الملخص
Objective:Migraine and tremor share some genetic mutation sites,and clinical studies have also confirmed their correlation.This study aims to explore the clinical and electrophysiological characteristics of migraine patients with concomitant tremor,and to analyze the relevant influential factors of tremor occurrence. Methods:We retrospectively analyzed the clinical data of 217 migraine patients who visited the Third Affiliated Hospital of Qiqihar Medical University from June 2022 to October 2023.The Clinical Rating Scale for Tremor(CRST),Numerical Rating Scale(NRS),Generalized Anxiety Disorder-7(GAD-7),and Patient Health Questionnaire-9(PHQ-9)were respectively used to assess the tremor symptoms,degree of headache,anxiety,and depression of patients.All patients underwent routine head MR scanning and electromyography examination,and were divided into a migraine with tremor group and a migraine without tremor group based on the electromyogram examination. Results:The migraine with tremor group and the migraine without tremor group were included 52 patients(23.96%)and 165 patients(76.04%),respectively.Compared with the migraine without tremor group,the migraine with tremor group had a longer course and duration of headache,higher frequency of headache attacks,higher NRS score,GAD-7 score,and PHQ-9 score,and fewer weekly physical exercises.The differences were statistically significant(all P<0.05).There were no statistically significant differences in the presence or absence of prodromal headache and white matter hyperintensities(WMHs)between the 2 groups(both P>0.05).The evaluation results of the CRST showed that out of 217 migraine patients,39 patients(17.97%)were accompanied by tremors.The electromyographic results showed that all 52 migraine patients with tremors had upper limb tremors,including 28 migraine patients with postural tremors and 24 migraine patients with static tremors.Compared with the migraine patients with static tremors,the migraine patients with postural tremors had lower average frequency,peak frequency,and headache onset frequency(all P<0.05).Multiple linear regression analysis showed that frequency of physical exercise,duration of illness,frequency of headache attacks,NRS score,GAD-7 score,and PHQ-9 score were risk factors for migraine patients with concomitant tremors(all P<0.05). Conclusion:Patients with migraine mainly experience upper limb postural tremors.Reduced physical exercise,long course of disease,long duration of headache,frequent headache attacks,severe headache,anxiety,and depression are risk factors for migraine patients with concomitant tremors.
الملخص
@#To investigate the expression and significance of Sox5 in serum and helper T cell 17（Th17）of patients with multiple sclerosis （MS）. Methods 20 acute exacerbation MS patients were collected as MS group and 20 healthy volunteers as health control group. The expression of Sox5 in serum was detected by ELISA，the peripheral blood CD4+T cells were isolated by flow cytometry，the Th17 cells were cultured in vitro and stimulated by IL-6（25 ng/ml）for 7 days，the Sox5 and IL-17A levels in medium were detected by ELISA，the Th17 cells were detected and isolated by flow cytometry，and the Sox5 and RORγt mRNA expressions of Th17 were detected by RT-PCR. Results The level of Sox5 in serum of MS patients was higher than that of healthy controls，the difference was significant （P<0.05）.The level of Sox5，IL-17A and Th17 cells in the CD4+T cell culture medium of the healthy control group did not increase （P>0.05），but the level of Sox5，IL-17A and Th17 cells in the MS patients significantly increased （P<0.05）；the level of Sox5 and RORγt in the CD4+T cell culture medium of the healthy control group did not increase （P<0.05）. The expression of Sox5 and RORγt mRNA in Th17 cells increased significantly in MS patients （P<0.05）. Conclusion Sox5 plays an important role in the pathogenesis of MS patients and is related to the differentiation of RORγt and Th17 cells.
الملخص
Objective To discuss the correlation between gastrointestinal symptoms concomitant with chronic migraine and sleep disorders,anxiety and depression.Methods Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS),Pittsburgh Sleep Quality Index (PSQI) and Gastrointestinal Symptom Rating Scale (GSRS) were adopted to conduct comparative analysis on gastrointestinal symptoms,anxiety,depression,sleep disorders,and related risk factors in 151 chronic migraine patients who conformed to International Headache Society International Classification of Headache Diseases-Ⅱ diagnostic code and 151 healthy controls in the Third Affiliated Hospital of Qiqihar Medical University from January 2015 to December 2017.Results PSQI scores (8.46±2.54 vs 4.53±1.95,t=2.913,P＜0.05),SAS scores (53.24± 11.66 vs 39.58±8.63,t=3.112,P＜0.05),SDS scores (51.09±8.80 vs 36.11±5.74,t=3.520,P＜0.05),and GSRS scores (4.53 (3.74,5.32) vs 1.29 (0.73,1.31),Z=30.804,P＜0.05) were all higher in migraine patients than that in healthy controls,and the differences were all statistically significant.In chronic migraine patients,139 (92.05％) had one gastrointestinal symptom at least,and the overall incidence of each gastrointestinal symptom was abdominal distension (60 cases,39.74％),exhaust increase (51 cases,33.77％),and endless defecation (43 cases,28.48％),etc.,in turn.Multiple regression analysis showed that headache degree,frequency,PSQI scores,SAS scores,and SDS scores were the main risk factors of gastrointestinal symptoms concomitant with chronic migraine.GSRS scores of chronic migraine patients presented positive correlation with PSQI scores (r=0.65,P=0.000),SAS scores (r=0.42,P=0.000),and SDS scores (r=0.48,P=0.000),respectively.Conclusion Chronic migraine patients are easy to be accompanied with gastrointestinal symptoms,and headache degree and frequency,sleep disorders,depression and anxiety are the main risk factors of concomitant gastrointestinal symptoms.