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1Efficacy of short-term multidisciplinary intensive rehabilitation in patients with different Parkinson's disease motor subtypes: a prospective pilot study with 3-month follow-up显示文摘Parkinson's disease(PD) can be classified into three motor-based subtypes: postural instability/gait difficulty(PIGD), tremor dominant(TD), and indeterminate.The neuropathophysiological mechanisms of the three motor subtypes are different, which may lead to different responses to therapy.Sixty-nine patients with idiopathic Parkinson's disease(Hoehn–Yahr stage ≤ 3) were screened from 436 patients with Parkinsonism recruited through outpatient services and the internet.According to the Movement Disorder Society Unified Parkinson's Disease Rating Scale(MDS-UPDRS) TD/PIGD ratio, the patients were divided into PIGD(TD/PIGD ≤ 0.09;n = 36), TD(TD/PIGD ≥1.15;n = 19), and indeterminate(TD/PIGD = 0.90–1.15;n = 14) groups.All patients received 2 weeks of multidisciplinary intensive rehabilitation treatment(MIRT) during hospitalization, as well as a remote home rehabilitation health education class.Compared with the scores at admission, all patients showed significant improvements in their MDS-UPDRS III score, walking ability, balance, and posture control at discharge.Moreover, the MDS-UPDRS III score improvement was greater in the PIGD group than in the TD group.The follow-up data, collected for 3 months after discharge, showed that overall symptom improvement in each group was maintained for 1–3 months.Furthermore, there were no significant differences in the duration or grade effects of symptom improvement among the three groups.These findings suggest that 2 weeks of MIRT is effective for improving motor performance in all three motor subtypes.Patients in the PIGD group had a better response after hospitalization than those in the TD group.This study was approved by the Institutional Ethics Committee of Beijing Rehabilitation Hospital of Capital Medical University of China(approval No.2018 bkky022) on May 7, 2018 and registered with the Chinese Clinical Trial Registry(registration No.Chi CTR1900020771) on January 19, 2019.Ke-Ke Chen Zhao-Hui Jin Lei Gao Lin Qi Qiao-Xia Zhen Cui Liu Ping Wang Yong-Hong Liu Rui-Dan Wang Yan-Jun Liu Jin-Ping Fang Yuan Su Xiao-Yan Yan Ai-Xian Liu Bo-Yan Fang 2021Neural Regeneration Research2021,16,7:8
2百草枯诱导帕金森病样小鼠蓝斑核损伤的动态变化显示文摘目的观察百草枯(PQ)诱导的帕金森病(PD)样小鼠脑干蓝斑核(LC)损伤的动态变化。方法于2019年10月,将36只雄性C57BL/6小鼠按随机数字表法分为染毒组和对照组,各18只。染毒组小鼠给予腹腔注射15 mg/kg PQ,对照组小鼠腹腔注射等容量0.9%生理盐水,每周2次,连续8周。分别于4周、6周、8周末次给药后,观察各组小鼠的神经行为学(爬杆、游泳、旷场、悬尾、高架十字迷宫及水迷宫实验)变化,评估小鼠的运动能力、情绪和认知功能变化。取小鼠脑组织,苏木素-伊红(HE)染色观察LC区病理变化;尼氏染色检测LC区神经元尼氏体数量变化;免疫组织化学(IHC)染色检测黑质(SN)区与LC区神经元标志物神经元核抗原(NeuN),多巴胺(DA)能神经元和去甲肾上腺素(NE)能神经元标志物酪氨酸羟化酶(TH),以及α突触核蛋白(α-syn)表达情况;蛋白免疫印迹(Western blotting)法检测中脑及脑干NeuN、TH、α-syn蛋白表达水平;TUNEL染色检测LC区神经元凋亡情况。结果与PQ染毒第4周组比较,随着染毒时间的进展,PQ染毒组小鼠爬杆时间、游泳不动时间逐渐增加,高架十字迷宫实验开放臂停留时间比和水迷宫实验小鼠穿越平台次数、平台象限停留时间逐渐减少(P<0.05)。HE与尼氏染色结果显示,随着染毒时间的进展,染毒组小鼠LC区神经元逐渐排列疏松,细胞核深染,胞质发生固缩,尼氏体数目逐渐减少(P<0.05)。IHC结果显示,随着染毒时间的进展,染毒组小鼠SN区与LC区神经元NeuN、TH阳性细胞数目逐渐减少,α-syn阳性表达量逐渐增多(P<0.05)。Western blotting结果显示,随着染毒时间的进展,染毒组小鼠中脑和脑干NeuN、TH表达水平逐渐降低,α-syn寡聚体表达水平逐渐升高(P<0.05)。TUNEL染色显示,随着染毒时间的进展,染毒组小鼠LC区神经元凋亡率逐渐升高(P<0.05)。结论PQ诱导PD样小鼠LC区出现渐进性损伤,可能是LC区出现病理性α-syn的异常聚集所引起的。张冰洋 王楷栋 张宝馥 田甜 王一帆 黄敏 2022中华劳动卫生职业病杂志2022,40,4:0
3事件相关电位P300在帕金森病认知功能障碍中的研究进展显示文摘帕金森病(Parkinson disease,PD)是临床常见的神经系统退行性疾病。认知功能障碍严重影响PD患者的生活质量,增加家庭负担。目前临床上尚无相关的生物标志物协助PD认知功能障碍早期诊断。事件相关电位P300是一项灵敏的电生理指标,可以检测PD患者疾病初期隐匿的认知能力下降。本文就P300在PD患者认知障碍中的诊断价值及临床应用进行综述。黄艺锦 孙鹏伦 王姣琦(综述) 徐忠信(审校) 2023中风与神经疾病杂志2023,40,12:0
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