Effect of Repetitive Transcranial Magnetic Stimulation on the Nutritional Status and Neurological Function of Patients With Postischemic Stroke Dysphagia.

BACKGROUND: This project aimed to explore the effects of repetitive transcranial magnetic stimulation (rTMS) on the nutritional status and neurological function of patients with postischemic stroke dysphagia. MATERIALS AND METHODS: After recruiting 70 inpatients with cerebral infarction combined with dysphagia hospitalized in the Cerebrovascular Center of Guangdong Second Provincial General Hospital from June 2017 to June 2020, we assigned them randomly into a control group and an rTMS group. Patients in the control group received swallowing training, while patients of the rTMS group received swallowing training and rTMS. RESULTS: Fifteen days after treatment, serum nutrition indexes and neurotrophic indexes of both groups were higher than before treatment, and their serum nerve injury indexes were lower than before treatment. After 15 days of treatment, the body nutrition indexes and neuronutrition indexes of the rTMS group were higher than those of the control group, while the nerve injury indexes of the rTMS group were lower than those of the control group. CONCLUSION: rTMS in the treatment of dysphagia after stroke can better improve nutritional status and nerve function, reducing nerve damage.

Development and validation of police mental health ability scale.

OBJECTIVES: Police officers are generally under long-term occupational stress. Good mental health ability enables them to better deal with emergencies and enhance their combat effectiveness. We aimed to develop the Police Mental Health Ability Scale (PMHAS) to provide a reference for police selection and ability training. METHODS: Through literature analysis, individual interviews, half-open and half-closed questionnaire surveys, and expert consultations, the components of police mental health ability (PMHA) were theoretically constructed. Then, we enrolled 824 in-service police officers who participated in the training in Chongqing City and Sichuan Province from November 2018 to January 2019 and recovered 767 valid questionnaires (recovery rate, 93.08%). RESULTS: Exploratory factor analysis generated five factors for PMHAS, including cognitive intelligence, emotional catharsis, swift decisiveness, behavioral drive, and reward pursuit, accounting for 58.904% of the variance. Confirmatory factor analysis demonstrated that the model fit well (χ2/df = 1.117, RMSEA = 0.020, GFI = 0.948, CFI = 0.990, IFI = 0.990, TLI = 0.987). The correlation coefficients of factors (r = -0.023 ~ 0.580) were lower than that of each factor and total score (r = 0.477 ~ 0.819). The Cronbach's α coefficients of PMHAS and its factors were 0.606-0.863, and the test-retest reliabilities were 0.602-0.732. CONCLUSION: These results suggest that PMHAS is reliable and valid enough for measuring PMHA, which shows that it is a potentially valuable tool for assessing the mental health ability of police officers.

Clinical effect of repetitive transcranial magnetic stimulation on dysphagia due to stroke.

BACKGROUND: Repetitive transcranial magnetic stimulation (rT) could change the excitability of the cerebral cortex, and control the neurotransmitter release, with the therapeutic effect depending on stimulation intensity and position. In this study, we used 3 Hz rTMS to stimulate the pharyngeal cortical area of the lesioned hemisphere and to explore its clinical significance in the treatment of dysphagia after acute cerebral infarction. METHODS: A total of 61 in-patients with acute dysphagia caused by cerebral infarction hospitalized in the department of neurology of our hospital were included in this study and were assigned into the control and rTMS group. Patients in the control group only accepted the basic treatment of rehabilitation training, while patients in the rTMS group received additional rTMS (3 Hz) stimulation. The levels of the water swallowing test (WST) 14 days before and after the treatment of rTMS (3 Hz) would be recorded. RESULTS: After different therapies in two groups, 9 patients of the control group showed excellent curative effect, with a recovery rate of 31.0%. However, in the rTMS group, the swallowing function of 21 patients was significantly improved, with a recovery rate of 65.6%. Comparison results showed that the recovery rate of the rTMS group was much better than the control group (P < 0.05), indicating an effective therapeutic effect of 3 Hz rTMS on patients with dysphagia after acute cerebral infarction. CONCLUSION: Stimulating the target cortical representation areas of pharyngeal of the lesioned hemisphere with cerebral infarction by the rTMS (3 Hz) could improve the patients' function.

