cognitive function scores including MMSE and MoCA scale scores in the sleep disorder group decreased significantly than those in the non-sleep disorder group, and the anxiety and depression scores in the sleep disorder group increased significantly than those in the non-sleep disorder group（all P＜0.05）.Conclusion Analysis was used to show negative associations between age（r=-0.482,P=0.001）,H-Y stage（r=-0.414,P=0.005）,HAMA score（r=-0.591,P＜0.001）,HAMD score（r=-0.574,P＜0.001）,and MoCA scale score（r=-0.583,P＜0.001） with sleep disorders Conclusion There is a certain correlation between cognitive dysfunction and sleep structure disorder in PD patients.Sleep structure disorder may lead to increased cognitive impairment.
Objective To investigate the role ofprotectin D1 on cerebral ischemia reperfusion injury（CIRI） in mice.Methods Ninety C57BL/6 male mice were randomly divided into control group, model group and protectin D1 group.The CIRI model in mice was established by thread embolism method.The mice in the protectin D1 group were injected with 5 mg/kg protectin D1 through the tail vein 30 minutes before ischemia, and the mice in the control group and the model group were given the same amount of normal saline.After 24 hours of reperfusion, the infarct volume, brain water content and blood-brain barrier permeability of mice were measured.The neural function of mice was evaluated by Bederson scoring.The content of interleukin-1β（IL-1β）,cyclooxygenase-2（COX-2）,tumor necrosis factor-α（TNF-α）,superoxide dismutase（SOD）,glutathione（CAT） and malondialdehyde（MDA） in the brain tissue of mice were detected.TUNEL staining was used to evaluate the apoptosis of brain tissue of mice.Results Compared with the control group, the volume of cerebral infarction, brain water content, blood brain barrier permeability, Bederson scoreand adhesion removal time in the model group were significantly increased, and the rotational drop time was significantly decreased（P＜0.05）;Compared with the model group, the volume of cerebral infarction, brain water content, blood brain barrier permeability, Bederson score and adhesion removal time in the protectin D1 group were significantly decreased, and the rotational drop time was significantly decreased（P＜0.05）.Compared with the control group, the level of IL-1β,COX-2 and TNF-α in the model group were increased significantly（P＜0.05）;Compared with model group, the level of IL-1β,COX-2 and TNF-α were significantly decreased（P＜0.05）.Compared with the control group, the contents of SOD and CAT in the model group were decreased significantly, while the content of MDA were increased（P＜0.05）;Compared with the model group, the contents of SOD and CAT in the protectin D1 group were significantly increased, while the contents of MDA was significantly decreased（P＜0.05）.Compared with the control group, the apoptosis index in the model group was increased significantly（P＜0.05）;Compared with the model group, the apoptosis index in the protectin D1 group was significantly lower（P＜0.05）.Conclusion Protectin D1 alleviates cerebral ischemia reperfusion injury in mice, and its mechanism is related to reducing inflammatory reaction, oxidative stress and apoptosis.
左旋多巴反应试验是一项临床常用的简便有效的评价帕金森病患者多巴反应性的方法,对于帕金森病的诊断和指导药物治疗具有重要意义,也是外科脑深部电刺激手术(DBS)的患者筛选指标及术后疗效的预测因素之一.目前普遍认为左旋多巴反应试验的改善率大于30％适合DBS手术,然而关于改善率临界值尚存在争议.左旋多巴反应试验与手术患者筛选及术后疗效预测之间的关系也没有定论.了解左旋多巴反应试验的发展历史可以更科学地指导外科手术患者的筛选及个体化治疗.
