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The effects of CoCl2-induced in vitro hypoxia on aquaporin-4 expression in cultured astrocytes

Chinese Journal of Neurology.2011;44(2):117-121. doi:10.3760/cma.j.issn.1006-7876.2011.02.011

Objective To investigate the expression of aquaporin-4 (AQP4) in cultured astrocytes after in vitro hypoxia induced by CoCl2. Methods After primary culture and subculture, the astrocytes were placed in a controlled atmosphere culture chamber. Both control group and hypoxia groups were established.These groups were further divided into seven sub-groups according to the different time intervals: 15, 30minutes and 1,2, 4, 6, 12 hours, respectively (6 apertures for each group). The shape of the astrocytes in each group was observed with light microscopy and transmission electron microscopy ( TEM ). All groups were examined using in situ hybridization, real time fluorescence quantitative reverse transcriptase polymerase chain reaction, immunocytochemistry and Western blot. The data was analyzed statistically with SPSS 13.0 software. Results There was significant consistency between the AQP4 mRNA and protein ( r =0. 85, P ＜0. 01 ). There was slight positive expression of AQP4 in a few astrocytes of the control groups. In the hypoxia groups, the expression of AQP4 increased within 15 minutes; the increase was most prominent between 1 and 4 hours( mRNA in hypoxia groups: 0. 26 ± 0. 04, 0. 31 ± 0. 02, 0. 36 ± 0. 04; control groups:0. 06 ±0. 01,0. 09 ±0. 01,0. 08 ±0. 01 )after hypoxia and became less between 6 and 12 hours; There was significant difference in the AQP4 expression between the hypoxia groups and control groups among different time points (t = 16. 51, 18.20, 15.26,all P＜0. 01 ). The corresponding pathological changes were cellular edema, which was most prominent between 1 and 4 hours. Under TEM, increase in size of the nucleolus and swelling of endoplasmic reticulum and mitochondria; these changes became more marked with time.Disruption of a few astrocytes was detected in the hypoxia groups at 12 hours. Conclusions The pathological change of astrocytes is cellular edema following hypoxia. There is a positive relationship between the presence and degree of cellular edema as well as the duration of hypoxia and the up-regulating of AQP4.These results imply that AQP4 expression is an important molecular mechanism of celluar edema of astrocytes.

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Expression of Vascular endothelial growth factor mRNA and protein in endothelial progenitor cells in patients during acute cerebral hemorrhage associated with hypertension

Wang MIAO ; Qidong YANG ; Weixin GUO ; Xiaoyun XIE ; Hengfang LIU ; Hongbo LUO ; Juan BAO

Chinese Journal of Neurology.2011;44(2):101-104. doi:10.3760/cma.j.issn.1006-7876.2011.02.007

Objective To explore the expression of vascular endothelial growth factor (VEGF)mRNA and protein in endothelia progenitor cells (EPCs) and VEGF in the culture medium and serum of patients during acute period of cerebral hemorrhage associated with hypertension (APCHH). Methods Mononuclear cells from peripheral blood of patients with APCHH ( 16 patients) and hypertension ( 16 patients) were isolated and induced to EPCs. Semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) analysis was performed to assay VEGF mRNA. VEGF protein was assessed by Western blotting. The VEGF protein level in patient's serum and culture medium ( at day 7 ) were assayed using VEGF ELISA Kit and compared between APCHH group and hypertension group. Results Compared with hypertension group, VEGF mRNA (0. 186 ±0. 035 versus 0.090 ±0.031, t =8.318, P ＜0.0l ) and protein (0. 223 ± 0. 028 versus 0.169 ± 0. 022, t = 3. 744, P ＜ 0. 01 ) expression of EPCs, the concentration of VEGF protein in the supernatant (414 ±37 versus 316 ±29, t =8. 270, P ＜0. 01 ) and in serum (408 ±49versus 222 ±34, t = 12.406, P ＜0. 01 ) were all significantly increased in APCHH group. Conclusion The VEGF protein levels in serum of patients and in the culture medium, VEGF mRNA and protein expression in EPCs were all significantly increased during acute periods of cerebral hemorrhage.