Regional Neural Activity Changes in Parkinson's Disease-Associated Mild Cognitive Impairment and Cognitively Normal Patients.

PURPOSE: The aim of this study was to compare regional homogeneity (ReHo) changes in Parkinson's disease mild cognitive impairment (PD-MCI) patients with respect to normal controls (NC) and those with cognitively normal PD (PD-CN). Further, the study investigated the relationship between ReHo changes in PD patients and neuropsychological variation. PATIENTS AND METHODS: Thirty PD-MCI, 19 PD-CN, and 21 NC subjects were enrolled. Resting state functional magnetic resonance imaging data of all subjects were collected, and regional brain activity was measured for ReHo. Analysis of covariance for ReHo was determined between the PD-MCI, PD-CN, and NC groups. Spearman rank correlations were assessed using the ReHo maps and data from the neuropsychological tests. RESULTS: In comparison with NC, PD-CN patients showed significantly higher ReHo values in the right middle frontal gyrus (MFG) and lower ReHo values in the left supramarginal gyrus, bilateral inferior parietal lobule (IPL), and the right postcentral gyrus (PCG). In comparison with PD-CN patients, PD-MCI patients displayed significantly higher ReHo values in the right PCG, left middle occipital gyrus (MOG) and IPL. No significant correlation between ReHo indices and the neuropsychological scales was observed. CONCLUSION: Our finding revealed that decreases in ReHo in the default mode network (DMN) may appear before PD-related cognitive impairment. In order to preserve executive attention capacity, ReHo in the right MFG in PD patients lacking cognition impairment increased for compensation. PD-MCI showed increased ReHo in the left MOG, which might have been caused by visual and visual-spatial dysfunction, and increased ReHo in the left IPL, which might reflect network disturbance and induce cognition deficits.

Influencing factors of hemorrhagic transformation in non-thrombolysis patients with cerebral infarction.

OBJECTIVES: Hemorrhagic transformation (HT) is a serious complication of acute cerebral infarction. The aim of study is to investigate the influencing factors of HT in non-thrombolysis patients with acute cerebral infarction, and to explore its clinical significance. PATIENTS AND METHODS: From June 2016 to March 2017, a total of 346 non-thrombolysis patients with acute cerebral infarction hospitalized in the Department of Neurology of Guangdong Second Provincial General Hospital, were chosen and randomly devided into the non-HT group (control) and HT group. A record of 17 indices including the patients'age, gender, hypertension, diabetes, dyslipidemia, hyperhomocystinemia, atrial fibrillation, drinking or smoking, anticoagulation, antithrombosis, international normalized ratio (INR) and platelet count were measured. Then regression analysis was made to find the independent factors for HT. RESULTS: It was found that 38 of non-thrombolysis patients with acute cerebral infarction involved in this study were with HT. The indices including dyslipidemia, drinking, atrial fibrillation, antiplatelet aggregation, anticoagulation, INR > 1.7, cholesterin, triglyceride and platelet count showed statistical differences between the HT group and the non-HT group (P < 0.05). According to the binary logistic regression analysis, there was a negative correlation between dyslipidemia and HT (odds ratio (OR)=0.371, 95% confidence interval (CI) 0.186-0.740, P = 0.005), while there was a positive correlation between atrial fibrillation (OR=2.476, 95% CI 1.140-5.377, P=0.022), platelet count (OR=1.006, 95% CI 0.682-1.611, P = 0.007), INR>1.7 (OR=10.889, 95% CI 4.760-24.910, P = 0.000) and HT. CONCLUSION: There is independent correlation between dyslipidemia, atrial fibrillation, platelet count, INR > 1.7 and HT. Dyslipidemia is the protective factor for HT, and atrial fibrillation, platelet count, INR > 1.7 are the risk factors for HT.

