Objective: To observe abnormal tinnitus activity by evaluating the amplitude of low-frequency fluctuation (ALFF) changes in the brain was which detected by resting-state functional magnetic resonance imaging (rs-fMRI) in patients with intractable tinnitus before and after repetitive transcranial magnetic stimulation (rTMS). We hy-pothesized that rTMS could progressively revert local brain function back to a relatively normal range.Methods: This prospective observational research study recruited 25 patients with intractable tinnitus, with 28 healthy controls matched by age, sex, and education level. Participants' Tinnitus Handicap Inventory (THI) scores and the visual analog scale (VAS) were used to determine the severity of their tinnitus before and after treatment. We processed the brain spontaneous neural activity of intractable tinnitus patients by ALFF, then, we determined its association with clinically evaluated indicators of intractable tinnitus.Results: The total and the three sub-modules (functional [F], emotional [E], and catastrophic [C]) score of the THI and VAS in patients with intractable tinnitus decreased after treatment (P < 0.001). The effective rate of tinnitus patients was 66.9%. A few patients had a slight left facial muscle tremor or temporary mild scalp pain during treatment. Compared with healthy controls, participants with tinnitus significantly reduced ALFF within the left and right medial superior frontal gyrus (P < 0.005). After rTMS treatment, the left fusiform gyrus and right superior cerebellar lobe increased ALFF in those with tinnitus (P < 0.005). The changes in THI, VAS, and ALFF were positively correlated (P < 0.05).Conclusion: RTMS is effective in the treatment of tinnitus. It significantly reduces the THI/VAS score and im-proves the symptoms of tinnitus. No serious adverse reaction during rTMS were reported. The changes in the left fusiform gyrus and right superior part of the cerebellum may explain the mechanism of rTMS treatment in intractable tinnitus.

Migraine is a complex disorder characterized by debilitating headaches. Despite its prevalence, its pathophysiology remains unknown, with subsequent gaps in diagnosis and treatment. We combined machine learning with connectivity analysis and applied a whole-brain network approach to identify potential targets for migraine diagnosis and treatment. Baseline anatomical T1 magnetic resonance imaging (MRI), resting-state functional MRI(rfMRI), and diffusion weighted scans were obtained from 31 patients with migraine, and 17 controls. A recently developed machine learning technique, Hollow Tree Super (HoTS) was used to classify subjects into diagnostic groups based on functional connectivity (FC) and derive networks and parcels contributing to the model. PageRank centrality analysis was also performed on the structural connectome to identify changes in hubness. Our model attained an area under the receiver operating characteristic curve (AUC-ROC) of 0.68, which rose to 0.86 following hyperparameter tuning. FC of the language network was most predictive of the model’s classification, though patients with migraine also demonstrated differences in the accessory language, visual and medial temporal regions. Several analogous regions in the right hemisphere demonstrated changes in PageRank centrality, suggesting possible compensation. Although our small sample size demands caution, our preliminary findings demonstrate the utility of our method in providing a network-based perspective to diagnosis and treatment of migraine.

Objective:To compare the differences of brain activation in patients with neuromyelitis optica spectrum disorders (NMOSD) and multiple sclerosis (MS) under contact heat stimulation (CHS), and to explore the characteristics of pain-related brain networks in NMOSD and MS patients.Methods:Fourteen NMOSD patients (NMOSD group) and 12 MS patients (MS group) admitted to Affiliated Hospital of North Sichuan Medical College from September 2022 to December 2022 who met the diagnostic criteria were collected. Twelve healthy individuals (HC group) matched with gender and age were recruited during the same period. Visual Analogue Scale (VAS) score was used to evaluate the pain of the subjects, CHS painful stimuli were given, and task-state functional magnetic resonance imaging (fMRI) scans were performed at the same time, and the differences in brain activation among the 3 groups were analyzed and compared.Results:(1) Compared with the HC group, the NMOSD group had a stronger activation degree than the HC group in the brain regions including the cortex around the left distance fissure, bilateral medial superior frontal gyrus; the activation degree of the NMOSD group was weaker than that of the HC group in the brain areas including the left medial and paracingulate gyrus, right superior parietal gyrus, left postcentral gyrus, and right supplementary motor area (all P<0.05). (2) Compared with the HC group, the brain regions whose activation degree was weaker in the MS group included the left caudate nucleus, left medial and paracingulate gyrus, left paracentral lobule, right superior parietal gyrus, left postcentral gyrus, left precuneus, right supplementary motor area, right superior temporal gyrus and right thalamus, and there was no brain area in the MS group whose activation degree was stronger than that of the HC group (all P<0.05). (3) Compared with the MS group, the brain regions with stronger activation degree in the NMOSD group included the left perifissure cortex and right thalamus, but no brain regions with weaker activation degree were found in the NMOSD group (all P<0.05). (4) There was a correlation between somatic pain VAS scores and activation of the medial superior frontal gyrus in the NMOSD group ( r=0.66, P<0.05). Conclusions:The results of CHS-fMRI in the NMOSD group, MS group and HC group showed that multiple brain regions were activated, indicating that multiple brain regions were involved in the generation and processing of pain, and there was a pain-related brain network. Pain-related brain networks were altered in NMOSD patients and MS patients, and there were differences in pain-related brain networks between the two diseases.