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Relationship between gene polymorphisms of coagulation factor Ⅶ and ischemic cerebrovascular diseases in Henan Han population

Ying HE ; Qingchuan FENG ; Haidong YU ; Junyu BAI ; Hua QI ; Hong ZHENG

Chinese Journal of Neurology.2011;44(2):96-100. doi:10.3760/cma.j.issn.1006-7876.2011.02.006

Objective To explore the associations between coagulation factor Ⅶ (FⅦ)polymorphisms and its haplotype with risk of ischemic cerebrovascular diseases (ICVD) in Henan Han population. Methods Five hundred and twelve cases with ICVD as patient group and 560 healthy subjects as control were recruited in the study. The polymorphisms of R353Q, 5'F7 and IVS7 were detected by PCR-RFLP. The genotype frequency and allele gene frequency were compared between ICVD group and control group. The haplotype was analyzed by SHEsis software. Results The RQ genotype frequencies and Q allele frequencies of ICVD group were significantly lower than those of control group. The distribution of H7 allele frequencies and H6H7 genotype frequencies of FⅦ/IVS7 polymorphisms had significant difference between ICVD group and control group. Finally, the prevalence of R-P0-H6 haplotype in ICVD group(53. 3% )was higher than that in control group (47.5%, OR = 1. 219, 95% CI 1. 028-1. 446,P =0.023). Conclusions In Henan Han population, the Q allele of F Ⅶ/R353Q polymorphisms and the H7 allele of F Ⅶ/IVS7 polymorphisms may be protective genetic factors against ischemic cerebrovascular disease, and the R-P0-H6 haplotype may be a risk factor of ischemic cerebrovascular disease.

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Clinical and pathological features of 20 patients of glycogen storage disease type Ⅱ

Yingjie DAI ; Lin CHEN ; Yupu GUO ; Hongzhi GUAN ; Zhi LIU ; Haitao REN ; Yanhuan ZHAO ; Liying CUI

Chinese Journal of Neurology.2011;44(2):91-95. doi:10.3760/cma.j.issn.1006-7876.2011.02.005

Objective To summarize the clinical and pathological features of glycogen storage disease (GSD) type Ⅱ. Methods The clinical and pathological data of the 20 GSD type Ⅱ patients were reviewed. Results One patient with infantile-onset mainly presented hypotonia, muscle weakness, feeding difficulties, pulmonary infection and cardiomyopathy insufficiency and increase of serum creatine kinase (778 IU/L) and echographic evidence of hypertrophic cardiomyopathy were detected. Electromyography studies indicated a definite myopathy. Nineteen cases were late-onset, presenting a slowly progressive proximal myopathy with truncal involvement or with symptoms dominated by respiratory insufficiency. Not all muscles were equally affected. Increase of serum creatine kinase (208-2600 IU/L) was detected in 14 patients and normal level in 1 patient. Electromyography studies indicated a definite myopathy in 9 patients,with abnormal irritability in 1 patient and susceptible in 4 patients and myotonic discharge in 1 patient and no abnormalities in 2 patients. Echographic evidence of thickening of the interventricular septum and pulmonary hypertension were detected in 2 patients respectively. The common light microscopic feature of all case was a vacuolar myopathy with high glycogen content and acid phosphatase activity in the vacuoles. Conclusions GSD type Ⅱ often presents slowly progressive myopathy which often affect the toro and respiratory muscles.In most patients the serum creatine kinase level is elevated slightly. Muscle biopsy is of use to make the definite diagnosis of this disease.

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The significance in diagnosing tuberculous meningitis by detecting specific antigen in cerebrospinal fluid

Kunnan ZHANG ; Ziqiang XU ; Chaodong WANG ; Xinhui QU ; Xufang XIE ; Xiaomu WU

Chinese Journal of Neurology.2011;44(2):86-90. doi:10.3760/cma.j.issn.1006-7876.2011.02.004