Dopamine receptor 1 modulates the discharge activities of inspiratory and biphasic expiratory neurons via cAMP-dependent pathways.

Dopamine receptor 1 (D(1)R) plays an essential role in regulating respiratory activity in mammals, however, little is known about how this receptor acts to modulate the basic respiratory rhythmogenesis. Here, by simultaneously recording the discharge activities of biphasic expiratory (biphasic E) neurons/inspiratory (I) neurons and the XII nerve rootlets from brainstem slices, we found that the application of D(1)R agonist cis-(±)-1-(aminomethyl)-3,4-dihydro-3-phenyl-1H-2-benzopyran-5,6-diolhydrochloride (A68930, 5 µM), or forskolin, an intracellular cAMP-increasing agent, substantially decreased respiratory cycle and expiratory time of both types of neurons, and elevated the integral amplitude and frequency of XII nerve rootlets discharge. These changes were reversed by subsequent application of their antagonists SCH-23390 and Rp-Adenosine 3',5'-cyclic monophosphorothioate triethylammonium salt hydrate (Rp-cAMPS), respectively. Importantly, after pretreatment with Rp-cAMPS, the effects of A68930 in both types of neurons were blocked, suggestive of a cAMP-dependent action of A68930. Thus, the current study indicates that D(1)R may modulate basic breathing rhythmogenesis via cAMP-dependent mechanisms.

[Group II metabotropic glutamate receptors is involved in the modulation of respiratory rhythmical discharge activity in neonatal rat medullary brain slices].

OBJECTIVE: To explore the role of group II metabotropic glutamate receptors in the modulation of basic respiratory rhythm. METHODS: Neonatal (0-3 days) SD rats of either sex were used. The medulla oblongata brain slice containing the medial region of the nucleus retrofacialis (mNRF) and the hypoglossal nerve rootlets was prepared, and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous carbogen (95% O2 and 5% CO2) within 3 min. The brain slices were quickly transferred to a recording chamber and continuously perfused with oxygen-saturated MKS at a rate of 4-6 ml/min at 27-29 degrees celsius. Eighteen medulla oblongata slices were divided into 3 groups and treated for 10 min with group II metabotropic glutamate receptor-specific agonist 2R,4R-4-aminopyrrolidine-2,4-dicarboxylate (APDC) (at concentrations of 10, 20, 50 micromol/L), group II metabotropic glutamate receptor antagonist (2S)-alpha-ethylglutamic acid (EGLU) (300 micromol/L), or APDC (50 micromol/L)+EGLU (300 micromol/L) after a 10 min APDC (50 micromol/L) application. Respiratory rhythmical discharge activity (RRDA) of the rootlets of the hypoglossal nerve was recorded by suction electrodes. RESULTS: APDC produced a dose-dependent inhibitory effect on the RRDA, prolonging the respiratory cycle and expiratory time and decreasing the integral amplitude and inspiratory time. EGLU induced a significant decrease in the respiratory cycle and expiratory time. The effect of APDC on the respiratory rhythm was partially reversed by the application of APDC+EGLU. CONCLUSION: Group II metabotropic glutamate receptors are probably involved in the modulation of the RRDA in isolated neonatal rat brainstem slice.

Glial cells are involved in the exciting effects of doxapram on brainstem slices in vitro.

