Orexin, released from the hypothalamus, has been implicated in various basic non-somatic functions including feeding, the sleep-wakefulness cycle, emotion,and cognition. However, the role of orexin in somatic motor co...Orexin, released from the hypothalamus, has been implicated in various basic non-somatic functions including feeding, the sleep-wakefulness cycle, emotion,and cognition. However, the role of orexin in somatic motor control is still little known. Here, using whole-cell patch clamp recording and immunostaining, we investigated the effect and the underlying receptor mechanism of orexin-A on neurons in the globus pallidus internus（GPi）,a critical structure in the basal ganglia and an effective target for deep brain stimulation therapy. Our results showed that orexin-A induced direct postsynaptic excitation of GPi neurons in a concentration-dependent manner.The orexin-A-induced excitation was mediated via co-activation of both OX1 and OX2 receptors. Furthermore, the immunostaining results showed that OX1 and OX2 receptors were co-localized in the same GPi neurons. These results suggest that the central orexinergic system actively modulates the motor functions of the basal ganglia via direct innervation on GPi neurons and presumably participates in somatic-non-somatic integration.展开更多
Chorea-acanthocytosis(ChAc)is the most common subtype of neuroacanthocytosis syndrome,characterized by the presence of acanthocytes and neurological disorders.It is thought to be caused by VPS13A mutations.Characteris...Chorea-acanthocytosis(ChAc)is the most common subtype of neuroacanthocytosis syndrome,characterized by the presence of acanthocytes and neurological disorders.It is thought to be caused by VPS13A mutations.Characteristic movement disorders in ChAc is choreiform movements affecting both trunk and extremities and prominent orolingual dyskinesia is pathognomonic.Acanthocytosis in peripheral blood smear,elevated serum creatine kinase and atrophy of heads of caudate nuclei and dilation of the anterior horn of the lateral ventricles in magnetic resonance imaging could assist the diagnosis of ChAc.Botulinum toxin injection is a possible treatment for the typical orofacial dystonia.Deep brain stimulation is a novel surgical treatment modality.Most cases chose globus pallidus internus as target.Patients with dystonia as a major manifestation will benefit more from high-frequency stimulation and those with major findings of chorea and dysarthria are suitable for low-frequency stimulation.More evidence of long-term outcomes is warranted.展开更多
Introduction: In my daily practice as a hip surgeon, I have observed some circumstances where urinary incontinence (UI) improves after total hip arthroplasty (THA). We investigated UI symptoms before and after THA at ...Introduction: In my daily practice as a hip surgeon, I have observed some circumstances where urinary incontinence (UI) improves after total hip arthroplasty (THA). We investigated UI symptoms before and after THA at our facility and considered the factors that influence UI. Patients and Method: The subjects were 113 female patients who underwent primary THA in our facility. An anterior lateral approach was used in all cases. Using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), we conducted an investigation into the presence of UI before and 2 weeks after THA. An improvement in UI was defined as a decrease of 1 point or more, a worsening is defined as an increase of 1 point or more. Results: The responses from the 113 subjects were analyzed. Of the 113 patients, prior to THA, UI was prevalent among 59 patients and was absent among 54 patients. In the group where UI was prevalent, it improved after THA in 50 patients (85%), remained unchanged in 5 (8%) and worsened in 4 (7%). In the group where UI was absent, 49 patients (91%) remained unchanged and UI appeared in 5 (9%). Compared with the non-prevalence group (62 patients), the prevalence group (50 patients) had a noticeable improvement rate of internal rotation of the surgical hip side (P Conclusion: UI greatly reduces the quality of life (QOL). In this study, there is a possibility that THA improves UI.展开更多
The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency i...The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore,bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico–striato–pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease,particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremordominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia–thalamus network. Therefore, the composition of the globus pallidus neurons, th展开更多
Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to ...Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is mo展开更多
