<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questio...<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.展开更多
Psychosis is a common non-motor symptom of Parkinson’s disease whose pathogenesis remains poorly understood. Parkinson’s disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tr...Psychosis is a common non-motor symptom of Parkinson’s disease whose pathogenesis remains poorly understood. Parkinson’s disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tracts as wel as within some cortical areas. In this study, Parkinson’s disease patients with psychosis who did not receive antipsychotic treatment and those without psychosis underwent diffusion tensor imaging. Results revealed that in Parkinson’s disease patients with psychosis, damage to the left frontal lobe, bilateral occipital lobe, left cingulated gyrus, and left hippocampal white-matter fibers were greater than damage to the substantia nigra or the globus pal idus. Damage to white-matter fibers in the right frontal lobe and right cingulate gyrus were also more severe than in the globus pal idus, but not the substantia nigra. Damage to frontal lobe and cingulate gyrus white-matter fibers was more apparent than that to occipital or hippocampal fiber damage. Compared with Parkinson’s disease patients without psychosis, those with psychosis had significantly lower fractional anisotropy ratios of left frontal lobe, bilateral occipital lobe, left cingu-lated gyrus, and left hippocampus to ipsilateral substantia nigra or globus pal idus, indicating more severe damage to white-matter fibers. These results suggest that psychosis associated with Par-kinson’s disease is probably associated with an imbalance in the ratio of white-matter fibers be-tween brain regions associated with psychiatric symptoms （frontal lobe, occipital lobe, cingulate gyrus, and hippocampus） and those associated with the motor symptoms of Parkinson’s disease （the substantia nigra and globus pal idus）. The relatively greater damage to white-matter fibers in psychiatric symptom-related brain regions than in extracorticospinal tracts might explain why psy-chosis often occurs in Parkinson’s disease patients.展开更多
目的:利用静息态功能磁共振成像(rs-fMRI)技术的低频振幅(ALFF)算法探讨针刺治疗儿童屈光参差性弱视的脑功能机制。方法:将80例屈光层参差性单眼弱视儿童分为常规组(40例,脱落1例)和针刺组(40例,脱落1例)。常规组予以配镜、红闪光栅和...目的:利用静息态功能磁共振成像(rs-fMRI)技术的低频振幅(ALFF)算法探讨针刺治疗儿童屈光参差性弱视的脑功能机制。方法:将80例屈光层参差性单眼弱视儿童分为常规组(40例,脱落1例)和针刺组(40例,脱落1例)。常规组予以配镜、红闪光栅和视刺激治疗,每项5 min/次;针刺组在常规治疗的基础上给予“调气通经明目”针法治疗,取双侧睛明、攒竹、光明、风池,每次留针30 m in;两组均隔日治疗1次,3次/周,共4周。治疗结束后,检测两组患者视力和视觉诱发电位(P-VEP)P100波潜伏期和振幅改变。同时从两组中各随机选取9例左眼弱视患儿,于治疗前后分别予以rs-fMRI扫描,比较分析两组患儿脑区ALFF差异。结果:①治疗后两组患儿矫正视力均较治疗前提高(P<0.05);与治疗前比较,治疗后两组患儿P-VEP P100波潜伏期缩短、振幅升高(P<0.05),针刺组改善程度显著优于常规组(P<0.05)。②治疗后,常规组右侧豆状核ALFF值增高;针刺组右侧颞叶ALFF值增高(P<0.05);针刺组与常规组比较,右侧边缘叶/扣带回左侧胼胝体/扣带回、左侧额叶/双侧辅助运动区的ALFF值降低(P<0.05),右侧顶叶/顶下小叶增高(P<0.05)。结论:针刺联合常规治疗可改善屈光参差性弱视儿童的矫正视力,增强视神经传导功能;两种疗法的效应机制与有效调节不同脑区自发功能活动和响应有关,但二者脑功能响应区域存在明显差异。与常规疗法相比,边缘系统、额叶、顶叶可能是针刺治疗屈光参差性弱视重点调控的脑区。展开更多