This study tested whether the glial cells are involved in the exciting effects of doxapram on brainstem slice in vitro. Experiments were performed in brainstem slice preparations from neonatal rats. The medial area of nucleus retrofacialis (mNRF) and the hypoglossal nerve (XII nerve) were contained in the preparations. The slices were perfused with modified Kreb's solution (MKS), and the rhythmical respiratory discharge activity (RRDA) was simultaneously recorded from the XII nerve by using suction electrodes, including the discharge time course of inspiratory (Ti), expiratory (Te), respiratory cycle (RC), and integrity amplitude of inspiratory discharge (IA). After applying of doxapram (5 microM) to the MKS for 10 min, Ti and IA increased significantly (85.0 +/- 25.0%, 13.2 +/- 2.5%, respectively, P < 0.05), the Te and the RC decreased significantly (19.0 +/- 1.4%, 12.8 +/- 1.4%, respectively, P < 0.05) when compared with control group. When the methionine sulfoximine (MS, 10 microM), a blockage of glutamine synthetase, was applied, all the exciting effects of doxapram on RRDA were reversed. After the glutamine (20 microM) was applied to the MKS for 10 min, the exciting effects were revealed again. Our results suggest that the normal metabolism of glial cells takes a key role in the modification of the RRDA in the slices. In conclusion, glial cells are involved in the exciting effects of doxapram on brainstem slice in vitro.

[Effect of doxapram on the respiratory rhythmical discharge activity in the brainstem slice of neonatal rats].

OBJECTIVE: To investigate the effects of doxapram on the respiratory rhythmical discharge activity (RRDA) in the brainstem slices of neonatal rats. METHODS: Thirty neonatal SD rats (of either sex, 0-3 days old) were randomly divided into 6 equal groups (groups I-VI), and the brainstem slices which contained the medial region of the nucleus retrofacialis (mNRF) were prepared. All the slices were perfused with modified Kreb's solution (MKS), and in group I (control group), the slices were perfused with MKS only; in groups II to IV, the slices were perfused with doxapram in MKS continuously at the concentrations of 2, 5, and 10 micromol/L, respectively; in groups V and VI, the slices were perfused with 20 micromol/L propofol and 20 micromol/L propofol plus 5 micromol/L doxapram, respectively. The RRDA in the hypoglossal nerve was recorded by suction electrode. The discharge time course of the inspiratory (TI), expiratory (TE), respiratory cycle (RC) and integral amplitude of the inspiratory discharge (IA) were recorded at 1, 3, 5, 10, 15, and 30 min after the application of the drugs. RESULTS: The hypoglossal nerve in groups I, II and VI showed no significant changes of RRDA in the entire course of the experiment (P>0.05). In groups III and IV, the TI, IA increased and TE decreased significantly 5 min after doxapram application (P<0.05), and the RC was shortened only at 10 min. In group V, the TI and IA decreased and the RC and TE increased significantly after the drug application (P<0.05). CONCLUSION: Doxapram (>5 micromol/L ) can directly stimulate the RRDA and prevent propofol-induced inhibitory effects in the brainstem slice of neonatal rats, and the effects are mediated by its actions upon the inspiratory neurons in the mNRF.

[Effect of glial cell metabolism on respiratory rhythmical discharge activity in neonatal rat medulla oblongata slices].

OBJECTIVE: To explore the role of glial cell metabolism in the generation and regulation of central respiratory rhythm. METHODS: The medulla oblongata slices (600-700 microm) containing the medial region of the nucleus retrofacialis (mNRF) with the hypoglossal nerve rootlets retained from 12 neonatal (0-3 days) Sprague-Dawley rats were prepared and perfused with modified Kreb's solution (MKS). Upon recording of respiratory rhythmical discharge activity (RRDA) of the rootlets of the hypoglossal nerve, the brain slices were treated with glial cell metabolism antagonist L-methionine sulfoximine (L-MSO, 50 micromol/L) for 20 min followed by application of glial cell metabolism agonist L-glutamine (L-GLN, 30 micromol/L) for 20 min, or with L-MSO for 20 min with additional L-GLN for 20 min. The changes in the RRDA of the rootlets of the hypoglossal nerve in response to the treatments were recorded. RESULTS: L-MSO prolonged the respiratory cycle (RC) and expiratory time (TE), and reduced the integral amplitude (IA) and the inspiratory time (TI) in the brain slices. L-GLN induced a significant decrease in RC and TE, but IA and TI showed no obvious variations. The effect of L-MSO on the respiratory rhythm was reversed by the application of L-GLN. CONCLUSION: Glial cell metabolism may play an important role in the modulation of RRDA in neonatal rat brainstem.