Objective To assess diagnostic performance of the intraoperative ultrasonography in neuro-oncology practice based on the clinical features of patients with deep-seated brain tumors.Methods A retrospective review of 24 patients who were treated for deeply seated brain tumors has been performed.Among these cases, 13 patients underwent tumor resection via dissection of the non-eloquent cortex or trans-sulcal approach depending on the intraoperative ultrasonic findings（ultrasound-guided group）,while 11 patients experienced trans-sulcal approach without intraoperative ultrasonography（control group）.Data regarding clinical findings and technical considerations were analyzed.Results No statistically significant difference was observed in the age, tumor diameter, depth of the lesions, and preoperative Karnofsky Performance Scale（KPS） of these 2 groups.However, shorter exposure time, less microscopic or endoscopic procedure time, reduced duration of hospitalization, a fewer extent of focal encephalomalacia, and higherKPS 3 months after surgery were all achieved statistical significance in patients in the ultrasound-guided group when compared with the control group（P＜0.05）.Moreover, the ultrasound-guided surgery provided higher rate of gross total resection, fewer complications, and less degree of postoperative brain edema.Conclusion Intraoperative ultrasonography can accurately identify deeply seated brain tumors, andmay compensate for craniotomy-induced brain-shift.Shortening operation duration, complete tumor resection with minimal invasion, and improved recovery time can be obtained via the ultrasonic-guided surgery, resulting insurvival benefits.
Objective To investigate the effect of serum soluble lectin-like oxidized low-density lipoprotein receptor-1（sLOX-1） on aneurysmal subarachnoid hemorrhage（aSAH）) value of patient prognosis assessment.Methods A total of 232 aSAH patients who visited our hospital’s neurosurgery department from March 2020 to March 2022 were selected as the analysis group, and 114 healthy subjects were selected as the control group.The general clinical data of the research subjects were collected, and the Hunt-Hess grade, modified Fisher grade, and aneurysm rupture size were evaluated and recorded.The venous blood of the patients admitted to the hospital within 24 hours was collected to detect the level of sLOX-1,and the mRS score was used to analyze and compare the good prognosis group and the poor group.For various clinical indicators, Spearman correlation test was used to analyze the correlation between sLOX-1 and the severity of aSAH;multivariate logistic regression was used to analyze the risk factors for the prognosis of patients with aSAH;receiver operating characteristic curve（ROC curve） was used to analyze the relationship between sLOX-1 Evaluation value in the prognosis of aSAH patients.Results The level of serum sLOX-1 in the aSAH group was significantly higher than that in the healthy control group（P＜0.05）,and the level of sLOX-1 in the poor prognosis group was significantly higher than that in the good prognosis group（P＜0.05）.Serum sLOX-1 level was positively correlated with Hunt-Hess classification and modified Fisher classification（P＜0.001）Logistic regression analysis showed that Hunt-Hess grade（grade 3-5）,aneurysm size（≥5 mm）,serum sLOX-1 concentration and modified Fisher grade（grade 3-4） were associated with poor postoperative prognosis in patients with aSAH Influencing factors（P＜0.05）,The AUC of serum sLOX-1 for evaluating the prognosis of aSAH patients was 0.739,the cutoff value was 1.68 ng/ml, the sensitivity was 67.82%,the specificity was 76.37%,（Youden index=0.659;95% CI 0.741-0.902）.Conclusion The level of serum sLOX-1 is related to the severity of aSAH patients, and is an independent influencing factor for patients with poor prognosis.
Objective To investigate the prognostic value of plasma lipoprotein-associated phospholipase A2（Lp-PLA2） combined with Glasgow Outcome Scale（GOS） score in assessing the prognostic value of interventional therapy for aneurysmal subarachnoid hemorrhage（aSAH）.Methods From June 2018 to December 2020,86 patients with aSAH who received endovascular interventional aneurysm embolization were selected.GOS score was performed at discharge; modified Rankin Scale（mRS） score was performed at 6 months after discharge, with 0 2 being a good prognosis（n=63）;3 6 being a poor prognosis（n=23）.Plasma Lp-PLA2 levels were detected by enzyme-linked immunosorbent assay kit.Logistic multivariate analysis was used to analyze the influencing factors of poor prognosis in patients with aSAH;receiver operating characteristic curve（ROC） was used to analyze the value of Lp-PLA2 and GOS score to evaluate the prognosis.Results Logistic multivariate analysis showed that age（OR=1.834）,preoperative Hunt-Hess grade（OR=4.123）,aneurysm diameter（OR=5.002）,number of aneurysms（OR=2.567）,Lp-PLA2 expression level（OR=4.671） and GOS score at discharge（OR=2.678） were independent influencing factors of poor prognosis of aSAH patients（P＜0.05）.The AUCs of Lp-PLA2 and GOS scores for predicting poor prognosis were 0.793 and 0.725,respectively, and the combined AUC was 0.891.The combined prediction had a sensitivity of 87.23% and a specificity of 76.12%.Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients.Conclusion Plasma Lp-PLA2 combined with GOS score has important value in evaluating the prognosis of aSAH patients.
