Presently,we develop a simplified corticothalamic(SCT)model and propose a single-pulse alternately resetting stimulation(SARS)with sequentially applying anodic(A,“+”)or cathodic(C,“−”)phase pulses to the thalamic ...Presently,we develop a simplified corticothalamic(SCT)model and propose a single-pulse alternately resetting stimulation(SARS)with sequentially applying anodic(A,“+”)or cathodic(C,“−”)phase pulses to the thalamic reticular(RE)nuclei,thalamus-cortex(TC)relay nuclei,and cortical excitatory(EX)neurons,respectively.Abatement effects of ACC-SARS of RE,TC,and EX for the 2 Hz-4 Hz spike and wave discharges(SWD)of absence seizures are then concerned.The m∶n on-off ACC-SARS protocol is shown to effectively reduce the SWD with the least current consumption.In particular,when its frequency is out of the 2 Hz-4 Hz SWD dominant rhythm,the desired seizure abatements can be obtained,which can be further improved by our proposed directional steering(DS)stimulation.The dynamical explanations for the SARS induced seizure abatements are lastly given by calculating the averaged mean firing rate(AMFR)of neurons and triggering averaged mean firing rates(TAMFRs)of 2 Hz-4 Hz SWD.展开更多
Background: Drug-resistant epilepsy can be defined as the existence of seizures within 6 months, despite adequate therapy regimens with one or more antiepileptic drugs. Epilepsy surgery has been the standard therapy t...Background: Drug-resistant epilepsy can be defined as the existence of seizures within 6 months, despite adequate therapy regimens with one or more antiepileptic drugs. Epilepsy surgery has been the standard therapy to help those patients who suffer from drug-resistant epilepsy. The goal of this surgery is to halt or reduce the intensity of seizures. This literature review aims to provide an overview of existing surgical procedures for the treatment of drug-resistant epilepsy and the degree of seizure control they provide based on available literature. Methods: Data were collected from medical journal databases, aggregators, and individual publications. The most used databases were PubMed, Medline and NCBI. Some of the keywords used to search these databases include: “drug resistant epilepsy”, “seizure control”, and “neurosurgery”. Results: Epileptic surgery is divided into resective and non-resective procedures. Studies have shown that a full resection of the epileptogenic brain area increases the probability of seizure eradication, however, the risks of postoperative impairments grow as the resection area is extended. On the other hand, patients who are unsuitable for seizure focus removal by resective surgery, such as those with multifocal seizures or overlapping epileptogenic zone with a functional cortex, may benefit from non-resective surgical options such as Vagus Nerve Stimulation and Responsive Neurostimulation. Conclusion: This literature review discusses the comprehensive treatment of epilepsy, especially the surgical treatment of drug-resistant epilepsy. The reviewed studies have shown that epilepsy surgery has promising outcomes in achieving seizure freedom/reducing seizure frequency with minimal adverse effects when performed correctly with the appropriate choice of surgical candidates.展开更多
The demands of aircraft quality design criterion on main control system failure and subsequently instantaneous response were analyzed.According to the simulation,the flight characteristics of an aircraft were studied ...The demands of aircraft quality design criterion on main control system failure and subsequently instantaneous response were analyzed.According to the simulation,the flight characteristics of an aircraft were studied in different angle of rudder seizure.It demonstrated that when rudder seizure with high angle and pilot could not take action immediately,the flight parameters would change sharply.The yaw angle increased 50 degrees in 5 minutes,side velocity could attain 40 meters per-second,the angle of attack and sideslip would surpass 30 degrees,roll rate would reach -20 degrees per second,side load would arrive 0.6g.Simultaneity the angle of