目的:探讨轻度认知障碍(MCI)和阿尔茨海默病(AD)患者扣带回代谢物的改变及分布规律,以帮助理解疾病病理改变。方法:使用Achieva 3.0 T TX双梯度双射频源磁共振成像系统、SENSE-8-HEAD线圈,对性别、年龄和教育程度匹配的20例AD患者(AD组)...目的:探讨轻度认知障碍(MCI)和阿尔茨海默病(AD)患者扣带回代谢物的改变及分布规律,以帮助理解疾病病理改变。方法:使用Achieva 3.0 T TX双梯度双射频源磁共振成像系统、SENSE-8-HEAD线圈,对性别、年龄和教育程度匹配的20例AD患者(AD组)、25例MCI患者(MCI组)及22例正常老年人(对照组,NC组)进行双侧扣带回多体素2D-PRESS1H-MRS扫描。比较3组间双侧扣带回的N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、肌醇(MI)/Cr、MI/NAA值的差异。结果:3组比较只有MI/Cr值的差异有统计学意义,组间比较提示MCI组和AD组的MI/Cr值均高于NC组(P<0.05),AD组的MI/NAA值高于NC组(P<0.05),NAA/Cr值3组间差异未见统计学意义。扣带回MI/Cr值与Mo CA评分呈显著负相关,MI/NAA值与MMSE评分呈负相关。结论:在AD和MCI患者中扣带回MI/Cr值明显升高,与认知功能呈负相关,MI变化较NAA变化更早更明显,有助于AD早期诊断。展开更多
文摘<strong>Introduction:</strong> Numerous studies show the involvement of the cingulate gyrus in affective disorders, particularly in depression. With a preventive and curative aim, the authors raise questions leading to therapeutic applications such as focal brain stimulation. The cingulate gyrus is the primary target of these brain stimulation therapies for the treatment of depression. The objective of this work is to establish anatomoclinical correlations and to deduce the therapeutic implications. <strong>Methodology:</strong> Our work is a review of the literature. The inventory of the cingulate gyrus and depression was based on the development of a critical synthesis of bibliographic knowledge. <strong>Results:</strong> We found a bipartite Brodmann subdivision which evolved into a subdivision into four regions of the cingulate gyrus. Descriptions of the cingulate gyrus boundaries are imprecise and divergent. The anterior end of the anterior cingulate cortex is a confirmed target of stimulation in the treatment of major and resistant depression, thus requiring the authors, a consensus in its delineation. Brodmann’s area 25 has been described as the main target of brain stimulation therapies. Dysfunction by local lesion or by alteration of the connectivity of Brodmann’s area has repercussions on these different structures to which it is interconnected. These disturbances when they are in the direction of collapse paint a picture similar to major depression. <strong>Conclusion: </strong>The anterior cingulate cortex is involved in depression. The functional system organization of affectivity will allow new brain stimulation techniques to act on the entire functional system or on one of its components.
