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Aberrant resting-state functional connectivity of default mode and salience network in patients with schizo-phrenia

Yingchan WANG ; Weijun TANG ; Jianye ZHANG ; Dengtang LIU ; Kaida JIANG ; Zeping XIAO

Chinese Journal of Nervous and Mental Diseases.2013;(12):744-749. doi:10.3936/j.issn.1002-0152.2013.12.009

Objective To explore the feature of functional connectivity of default mode network (DMN) and salience network (SN) in unmedicated schizophrenia patients during a resting state by functional magnetic resonance imaging (fM-RI). Methods The SPM8 and DPARSFA softwares combined with independent component analysis (ICA) were used to in-vestigate functional connectivity (FC) of the DMN and SN in 27 unmedicated patients with schizophrenia and 27 age-and gender-matched healthy controls. Results Concerning the DMN, patients with schizophrenia showed decreased FC in right inferior frontal gyrus , right precuneus(unadjusted P<0.05)and increased FC in right middle cingulate gyrus, left middle frontal gyrus(unadjusted P<0.05). With regard to the SN, patients showed reduced connectivity in left inferior frontal gyrus, right inferior frontal gyrus, left anterior cingulate, left postcentral gyrus(unadjusted P<0.05)and increased connectivity in left superior temporal gyrus(unadjusted P<0.05). Correlation analyses showed that the increased FC of left superior temporal gyrus significantly correlated with PANSS-positive symptoms(r=0.568,P=0.002)and decreased FC of right precuneus significantly negatively correlated with delusion symptom(r=-0.458,P=0.016). Conclusion This study provides evidence for resting state functional abnormalities of DMN and SN in unmedicated schizophrenia patients. These aberrant function connectivities in some brain regions of the two networks could be a source of abnormal introspectively-oriented mental actives.

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Genetic and environmental influences on emotional and behavioral problems in children and adolescents

Xiaomei HU ; Xingshun MA ; Yixiao FU ; Yingqing ZHOU ; Wenfen ZHU ; Xiao HOU ; Huaqing MENG ; Lu JIA ; Qing QIN ; Tian QIU ; Yang LIU ; Xiao LI ; Yingcheng WANG ; Wei DENG ; Tao LI

Chinese Journal of Nervous and Mental Diseases.2013;(12):739-743.

Objective To explore the influence of genetic and environmental factors on emotional and behavioral problems in children and adolescents using twins quantitative method. Methods One hundred fifty-six twins pairs, aged from 6 to 18, were included in the present study. The parental version of the strengths and difficulties questionnaire (SDQ)was used to evaluate their emotional and behavioral problems. The DNA test of twin zygosity was conducted using DNA extracted from buccal mucosa or venous blood samples. The influence of genetic and environmental factors on emo-tional and behavioral problems was analyzed using structural equation modeling(SEM). Results Shared environment and special environment had impact on emotional symptoms and their contribution to the total variance of emotional symp- tom was 0.42 and 0.58, respectively. Prosocial behavior was mainly affected by shared environment and the contribution of shared environment to the total variance of prosocial behavior was 0.89. Genetic factors had greater influence on hyperac-tivity/attention deficit and the contribution of genetic factors to the total variance was 0.62. Shared environment had more influence on conduct disorder and the contribution of shared environment to total variance was 0.56. Heredity, shared envi-ronment and special environment had impact on peer problems and their contribution to the total variance was 0.24, 0.33 and 0.43, respectively. Conclusion In child and adolescent period, emotional symptoms are only affected by environ-ment, while behavior problems are affected by the combination of heredity and environment. Different behavior problems are affected by different genetic and environmental factors.

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The effects of neonatal MK-801 treatment on expression of NMDA receptors and NGF in rats

Jiao JIA ; Jitao LI ; Runhu HUANG ; Hong YANG ; Yunai SU ; Tianmei SI

Chinese Journal of Nervous and Mental Diseases.2013;(12):733-738. doi:10.3936/j.issn.1002-0152.2013.12.007