attack exceeded the limited angle,the aircraft would stall.If control wasn't working,the disaster would happen.These phenomena supply the sufficient information of the rudder malfunction. The validity of correcting yaw moment by asymmetry thrust was testified,the simulation results showed that even rudder seizure in most serious conditions,adopting asymmetry thrust can correct yaw moment caused by the rudder seizure.The judgment standards of flight safety level for the state of malfunction were given.The safety level was assessed caused by the rudder seizure.For an aircraft with two engines on one side,the pilots need to adjust the 4 engines to balance the asymmetric moment,the work load is increased enormously.According the flight safety standards,the safety level is level Ⅲ.展开更多
In this paper,a reduced globus pallidus internal(GPI)-corticothalamic(GCT)model is developed,and a tri-phase delay stimulation(TPDS)with sequentially applying three pulses on the GPI representing the inputs from the s...In this paper,a reduced globus pallidus internal(GPI)-corticothalamic(GCT)model is developed,and a tri-phase delay stimulation(TPDS)with sequentially applying three pulses on the GPI representing the inputs from the striatal D_(1)neurons,subthalamic nucleus(STN),and globus pallidus external(GPE),respectively,is proposed.The GPI is evidenced to control absence seizures characterized by 2 Hz–4 Hz spike and wave discharge(SWD).Hence,based on the basal ganglia-thalamocortical(BGCT)model,we firstly explore the triple effects of D_(1)-GPI,GPE-GPI,and STN-GPI pathways on seizure patterns.Then,using the GCT model,we apply the TPDS on the GPI to potentially investigate the alternative and improved approach if these pathways to the GPI are blocked.The results show that the striatum D_(1),GPE,and STN can indeed jointly and significantly affect seizure patterns.In particular,the TPDS can effectively reproduce the seizure pattern if the D_(1)-GPI,GPE-GPI,and STN-GPI pathways are cut off.In addition,the seizure abatement can be obtained by well tuning the TPDS stimulation parameters.This implies that the TPDS can play the surrogate role similar to the modulation of basal ganglia,which hopefully can be helpful for the development of the brain-computer interface in the clinical application of epilepsy.展开更多
Background:Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy(WWE)and their families.Advanced maternal age(≥35 years)shows a growing trend in the society with ch...Background:Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy(WWE)and their families.Advanced maternal age(≥35 years)shows a growing trend in the society with changes of lifestyle,which also occurs in diseased populations.The advanced maternal age is an independent factor for some unsatisfying obstetric outcomes.In this study we explored the seizure control and obstetric complications associated with advanced maternal age in WWE.Methods:This study was based on the epilepsy pregnancy registry at West China Hospital.Patients with epilepsy in this registry who were aged 35 or older when starting pregnancy were included in this study.Their basic demographics and detailed information on epilepsy management and obstetric issues in all trimesters and during 1-year follow-up after birth were documented and reviewed.Data were processed by IBM SPSS version 22.0.The demographic characteristics,seizure frequency,treatment change,obstetric complications,and outcomes were analyzed and compared.Results:Fifteen patients were included in this study,with an average age of 36.32±2.39 years at pregnancy,and 73.33%of them were primiparas.The change of seizure frequency during pregnancy was not in a clear pattern,but there was an increased incidence of tonic-clonic seizures during the mid-and last trimesters.More than 20%of the patients had obstetric complications throughout the trimesters,including vaginal bleeding,hypothyroidism,and pre-eclampsia.The pre-eclampsia seemed extraordinarily complicated with other conditions.However,none of the complications were related with malformations or poor outcome of babies after 1-year follow-up.Conclusion:Advanced maternal age combined with WWE is associated with frequent common obstetric complications.Future controlled studies with large sample sizes are needed to explore the related risks in comparison with other WWE and non-epileptic populations.展开更多
