Electroencephalography(EEG)is a non-invasive measurement method for brain activity.Due to its safety,high resolution,and hypersensitivity to dynamic changes in brain neural signals,EEG has aroused much interest in sci...Electroencephalography(EEG)is a non-invasive measurement method for brain activity.Due to its safety,high resolution,and hypersensitivity to dynamic changes in brain neural signals,EEG has aroused much interest in scientific research and medical felds.This article reviews the types of EEG signals,multiple EEG signal analysis methods,and the application of relevant methods in the neuroscience feld and for diagnosing neurological diseases.First,3 types of EEG signals,including time-invariant EEG,accurate event-related EEG,and random event-related EEG,are introduced.Second,5 main directions for the methods of EEG analysis,including power spectrum analysis,time-frequency analysis,connectivity analysis,source localization methods,and machine learning methods,are described in the main section,along with diferent sub-methods and effect evaluations for solving the same problem.Finally,the application scenarios of different EEG analysis methods are emphasized,and the advantages and disadvantages of similar methods are distinguished.This article is expected to assist researchers in selecting suitable EEG analysis methods based on their research objectives,provide references for subsequent research,and summarize current issues and prospects for the future.展开更多
BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this obser...BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) [difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674]. AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability.展开更多
BACKGROUND: Cerebrovascular accident(CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis ...BACKGROUND: Cerebrovascular accident(CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't signi? cant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients.METHODS: A descriptive hospital-based study of the neurological symptoms and signs of 503 patients with ischemic stroke, including severe headache, seizure, eye movement disorder, pupil size, Glasgow Coma Scale(GCS), agitation were analyzed in this study.RESULTS: In the current study, dilated pupils, agitation, acute onset headache, lower GCS score, seizure, and eye gaze impairment had signi? cantly higher prevalence in hemorrhagic stroke patients(P<0.001). However, the rate of gradual progressive headache is significantly higher in ischemic stroke patients(P<0.001).CONCLUSION: Although this result provides reliable indicators for discrimination of stroke types, imaging studies are still the gold standard modality for diagnosis.展开更多
Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA). Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital ...Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA). Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010. All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology. Among the 63 TA patients, 27 with neurological manifestations were included in the present study. All the patients were evaluated using standardized neurological examination, sonography, computed tomography (CT) angiography, and cerebral CT or magnetic resonance imaging. Results Dizziness and visual disturbance were the most common symptoms, which occurred in 20 (74.1%) and 16 (59.3%) patients respectively. Another common symptom was headache, observed in 15 (55.6%) patients. Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures. Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations. Conclusions Neurological manifestations are common symptoms in TA patients in the chronic phase, including dizziness, visual disturbance, headache, ischemic stroke, seizures, and some unusual ones such as RPES. We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.展开更多
Objective: Neurological evaluation is commonly applied to identify ischemia in focal cerebral ischemia model though it might not be sensitive. In present study, we hired sleeping time to assess ischemia occurrence. Me...Objective: Neurological evaluation is commonly applied to identify ischemia in focal cerebral ischemia model though it might not be sensitive. In present study, we hired sleeping time to assess ischemia occurrence. Methods: Permanent middle cerebral artery occlusion was induced in Sprague-Dawley rats under pentobarbital and ketamine anesthesia respectively. Sleeping time was recorded. Neurological evaluation was conducted by modified Bederson’s scoring system at 4 h and histopathological evaluation was performed at 3 d after middle cerebral artery occlusion. Results: Slices of brain stained by TTC, H&E and hoechst 33258 revealed extensive lesion in the two ischemic groups. The sensitivity to identify ischemia by neurological evaluation was 62.5%, but it was 81.3% and 80% respectively when evaluating by sleeping time (pentobarbital: ≥90.7 min, ketamine: ≥36.1 min). The sensitivity to identify ischemia by sleeping time was significantly higher than that by neurological evaluation (P<0.05). Conclusion: Our results suggested that to identify ischemia by sleeping time is a simple and sensitive method in the setting of focal cerebral ischemia in rat.展开更多