Objective To investigate the efficacy and safety of multimodal neuroelectrophysiological monitoring in the treatment of pain after spinal cord injury by incision of the dorsal root of the spinal cord into the medullary region.Methods Four patients with pain after spinal cord injury were treated with Dorsal Root Entry Zone（DREZ） incision under multimodal neuroelectrophysiological monitoring, including 2 cases of brachial plexus avulsion, 1 case of thoracic spine injury, and 1 case of lumbar spine injury.All patients were monitored for lower limb movement and sensation through sensory evoked potentials（SEP） and motor evoked potentials（MEP）.When the latency of SEP and MEP decreases by 10% on the healthy side or the amplitude decreases by 30% on the baseline, a warning is given to guide the incision angle and deep range of DREZ.All patients were analyzed for preoperative and postoperative pain visual analysis scale（VAS）,muscle strength and deep sensory function of healthy limbs on the surgical side, and second bowel function.At the same time, the quality of life of patients before and after surgery was evaluated using the SF-36 quality of life scale.Results After a follow-up of 9 months to 3 years, the pain relief rate in 3 patients was 100%,and the pain relief rate in 1 patient was greater than 50%.None of the patients had muscle decline and deep sensory decline in the healthy limb on the surgical side, and there was no decline in the second bowel function in all patients.The total score of SF-36 increased from 80.6±10.2 before surgery to 108.9±12.4（P＜0.05）.Conclusion Multimodal neuroelectrophysiological monitoring of spinal dorsal root incision can not only effectively alleviate pain, improve quality of life, but also effectively protect spinal cord function.
Objective To investigate the effect of small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring in the treatment of hypertensive hemorrhage.Methods Sixty-eight patients with hypertensive hemorrhage admitted to our hospital from July 2021 to July 2022 were selected and divided into two groups: In the trial group, 35 patients underwent small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring, and in the control group, 33 patients only underwent small bone-window craniotomy under microscope.Postoperative complicationsand GOS score were compared between the two groups.Results The incidence of postoperative complications in the trial group were significantly lower than those in the control group（P＜0.05）.The GOS score of trial group was significantly higher than that of control group 6 months after operation（P＜0.05）.Conclusion Small bone-window craniotomy under microscope combined post-operative intracranial pressure monitoring can improve the prognosis of hypertensive hemorrhage patients, reduce postoperative complications, reduce hospital stay, and improve the quality of life of patients.
目的 探讨颅内动脉瘤破裂早期行血管内介入栓塞术对丙二醛(Malondialdehyde,MDA)、超氧化物歧化酶(Superoxide Dismutase,SOD)、D二聚体(D—Dimer,DD)水平的影响.方法 以2018年5月～2021年6月在本院进行治疗的126例颅内动脉瘤破裂作为研究对象,根据手术时机不同分为早期组61例、延期组65例.观察两组治疗前后MDA、SOD、D-D水平,对比栓塞成功率、术中出血及术后并发症率.对两组均随访3个月(截止至2021年11月),评估患者近期预后.结果 术后,两组MDA、D-D水平均下降,SOD水平升高,且早期组MDA、D—D水平低于延期组,SOD水平高于延期组(P＜0.05);早期组栓塞成功率高于延期组(93.44％VS 81.45％)(P＜0.05);早期组术后并发症总发生率低于延期组(6.56％VS 20.00％)(P＜0.05);早期组近期预后良好占比高于延期组(81.97％VS 55.38％)(P＜0.05).结论 颅内动脉瘤破裂患者早期行血管内介入栓塞术安全性较高,能改善MDA、SOD、D-D水平,提高栓塞成功率,患者近期预后较好.