Objective To evaluate the detection of culture filtrate protein 10 (CFP10) and 6000 early secretory antigenic target (ESAT-6) in cerebrospinal fluid to be used in diagnosing tuberculous meningitis. Methods Dot enzyme linked immunosorbent assay ( Dot ELISA) method that was improved by applying concentrated cerebrospinal fluid was used to detect CFP10 and ESAT-6 in cerebrospinal fluid to analyze small protein antigen secreted by M. tuberculosis. Cerebrospinal fluid of 111 subjects were collected,in which 58 specimens were clinically diagnosed as tuberculous meningitis and 53 as non-tuberculous.CFP10 and ESAT-6 were detected in cerebrospinal fluid using Dot ELISA method and the results were analyzed. Results The sensitivities of detecting CFP10 and ESAT-6 antigen were 93.1% and 91.4% respectively, and the specificities were 92. 5% and 94. 3% respectively. The sensitivities and specificities are generally higher compared with the other methods of detecting M. tuberculosis or materials of M. tuberculosis by acid-fast staining or mycobacterium tuberculosis culture and polymerase chain reaction.Conclusions Using Dot ELISA method to detect CFP10 and ESAT-6 in cerebrospinal fluid to diagnose tuberculous meningitis has a high sensitivity and specificity. Our study provided the evidence of detecting the specific antigen of M. tuberculosis to be used in diagnosing tuberculosis.

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External anal sphincter electromyography and related clinical aspects in patients with multiple system atrophy, Parkinson's disease and progressive supranuclear palsy

Han WANG ; Liying CUI ; Hua DU ; Benhong LI ; Shuang WU ; Yuzhou GUAN

Chinese Journal of Neurology.2011;44(1):52-55. doi:10.3760/cma.j.issn.1006-7876.2011.01.014

Objectives To assess the value of external anal sphincter electromyography (EASEMG) in evaluating the related autonomic dysfunction in Parkinson's disease ( PD), parkinsonism dominant multiple system atrophy (MSA-P) and progressive supranuclear palsy (PSP). Methods From the records of EAS-EMG collected in our lab (total 562 cases), 60 PD (male 41, female 19), 68 MSA-P (male 35,female 33) and 13 PSP (male 10, female 3) were included in the analysis in this study. Mean duration,polyphasic ratio and satellite potential occurrence rate were comparable among the groups. Mean duration prolongation were graded as normal ( ＜ 10.0 ms), mild ( 10.0-11.9 ms), moderate ( 12.0-13.9 ms)and severe ( ≥ 14.0 ms). Results Among all related autonomic symptoms, the occurrence rate of constipation, urinary incontinence, urgency and frequency in patients with MSA-P(95.8% (23/24) ,94.6% (53/56) ,87.7% ( 50/57 ), 85.7% (42/49), 76.5% ( 39/51 ) ) were higher than that of PD ( 61.5%(16/26), 62.3% (33/53), 30.6% (15/49), 46.2% (24/52), 45.7% (21/46)) and PSP (75.0%(3/4) , 62.5% (5/8), 50.0% (4/8), 42.9% (3/7), 42.9% (3/7)). The abnormal rate of EAS-EMG in PD, MSA-P and PSP were 60.0%, 94.2% and 84.6%, accordingly. Mean duration ( PD ( 12.0 ± 1.6)ms, MSA-P (15.4±3.0) ms, PSP (13.8±1.8) ms), polyphasic ratio (PD 46.2% ±19.2%, MSA-P 63.9% ± 15.8%, PSP 51.5% ± 12.1% ) and satellite potential occurrence rate ( PD 9.5% ± 8.3%,MSA-P 26.5% ± 15.9%, PSP 19.2% ± 12.5% ) varied significantly different among the groups ( F =31.724, F = 17.412, x2 =45. 335, all P ＜0.01 ). Severe mean duration prolongation was overwhelming in MSA-P (66.2% ) , compared with mild 10.3% and moderate 23.5%. The predominant prolongation degree was moderate in PSP (61.5%, mild 7.7%, severe 30.8% ), and mild in PD (36.7%, moderate 36.7% ,severe 11.7%, normal 15.0% ). Conclusions EAS-EMG could play a role in evaluating the related autonomic dysfunctions in PD, MSA-P and PSP. The EAS-EMG impairment was severe and frequent in MSA-P, mild and infrequent in PD, moderate in PSP. The spectrum of mean duration prolongation suggested the possibility of Onuf's nucleus involvement in these diseases.