Disorders of consciousness(DoCs) are chronic conditions resulting usually from severe neurological deficits. The limitations of the existing diagnosis systems and methodologies cause a need for additional tools for re...Disorders of consciousness(DoCs) are chronic conditions resulting usually from severe neurological deficits. The limitations of the existing diagnosis systems and methodologies cause a need for additional tools for relevant patients with DoCs assessment, including brain-computer interfaces(BCIs). Recent progress in BCIs' clinical applications may offer important breakthroughs in the diagnosis and therapy of patients with DoCs. Thus the clinical significance of BCI applications in the diagnosis of patients with DoCs is hard to overestimate. One of them may be brain-computer interfaces. The aim of this study is to evaluate possibility of non-invasive EEG-based brain-computer interfaces in diagnosis of patients with DOCs in post-acute and long-term care institutions.展开更多
BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothr...BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare.METHODS:We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure,a rare clinical manifestation in this type of stroke.The patient was treated with anti-epileptic therapy after admission.RESULTS:The patient was discharged with oral administration of phenytoin 100 mg TDS,aspirin 80 mg daily,and atorvastatin 40 mg daily.CONCLUSION:Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit.展开更多
BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as &quo...BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as "bath salt" is on the rise.METHODS: We report the case of a 33-year-old man who complained of "flashbacks" and right arm shaking that followed a night of "bath salt" snorting. The active compound methylenedioxypyrovalerone methamphetamine(MDPV) was confirmed; however, analysis of three different "bath salt" products showed difference in their active components.RESULTS: The patient's symptoms remained stable and he was discharged home after observation in the emergency department with instructions to return for any symptom progression.CONCLUSION: Practitioners should be aware of the abuse of the compounds and that not all "bath salt" products contain MDPV.展开更多
The bone marrow in the skull is important for shaping immune responses in the brain and meninges, but its molecular makeup among bones and relevance in human diseases remain unclear. Here, we show that the mouse skull...The bone marrow in the skull is important for shaping immune responses in the brain and meninges, but its molecular makeup among bones and relevance in human diseases remain unclear. Here, we show that the mouse skull has the most distinct transcriptomic profile compared with other bones in states of health and injury, characterized by a late-stage neutrophil phenotype. In humans, proteome analysis reveals that the skull marrow is the most distinct, with differentially expressed neutrophil-related pathways and a unique synaptic protein signature. 3D imaging demonstrates the structural and cellular details of human skull-meninges connections (SMCs) compared with veins. Last, using translocator protein positronemission tomography (TSPO-PET) imaging, we show that the skull bone marrow reflects inflammatory brain responses with a disease-specific spatial distribution in patients with various neurological disorders. The unique molecular profile and anatomical and functional connections of the skull show its potential as a site for diagnosing, monitoring, and treating brain diseases.展开更多
基金supported by the STI2030 Major Projects(2021ZD0204300)the National Natural Science Foundation of China(61803003,62003228).
文摘Electroencephalography(EEG)is a non-invasive measurement method for brain activity.Due to its safety,high resolution,and hypersensitivity to dynamic changes in brain neural signals,EEG has aroused much interest in scientific research and medical felds.This article reviews the types of EEG signals,multiple EEG signal analysis methods,and the application of relevant methods in the neuroscience feld and for diagnosing neurological diseases.First,3 types of EEG signals,including time-invariant EEG,accurate event-related EEG,and random event-related EEG,are introduced.Second,5 main directions for the methods of EEG analysis,including power spectrum analysis,time-frequency analysis,connectivity analysis,source localization methods,and machine learning methods,are described in the main section,along with diferent sub-methods and effect evaluations for solving the same problem.Finally,the application scenarios of different EEG analysis methods are emphasized,and the advantages and disadvantages of similar methods are distinguished.This article is expected to assist researchers in selecting suitable EEG analysis methods based on their research objectives,provide references for subsequent research,and summarize current issues and prospects for the future.