Objective To study the predictive value of serum and cerebrospinal fluid（CSF） neurofilament light chain（NFL） and glial fibrillary acidic protein（GFAP） in elderly patients with traumatic brain injury（TBI） after surgery.Methods A retrospective analysis of 116 cases of craniocerebral injury elderly patients admitted to our hospital from April 2018 to February 2020.According to the clinical diagnosis results of at least 6 months of follow-up after decompressive craniectomy and external ventricular drainage（EVD）,the patients were divided into 30 cases of secondary communicating hydrocephalus group and 86 cases of non-hydrocephalus group.CSF drained immediately, 24h and 48h after operation were collected, and serum at the same time were also collected.NFL and GFAP levels were analyzed by enzyme-linked immunoassay.Results CSF NFL and GFAP levels existed for time, group and interaction between time and group（P＜0.05）.The levels of CSF NFL and GFAP in the secondary hydrocephalus group were higher than those in the non hydrocephalus group immediately, 24h and 48h after operation（all P＜0.05）;compared with immediately after operation, with the prolongation of EVD drainage time, the levels of CSF NFL and GFAP decreased gradually（all P＜0.05）.Multiple Logistic regression analysis showed CSF NFL and GFAP immediately after surgery were the independent risk factors for the development of communicating hydrocephalus in elderly patients with traumatic brain injury（P＜0.05）.Besides, there was a positive correlation between serum and CSF NFL and GFAP levels immediately after surgery（r=0.669,0.797,P＜0.001）.With the non-hydrocephalus group as a control, after ROC curve analysis, the area of the receiver operating characteristic curve for the serum NFL+GFAP or CSF NFL+GFAP immediately after surgery predicted postoperative hydrocephalus were 0.910（95%CI:0.856～0.964） and 0.966（95%CI:0.937～0.994）.Conclusion Detection of NFL and GFAP levels in serum and CSF immediately after operation can effectively predict the risk of secondary communicating hydrocephalus in elderly patients with craniocerebral injury after decompressive craniectomy.
Objective To explore the effect of base note conformal radiotherapy（IMRT） based on multimodal magnetic resonance imaging（MRI） on autonomic nervous response in patients with glioma after surgeryMethods From June 2018 to June 2020,110 patients with malignant glioma diagnosed by surgical cases were collected and they were divided into study group and control group by random number table method, there were 55 patients in each group.Patients in the control group were given intensity-modulated conformal radiotherapy.The patients in the study group were given multimodal magnetic resonance imaging technology examination combined with intensity-modulated conformal radiotherapy.The autonomic nervous response indexes, sleep quality, compliance, adverse reactions, recurrence rate within one year, and survival rate of the two groups of patients were observed.The multimodal MRI indexes of patients in the study group were collected and compared.Results Compared with the control group, the study group’s heart rate（HR）significantly reduced, the standard deviation of the mean RR interval（SDNN）of the 24-hour normal heart rhythm, the standard deviation of the mean RR interval every 5 minutes（SDANN）,and the normal adjacent RR.The root mean square of the interval difference（rMSSD）,the percentage of adjacent normal RR intervals exceeding 50 ms（pNN50）,high-frequency power（HF）,and low-frequency power（LF）significantly increased（all P＜0.05）;Compared with the sleep quality of the control group, the sleep quality of the patients in the study group significantly improved（P＜0.05）;There was no significant difference in compliance and adverse reactions between the two groups（all P＞0.05）;After a one-year follow-up, it was found that compared with the control group, the recurrence rate of patients in the study group significantly reduced within one year, and the survival rate significantly increased（all P＜0.05）.The study group was divided into a good prognosis group（n=8） and a poor prognosis group（n=47） according to the prognosis.There was no significant difference in the expression of apparent diffusion coefficient（ADC） measured by DTI between the two groups（P＞0.05）,but the good prognosis group The other parameters of multimodal MRI in patients were significantly lower than those in the poor prognosis group（P＜0.05）.Conclusion The application of intensity-modulated radiotherapy combined with multimodal magnetic resonance imaging examination for clinical examination and treatment of postoperative patients with glioma can not only improve patients’ sleep and prognosis, improve patients’ compliance with treatment, but especially improve patients’ autonomic nervous system response At the same time, multimodal magnetic resonance imaging can also be used as an indicator for the prognosis of clinical glioma after surgery, which is worthy of clinical application.