[Effects of A68930 on rhythmical respiratory discharge in isolated neonatal rat brainstem slice].

OBJECTIVE: To investigate the role of dopamine-1 receptor in the modulation of basic respiration rhythm. METHODS: Newborn SD rat (0-3 days, n=20) brain stem slices containing the medial region of the nucleus retrofacialis (mNRF) were prepared with the hypoglossal nerve roots retained. The respiratory rhythmical discharge activity (RRDA) of the hypoglossal nerve was recorded using suction electrodes on these preparations, and the effects of dopamine-1 receptor on RRDA were investigated by application of the specific agonist of dopamine-1 receptor A68930 at different concentrations (0, 1, 2, and 5 micromol/L) in the perfusion solution. RESULTS: The respiratory cycles (RC) and the expiratory time (TE) decreased progressively with gradual increment of the integrated amplitude (IA) after A68930 administration, and their changes were the most conspicuous at 5 min after the administration. A68930 at the concentrations of 2 and 5 micromol/L resulted in the most obvious changes in RC, TE, and IA (P<0.05), but IA exhibited no significant variation at 1 min after perfusion with 2 micromol/L A68930 (P>0.05). RC and TE were gradually shortened after treatment with increasing concentrations of A68930, which also caused gradual increment of IA, and at the concentration of 5 micromol/L, RC, TE, and IA all showed the most obvious changes (P<0.01). CONCLUSIONS: Dopamine-1 receptor plays a role in the modulation of RRDA in isolated neonatal rat brainstem slice. A68930 may increase the frequency of respiration by shortening TE and enhance the respiratory activity by increasing the amplitude of inspiratory discharge of the respiratory neurons.

[D(1)-dopamine receptor is involved in the modulation of the respiratory rhythmical discharge activity in the medulla oblongata slice preparation of neonatal rats in vitro.].

To explore the role of D(1)-dopamine receptor in the modulation of basic respiratory rhythm, neonatal (0-3 d) Sprague-Dawley rats of either sex were used. The medulla oblongata slice was prepared and the surgical procedure was performed in the modified Kreb's solution (MKS) with continuous ventilating 95% O2 and 5% CO2 and ended in 3 min. A 600-700 mum single transverse slice containing the hypoglossal nerve roots and some parts of the ventral respiratory group was cut. The preparation was quickly transferred to a recording chamber and continuously perfused with oxygen-saturated MKS at a rate of 4-6 mL/min at 27-29 degrees C. Ten medulla oblongata slice preparations were randomly divided into two groups. In group I, the preparations were perfused with perfusion solution containing D(1)-dopamine receptor specific agonist cis-(+/-)-1-(Aminomethyl)-3,4-dihydro-3-phenyl-1H-2-Benzopyran-5,6-Diolhy-drochlo-ride (A68930, 5 mumol/L) for 10 min first; after washing out, the preparations were then perfused with perfusion solution containing D(1)-dopamine receptor specific antagonist R(+)-7-Chloro-8-hydroxy-3-methyl-1-phenyl-2,3,4,5-tetrahydro-1H-3-benzazepine hydrochloride (SCH-23390, 2 mumol/L) for 10 min. In group II, after perfusion with A68930 for 10 min, the preparations were perfused with additional A68930 + SCH-23390 for 10 min. Respiratory rhythmical discharge activity (RRDA) of the rootlets of hypoglossal nerve was recorded by suction electrodes. The results showed that A68930 shortened the respiratory cycle (RC) and expiratory time (TE) with an increase in the integral amplitude (IA). However, SCH-23390 significantly prolonged RC and TE, and decreased IA with a decrease in inspiratory time (TI). Moreover, the effect of A68930 on the respiratory rhythm was partially reversed by additional application of A68930 + SCH-23390. These results indicate that D(1)-dopamine receptor is possibly involved in the modulation of the RRDA in the isolated neonatal rat brainstem slice.