The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided foc...The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA General Hospital.This prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(ClinicalTrials.gov Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local population.From 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm study.The treatment efficacy was determined using the Clinical Rating Scale for Tremor.Safety was evaluated according to the incidence and severity of adverse events.All of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate nucleus.At the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as serious.The most common intraoperative adverse events were nausea and headache.The most frequent postoperative adverse events were paresthesia and equilibrium disorder.Most of the adverse events were mild and usually disappeared within a few days.Our findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.展开更多
Essential tremor, also referred to as familial tremor, is an autosomal dominant genetic disease and the most common movement disorder. It typically involves a postural and motor tremor of the hands, head or other part...Essential tremor, also referred to as familial tremor, is an autosomal dominant genetic disease and the most common movement disorder. It typically involves a postural and motor tremor of the hands, head or other part of the body. Essential tremor is driven by a central oscillation signal in the brain. However, the corticospinal mechanisms involved in the generation of essential tremor are unclear. Therefore, in this study, we used a neural computational model that includes both monosynaptic and multisynaptic corticospinal pathways interacting with a propriospinal neuronal network. A virtual arm model is driven by the central oscillation signal to simulate tremor activity behavior. Cortical descending commands are classified as alpha or gamma through monosynaptic or multisynaptic corticospinal pathways, which converge respectively on alpha or gamma motoneurons in the spinal cord. Several scenarios are evaluated based on the central oscillation signal passing down to the spinal motoneurons via each descending pathway. The simulated behaviors are compared with clinical essential tremor characteristics to identify the corticospinal pathways responsible for transmitting the central oscillation signal. A propriospinal neuron with strong cortical inhibition performs a gating function in the generation of essential tremor. Our results indicate that the propriospinal neuronal network is essential for relaying the central oscillation signal and the production of essential tremor.展开更多
Now,daoyin has developed into a complete set of conventional movement patterns,such as Baduanjin,Yijinjing,and Wuqinxi.However,the original meaning and the connotation of daoyin is ignored by people gradually,which wi...Now,daoyin has developed into a complete set of conventional movement patterns,such as Baduanjin,Yijinjing,and Wuqinxi.However,the original meaning and the connotation of daoyin is ignored by people gradually,which will hinder the development of daoyin and make the specific application difficult.In this article,we will explore the basic composition of the daoyin–“movement”and its intrinsic basis–“essential qi”to think about the original meaning and connotation of daoyin.展开更多
Previous reports on the pathogenesis of age-related movement disorders,such as Parkinson’s disease(PD)and essential tremor(ET),have demonstrated the potential implications of LINGO1(leucine-rich repeat and immunoglob...Previous reports on the pathogenesis of age-related movement disorders,such as Parkinson’s disease(PD)and essential tremor(ET),have demonstrated the potential implications of LINGO1(leucine-rich repeat and immunoglobulin domain-containing protein)gene.Although LINGO2 has a high degree of homology with LINGO1,but it is less characterized and the role of LINGO2 in the development of PD/ET remains unreported.Hence,this metaanalysis was conducted to evaluate the role of LINGO2 in PD/ET pathogenesis.A total of 4 studies,which complied with the Hardy-Weinberg equilibrium,were included in the meta-analysis.Analysis of the pooled odds ratio and confidence interval of the studies were performed for five genetic models,namely:allelic,dominant,recessive,homozygous,and heterozygous.No significant association was observed between the LINGO2 polymorphism and PD/ET,although subgroup analysis through conventional metaanalysis indicated that the recessive models of rs7033345 and rs10812774 are significantly associated with predisposition to ET in the Asian population.However,trial sequential analyses for both polymorphisms were unlikely to reveal any robust effect.Hence,studies with larger samples on this association are needed in the future to corroborate our results.展开更多
基金sponsored by Insightec Co.Ltd.(Israel)China National Clinical Research Center for Geriatrics,No.NCRCG-PLAGH-2019005 (to LP)
文摘The safety and effectiveness of magnetic resonance-guided focused ultrasound thalamotomy has been broadly established and validated for the treatment of essential tremor.In 2018,the first magnetic resonance-guided focused ultrasound system in Chinese mainland was installed at the First Medical Center of the PLA General Hospital.This prospective,single center,open-label,single-arm study was part of a worldwide prospective multicenter clinical trial(ClinicalTrials.gov Identifier:NCT03253991)conducted to confirm the safety and efficacy of magnetic resonance-guided focused ultrasound for treating essential tremor in the local population.From 2019 to 2020,10 patients with medication refractory essential tremor were recruited into this open-label,single arm study.The treatment efficacy was determined using the Clinical Rating Scale for Tremor.Safety was evaluated according to the incidence and severity of adverse events.All of the subjects underwent a unilateral thalamotomy targeting the ventral intermediate nucleus.At the baseline assessment,the estimated marginal mean of the Clinical Rating Scale for Tremor total score was 58.3±3.6,and this improved after treatment to 23.1±6.4 at a 12-month follow-up assessment.A total of 50 adverse events were recorded,and 2 were defined as serious.The most common intraoperative adverse events were nausea and headache.The most frequent postoperative adverse events were paresthesia and equilibrium disorder.Most of the adverse events were mild and usually disappeared within a few days.Our findings suggest that magnetic resonance-guided focused ultrasound for the treatment of essential tremor is effective,with a good safety profile,for patients in Chinese mainland.
