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Objective:To explore the short-term clinical efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in thalamic pain.Methods:A prospective study was performed; 41 patients with thalamic pain who received hrTMS in Department of Neurology, Anqing Medical Center Affiliated to Anhui Medical University from December 2022 to August 2023 were selected. According to different stimulation sites, these patients were divided into S2 group (intervening secondary sensory cortex of the unaffected side, n=21) and M1 group (intervening primary motor cortex of the unaffected side, n=20). Before treatment, at the 1 st weekend after pseudo-stimulation treatment and at the 1 st, 2 nd and 3 rd weeks after effective stimulation treatment, short-form McGill Pain Questionnaire (SF-MPQ) was performed, and N100 amplitude was monitored by myoelectric evoked potentiometer; adverse reactions during treatment cycles were observed. Results:(1) Compared with those before treatment, scores of sensory item, emotional item and visual analogue scale (VAS), and present pain intensity in S2 group were significantly decreased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). Compared with those before treatment, scores of sensory item and VAS, and present pain intensity in M1 group were significantly decreased at the 2 nd weeks after effective stimulation treatment, and scores of sensory item, emotional item and VAS, and present pain intensity in M1 group were significantly decreased at the 3 rd weeks after effective stimulation treatment( P<0.05). At the 3 rd weeks after effective stimulation treatment, compared with the M1 group, the S2 group had significantly decreased scores of sensory item, emotional item, and VAS, and present pain intensity (5.35±0.54 vs. 4.86±0.74; 3.55±0.69 vs. 3.14±0.57; 5.50±0.69 vs. 5.00±0.78; 2.20±0.42 vs. 1.81±0.41, P<0.05). (2) Compared with those before treatment, N100 amplitude in S2 group and M1 group was significantly increased at the 2 nd and 3 rd weeks after effective stimulation treatment ( P<0.05). At the 3 rd weeks after effective stimulation treatment, the S2 group had significantly higher N100 amplitude than the M1 group (3.43±0.60 vs. 3.00±0.65, P<0.05). (3) No adverse reactions such as seizure or scalp burning occurred in the 2 groups during the treatment cycles, without significant difference in headache or tinnitus incidences ( P>0.05). Conclusion:The hrTMS on secondary sensory cortex and primary motor cortex of the unaffected side can relief the short-term pain intensity in patients with thalamic pain, without obvious side effects; and hrTMS on secondary sensory cortex enjoys better effect.
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Objective:To study the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in migraine without aura.Methods:A prospective sutdy was conducted; 74 patients with migraine without aura had definite diagnosis in our hospital from September 2019 to November 2020 were chosen and divided into hrTMS treatment group ( n=39) and control group ( n=35) by random number method. Patients in the hrTMS treatment group were treated with hrTMS once per d; the stimulation frequency was 20 Hz, each stimulus consisted of 20 sequences, and the amount of stimulus was 500 pulses; the treatment lasted for 6 d was as a course of treatment, and the next course of treatment was conducted at an interval of 1 d; a total of 4 courses of treatment was given. Patients in the control group were treated with pseudo-stimulation; treatment frequency was the same as above. Patients in the 2 groups were given oral conventional migraine drug (celecoxib, 0.2 g per time) according to the demands for analgesia (visual analog scale [VAS] scores≥4). The evoked potential N100 amplitudes and therapeutic effects 1, 2, and 4 weeks after treatment were evaluated and compared between the 2 groups; the occurrence of adverse reactions was observed. Results:There were significant differences in VAS scores and N100 amplitudes at each time point before and after treatment in the hrTMS treatment group ( P<0.05); the VAS scores decreased with time, while the N100 amplitudes increased with time. At 2 and 4 weeks after treatment, patients in the hrTMS treatment group had significantly lower VAS scores and statistically higher N100 amplitudes than those in the control group ( P<0.05). As compared with that in hrTMS treatment group before treatment and that in the control group at the same time point, the average days of headache per month in the hrTMS treatment group 4 weeks after treatment was significantly decreased ( P<0.05). No epileptic seizure, hearing loss, scalp burn or other adverse reactions occurred in the 2 groups after treatment. After treatment, there was no statistical significance in the incidence of dizziness, head discomfort, tinnitus or other adverse reactions between the 2 groups ( P>0.05). Conclusion:Long course of hrTMS can effectively improve the pain degree of patients with migraine without aura, and reduce the number of headache attacks, without obvious side effects, which is worthy of clinical application.
