Clinical features and immunotherapy outcomes of anti-glutamic acid decarboxylase 65 antibody-associated neurological disorders.

We described the clinical and neuroimaging characteristics of seven Chinese patients with anti-GAD65 antibody-associated neurological disorders of whom epileptic seizures were the initial and main symptoms. All patients were given immunotherapy and followed up monthly. The outcome demonstrates that immunotherapy is helpful for non-seizure manifestations of anti-GAD65-associated neurological autoimmunity and is less effective in the treatment of seizures, yet partial responses can still occur in the early stage. Taken together we suggest a trial with immunotherapy in all patients in the early stage of the disease, and in patients with non-epilepsy symptoms in the later stage.

Clinical analysis of 42 autoimmune epilepsy patients with autoantibody / 中华神经科杂志

Objective To analyze the characteristics of clinical manifestation, brain magnetic resonance imaging ( MRI ) and 18 F-fluoro-deoxy-glucose positron emission tomography ( FDG-PET ) , inflammatory cerebrospinal fluid ( CSF ) , electroencephalography ( EEG ) , and associated tumour in autoimmune epilepsy ( AE) patients with different autoantibodies. Methods Forty-two patients diagnosed as AE with different autoantibodies in Beijing Tiantan Hospital, Capital Medical University between May 2014 and May 2017 were recruited. The clinical manifestation, brain MRI and PET, CSF findings, EEG and biochemical examination of these patients were analyzed. Results Specific autoimmune antibodies were detected in 42 patients, including anti-amphiphysin in one patient, anti-contactin-associated protein 2 in two, anti-γ-aminobutyric acid-B receptor in six, anti-leucine-rich glioma inactivated 1(LGI1) in 24, anti-N-methyl-D-aspartate receptor ( NMDAR ) in nine. The case series of 42 patients had an average age of (49. 9 ± 14. 5) years with a male to female ratio of 5:1. Except anti-NMDAR associated AE, most patients (21/33) presented with the symptoms of limbic encephalitis including temporal lobe seizures, memory decline, personality and neuropsychiatric changes, mesial temporal lobe abnormality in MRI or FDG-PET, and CSF inflammation. The seizure semiologic characteristics included frequent seizure, short seizure duration and common secondarily generalized tonic-clonic seizures during sleeping. Faciobrachial dystonic seizures and hyponatremia were the special clinical manifestation of AE with anti-LGI1. AE patients with all kinds of antibodies presented as initial resistance to anti-epilepsy drugs ( AEDs) and favorable outcome of immunosuppressive treatment in combination with AEDs. Conclusions AE patients with each type of antibody have the special clinical manifestation. Except anti-NMDAR associated AE, the seizure semiologic characteristics often present as frequent and short seizures. All AE patients present as drug refractory epilepsy initially. Seizures in AE patients can be well controlled by immunotherapy combined with AEDs.

motor relearning program (MRP), stroke, balance function / 中国康复理论与实践

@#Objective To investigate the relationship between MRI rating of white matter hyperintensities (WMH) within cholinergic pathway and vascular dementia in Binswanger's disease.Methods 41 patients with Binswanger's disease undergone inspection of MRI. On 4 selected axial images, the severity of WMH in the cholinergic pathways was rated on a 3-point scale for ten regions identified with major anatomical landmarks. The cholinergic pathways hyperintensities scale (CHIPS) were developed by Bocti based immunohistochemical tracings of the cholinergic pathways. Subjects underwent neuropsychological testing with the Mattis Dementia Rating Scale (DRS) to assess cognitive domains of interest (attention, episodic memory, executive functions). Spearman correlation coefficients were used to compute association between CHIPS score and DRS score.Results The total score of DRS, the scores of DRS attention subscale and memory subscale were 105.6±18.2, 29.5±4.2 and 11.3±3.2 respectively. The score of CHIPS was 35.6±13.7. After accounting for age and education in a multiple linear regression model, the CHIP ratings were associated with impaired performance on the DRS ( r=-0.43, P<0.05).Conclusion The MRI rating of WMH within cholinergic pathway has strong correlations with cognitive performance in patients with Binswanger's disease.

Ability of Chinese Characters Reading in Patients with Alzheimer's Disease / 中国临床心理学杂志

Objective: To analyze the ability of Chinese characters reading and characteristics of alexia among patients with mild, moderate and severe Alzheimer's Disease(AD). Methods: Chinese characters reading test was performed in 20 normal controls(average MMSE total score is 27.7), 20 mild AD(average MMSE is 21.2),20 moderate AD(average MMSE is 15.2) and 20 severe AD(average MMSE is 6.9). Chinese characters reading test consists of 22 mark-symbol characters, 17 phonetic symbol characters and 17 meaning-symbol characters. Results: No significant difference were found in scores of Chinese characters reading test among normal controls, patients with mild, moderate AD group. Compared with moderate AD, severe AD showed manifest decline for scores of phonetic symbol characters and meaning-symbol characters reading. There wasn't significant different visual paralexia among 4 groups. Surface alexia occurred at early stage of AD and advanced at late stage of AD. These wrong reading were seen frequently in meaning-symbol characters. Deep alexia occurred only at late stage of AD. Compound words phanomenon is the major class of deep alexia. Conclusion: Ability of Chinese characters reading was helpful to estimate premorbid intelligence of the patients with dementia. There are different classes of alexia between Chinese and western languages.

Dynamic changes of neurokinin A and calcitonin gene-related peptide levels in gastric mucosal and plasma in rats with celiac seawater-immersing trauma / 中国病理生理杂志

AIM:To observe the dynamic changes of neurokinin A(NKA) and calcitonin gene-related peptide(CGRP) levels in gastric mucosal and plasma in rats after abdominal seawater-immersing trauma,and to investigate the influence of these two sensory neuropeptides on acute gastric mucosal lesion.METHODS:Thirty-two SD rats were randomly divided into four groups(normal group,celiac seawater-immersing trauma 1,2 and 3 h groups).With emzyoimmunoassay and radioimmunoassay respectively,gastric mucosal and plasma NKA and CGRP levels in rats were measured.RESULTS:Compared with normal rats,with the seawater-immersing time prolonged,gastric mucosal NKA and CGRP levels in rats were progressively decreased(P