Limbic encephalitis represents a cluster of autoimmune disorders, with inflammation in the medial temporal lobe characterised by the subacute onset of neuropsychiatric symptoms such as anxiety, affective symptoms, psy...Limbic encephalitis represents a cluster of autoimmune disorders, with inflammation in the medial temporal lobe characterised by the subacute onset of neuropsychiatric symptoms such as anxiety, affective symptoms, psychosis, short-term memory impairment, as well as faciobrachial and grand mal seizures. The limbic system is a complex anatomical structure which this paper seeks to explain in terms of its anatomy and physiology, before exploring what happens when it is impaired as is the case of autoimmune and limbic encephalitis. We will discuss the pathophysiology, clinical symptomatology and diagnosis of autoimmune encephalitis, a cluster of symptoms which can be easily overlooked or misdiagnosed within psychiatric settings. Characteristic indicators of autoimmune encephalitis include neurologic symptoms such as facial twitching, seizures, confusion, and cognitive decline;however, our experience realises that autoimmune encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology rather than these neurological symptoms. Furthermore, immunological and laboratory testing take a long time to diagnose the condition. Importantly, few psychiatrists consider the autoimmune nature of the neuropsychiatric presentation. It is hence vital to consider autoimmune encephalitis in all patients with atypical presentations.展开更多
Voxel-based morphometry is gaining considerable interest for studies examining Parkinson＇s disease dementia patients. In this study, 12 patients with clinically defined Parkinson＇s disease and dementia and 12 non-de...Voxel-based morphometry is gaining considerable interest for studies examining Parkinson＇s disease dementia patients. In this study, 12 patients with clinically defined Parkinson＇s disease and dementia and 12 non-demented patients with Parkinson＇s disease were examined using a T1WI three-dimensional fast spoiled gradient echo sequence. Gray matter data were analyzed using a voxel-based morphometry method and independent sample t-test based on Statistical Parametric Mapping 5 software. Differences in gray matter volume were represented with statistical parametric mapping. Compared with Parkinson＇s disease patients without dementia, decreased gray matter volume in Parkinson＇s disease dementia patients was observed in the bilateral superior temporal gyrus, bilateral posterior cingulate and left cingulate gyrus, right parahippocampal gyrus and hippocampus, right precuneus and right cuneus, left inferior frontal gyrus and left insular lobe. No increased gray matter volume was apparent. These data indicate that gray matter atrophy in the limbic system and cerebral neocortex is related to the presence of dementia.展开更多
文摘Limbic encephalitis represents a cluster of autoimmune disorders, with inflammation in the medial temporal lobe characterised by the subacute onset of neuropsychiatric symptoms such as anxiety, affective symptoms, psychosis, short-term memory impairment, as well as faciobrachial and grand mal seizures. The limbic system is a complex anatomical structure which this paper seeks to explain in terms of its anatomy and physiology, before exploring what happens when it is impaired as is the case of autoimmune and limbic encephalitis. We will discuss the pathophysiology, clinical symptomatology and diagnosis of autoimmune encephalitis, a cluster of symptoms which can be easily overlooked or misdiagnosed within psychiatric settings. Characteristic indicators of autoimmune encephalitis include neurologic symptoms such as facial twitching, seizures, confusion, and cognitive decline;however, our experience realises that autoimmune encephalitis is not easy to identify as most patients initially present with psychiatric symptomatology rather than these neurological symptoms. Furthermore, immunological and laboratory testing take a long time to diagnose the condition. Importantly, few psychiatrists consider the autoimmune nature of the neuropsychiatric presentation. It is hence vital to consider autoimmune encephalitis in all patients with atypical presentations.
基金supported by the Medical Clinical Science and Technology Development Fund of Jiangsu University,No.JLY20120122Innovative Climb Program of Natural Science Foundation of Jiangsu Province,No.BK2008010+1 种基金Natural Science Foundation of Nantong University,China,No.11Z001Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Voxel-based morphometry is gaining considerable interest for studies examining Parkinson＇s disease dementia patients. In this study, 12 patients with clinically defined Parkinson＇s disease and dementia and 12 non-demented patients with Parkinson＇s disease were examined using a T1WI three-dimensional fast spoiled gradient echo sequence. Gray matter data were analyzed using a voxel-based morphometry method and independent sample t-test based on Statistical Parametric Mapping 5 software. Differences in gray matter volume were represented with statistical parametric mapping. Compared with Parkinson＇s disease patients without dementia, decreased gray matter volume in Parkinson＇s disease dementia patients was observed in the bilateral superior temporal gyrus, bilateral posterior cingulate and left cingulate gyrus, right parahippocampal gyrus and hippocampus, right precuneus and right cuneus, left inferior frontal gyrus and left insular lobe. No increased gray matter volume was apparent. These data indicate that gray matter atrophy in the limbic system and cerebral neocortex is related to the presence of dementia.