文摘BACKGROUND: This study was done to compare the admission Full Outline of Unresponsiveness(FOUR) score and Glasgow Coma Scale(GCS) as predictors of outcome in children with impaired consciousness.METHODS: In this observational study, children(5–12 years) with impaired consciousness of <7 days were included. Children with traumatic brain injury, on sedatives or neuromuscular blockade; with pre-existing cerebral palsy, mental retardation, degenerative brain disease, vision/hearing impairment; and seizure within last 1 hour were excluded. Primary outcomes: comparison of area under curve(AUC) of receiver operating characteristic(ROC) curve for in-hospital mortality. Secondary outcomes: comparison of AUC of ROC curve for mortality and poor outcome on Pediatric Overall Performance Category Scale at 3 months.RESULTS: Of the 63 children, 20 died during hospital stay. AUC for in-hospital mortality for GCS was 0.83(CI 0.7 to 0.9) and FOUR score was 0.8(CI 0.7 to 0.9) [difference between areas –0.0250(95%CI 0.0192 to 0.0692), Z statistic 1.109, P=0.2674]. AUC for mortality at 3 months for GCS was 0.78(CI 0.67 to 0.90) and FOUR score was 0.74(CI 0.62 to 0.87)(P=0.1102) and AUC for poor functional outcome for GCS was 0.82(CI 0.72 to 0.93) and FOUR score was 0.79(CI 0.68 to 0.9)(P=0.2377), which were also comparable. Inter-rater reliability for GCS was 0.96 and for FOUR score 0.98.CONCLUSION: FOUR score was as good as GCS in prediction of in-hospital and 3-month mortality and functional outcome at 3 months. FOUR score had a good inter-rater reliability.
文摘BACKGROUND: Cerebrovascular accident(CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't signi? cant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients.METHODS: A descriptive hospital-based study of the neurological symptoms and signs of 503 patients with ischemic stroke, including severe headache, seizure, eye movement disorder, pupil size, Glasgow Coma Scale(GCS), agitation were analyzed in this study.RESULTS: In the current study, dilated pupils, agitation, acute onset headache, lower GCS score, seizure, and eye gaze impairment had signi? cantly higher prevalence in hemorrhagic stroke patients(P<0.001). However, the rate of gradual progressive headache is significantly higher in ischemic stroke patients(P<0.001).CONCLUSION: Although this result provides reliable indicators for discrimination of stroke types, imaging studies are still the gold standard modality for diagnosis.
文摘Objective To investigate the clinical neurological manifestations of Takayasu arteritis (TA). Methods A retrospective study was conducted with 63 consecutive TA cases admitted to Peking Union Medical College Hospital from January 2009 to May 2010. All the patients fulfilled the diagnostic criteria of TA by the American College of Rheumatology. Among the 63 TA patients, 27 with neurological manifestations were included in the present study. All the patients were evaluated using standardized neurological examination, sonography, computed tomography (CT) angiography, and cerebral CT or magnetic resonance imaging. Results Dizziness and visual disturbance were the most common symptoms, which occurred in 20 (74.1%) and 16 (59.3%) patients respectively. Another common symptom was headache, observed in 15 (55.6%) patients. Six (22.2%) patients had suffered from ischemic stroke; 7 (25.9%) patients had epileptic seizures. Two (7.4%) patients were diagnosed as reversible posterior encephalopathy syndrome (RPES) based on typical clinical and imaging manifestations. Conclusions Neurological manifestations are common symptoms in TA patients in the chronic phase, including dizziness, visual disturbance, headache, ischemic stroke, seizures, and some unusual ones such as RPES. We suggested RPES be included into the differential diagnosis of acute neurological changes in TA.