The transobturator tape (TOT) procedure is generally felt to be a safer surgical alternative to the ten sion-free vaginal tape procedure for women with stress urinary incontinence. We report a case of adductor internu...The transobturator tape (TOT) procedure is generally felt to be a safer surgical alternative to the ten sion-free vaginal tape procedure for women with stress urinary incontinence. We report a case of adductor internus myositis not associated with infection following the TOT procedure. To our knowledge this is the first case of this type reported in the literature. A 43 year old lady underwent a straightforward elective TOT procedure. There were no intraoperative complications. Immediately following the procedure she complained of pain in her right thigh. MRI confirmed abnormal oedema within the antero-inferior aspect of the right obturator internus muscle consistent with myositis secondary to tape insertion. The tape was removed the following day in theatre, following which her pain resolved. This case highlights a previously unreported complication as a result of the TOT procedure.展开更多
目的:三维重建女性盆底组织闭孔内肌、骨盆和肛提肌的复杂几何结构,为从力学角度进一步认识女性盆底组织的力学特性和盆底功能障碍性疾病的发病机理做前期准备.方法:选取一系列层厚为0.8 mm MRI图像,运用三维图像重建软件MIMICS进行图...目的:三维重建女性盆底组织闭孔内肌、骨盆和肛提肌的复杂几何结构,为从力学角度进一步认识女性盆底组织的力学特性和盆底功能障碍性疾病的发病机理做前期准备.方法:选取一系列层厚为0.8 mm MRI图像,运用三维图像重建软件MIMICS进行图像重建,建立其三维几何结构.结果:获得了闭孔内肌、骨盆和肛提肌的独立三维几何结构,从解剖结构上完全还原其相对位置.结论:所获得的三维模型真实地反映了其解剖构型和几何外形,且通过有限元软件验证了本模型力学分析的可行性.展开更多
基金supported by grants from the National Natural Science Foundation of China(NSFC31330033,91332124,31471112,31500848,81671107,31600834,J1210026)+3 种基金the NSFC/Research Grants Council(RGC)Joint Research Scheme(31461163001)the Ministry of Education of China(Specialized Research Fund for the Doctoral Program of Higher Education/RGC Earmarked Research Grant 20130091140003,and Fundamental Research Funds for the Central Universities)the Natural Science Foundation of Jiangsu Province,China(BK2011014,BK20140599,and BK20151384)the Postdoctoral Sciences Foundation,China(2013T60520)
文摘Orexin, released from the hypothalamus, has been implicated in various basic non-somatic functions including feeding, the sleep-wakefulness cycle, emotion,and cognition. However, the role of orexin in somatic motor control is still little known. Here, using whole-cell patch clamp recording and immunostaining, we investigated the effect and the underlying receptor mechanism of orexin-A on neurons in the globus pallidus internus（GPi）,a critical structure in the basal ganglia and an effective target for deep brain stimulation therapy. Our results showed that orexin-A induced direct postsynaptic excitation of GPi neurons in a concentration-dependent manner.The orexin-A-induced excitation was mediated via co-activation of both OX1 and OX2 receptors. Furthermore, the immunostaining results showed that OX1 and OX2 receptors were co-localized in the same GPi neurons. These results suggest that the central orexinergic system actively modulates the motor functions of the basal ganglia via direct innervation on GPi neurons and presumably participates in somatic-non-somatic integration.
文摘Chorea-acanthocytosis(ChAc)is the most common subtype of neuroacanthocytosis syndrome,characterized by the presence of acanthocytes and neurological disorders.It is thought to be caused by VPS13A mutations.Characteristic movement disorders in ChAc is choreiform movements affecting both trunk and extremities and prominent orolingual dyskinesia is pathognomonic.Acanthocytosis in peripheral blood smear,elevated serum creatine kinase and atrophy of heads of caudate nuclei and dilation of the anterior horn of the lateral ventricles in magnetic resonance imaging could assist the diagnosis of ChAc.Botulinum toxin injection is a possible treatment for the typical orofacial dystonia.Deep brain stimulation is a novel surgical treatment modality.Most cases chose globus pallidus internus as target.Patients with dystonia as a major manifestation will benefit more from high-frequency stimulation and those with major findings of chorea and dysarthria are suitable for low-frequency stimulation.More evidence of long-term outcomes is warranted.
文摘Introduction: In my daily practice as a hip surgeon, I have observed some circumstances where urinary incontinence (UI) improves after total hip arthroplasty (THA). We investigated UI symptoms before and after THA at our facility and considered the factors that influence UI. Patients and Method: The subjects were 113 female patients who underwent primary THA in our facility. An anterior lateral approach was used in all cases. Using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), we conducted an investigation into the presence of UI before and 2 weeks after THA. An improvement in UI was defined as a decrease of 1 point or more, a worsening is defined as an increase of 1 point or more. Results: The responses from the 113 subjects were analyzed. Of the 113 patients, prior to THA, UI was prevalent among 59 patients and was absent among 54 patients. In the group where UI was prevalent, it improved after THA in 50 patients (85%), remained unchanged in 5 (8%) and worsened in 4 (7%). In the group where UI was absent, 49 patients (91%) remained unchanged and UI appeared in 5 (9%). Compared with the non-prevalence group (62 patients), the prevalence group (50 patients) had a noticeable improvement rate of internal rotation of the surgical hip side (P Conclusion: UI greatly reduces the quality of life (QOL). In this study, there is a possibility that THA improves UI.