Objective To investigate the effects of repeated neonatal administration of dizocipline maleate (MK-801), the N-methyl-D-aspartate (NMDA) receptor antagonist, on the expression of NMDA receptor subunits NMDAR 1 (NR1), NMDAR2A (NR2A), NMDAR2B (NR2B) and the protein levels of nerve growth factor (NGF) in neonatal rats. Methods Neonatal Sprague-Dawley (SD) rats were randomly divided into research group and control group, with 15 ani-mals in each group. Rats were administrated subcutaneously with MK-801 or normal saline from postnatal day (PND) 5 to PND14 (0.25 mg/kg, twice a day). The expression levels of NR1, NR2A, NR2B and NGF were examined on PND15, PND42 and PND70 in the prefrontal cortex and hippocampus. Results At PND15 (neonatal period), there were no signifi-cant differences in the expression levels of NR1, NR2A, NR2B and NGF in the prefrontal cortex and hippocampus be- tween the two groups (P>0.05). At PND42 (adolescence), NGF protein levels in the prefrontal cortex was significantly low-er in research group than in control group [(56.19±37.87) vs. (152.54±53.92), P<0.01]. At PND70 (adulthood), the expres-sion of NR1, NR2A in the hippocampus was significantly higher in research group than in control group [NR1:(149.55%± 27.00%) vs. (100.00%±32.08%);NR2A:(171.54%±19.85%) vs. (100.00%±51.04%). P<0.05]. Conclusion Neonatal re-peated treatment of MK-801 increases the expression of NMDA receptor subunits NR1, NR2A in the hippocampus in adulthood while decreases the expression of NGF in the prefrontal cortex in adolescence, suggesting that neonatal block-ade of the NMDA receptor may influence the growth and development of the nervous system.

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The diagnostic value of ABCD2 for stroke in hospitalized patients with dizziness

Yanli CAI ; Yong LUO

Chinese Journal of Nervous and Mental Diseases.2013;(12):715-718. doi:10.3936/j.issn.1002-0152.2013.12.003

Objective To evaluate whether ABCD2 score can discriminate dizziness patients with and without stroke. Methods This retrospective case-control observational study was conducted in 403 hospitalized patients. According to the final discharge diagnosis, the patients were divided into two groups:the stroke group and non-stroke group. The areas un-der the receiver-operator curves and 95%confidence intervals were then generated to estimate the diagnostic value. Re-sults ABCD2 score was higher in stroke group than in non-stroke group. Conclusions ABCD2 score can be used to quickly identify dizziness patients with cerebrovascular diseases.

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The current status of secondary prevention of cerebral infarction in Longquanyi District of Chengdu

Cuiping XU ; Meirong ZHU ; Rui LUO ; Dan TANG ; Bo NING ; Yan YANG ; Li ZHONG ; Wei LI ; Fei YANG

Chinese Journal of Nervous and Mental Diseases.2013;(12):729-732. doi:10.3936/j.issn.1002-0152.2013.12.006

Objective To investigate the current status of secondary prevention of cerebral infarction in Longquanyi District of Chengdu. Methods Prospective Investigation on the secondary prevention was conducted in 94 pa-tients with cerebral infarction at 3, 12 and 24 months following stroke. Results The percentages of patients receiving anti-platelet therapy, antihypertensive treatment, antidiabetic drug treatment and statin therapy were 96.8%, 92.1%, 91.7%and 63.8%at hospital discharge, 79.8%, 88.9%, 91.7%and 55.3%at 3 months, 76.1%, 75.0%and 41.4%, 63.8%at 12 months and 33.0%, 71.4%;58.3%and 22.3%at 24 months, respectively. None of stroke patients with atrial fibrillation re-ceived anticoagulation therapy. Conclusion There is a large gap between the current practice of secondary prevention and guideline in patients with cerebral infarction in Longquanyi District of Chengdu.

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The effect of tanshinone IIA on apoptosis and the expression of, Drp-1 and TRPM7 in a rat model of cerebral ischemia reperfusion

Han XIAO ; Qiqiang TANG ; Leilei LIU ; Ruodong HAN

Chinese Journal of Nervous and Mental Diseases.2013;(12):719-723. doi:10.3936/j.issn.1002-0152.2013.12.004