基金supported by the Applied Basic Research Foundation of Yunnan Province in China,No.2009CD193
文摘Psychosis is a common non-motor symptom of Parkinson’s disease whose pathogenesis remains poorly understood. Parkinson’s disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tracts as wel as within some cortical areas. In this study, Parkinson’s disease patients with psychosis who did not receive antipsychotic treatment and those without psychosis underwent diffusion tensor imaging. Results revealed that in Parkinson’s disease patients with psychosis, damage to the left frontal lobe, bilateral occipital lobe, left cingulated gyrus, and left hippocampal white-matter fibers were greater than damage to the substantia nigra or the globus pal idus. Damage to white-matter fibers in the right frontal lobe and right cingulate gyrus were also more severe than in the globus pal idus, but not the substantia nigra. Damage to frontal lobe and cingulate gyrus white-matter fibers was more apparent than that to occipital or hippocampal fiber damage. Compared with Parkinson’s disease patients without psychosis, those with psychosis had significantly lower fractional anisotropy ratios of left frontal lobe, bilateral occipital lobe, left cingu-lated gyrus, and left hippocampus to ipsilateral substantia nigra or globus pal idus, indicating more severe damage to white-matter fibers. These results suggest that psychosis associated with Par-kinson’s disease is probably associated with an imbalance in the ratio of white-matter fibers be-tween brain regions associated with psychiatric symptoms （frontal lobe, occipital lobe, cingulate gyrus, and hippocampus） and those associated with the motor symptoms of Parkinson’s disease （the substantia nigra and globus pal idus）. The relatively greater damage to white-matter fibers in psychiatric symptom-related brain regions than in extracorticospinal tracts might explain why psy-chosis often occurs in Parkinson’s disease patients.
文摘目的:利用静息态功能磁共振成像(rs-fMRI)技术的低频振幅(ALFF)算法探讨针刺治疗儿童屈光参差性弱视的脑功能机制。方法:将80例屈光层参差性单眼弱视儿童分为常规组(40例,脱落1例)和针刺组(40例,脱落1例)。常规组予以配镜、红闪光栅和视刺激治疗,每项5 min/次;针刺组在常规治疗的基础上给予“调气通经明目”针法治疗,取双侧睛明、攒竹、光明、风池,每次留针30 m in;两组均隔日治疗1次,3次/周,共4周。治疗结束后,检测两组患者视力和视觉诱发电位(P-VEP)P100波潜伏期和振幅改变。同时从两组中各随机选取9例左眼弱视患儿,于治疗前后分别予以rs-fMRI扫描,比较分析两组患儿脑区ALFF差异。结果:①治疗后两组患儿矫正视力均较治疗前提高(P<0.05);与治疗前比较,治疗后两组患儿P-VEP P100波潜伏期缩短、振幅升高(P<0.05),针刺组改善程度显著优于常规组(P<0.05)。②治疗后,常规组右侧豆状核ALFF值增高;针刺组右侧颞叶ALFF值增高(P<0.05);针刺组与常规组比较,右侧边缘叶/扣带回左侧胼胝体/扣带回、左侧额叶/双侧辅助运动区的ALFF值降低(P<0.05),右侧顶叶/顶下小叶增高(P<0.05)。结论:针刺联合常规治疗可改善屈光参差性弱视儿童的矫正视力,增强视神经传导功能;两种疗法的效应机制与有效调节不同脑区自发功能活动和响应有关,但二者脑功能响应区域存在明显差异。与常规疗法相比,边缘系统、额叶、顶叶可能是针刺治疗屈光参差性弱视重点调控的脑区。
文摘目的:探讨轻度认知障碍(MCI)和阿尔茨海默病(AD)患者扣带回代谢物的改变及分布规律,以帮助理解疾病病理改变。方法:使用Achieva 3.0 T TX双梯度双射频源磁共振成像系统、SENSE-8-HEAD线圈,对性别、年龄和教育程度匹配的20例AD患者(AD组)、25例MCI患者(MCI组)及22例正常老年人(对照组,NC组)进行双侧扣带回多体素2D-PRESS1H-MRS扫描。比较3组间双侧扣带回的N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、肌醇(MI)/Cr、MI/NAA值的差异。结果:3组比较只有MI/Cr值的差异有统计学意义,组间比较提示MCI组和AD组的MI/Cr值均高于NC组(P<0.05),AD组的MI/NAA值高于NC组(P<0.05),NAA/Cr值3组间差异未见统计学意义。扣带回MI/Cr值与Mo CA评分呈显著负相关,MI/NAA值与MMSE评分呈负相关。结论:在AD和MCI患者中扣带回MI/Cr值明显升高,与认知功能呈负相关,MI变化较NAA变化更早更明显,有助于AD早期诊断。