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A clinicopathologic analysis of specimens of hemispherectomy or multilobar resection from 46 cases of refractory epilepsy

Yuefeng WANG ; Yueshan PIAO ; Dehong LU ; Wei WANG ; Li CHEN ; Lifeng WEI ; Hong YANG

Chinese Journal of Neurology.2011;44(1):24-29. doi:10.3760/cma.j.issn.1006-7876.2011.01.008

Objective To investigate the clinicopathologic features of the brain tissue from multilobar resection or hemispherectomy for refractory epilepsy. Methods The clinical and pathologic findings of 46 cases seen at Xuanwu hospital from 2005 to 2009 were reviewed retrospectively. Results The mean age of seizure onset and disease duration were 3.9 years and 10.2 years, respectively. There were 33 cases of hemispherectomy and 13 cases of multilobar resection. Temporal lobe abnormality was seen in all cases. The pathologic subgroups were as follows: ulegyria (31/46), malformation of cortical development (MCD, 7/46 ) and infection (8/46). Microscopic examination of ulegyria showed cortical architectural disturbances, neuronal loss, reactive gliosis and appearance of corpora amylacea. We also noted deposition of hemosiderin (13 cases), calcification (9 cases) and island-like neurons (5 cases). All ulegyria cases were accompanied by varying degree of cortical dysplasia, and hippocampus sclerosis were identified in 7 cases. MCD comprised of 5 cases of focal cortical dysplasia ( FCD), including 3 cases of FCDⅠB, 1 case of FCDⅡA and 1 case of FCDⅠA, 1 case of polymicrogyria and 1 case of porencephaly. Among 8 infection eases, there were 5 cases of Rasmussen encephalitis ( RE), l case of cysticercosis, 1 case of tuberculous meningitis and l case of Cytomegalovirus encephalitis. Conclusions The most common pathological category of specimens from hemispherectomy or multilobar resection is ulegyria with obvious temporal lobe abnormality. This is followed by MCD ( with FCDⅠB as the main type) and central nervous system infection (RE as the most frequent abnormality).

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Quantitative pharmacoelectroencephalographic effects of levetiracetam

Jianchuan LI ; Rui ZHANG ; Weiwei WANG ; Xun WU

Chinese Journal of Neurology.2011;44(1):20-23. doi:10.3760/cma.j.issn.1006-7876.2011.01.007

Objective The quantitative pharmacoelectroencephalography ( QPEEG ) of many antiepileptic drugs (AEDs), such as carbamazepine, valproic acid, phenobarbital and topiramate but not levetiracetam (LEV), have been studied. This study is to investigate the effect of LEV on QPEEG. Methods One dose of LEV at l g was administrated to 12 healthy adults (6 males, average age at 26 years, average height at l.67 m). The EEG samples (of 180 seconds each) were obtained prior to and at regular intervals ( 1, 1.5, 2, 3, 4, 6, 7, 8, 12, 24 hours) after administration of LEV. The EEG activity was processed with the power spectral analysis and separated into different frequency bands. The absolute powers of both occipital and frontal lobes were calculated through 30 seconds epochs without artifacts for each recording. The statistical difference between baseline pre-drug control and each post-drug assessment was evaluated by the Wilcoxon matched-paired rank test. Results The power of α1-band and β-band increased bilaterally over both frontal and occipital lobes after the administration of LEV. There was no change of α2-band over bilateral frontal lobes, but increased in double peaks shape with the low point at the 6 hours after the administration. The power of α1-band showed the significant change after the administration at the 1.5 hours (18.8950, Z= -3.059, P=0.002) in the left front, 3 hours (18.6150, Z= -2.981, P =0.003)in the right front, 1.5, 2, 3 and 4 hours (61.0233, 53.9425, 47.6192 and 51.8250 respectively, Z =-3.059, -3.059, -2.903 and -3.059, all P ＜ 0.01 ) in the left occipital, and 1, 1.5, 2 and 3 hours (53.5358, 56.8092, 50.3500 and 47.1733 respectively, Z = -2.903, -3.059, -3.059 and -2.981,all P ＜ 0.01 ) in the right occipital. The power of α2-band showed the significant change after the administration at the 3 hours (73.5450, Z = - 3.059, P = 0.002) in the left occipital, and 1, 3 hours (80. 6808 and 87. 1750, Z = -2.903 and - 3.059, P = 0.004 and 0.002 respectively ) in the right occipital. The power of β-band showed the significant change after the administration at the 3 hours (3.8000, Z = -3.059, P = 0.002) in the left front, 1.5, 2 and 3 hours (4.0408, 4.3217 and 4. 1050,Z= -2.903, -3.059 and -3.061, all P＜0.01) in the right frontal, 3 hours (9.1408, Z= -3.059,P =0.002) in the left occipital, and 1.5, 3 hours (8.9267 and 9.3033, Z = -2.981 and -2.981, both P = 0.003) in the right occipital. Conclusions LEV can change the background activity of QPEEG. The changes are different from those of the other AEDs.