Objective To explore the effect of Tanshinone IIA on apoptosis and expression of Drp-1 and TRPM7 in a rat model of focal cerebral ischemia and reperfusion. Methods Rats were pretreated with high or low dose of tanshinone IIA before 2 h-focal cerebral ischemia plus 24 h-reperfusion. Cerebral blood flow in the middle cerebral artery was moni-tored during reperfusion. TTC, TUNEL and western blotting were used to detect the volume of cerebral infarction, apopto-sis and the protein expression of Drp-1 as well as TRPM7, respectively. Results Compared with control group, pretreat-ment with Tanshinone IIA could significantly down-regulate the expression of protein Drp-1 and TRPM7 (P<0.05), attenu-ate apoptosis (P<0.05), and reduce the volume of ischemia infarction. The volumes of right middle cerebral artery blood flow were(31.80%± 2.49%),(54.8%± 3.27%), and(58.8%± 3.03%)in controls, low-dose and high dose of tanshinone, respectively. Both low-dose and high-dose tanshinones improved cerebral blood flow. (tanshinone vs. control;all P<0.05). However, there was no statistical difference between low-dose and high-dose Tanshinone IIA groups in all measured out-comes (P>0.05). Conclusions Tanshinone IIA can inhibit ischemia-induced neuronal apoptosis and mitochondrial fission probably through improving cerebral artery blood flow and reducing the overexpression of Drp-1,TRPM7.

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Expression of Hepcidin in rats after subarachnoid hemorrhage

Liu LIU ; Guanping TAN ; Yaolong CHEN ; Ao ZHAN ; Weiming XIONG ; Zhaohui HE

Chinese Journal of Nervous and Mental Diseases.2013;(12):710-714. doi:10.3936/j.issn.1002-0152.2013.12.002

Objective To examine the iron content and the expression of hepcidin in early period after subarach-noid hemorrhage (SAH) in rats, and to explore the role of hepcidin in dysregulation of brain iron metabolism after SAH. Methods Totally 90 adult male SD rats were randomly divided into two groups:the sham-operation group and SAH group. The SAH model was established by single blood injection to prechiasmatic cistern. Immunohistochemical and Western Blotting were used to examine the expression of hepcidin at 12, 24, 48 and 72h after SAH. Meanwhile, Atomic Absorption Spectrometer was used to detect the iron content. Results Immunochemistry showed that hepcidin expression in rats in SAH group began to rise at 12 h(0.30±0.06)and gradually increased over time until 72 h(0.56±0.07)compared with the sham group(0.19±0.05). The expression of hepcidin was significantly higher in SAH group than in the sham group(F=31.911, P<0.05). Western blot showed that hepcidin expression in rats in SAH group began to rise at 12h(0.481±0.065) and gradually increased over time until 72h(1.627±0.143)Compared with the sham group(0.238±0.047). The expression of hepcidin was significantly higher in SAH group than in the sham group after SAH(F=147.314,P<0.05). Iron content in SAH group began to rise at 12h after SAH(58.50±9.19)and gradually increased until 72 h(99.34±7.68). The iron con-tents in SAH group were higher at every time points than those in sham group(43.51±4.59)(F=28.799,P﹤0.05). The ex-pression of hepcidin was correlated with the iron content in SAH group(r=0.914,P﹤0.01). Conclusion The increase in iron content following SAH is associated with the increased hepcidin expression.

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The application of small dural window exposure for craniectomy in patients with severe brain injury

Zhijie ZHANG ; Zhenzhong WANG ; Liping WU ; Bo ZHANG

Chinese Journal of Nervous and Mental Diseases.2014;(1):35-38. doi:10.3936/j.issn.1002-0152.2014.01.008

Objective To evaluate the application of small dural window exposure strategy for removal of subdu-ral hematomas and decompressive craniectomy in patients with severe brain injury. Methods Eighty patients with an ad-mission Glasgow Coma Scale score of 8 or less were randomly divided into two groups:Routine craniectomy group (42 pa-tients) and small dural window exposure strategy group (38 patients). The clinical outcomes were compared between these two groups. Results The average quantity of blood transfusion (erythrocyte suspension)at 24 h was 2.85 ± 1.98 and 1.43±1.40 unit in the routine craniectomy group and small dural window exposure strategy group, respectively. The num-bers of the delayed intracranial hematomas, traumatic epileptic seizure as well as acute encephalomyelocele were 10, 12 as well as 9 in the routine craniectomy group and 2, 3 as well as 1 in the small dural window exposure strategy group. However, the time of operate duration and the incidence of cerebral infaction were not significantly different between two groups (P>0.05). After 6-month follow-up, there were 16 cases with favorable outcomes including 10 with good recov-ery and 6 with mild disability and 26 cases with unfavorable outcomes, including 7 with severe deficits, 6 with persistent vegetative status and 13 dead in the routine craniectomy group. In contrast, there were 23 cases with favorable outcomes including 12 good recovery and 11 mild disability and 15 cases with unfavorable outcome including 6 with severe deficits, 4 with persistent vegetative status and 5 dead in the small dural window exposure strategy (P﹤0.05). Conclusion small dural window exposure strategy is an excellent technique for the complete evacuation of the traumatic intracranial hemato-ma, especially those with massive intraoperative swelling .