Objective:To observe the changes in brain functional magnetic resonance imaging (fMRI) in migraine patients under olfactory stimuli and analyze the characteristics of olfactory-related brain networks.Methods:Twenty-seven migraine patients (migraine group) enrolled in the Department of Neurology, Affiliated Hospital of North Sichuan Medical College from January 2021 to January 2022 were included, and 20 healthy adults were recruited as control group during the same period. All subjects underwent synchronous fMRI scanning under olfactory task stimulation, and magnetic resonance imaging data processing was performed using SPM12 and Matlab2019b softwares, and statistical analysis was performed with SPSS 23.0 software.Results:The activated brain regions in the control group included the left cerebellum, left inferior temporal gyrus, left fusiform gyrus, right middle frontal gyrus, right anterior central gyrus, insula, right central sulcus, superior marginal gyrus, right lenticular putamen, middle cingulate gyrus, paracentral lobule, and superior parietal gyrus ( P<0.05). The activated brain regions in the migraine group included the left cerebellum, right fusiform gyrus, right inferior temporal gyrus, right anterior central gyrus, and right posterior central gyrus ( P<0.05). Compared with the control group, the activation intensity of the migraine group was weaker in the right insula, right middle frontal gyrus orbit, left inferior frontal gyrus orbit, right dorsolateral superior frontal gyrus, right superior temporal gyrus, right superior occipital gyrus, medial and paracingulate gyrus, and right superior parietal gyrus ( P<0.05). Conclusion:Migraine patients have multiple brain regions involved in olfactory processing and have specific olfactory-related brain networks.

Objective: To observe the characteristics of brain fMRI during olfactory stimulation in patients with neuromyelitis optica spectrum disease (NMOSD) and multiple sclerosis (MS), compare the differences of brain functional activation areas between patients with NMOSD and MS, and explore the characteristics of olfactory-related brain networks of NMOSD and MS. Methods: Nineteen patients with NMOSD and 16 patients with MS who met the diagnostic criteria were recruited, and 19 healthy controls matched by sex and age were recruited. The olfactory function of all participants was assessed using the visual analog scale (VAS). Olfactory stimulation was alternately performed using a volatile body (lavender and rose solution) and the difference in brain activation was evaluated by task-taste fMRI scanning simultaneously. Results: Activation intensity was weaker in the NMOSD group than in the healthy controls, including the left rectus, right superior temporal gyrus, and left cuneus. The activation intensity was stronger for the NMOSD than the controls in the left insula and left middle frontal gyrus (P < 0.05). Activation intensity was weaker in the MS group than the healthy controls in the bilateral hippocampus, right parahippocampal gyrus, right insula, left rectus gyrus, and right precentral gyrus, and stronger in the left paracentral lobule among the MS than the controls (P < 0.05). Compared with the MS group, activation intensity in the NMOSD group was weaker in the right superior temporal gyrus and left paracentral lobule, while it was stronger among the NMOSD group in the bilateral insula, bilateral hippocampus, bilateral parahippocampal gyrus, left inferior orbital gyrus, left superior temporal gyrus, left putamen, and left middle frontal gyrus (P < 0.05). Conclusion: Olfactory-related brain networks are altered in both patients, and there are differences between their olfactory-related brain networks. It may provide a new reference index for the clinical differentiation and disease evaluation of NMOSD and MS. Moreover, further studies are needed.