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Identification of a rare amyloid precursor protein gene mutation in a Chinese family with early-onset familial Alzheimer's disease

Shanji NAN ; Yanqiu HAN ; Jia FAN ; Qiuhui CHEN

Chinese Journal of Neurology.2011;44(1):47-51. doi:10.3760/cma.j.issn.1006-7876.2011.01.013

Objective To analyze the phenotype and genatics in a Chinese family with early-onset familial Alzheimer's disease(EOFAD). Methods Peripheral blood were collected in available members in the family and genomic DNA was extracted. PCR-sequencing of exon 16 and exon 17 of the amyloid precursor protein(APP) gene, presenilin 1 (PSEN1), and presenilin 2 (PSEN2) was performed. Results At age 40, two EOFAD patients (siblings) in the family developed an insidious onset of difficulties in memory. One ( Ⅱ3 in the pedigree) showed blinking. The other ( Ⅱ 5 ) showed irritability and bradykinesia.Progressive diffuse coritcal atrophy in bilateral temporal cortex was observed. Moderate diffuse cerebral dysfunction was observed in Ⅱ3 by the electroencephalogram study and neuropsychological assessments.Sequencing revealed that both patients were heterozygous for a mutation c. 2343 G ＞ A in exon 17 of APP,causing the amino acid substitution Val715Met. Four members ( Ⅱ1, Ⅱ 3, Ⅱ 5 and Ⅲ1 ) were homozygous for ApoE ε4 allele. Ⅱ9 was ε2/ε4. Conclusions This study identified a mutation, Val715Met in the APP gene in Chinese patients with EOFAD. We suggest screening for APP gene mutations in Chinese patients with EOFAD.

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Study of relationship between scattered or single lesion on diffusion-weighted imaging and arterial stenosis in acute cerebral infarction

Wenke WANG ; Yan YIN

Chinese Journal of Neurology.2011;44(1):43-46. doi:10.3760/cma.j.issn.1006-7876.2011.01.012

Objective To investigate the relationship between scattered or single lesion of acute cerebral infarction in middle cerebral artery territory on diffusion-weighted imaging (DWI) and stenosis of middle cerebral artery (MCA) or internal carotid artery (ICA). Methods With exclusion of cardioembolism, 73 consecutive patients with acute cerebral infarction of the unilateral MCA territory on DWI were analyzed. All patients got magnetic resonance imaging (MRI) and angiography (MRA) within 24 hours after onset, and 7 patients also had digital subtraction angiography (DSA). The patients were classified into single lesion group or scattered lesions group according to the DWI findings. The incidence of stenosis or occlusion of ipsolateral MCA, intracranial and extracranial ICA were compared between the two groups. Results 42 patients had scattered lesions and 31 patients had single lesion. The scattered-lesions group had a high incidence of ipsilateral extracranial ICA or MCA occlusion or severe stenosis ( 25.6%versus 0, x2 = 10.6, P = 0.001 ) and a high incidence of ipsilateral intracranial ICA or MCA moderate or mild stenosis (31.0% versus 9.7% ,x2 =4.717, P =0.03 ). A positive correlation was found between the scattered lesions and severe or multifocal stenosis of ipsilateral ICA and MCA ( OR: 13.7, 95% CI: 3.6 to 52.5). There was a low incidence of absence of extra- and intracranial stenosis on MRA or DSA in the scattered-lesions group ( 11.9% versus 32.3%, x2= 4.526, P = 0.033 ). A negative correlation was found between the scattered lesions and absence of large-artery stenosis ( OR: 0.284, 95% CI: 0.09 to 0.94).Conclusions ( 1 ) Patients with acute cerebral infarction and scattered lesions on DWI were more likely to suffer from stenosis or occlusion of ICA or MCA, especially over the extracranial ICA. (2) Patients with single lesion were less likely to have severe or multiple stenosis of MCA and ICA, indicating the relevance of small-vessel pathogenesis.

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