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Clinical value of the combination of carotid artery ultrasound and TCD in the evaluation of carotid artery stenosis stenting

Hongke WANG ; Xiaoning ZHANG ; Peiqin LIU ; Jun ZHOU ; Xiaoguang ZHANG

Chinese Journal of Nervous and Mental Diseases.2014;(1):31-34. doi:10.3936/j.issn.1002-0152.2014.01.007

Objective In order to examine the value of the combination of carotid artery ultrasound and Transcrani-al Doppler (TCD) in the evaluation of carotid artery stenosis stenting. Methods Seventy-one carotid stenosis cases con-firmed by digital subtraction angiography (DSA) who had cerebral ischemia symptoms and received stent implantation were reviewed. Carotid artery ultrasound and TCD were adopted to measure the vessel diameter, peak systolic velocity (PSV) of the narrow segment, PSV and pulsatility index (PI) of ipsilateral middle cerebral artery (MCA) before and after the treatment of intravascular stents, and a comparison analysis was made. Results Carotid stent implantation significant-ly improved the inner diameter, PSV of the narrow part, PSV and PI of the MCA on the stenotic side. Inner diameter of the narrow part was 3.13±0.83, 4.77±0.51 and 4.64±0.52 mm at before, one week and one year after the implantation, re-spectively (P<0.05). The PSV of the narrow part was 190.69±113.65, 86.15±30.52 and 90.28±29.79 cm/s at before, one week and one year after the implantation, respectively(P<0.05).PSV of the MCA on the stenotic side was 77.68±14.66, 115.62±22.32 and 108.89±20.29 cm/s at before, one week and one year after the implantation, respectively(P<0.05). PI of the MCA on the stenotic side was 0.81±0.01, 1.07±0.01 and 1.06±0.02 at before, one week and one year after the implantation, respectively (P<0.05). Conclusions The present study demonstrates that the combination of carotid artery ultrasound and TCD can quantitatively detect the vascular structural and hemodynamic improvements following the endo-vascular stenting, indicating that the combination of carotid artery ultrasound and TCD can be used for the accurate as-sessment and follow up of carotid artery stenting treatment.

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The application of CHA2DS2-VASc score in ischemic stroke patients with non-valvular atrial fibrillation

Pengfei GAO ; Qinbao QIN

Chinese Journal of Nervous and Mental Diseases.2014;(1):21-25. doi:10.3936/j.issn.1002-0152.2014.01.005

Objective To study the relationship between CHA2DS2-VASc score and intracranial atherosclerosis, Chinese ischemic stroke subclassification (CISS) classification and the early neurological outcomes in ischemic stroke pa-tients with non-valvular atrial fibrillation (NVAF), and to evaluate the clinical value of CHA2DS2-VASc score. Methods The retrospective analysis method was used. The data from 149 cases of ischemic stroke patients with NVAF was retro-spectively analyzed. The clinical data mainly included clinical manifestations, routine lab tests, imaging examinations such as the color-echo doppler, brain CT and/or MRI and angiographic studies of CTA and/or MRA of brain, CHA2DS2-VASc score, the CISS and the National Institutes of Health stroke scale (NIHSS). Results The CHA2DS2-VASc score was significantly higher in patients with intracranial atherosclerosis than those without [(5.13±1.39) vs. (4.14±1.67)] (P<0.05). The occurrence rates of intracranial atherosclerosis were significantly different among different CHA 2DS2-VASc score subgroups (0~1, 2~3, 4~5 and≥6 subgroups) (P<0.05). There were significant differences in CHA2DS2-VASc score among CS+LAA group, CS+LAA+PAD,group CS, group and CS+PAD group (all P<0.05). There was statistical difference in CHA2DS2-VASc score between patients with and without improvements (P<0.05). Conclusion The CHA2DS2-VASc score may be associated with concomitant intracranial atherosclerosis of ischemic stroke patients with NVAF which can be used to predict the condition of intracranial atherosclerosis. The CHA2DS2-VASc score is positively correlated with se-verity of ischemic stroke with NVAF which can be used to predict the disease improvements in patient with NVAF.

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