目的 总结HIV感染合并视神经脊髓炎谱系疾病(NMOSD)患者的临床特点,以提高临床对其认识.方法 报道作者医院收治的1例以视神经脊髓炎症状起病的AIDS患者的临床资料,并结合文献进行复习.结果 文献检索HIV感染合并NMOSD患者7例,结合本文报道的1例共8例,年龄8～55岁,平均(39.1±14.4)岁,其中男5例、女3例.8例患者均发生脊髓炎,7例发生视神经炎.血CD4+T细胞降低3例(3/8).脑脊液(CSF)细胞学检测异常4例(4/8),表现为白细胞轻度升高,以淋巴细胞炎性反应为主,6例蛋白水平升高(6/8).血清水通道蛋白4抗体阳性3例(3/7).CSF寡克隆区带阳性3例(3/5).MRI检查显示颅内多发病灶2例(2/8),颈段或胸段脊髓病灶8例(8/8),其中4例为颈髓至胸髓连续长节段病灶.8例患者接受免疫治疗,其中7例接受糖皮质激素治疗,3例(3/8)肌力完全恢复或能独立行走,1例(1/8)肌力部分恢复,4例(4/8)肌力无明显恢复,3例(3/7)视力恢复至粗测正常,1例(1/7)视力部分恢复,3例(3/7)失明.复发5例,其中4例1年内复发.1例死亡.结论 HIV感染合并NMOSD患者致残率高,易复发,部分患者免疫治疗有效.

Epilepsy is a high incidence neurological disease, and its repeated attacks cause serious physical and psychological damage to the patient. Differentially expressed in normal and neoplastic cells (DENN) domain containing 5B (DENND5B) is a lipoprotein binding protein that mediates synaptic vesicle transport and regulates neuroplasticity and lipid metabolism. Nevertheless, the effect of DENND5B on seizures remains unclear. We aimed to investigate the association of DENND5B with epilepsy, detect its expression and distribution in the nervous system, and explore its role in epileptogenesis through western blot, immunofluorescence staining, and behavioral studies. In this experiment, two C57BL/6 mice models, which induced seizures by pentylenetetrazole and kainic acid, were established. We observed that the expression of DENND5B was reduced in the brains of patients with temporal lobe epilepsy, and its expression was also similarly decreased in both chronic epileptic mice. The findings strongly suggest that DENND5B may be associated with epileptic seizures. Results of immunofluorescence showed that DENND5B was mainly expressed in the hippocampal region and co-located with neurons but not with astrocytes. Next, we used lentivirus to induce both lentiviral vector-mediated overexpression and knockdown of DENND5B in mice to test the change of susceptibility and severity of seizures in the two chronic seizure models. Knockdown of DENND5B was found to promote epileptic seizures, increase chronic spontaneous recurrent epileptic seizures and epileptic discharge, and reduce the incubation period. However, overexpression of DENND5B showed the opposite effect. These results suggest that DENND5B overexpression decreased the behavioral phenotype of epileptic seizures, but DENND5B downregulation had the opposite effect. In summary, our findings suggest that DENND5B can regulate epileptic seizures and may provide a new target for antiepileptic therapy.

Fatty acid binding protein 7 (FABP7) is a small molecular cytoplasmic protein. As a cellular fatty acid chaperone, it binds specifically to ligands such as DHA and is widely involved in physiological and pathological processes. During brain development, FABP7 is heavily expressed in neural stem cells, astrocytes and oligodendrocyte precursor cells, which plays a key role in regulating the pathology process of the central nervous system diseases. This article reviews the structure, expression and function of FABP7 and its related research progress in central nervous system disease.