基金supported by the National Natural Science Foundation of China,No.31771143 (to QZ)Shanghai Municipal Science and Technology Major Project,ZJ Lab+1 种基金Shanghai Center for Brain Science and Brain-Inspired Technology,No.2018SHZDZX01 (to LC)Shanghai Zhou Liangfu Medical Development Foundation “Brain Science and Brain Diseases Youth Innovation Program”(to ZQ)。
文摘The globus pallidus plays a pivotal role in the basal ganglia circuit. Parkinson's disease is characterized by degeneration of dopamine-producing cells in the substantia nigra, which leads to dopamine deficiency in the brain that subsequently manifests as various motor and non-motor symptoms. This review aims to summarize the involvement of the globus pallidus in both motor and non-motor manifestations of Parkinson's disease. The firing activities of parvalbumin neurons in the medial globus pallidus, including both the firing rate and pattern, exhibit strong correlations with the bradykinesia and rigidity associated with Parkinson's disease. Increased beta oscillations, which are highly correlated with bradykinesia and rigidity, are regulated by the lateral globus pallidus. Furthermore,bradykinesia and rigidity are strongly linked to the loss of dopaminergic projections within the cortical-basal ganglia-thalamocortical loop. Resting tremors are attributed to the transmission of pathological signals from the basal ganglia through the motor cortex to the cerebellum-ventral intermediate nucleus circuit. The cortico–striato–pallidal loop is responsible for mediating pallidi-associated sleep disorders. Medication and deep brain stimulation are the primary therapeutic strategies addressing the globus pallidus in Parkinson's disease. Medication is the primary treatment for motor symptoms in the early stages of Parkinson's disease, while deep brain stimulation has been clinically proven to be effective in alleviating symptoms in patients with advanced Parkinson's disease,particularly for the movement disorders caused by levodopa. Deep brain stimulation targeting the globus pallidus internus can improve motor function in patients with tremordominant and non-tremor-dominant Parkinson's disease, while deep brain stimulation targeting the globus pallidus externus can alter the temporal pattern of neural activity throughout the basal ganglia–thalamus network. Therefore, the composition of the globus pallidus neurons, th
基金This work was supported by the National Natural Science Foundation of China(NSFC)(No.81371256,81171061,81361128012)Ministry of Education of Republic of China(BIBD-PXM2013-014226-07-000084)Seed Grant of International Alliance of Translational Neuroscience(PXM2014-014226-000015).
文摘Background:The cardinal features of Parkinson’s disease(PD)are bradykinesia,rigidity and rest tremor.Abnormal activity in the basal ganglia is predicted to underlie the mechanism of motor symptoms.This study aims to characterize properties of oscillatory activity in the basal ganglia and motor thalamus in patients with PD.Methods:Twenty-nine patients with PD who underwent bilateral or unilateral electrode implantation for subthalamic nucleus(STN)DBS(n=11),unilateral pallidotomy(n=9)and unilateral thalamotomy(n=9)were studied.Microelectrode recordings in the STN,globus pallidus internus(GPi)and ventral oral posterior/ventral intermediate of thalamus(Vop/Vim)were performed.Electromyography of the contralateral limbs was recorded.Single unit characteristics including interspike intervals were analyzed.Spectral and coherence analyses were assessed.Mean spontaneous firing rate(MSFR)of neurons was calculated.Analysis of variance and χ^(2) test were performed.Results:Of 76 STN neurons,39.5% were 4–6 Hz band oscillatory neurons and 28.9% were β frequency band(βFB)oscillatory neurons.The MSFR was 44.2±7.6 Hz.Of 62 GPi neurons,37.1% were 4–6 Hz band oscillatory neurons and 27.4% were βFB neurons.The MSFR was 80.9±9.6 Hz.Of 44 Vop neurons,65.9% were 4–6 Hz band oscillatory neurons and 9%were βFB neurons.The MSFR was 24.4±4.2 Hz.Of 30 Vim oscillatory neurons,70% were 4–6 Hz band oscillatory neurons and 13.3% were β FB neurons.The MSFR was 30.3±3.6 Hz.Further analysis indicated that proportion of βFB oscillatory neurons in STN and GPi was higher than that of similar neurons in the Vop and Vim(P<0.05).Conversely,the proportion of 4–6 Hz band oscillatory neurons and tremor related neurons in the Vim and Vop was higher than that of STN and GPi(P<0.05).The highest MSFR was for GPi oscillatory neurons whereas the lowest MSFR was for Vop oscillatory neurons(P<0.005).Conclusion:The alterations in neuronal activity in basal ganglia play a critical role in generation of parkinsonism.β oscillatory activity is mo
文摘The transobturator tape (TOT) procedure is generally felt to be a safer surgical alternative to the ten sion-free vaginal tape procedure for women with stress urinary incontinence. We report a case of adductor internus myositis not associated with infection following the TOT procedure. To our knowledge this is the first case of this type reported in the literature. A 43 year old lady underwent a straightforward elective TOT procedure. There were no intraoperative complications. Immediately following the procedure she complained of pain in her right thigh. MRI confirmed abnormal oedema within the antero-inferior aspect of the right obturator internus muscle consistent with myositis secondary to tape insertion. The tape was removed the following day in theatre, following which her pain resolved. This case highlights a previously unreported complication as a result of the TOT procedure.
文摘目的:三维重建女性盆底组织闭孔内肌、骨盆和肛提肌的复杂几何结构,为从力学角度进一步认识女性盆底组织的力学特性和盆底功能障碍性疾病的发病机理做前期准备.方法:选取一系列层厚为0.8 mm MRI图像,运用三维图像重建软件MIMICS进行图像重建,建立其三维几何结构.结果:获得了闭孔内肌、骨盆和肛提肌的独立三维几何结构,从解剖结构上完全还原其相对位置.结论:所获得的三维模型真实地反映了其解剖构型和几何外形,且通过有限元软件验证了本模型力学分析的可行性.