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Objective To explore the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in treatment of patients with primary trigeminal neuralgia. Methods Thirty-eight patients with primary trigeminal neuralgia were divided into hrTMS treatment group and control group (n=19) according to the willing of the patients; patients in the hrTMS treatment group were treated with 20 Hz hrTMS; those in the control group were given placebo-controlled transcranial magnetic stimulation. The visual analogue scale (VAS) scores one week before, and one, two and 4 weeks after treatment were compared between the two groups. Scores of pain scale of Barrow Neurologic Institute (BNI), evoked potential (N100) amplitude and incidence of adverse reactions one, two and 4 weeks after treatment were compared between the two groups. Results VAS scores in the hrTMS treatment group two and 4 weeks after treatment were significantly lower as compared with those in the control group (P<0.05). In patients from the hrTMS treatment group, VAS scores two and 4 weeks after treatment were significantly lower than those one week before and one week after treatment (P<0. 05); and those 4 weeks after treatment were significantly lower than those two weeks after treatment (P<0.05). Patients from the hrTMS treatment group two and 4 weeks after treatment had significantly lower BNI scores and statistically higher N100 amplitude as compared with those in the control group (P<0.05). In the hrTMS treatment group, BNI scores gradually decreased and N100 amplitude gradually increased one, two and 4 weeks after treatment, with statistically significant differences between each two time points (P<0.05). There were no significant differences in the incidence of headache (10.53％ vs. 21.05％) and head discomfort (36.84％ vs. 26.32％) after treatment between the two groups (P>0.05).Conclusion The hrTMS can effectively alleviate pain of primary trigeminal neuralgia, and it is safe and reliable.
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Objective To explore the characteristics of emotional memory in patients with earlystage Parkinson's disease (PD).Methods The methods of emotional memory neuro-cognitive test and event-related evoked potentials (ERPs) test were set.The emotional memory was detected in 30 early-stage PD patients without treatment (PD group) and 30 matched (including education level,etc) healthy controls (control group),who were recruited in the Department of Neurology,Anqing Municipal Hospital from June 2016 to June 2018.Results Compared with the control group (55.83％±4.17％),the negative valence picture recognition rate in the PD group (50.30％±4.04％) showed statistically significant difference (t=4.85,P＜0.05).The ERPs-P300 latency was (337.47 ± 7.87) ms,the amplitude was (6.34 ± 0.62) μV,and the reaction time was (3 729.21±226.85) ms in the control group,showing statistically significant difference (t=-3.30,4.04,2.76,P＜0.05) compared with that in the PD group ((344.20±7.94) ms,(5.75±0.52) μV,(3 935.33±222.24) ms,respectively).There was no statistically significant difference in positive and neutral stimuli recognition between the two groups (P＞0.05).In the PD group,the correct recognition in positive,neutral and negative valence pictures (57.97％ ±4.44％,49.77％ ±4.49％,50.30％ ±4.04％,respectively)showed statistically significant difference (F=39.17,P＜0.05),also seen in the reaction time ((3 725.87 ±210.10) ms,(4 085.80±231.67) ms and (3 935.33±222.24) ms,respectively;F=9.58,P＜0.05),P300 latency ((328.07±6,07) ms,(347.37±7.49) ms and (344.20±7.94) ms,respectively;F=60.32,P＜0.05),and amplitude ((6.55±0.66) μV,(5.57 ± 0.63) μV and (5.75 ± 0.52) μV,respectively;F=22.44,P＜0.05).But there was no statistically significant difference between negative and neutral stimuli recognition in the PD group (P＞0.05).In the control group,the correct recognition in positive,neutral and negative valence pictures (59.47％ ±4.61％,50.63％±4.96％,55.83％±4.17％,respectively) also showed statistically significant difference (F=25.85,P＜0.05),also seen in the reaction time ((3 657.13±218.85) ms,(4 026.81±221.23) ms and (3 729.21±226.85) ms,respectively;F=8.57,P＜0.05),P300 latency ((326.13±5.96) ms,(345.10±7.95) ms and (337.47±7.87) ms,respectively;F=51.04,P＜0.05),and amplitude ((6.69±0.68) μV,(5.59±0.67) μV and (6.34±0.62)μV,respectively;F=22.15,P＜0.05).There was no statistically significant difference in the rating of valence of emotional pictures between the PD and the control groups (P＞0.05).However,there was statistically significant difference in the latency and amplitude of P300 in the rating of negative valence of emotional pictures between the two groups (t=-5.63,4.16,P＜0.05).Conclusions The results suggest that there is emotional memory impairment in early stage of PD,which is mainly based on selective negative emotional valence.Testing the emotional memory of patients with PD is helpful for early identification and intervention.