目的探讨孕前6个月和孕前1年癫痫控制情况能否预测孕期癫痫发作风险以及母婴不良结局的发生,以指导女性癫痫患者(Women with epilepsy,WWE)最佳生育时机的选择。方法回顾性分析2016年8月—2020年1月期间在天津医科大学总医院癫痫门诊随...目的探讨孕前6个月和孕前1年癫痫控制情况能否预测孕期癫痫发作风险以及母婴不良结局的发生,以指导女性癫痫患者(Women with epilepsy,WWE)最佳生育时机的选择。方法回顾性分析2016年8月—2020年1月期间在天津医科大学总医院癫痫门诊随诊的WWE 46例,共48次妊娠,分析妊娠期癫痫发作的危险因素,根据患者孕期无发作的时间分组,分析各组在妊娠期的癫痫发作情况、妊娠期并发症以及妊娠结局的差异。结果①48次妊娠中,妊娠期有癫痫发作者较无发作者出现胎膜早破的风险显著升高(34.6%vs.0.0%),差异具有统计学意义(P<0.01);妊娠期高血压(Pregnancy-induced hypertension,PIH)、妊娠期糖尿病(Gestational diabetes mellitus,GDM)、妊娠期贫血以及总妊娠期并发症发生率无统计学差异(P>0.05);子代平均出生体重略低,低出生体重、胎儿宫内窘迫发生率较高,但差异无统计学意义(P>0.05);②孕前6个月有癫痫发作与孕期癫痫发作显著相关[RR=4.28,95%CI(2.10,8.74),P<0.01];与孕前6个月无发作组对比,总不良妊娠结局发生率升高,差异有统计学意义[RR=2.00,95%CI(1.10,3.65),P<0.05];③孕前6个月无发作组与孕前≥1年无发作组妊娠期癫痫发作率分别为25.0%和20.0%,差异无统计学意义(P>0.05);相比孕前6个月无发作组,孕前≥1年无发作组发生PIH、妊娠期贫血的风险较低,后代发生低出生体重、早产、胎儿宫内窘迫的风险较低,但差异无统计学意义(P>0.05)。结论保证至少孕前6个月无发作将显著降低孕期癫痫发作的概率,且与较低的不良妊娠结局发生率显著相关。建议育龄期的女性癫痫患者在达到至少6个月癫痫无发作后再计划妊娠。展开更多
基金Project supported by the National Natural Science Foundation of China(Nos.11702018,11932003,and 11672074)。
文摘Presently,we develop a simplified corticothalamic(SCT)model and propose a single-pulse alternately resetting stimulation(SARS)with sequentially applying anodic(A,“+”)or cathodic(C,“−”)phase pulses to the thalamic reticular(RE)nuclei,thalamus-cortex(TC)relay nuclei,and cortical excitatory(EX)neurons,respectively.Abatement effects of ACC-SARS of RE,TC,and EX for the 2 Hz-4 Hz spike and wave discharges(SWD)of absence seizures are then concerned.The m∶n on-off ACC-SARS protocol is shown to effectively reduce the SWD with the least current consumption.In particular,when its frequency is out of the 2 Hz-4 Hz SWD dominant rhythm,the desired seizure abatements can be obtained,which can be further improved by our proposed directional steering(DS)stimulation.The dynamical explanations for the SARS induced seizure abatements are lastly given by calculating the averaged mean firing rate(AMFR)of neurons and triggering averaged mean firing rates(TAMFRs)of 2 Hz-4 Hz SWD.
文摘Background: Drug-resistant epilepsy can be defined as the existence of seizures within 6 months, despite adequate therapy regimens with one or more antiepileptic drugs. Epilepsy surgery has been the standard therapy to help those patients who suffer from drug-resistant epilepsy. The goal of this surgery is to halt or reduce the intensity of seizures. This literature review aims to provide an overview of existing surgical procedures for the treatment of drug-resistant epilepsy and the degree of seizure control they provide based on available literature. Methods: Data were collected from medical journal databases, aggregators, and individual publications. The most used databases were PubMed, Medline and NCBI. Some of the keywords used to search these databases include: “drug resistant epilepsy”, “seizure control”, and “neurosurgery”. Results: Epileptic surgery is divided into resective and non-resective procedures. Studies have shown that a full resection of the epileptogenic brain area increases the probability of seizure eradication, however, the risks of postoperative impairments grow as the resection area is extended. On the other hand, patients who are unsuitable for seizure focus removal by resective surgery, such as those with multifocal seizures or overlapping epileptogenic zone with a functional cortex, may benefit from non-resective surgical options such as Vagus Nerve Stimulation and Responsive Neurostimulation. Conclusion: This literature review discusses the comprehensive treatment of epilepsy, especially the surgical treatment of drug-resistant epilepsy. The reviewed studies have shown that epilepsy surgery has promising outcomes in achieving seizure freedom/reducing seizure frequency with minimal adverse effects when performed correctly with the appropriate choice of surgical candidates.