文摘Objective: Neurological evaluation is commonly applied to identify ischemia in focal cerebral ischemia model though it might not be sensitive. In present study, we hired sleeping time to assess ischemia occurrence. Methods: Permanent middle cerebral artery occlusion was induced in Sprague-Dawley rats under pentobarbital and ketamine anesthesia respectively. Sleeping time was recorded. Neurological evaluation was conducted by modified Bederson’s scoring system at 4 h and histopathological evaluation was performed at 3 d after middle cerebral artery occlusion. Results: Slices of brain stained by TTC, H&E and hoechst 33258 revealed extensive lesion in the two ischemic groups. The sensitivity to identify ischemia by neurological evaluation was 62.5%, but it was 81.3% and 80% respectively when evaluating by sleeping time (pentobarbital: ≥90.7 min, ketamine: ≥36.1 min). The sensitivity to identify ischemia by sleeping time was significantly higher than that by neurological evaluation (P<0.05). Conclusion: Our results suggested that to identify ischemia by sleeping time is a simple and sensitive method in the setting of focal cerebral ischemia in rat.
文摘Disorders of consciousness(DoCs) are chronic conditions resulting usually from severe neurological deficits. The limitations of the existing diagnosis systems and methodologies cause a need for additional tools for relevant patients with DoCs assessment, including brain-computer interfaces(BCIs). Recent progress in BCIs' clinical applications may offer important breakthroughs in the diagnosis and therapy of patients with DoCs. Thus the clinical significance of BCI applications in the diagnosis of patients with DoCs is hard to overestimate. One of them may be brain-computer interfaces. The aim of this study is to evaluate possibility of non-invasive EEG-based brain-computer interfaces in diagnosis of patients with DOCs in post-acute and long-term care institutions.
文摘BACKGROUND:According to the literature,generalized seizure as a presenting sign of stroke is rare,and in the reported cases it was accompanied by a focal neurological deficit.Presentation of a small ischemic atherothrombotic brain infarction with convulsive generalized seizure is very rare.METHODS:We reported a patient with acute small ischemic atherothrombotic infarction associated with an episode of generalized tonic-clonic seizure,a rare clinical manifestation in this type of stroke.The patient was treated with anti-epileptic therapy after admission.RESULTS:The patient was discharged with oral administration of phenytoin 100 mg TDS,aspirin 80 mg daily,and atorvastatin 40 mg daily.CONCLUSION:Small ischemic atherothrombotic infarction can present only with a seizure without any focal neurological deficit.
文摘BACKGROUND: The use and abuse of designer drugs has been recognized for decades; however there are many derivatives of compounds that make their way into the community. Abuse of compound(s) known on the street as "bath salt" is on the rise.METHODS: We report the case of a 33-year-old man who complained of "flashbacks" and right arm shaking that followed a night of "bath salt" snorting. The active compound methylenedioxypyrovalerone methamphetamine(MDPV) was confirmed; however, analysis of three different "bath salt" products showed difference in their active components.RESULTS: The patient's symptoms remained stable and he was discharged home after observation in the emergency department with instructions to return for any symptom progression.CONCLUSION: Practitioners should be aware of the abuse of the compounds and that not all "bath salt" products contain MDPV.
文摘The bone marrow in the skull is important for shaping immune responses in the brain and meninges, but its molecular makeup among bones and relevance in human diseases remain unclear. Here, we show that the mouse skull has the most distinct transcriptomic profile compared with other bones in states of health and injury, characterized by a late-stage neutrophil phenotype. In humans, proteome analysis reveals that the skull marrow is the most distinct, with differentially expressed neutrophil-related pathways and a unique synaptic protein signature. 3D imaging demonstrates the structural and cellular details of human skull-meninges connections (SMCs) compared with veins. Last, using translocator protein positronemission tomography (TSPO-PET) imaging, we show that the skull bone marrow reflects inflammatory brain responses with a disease-specific spatial distribution in patients with various neurological disorders. The unique molecular profile and anatomical and functional connections of the skull show its potential as a site for diagnosing, monitoring, and treating brain diseases.