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Objective To investigate the clinical efficacy of adjustable external fixaor combined with limited internal fixation for type C distal radius fractures. Methods A total of 22 patients with type C distal radius fractures were treated with adjustable external fixator combined with limited internal fixation from October 2013 to January 2016. Accoiding to AO/ASIF classification, there were 6 cases defined as Cl, 7 cases as 02 and 9 cases as C3. All cases were followed up completely. The clinical efficacy was evaluated based on the wrist join function and X-ray materials. Results They were followed up from 6 month to 18 month(mean 11 months). It showed that all the fractures were healed within 3 months according to X-ray examination. According to Garland-werley evaluation standard, 15 cases were excellent, 5 cases were good and 2 cases were fair. The excellent and good rate was 90. 91％. Condusion For type C distal radius fractures, the method of adjustable external fìxaor combined with limited internal fixation can recover and maintain radius height, volar tilt angle and ulnar inclination angle effectively. It can provide satisfactory wrist join function.
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Objective To observe the correlation between the gene ploymorphisms of CYP2C19 and the curative effects of clopidogrel in patients with acute cerebral infarction.Methods The gene polymorphisms of CYP2C19 were tested in 171 acute cerebral infarction patients by PCR-restriction fragment length polymorphism method. All participants were treated with clopidogrel for 2 weeks.The platelet aggregation rates before treatment and 1 d, 5 d after treatment were detected.NIHSS and activities of daily living ( ADL) were detected before treatment and 1 week, 2 weeks after treatment.The inhibition rate of platelet aggregation ( IPA) was calculated and analyzed.Results In the 171 patients, homozygous wild CYP2C19 genotype was found in 79 cases (A group), with CYP2C19 *1/*1;heterozygous wild and mutant CYP2C19 genotype was found in 71 cases ( B group ) , including 55 cases with CYP2C19 *1/*2 and 16 cases with CYP2C19 *1/*3; homozygous or heterozygous mutant CYP2C19 genotype was found in 21 cases (C group), including 11 cases with CYP2C19*2/*2, 9 cases with CYP2C19*3/*3 and 1 cases with CYP2C19 *2/*3.The differences of IPA among the 3 groups were statistically significant at 1 d, 5 d after treatment (all P<0.05).Compared with before treatment, the NIHSS scores of the 3 groups at 1 week, 2 weeks after treatment were significantly decreased, and the ADL scores were significantly increased ( all P<0.05 ) . Compared with the A group, the NIHSS scores of B group and C group at 1 week, 2 weeks after treatment were significantly increased, and the ADL scores were significantly decreased (all P<0.05).Multiple Logistic regression analysis showed that smoking (OR=1.584,95%CI:1.079-2.136,P=0.004) and CYP2C19 gene polymorphisms (OR=1.837,95%CI:1.106 -2.540,P=0.002) were independently correlated with IPA in patients with acute cerebral infarction.Conclusion CYP2C19 gene ploymorphisms have influence on the curative effects of clopidogrel in patients with acute cerebral infarction.