Objective To investigate the changes of cognitive function before and after stereotactic resection in patients with Brain glioma（BG） and the prediction of cognitive dysfunction（CD） by β-endorphin（β-EP） and 3-nitrotyrosine（3-NT） the value of.Methods A total of 113 patients with BG from March 2018 to October 2021 in our hospital were selected and all received stereotactic resection.The cognitive function（MoCA score） was evaluated before operation and 2 weeks after operation, and the patients were divided into CD group and normal group according to the change of MoCA score.The baseline data, preoperative, postoperative 1d, and 2 weeks postoperative β-EP and 3-NT levels were compared between the two groups.The independent influencing factors of CD were analyzed.Logistic regression model was established and evaluated.Receiver operating characteristic curve（ROC） was used to analyze the predictive value of β-EP and 3-NT for CD.Results The MoCA score of 113 patients 2 weeks after operation of（27.31±1.03） was higher than that of（23.65±1.47） at admission（P＜0.05）,and the incidence of CD was 25.66%.The largest diameter of the lesion, the tumor grade of grade Ⅲ-Ⅳ,the patients with preoperative epilepsy, the level of 3-NT before surgery, 1d after surgery, and 2 weeks after surgery in the CD group were higher than those in the normal group, and the levels of β-EP before operation, 1d after operation and 2 weeks after operation were lower than those in normal group（P＜0.05）.After adjusting for the largest diameter of the lesion, tumor grade, and preoperative epilepsy, 3-NT and β-EP were independent influencing factors of CD（P＜0.05）.Logistic regression model was established: logit（P）=4.603+0.384×1d postoperative 3-NT-1.000×1d postoperative β-EP,and the fit was good.The AUC of β-EP and 3-NT combined to predict the occurrence of CD was greater than the predicted value of single index（P＜0.05）.Conclusion Cognitive function of BG patients improved after stereotactic resection, but some patients still developed CD after operation.
Objective To explore the potential role of autophagy related genes in ruptured intracranial aneurysm by bioinformatics methods.Methods Gene expression profile data and clinical related information on intracranial aneurysm patients were collected from the GEO database, and the significantly different-expression-genes（DEGs）were determined.Then, the autophagy related genes obtained from GeneCards were used to intersection with DEGs, and the intersection genes were performed by gene ontology（GO） and kyoto encyclopedia of genes and genomes（KEGG） enrichment analysis, and the protein-protein interaction（PPI） network were conducted to find out the hub genes.Finally, immune infiltraton was extracted and quantfied based on the processed gene expression matrix, and the correlaton between immune infiltratng cells and hub genes was analyzed.Results Seventeen significantly autophagic DEGs were identified for ruptured intracranial aneurysm, which were enriched in autophagy（animal）,estrogen pathway, necroptosis signaling pathway.Furthermore, Heat shock 70 kDa protein 8（HSPA8）Heat shock protein 90 kDA alpha, class B,member 1（HSP90AB1）,Phosphatase And Tensin Homolog（PTEN）,PTEN-induced putative kinase 1（PINK1） and Lysosomal Associated Membrane Protein 2（LAMP2） were identified as hub genes after PPI network analysis, and the hub genes expression was significantly correlated with the degree of immune infiltration.Conclusion The genes HSPA8,HSP90AB1,PINK1,PTEN and LAMP2 regulate the autophagy response and affect the occurrence and development of ruptured intracranial aneurysm.
Objective We explored the multimodal imaging characteristics of cortical tuber in patients with tuberous sclerosis complex（TSC）for better preoperative diagnosis and surgical decision-making.Methods Patients with TSC related epilepsy（TRE）from January 2015 to December 2021 from Beijing Tiantan Hospital and Beijing Fengtai Hospital were included retrospectively.Their clinical demographics and multimodal neuroimaging data were collected.We firstly quantitatively calculated the multimodal neuroimaging signals ofcortical tubers and normal cortex, as well as the volumes of cortical tubers.We then performed the inter-group comparison and correlation analysis between multimodal neuroimaging signals of cortical tubers and normal cortex.Results Finally, 31 patients with diagnosis of TSC and verification of responsible tubers after multidisciplinary preoperative evaluationwere included.The quantitative results showed that, comparedwith homotopic cortex, tubers displayed significantly higher T2w-FLAIR density signal（Student’s t=3.643,PFDR＜0.001） and lower PET metabolic value（Student’s t =-6.162,PFDR＜0.001）.Moreover, responsible tubers shown significant correlation between T1wMPRAGE and FDG-PET（Pearson R=-0.512,PFDR= 0.027） and significantly larger volume than that of non-responsible tubers（Mann Whitney U=3.378,P＜0.001）.Conclusion T 2 w-FLAIRsignal of TSC tubers is significantly higher than that of normal cortex, which is helpful to diagnosis.The characteristic structure-metabolism coupling and larger volume, render its value in preoperative evaluation and surgicaldecision-making.