文摘The demands of aircraft quality design criterion on main control system failure and subsequently instantaneous response were analyzed.According to the simulation,the flight characteristics of an aircraft were studied in different angle of rudder seizure.It demonstrated that when rudder seizure with high angle and pilot could not take action immediately,the flight parameters would change sharply.The yaw angle increased 50 degrees in 5 minutes,side velocity could attain 40 meters per-second,the angle of attack and sideslip would surpass 30 degrees,roll rate would reach -20 degrees per second,side load would arrive 0.6g.Simultaneity the angle of attack exceeded the limited angle,the aircraft would stall.If control wasn't working,the disaster would happen.These phenomena supply the sufficient information of the rudder malfunction. The validity of correcting yaw moment by asymmetry thrust was testified,the simulation results showed that even rudder seizure in most serious conditions,adopting asymmetry thrust can correct yaw moment caused by the rudder seizure.The judgment standards of flight safety level for the state of malfunction were given.The safety level was assessed caused by the rudder seizure.For an aircraft with two engines on one side,the pilots need to adjust the 4 engines to balance the asymmetric moment,the work load is increased enormously.According the flight safety standards,the safety level is level Ⅲ.
基金supported by the National Natural Science Foundation of China(Nos.11932003,12072021,and 11672074)。
文摘In this paper,a reduced globus pallidus internal(GPI)-corticothalamic(GCT)model is developed,and a tri-phase delay stimulation(TPDS)with sequentially applying three pulses on the GPI representing the inputs from the striatal D_(1)neurons,subthalamic nucleus(STN),and globus pallidus external(GPE),respectively,is proposed.The GPI is evidenced to control absence seizures characterized by 2 Hz–4 Hz spike and wave discharge(SWD).Hence,based on the basal ganglia-thalamocortical(BGCT)model,we firstly explore the triple effects of D_(1)-GPI,GPE-GPI,and STN-GPI pathways on seizure patterns.Then,using the GCT model,we apply the TPDS on the GPI to potentially investigate the alternative and improved approach if these pathways to the GPI are blocked.The results show that the striatum D_(1),GPE,and STN can indeed jointly and significantly affect seizure patterns.In particular,the TPDS can effectively reproduce the seizure pattern if the D_(1)-GPI,GPE-GPI,and STN-GPI pathways are cut off.In addition,the seizure abatement can be obtained by well tuning the TPDS stimulation parameters.This implies that the TPDS can play the surrogate role similar to the modulation of basal ganglia,which hopefully can be helpful for the development of the brain-computer interface in the clinical application of epilepsy.
基金supported by Key Research project of Sichuan Department of Science and Technology(No.2019YFS0211)National Natural Science Foundation of China(No.81901327)+1 种基金China Postdoctoral Science Foundation(No.208973)1.3.5 project for disciplines and excellence of West China Hospital,Sichuan University(No.2017305).
文摘Background:Seizure control during pregnancy and obstetric outcomes are of important concerns for women with epilepsy(WWE)and their families.Advanced maternal age(≥35 years)shows a growing trend in the society with changes of lifestyle,which also occurs in diseased populations.The advanced maternal age is an independent factor for some unsatisfying obstetric outcomes.In this study we explored the seizure control and obstetric complications associated with advanced maternal age in WWE.Methods:This study was based on the epilepsy pregnancy registry at West China Hospital.Patients with epilepsy in this registry who were aged 35 or older when starting pregnancy were included in this study.Their basic demographics and detailed information on epilepsy management and obstetric issues in all trimesters and during 1-year follow-up after birth were documented and reviewed.Data were processed by IBM SPSS version 22.0.The demographic characteristics,seizure frequency,treatment change,obstetric complications,and outcomes were analyzed and compared.Results:Fifteen patients were included in this study,with an average age of 36.32±2.39 years at pregnancy,and 73.33%of them were primiparas.The change of seizure frequency during pregnancy was not in a clear pattern,but there was an increased incidence of tonic-clonic seizures during the mid-and last trimesters.More than 20%of the patients had obstetric complications throughout the trimesters,including vaginal bleeding,hypothyroidism,and pre-eclampsia.The pre-eclampsia seemed extraordinarily complicated with other conditions.However,none of the complications were related with malformations or poor outcome of babies after 1-year follow-up.Conclusion:Advanced maternal age combined with WWE is associated with frequent common obstetric complications.Future controlled studies with large sample sizes are needed to explore the related risks in comparison with other WWE and non-epileptic populations.