阿尔茨海默病(AD)是最常见的中枢神经退行性疾病之一,常隐匿起病,目前尚缺乏有效的治疗手段.轻度认知障碍(MCI)是介于正常衰老与痴呆之间的一种认知功能损害状态,部分MCI可发展成为AD.AD的核心临床症状主要为记忆障碍、认知功能障碍、人格和行为改变.多项研究表明AD可能伴随有感觉障碍,如嗅觉、视觉、听觉等,其中嗅觉障碍可能是MCI或AD早期的临床症状之一,并且在MCI及AD患者中可出现感觉相关电生理改变.现就MCI及AD患者感觉障碍及其电生理研究进行综述.

急性一氧化碳中毒( acute carbon monoxide poi-soning,ACMP)常引起全身多个器官系统的损害,但其所致单眼全盲尚属少见.现将1例ACMP致视网膜中央动脉阻塞( central retinal artery occlusion, CRAO)报告如下. 1 临床资料 男性,47岁,主因突发左眼视物不能伴吐词不清6 d,于2020年4月14日入院,6 d前晨醒后发现左眼视物不能,枕边有呕吐物,为胃内容物,不能回忆呕吐当时情况,伴有头晕,感四肢乏力、纳差,当地医院诊断为"视神经炎".患者无明确既往病史,无吸烟、饮酒史.入院后体格检查:体温 36.7 ℃,脉搏78次/min,呼吸20次/min,血压124/84 mmHg.心肺腹部查体无明显异常.

Chronic refractory pain is an excruciating pain caused by various reasons, which is easily recurrent and barely responded to multiple drugs. It affects more than 10% of the global population and thus causes a huge burden on the society and the economy. With the development of neuroscience, neuromodulation technologies have been well concerned, which guide a novel direction in the treatment of chronic refractory pain. This review summarizes the research progresses on repetitive transcranial magnetic stimulation, transcranial direct current stimulation, transcranial focused ultrasound stimulation, optogenetics and other non-invasive neuromodulations in the treatment of chronic refractory pain.

目的:探讨经颅直流电刺激(tDCS)对脑卒中后中枢性疼痛(CPSP)患者的镇痛效果.方法:选取40例CPSP患者为研究对象,依据tDCS每次刺激时间不同分为试验组(n=19)和对照组(n=21).以2 mA电流在患侧初级运动皮层行阳极tDCS刺激,健侧眶上区行阴极tDCS刺激;试验组和对照组每次刺激时间分别为20 min/次和30 s/次,5次/周,疗程2周;比较两组患者自我疼痛感觉强度、疼痛区与对侧区皮肤温差、镇痛效果及神经电活动变化.结果:干预后及干预后4周,试验组自我疼痛感觉强度、皮肤温差及左右半球额区(δ+θ)/(α+β)值均低于干预前(P＜0.05),且低于对照组(P＜0.05).干预后4周,对照组左右半球额区(δ+θ)/(α+β)值低于干预前(P＜0.05).结论:tDCS能有效发挥对CPSP患者的镇痛作用,降低其患侧皮肤温度,增强患者大脑皮层电活动,且每次刺激时间越长效果越明显.

OBJECTIVE:To retrospectively analyze the symptoms and characteristics of nervous system damage in severe/critically severe patients with coronavirus disease 2019 (COVID-19) in Sichuan province, with a view to providing basic references for the prevention and treatment of COVID-19.METHODS:A total of 90 patients with severe/critically severe COVID-19 were included, who were diagnosed and treated in COVID-19 designated hospital of Sichuan province from 11 January 2020 to 20 March 2020. Clinical features, test results, treatment options and clinical outcomes were analyzed retrospectively.RESULTS:Of 90 patients, there were 54 males and 36 females, with an average age of (53.90±16.92) years. In addition to the classic symptoms such as fever and/or respiratory symptoms, 53 patients also had various degrees of neurologic manifestations, including 33 cases of fatigue, 21 muscle soreness, 12 dizziness, 8 headaches, 3 mental disorders, and 1 consciousness disorders and 1 case of neck pain. Compared with the patients without neurologic manifestations, those with neurologic manifestations took a longer time from admission to diagnosis of COVID-19 ( P<0.05), and received more antifungal treatment ( P<0.05).CONCLUSIONS:Neurological symptoms are not uncommon in severe/critically severe patients with COVID-19, and it's relatively difficult in the treatment. It should be paid attention in order to avoid misdiagnosis.