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Objective To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on cognitive function and safety in patients with lesions in prefrontal cortex (PFC).Methods Twenty-one patients with lesions in PFC hospitalized in the Department of Neurosurgery and Department of Neurology,Anqing Hospital Affiliated to Anhui Medical University between January 2012 and October 2014 were enrolled and given regular drug treatment as a background.Event-related potential (ERP) P300 latency and amplitude,Montreal Cognitive Assessment (MoCA) scores were recorded and compared before and after 4-week rTMS treatment.Results Compared with those before rTMS treatment,P300 latency ((367.38 ± 9.79) ms vs (345.43 ± 11.31) ms;t =5.33,P ＜ 0.05) was significantly shortened,while amplitude ((4.79 ± 1.02) μV vs (7.84 ± 1.40) μV;t =-8.08,P ＜ 0.05),MoCA scores (19.57 ±2.06 vs 23.91 ± 1.30;t =-8.14,P ＜ 0.05),memory test scores (2.19 ± 0.81 vs 4.10 ± 0.89;t =-7.24,P ＜ 0.05) and executive function test scores (2.52 ± 1.08 vs 3.57 ± 0.93;t =-3.38,P ＜0.05) were obviously increased.MoCA scores (18.22 ± 1.56 vs 20.58 ± 1.83;t =-3.11,P ＜ 0.05),memory test scores (1.89 ± 0.78 vs 2.42 ± 0.79;t =-2.26,P ＜ 0.05) and executive function test scores (1.56 ± 0.53 vs 3.25 ± 0.75;t =-5.76,P ＜ 0.05) showed statistically significant difference before rTMS treatment in patients with lesions in either right or left front lobe.Conclusions rTMS which is thought to be a safe procedure can improve cognitive function in patients with lesions in prefrontal cortex.
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Objective To identify age-related changes in emotional memory.Methods A neuropsychological battery was set to measure the education-matched 48 younger, 48 middle-aged and 48 normally aging adults who were given picture tasks.Results Compared with the younger [positive (67.02 ±9.70)%,neutral (60.83 ±9.18)%, negative(75.38 ±12.80)%] and middle-aged controls [positive (68.25 ±10.89),neutral (61.63 ±7.46)%, negative (72.19 ±11.34)%], the differences of the affective images recognition accuracy in the elderly [positive (61.10 ±10.06)%, neutral (49.77 ±8.35)%, negative (55.65 ±11.17)%] were statistically significant (F=6.70,F=30.17,F=38.72,P<0.05-0.01), older adults remembering positive image better than negative image (F=15.67,P<0.05).However, there was no significant difference in their rating of valence of the images. Conclusion Emotional memory is impaired in the healthy elderly people, and indicates that age-related changes in emotional memory indicates may have different neuromechanisms.
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Objective To explore the influence of emotional in memory in normally aging adults.Methods A neuropsychological battery was set to measure the education-matched 48 young, 48 middle-aged and 48 normally aging adults who were given picture tasks.Results As compared with the young adults (positive stimuli: [66.77±9.59]％, neutral one: [60.65±9.31]％ and negative one: [74.77± 12.40]％) and middle-aged controls (positive stimuli: [67.98± 10.73], neutral one: [61.63 ±7.20]％ and negative one: [71.81± 11.29]％), significant differences were noted in the images recognition in the elderly adults (positive stimuli: [62.04±10.41]％, neutral one: [49.58±8.25]％ and negative one: [55.67±11.08)％, P＜0.05);the elderly adults showed significant difference in remembering positive stimuli, neutral one and negative one (P＜0.05).Reaction times in positive stimuli, neutral one and negative one in elderly adults were significantly different as compared with those in the young and middle-aged controls (P＜0.05);the elderly adults showed significant difference in reaction times of positive stimuli, neutral one and negative one (P＜0.05).However, there was no significant difference in their rating of valence of the images and arousal of the images(P＞0.05).Conclusion Age-related changes exists in emotional memory, which indicates that age-related changes in these brain systems may have different neuromechanisms.