目的 探讨显微血管减压术治疗舌咽神经痛的手术技巧、疗效及并发症.方法 回顾性分析2例舌咽神经痛的临床特点、手术过程及术后随访结果,并结合相关文献资料进行分析.结果 2例患者均具有典型的舌咽神经痛症状,术前头部MRI 3D-TOF检查提示舌咽神经根部有动脉压迫,行显微血管减压术后疼痛即刻消失,术后随访1年以上无复发.结论 显微血管减压术是治疗舌咽神经痛的一种有效方法,熟悉局部解剖及变异,娴熟、规范的显微操作,正确合理选择适宜的术式,另外加上术中电生理监测的应用,术后并发症是可控和可接受的.
Objective The aim of this study was to investigate the differences in clinical response and imaging data before and after surgery in patients with Parkinson’s disease and to attempt to predict clinical response using connectivity differences.Methods Connectivity analysis was performed on resting-state functional magnetic resonance imaging（rs-MRI） of 41 patients with Parkinson’s disease who underwent deep brain stimulation, and the subcortical connectivity network was calculated, evaluated before and one year after surgery on the UPDRSIII scale, correlated with the above-mentioned brain connectivity network, and predicted clinical motor symptoms, and predictive performance was discussed based on actual clinical improvement.Results Functional connectivity（FC） between the subcortical nuclei of interest and the DBS response showed that FC from bilateral red nuclei to the shell nuclei correlated with overall changes in UPDRS-III（left: r=-0.44P=0.0056,right r=-0.46p=0.0029,P＜0.05 after FDR correction）.In addition, FC predicted the change in UPDRSIII 1 year after DBS（r=0.5P=0.0011 error rate=0.175）.Conclusion The functional connectivity between the putamen and the red nucleus can serve as an important predictor of treatment outcomes in PD patients undergoing DBS surgery.
Objective To investigate the therapeutic effect of Globus pallidus internus-Deep brain stimulation（GPi-DBS） in the treatment of segmental craniocervical dystonia（SCCD） non-motor symptoms（NMS） and the improvement of quality of life（QoL）.Methods A total of 16 patients undergoing GPi-DBS surgery for SCCD from March 2020 to June 2021 were collected and assessed for motor symptoms, non-motor symptoms, depression, anxiety and quality of life using the BFMDRS scale, DNMSQuest questionnaire, HAM-D scale, HAM-A scale and CDQ-24 questionnaire before surgery and at the 1st, 3rd, 6th, 12th and 18th months after postoperative onset.Pre-operative and post-operative patients were analyzed for differences, and NMS was correlated with QoL.Results Patients had a significant reduction in NMS and improvement in QoL after surgery compared to the preoperative period（P＜0.05）.The patients showed a significant correlation between each NMS and QoL（P＜0.01）.Conclusion GPi-DBS was effective in treating NMS in SCCD,and QoL could be significantly improved, and NMS was significantly correlated with QoL.
立体定向放射外科(SRS)是神经外科的一个重要组成部分,治疗神经外科疾病的适应证不断扩大.从技术诞生至今,神经外科医师一直占主导地位.但SRS技术不仅在发达国家神经外科专科医师的培训中明显不足,在国内神经外科专业从业人员关于SRS的培训基本上为零.神经外科专科医师应该掌握SRS基本原理,了解SRS的适应证、禁忌症,治疗流程,并发症的认识及处理等.本人对几个发达国家的培训现状做一阐述,并建议国内有关部门能在神经外科专科医师规范化培训中加入SRS相关内容,塑造高素质、高层次的神经外科专业人才,更好服务于广大患者.