基金supported in part by the National Natural Science Foundation of China,No.61361160415,81271684,81501570the Major State Basic Research Development of China(973 Program),No.2011CB013304+1 种基金the Medicine-Engineering Interdisciplinary Research Grant from Shanghai Jiao Tong University in China,No.YG2014ZD09a grant from the Youth Eastern Scholar Program at Shanghai Institutions of Higher Learning in China,No.QD2015007
文摘Essential tremor, also referred to as familial tremor, is an autosomal dominant genetic disease and the most common movement disorder. It typically involves a postural and motor tremor of the hands, head or other part of the body. Essential tremor is driven by a central oscillation signal in the brain. However, the corticospinal mechanisms involved in the generation of essential tremor are unclear. Therefore, in this study, we used a neural computational model that includes both monosynaptic and multisynaptic corticospinal pathways interacting with a propriospinal neuronal network. A virtual arm model is driven by the central oscillation signal to simulate tremor activity behavior. Cortical descending commands are classified as alpha or gamma through monosynaptic or multisynaptic corticospinal pathways, which converge respectively on alpha or gamma motoneurons in the spinal cord. Several scenarios are evaluated based on the central oscillation signal passing down to the spinal motoneurons via each descending pathway. The simulated behaviors are compared with clinical essential tremor characteristics to identify the corticospinal pathways responsible for transmitting the central oscillation signal. A propriospinal neuron with strong cortical inhibition performs a gating function in the generation of essential tremor. Our results indicate that the propriospinal neuronal network is essential for relaying the central oscillation signal and the production of essential tremor.
基金This is a budget Project of Shanghai Municipal Education Commission(2016YSN77).
文摘Now,daoyin has developed into a complete set of conventional movement patterns,such as Baduanjin,Yijinjing,and Wuqinxi.However,the original meaning and the connotation of daoyin is ignored by people gradually,which will hinder the development of daoyin and make the specific application difficult.In this article,we will explore the basic composition of the daoyin–“movement”and its intrinsic basis–“essential qi”to think about the original meaning and connotation of daoyin.
文摘Previous reports on the pathogenesis of age-related movement disorders,such as Parkinson’s disease(PD)and essential tremor(ET),have demonstrated the potential implications of LINGO1(leucine-rich repeat and immunoglobulin domain-containing protein)gene.Although LINGO2 has a high degree of homology with LINGO1,but it is less characterized and the role of LINGO2 in the development of PD/ET remains unreported.Hence,this metaanalysis was conducted to evaluate the role of LINGO2 in PD/ET pathogenesis.A total of 4 studies,which complied with the Hardy-Weinberg equilibrium,were included in the meta-analysis.Analysis of the pooled odds ratio and confidence interval of the studies were performed for five genetic models,namely:allelic,dominant,recessive,homozygous,and heterozygous.No significant association was observed between the LINGO2 polymorphism and PD/ET,although subgroup analysis through conventional metaanalysis indicated that the recessive models of rs7033345 and rs10812774 are significantly associated with predisposition to ET in the Asian population.However,trial sequential analyses for both polymorphisms were unlikely to reveal any robust effect.Hence,studies with larger samples on this association are needed in the future to corroborate our results.