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@#Objective To analyze the influencing factors of early neurological deterioration in acute cerebral infarction patients with middle cerebral artery (MCA) occlusion.Methods One hundred and thirty-four acute cerebral infarction patients with MCA occlusion in the department of neurology of our hospital from January 2017 to December 2019 were enrolled retrospectively.The definition of early neurological deterioration (END) was the national institutes of health stroke scale (NIHSS) score increased by ≥ 2 compared with the baseline NIHSS score of admission within 72 hours.Forty-eight cases in END group and 86 cases in non-END group.Baseline and clinical data at admission were compared between the two groups.Binary multivariate logistic regression analysis were used to assess the influencing factors of END in acute cerebral infarction patients with MCA occlusion.Results (1)Gender,age,time of onset,admission NIHSS score,collateral circulation and parameters of blood pressure variability (SBPsd,SBPcv,SBPmax-min,DBPsd,DBPcv,DBPmax-min) were statistically significant between non-END group and END group.(2)Multivariate logistic regression analysis suggested that poor collateral circulation(OR=8.330，95%CI 1.629~42.587,P=0.011) and SBPmax-min (OR=1.139,95%CI 1.032~1.258,P=0.01) were independent risk factors for END in acute cerebral infarction patients with MCA occlusion.SBPmax-min predicted effectively END with best cutoff value 35.5,sensitivity 93.8%,specificity 64% and AUC0.85 (95%CI 0.788~0.912,P<0.001).Conclusion There were many factors affecting END in patients with acute cerebral infarction with MCA occlusion.Poor collateral circulation and Blood pressure variability (BPV) were independent risk factors for END.
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Objective To investigate the high-risk factors of stroke in Anqing area, and to analyze the value of standard treatment for the intervention of high-risk population for stroke. Methods A total of 3 062 permanent residents over 40 years of age in Anqing were surveyed by a questionnaire for the high-risk population of stroke. Physical examination was carried out for people at a high risk of stroke. The physical examination included general physical examination, laboratory tests, and carotid artery color Doppler ultrasound examination. People at a high risk of stroke were investigated on whether or not they received standardized symptomatic treatment and prevention interventions. Results Hypertension or taking antihypertensive drugs accounted for the highest risk factors of stroke in Anqing area, followed by smoking and seldom physical exercise. The abnormal rates of body mass index, blood pressure, contents of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) , homocysteine (HYC), and blood glucose (GLU), as well as intimal thickening, plaque and carotid artery stenosis in people at high risk of stroke receiving standardized treatment were significantly lower than those in people receiving no standardized treatment, and the difference was statistically significant (P<0.05). The standard treatment was an independent factor influencing the body mass index, blood pressure, TC, TG, LDL, HDL, HYC, GLU, intimal thickening, plaque and carotid artery stenosis (P<0.05). Conclusion Hypertension accounted for the highest proportion of high-risk factors for stroke in Anqing area. Standardized symptomatic treatment can effectively control the physical indicators, laboratory test indicators and carotid artery state of stroke high-risk populations, which can play a positive role in the prevention of stroke.
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Objective To investigate the emotional memory impairment in patients with lesions located in prefrontal cortex(PFC), and to test the hypothesis that prefrontal cortex is involved in the emotional memory network. Methods The 40 patients with lesions in PFC and forty age-education-level matched healthy adults were given emotional memory tasks using positive, neutral and negative valence images. Results Compared with the healthy adults(positively(11.68 ± 2. 18)and negatively(12. 93 ±1.33)), the patients had significant loss in positively(8. 20 ± 2.02)and negatively(8. 68 ± 1.14)valence image memorizing(t = 7.41, - 2. 75, both P ＜ 0. 05). There was no insignificant impairment in neutral stimuli. Performance difference between left PFC and right PFC in positively(8. 90 ±2. 01 vs 7.50 ± 1.79)and negatively(7.30 ± 1.10 vs 9. 05 ± 1. 00)valence image recognition was significant(Z = -2. 15,-2. 07,both P ＜ 0. 05). Conclusion The results suggest that emotional memory is impaired in the patients with lesions in PFC. The impairment difference between left PFC and right PFC indicates that they may have different neuromechanisms.