BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay an...BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay and mortality. There are histological similarities to Alzheimer’s disease. Most early studies were conducted in patients receiving cardiac surgery. Since there is no information about POCD in liver transplant recipients, we measured the incidence of POCD in patients after liver transplantation and examined the correlation between neurological dysfunction and biological markers of dementia- based diseases. METHODS: We studied 25 patients who had a liver transplan- tation between July 2008 and February 2009. Patients with prior encephalopathy or risk factors associated with the development of POCD were excluded from the study. Five validated neuropsychiatric tests were used for diagnosis. The diagnosis was based on one standard deviation decline in two of the five neuropsychiatric tests. The correlation between patient variables and the development of POCD was examined. Serum levels of beta-amyloid and C-reactive protein were measured by standard ELISA and compared between patients with and without POCD. RESULTS: POCD was present in 11 (44%) of the 25 patients. Patients with POCD had significantly higher MELD scores, were more often Child-Pugh class C and received more blood transfusion during surgery. The serum beta-amyloid protein and C-reactive protein concentrations were significantly increased at 24 hours after surgery in the POCD group.CONCLUSIONS: The incidence of POCD in our group of liver transplant patients was greater than that reported in other surgical patients. The increase in the serum biomarkers of dementia in the POCD patients supports the hypothesis that chronic cognitive defects are due to a process similar to that seen in Alzheimer’s disease.展开更多
认知功能障碍是脑高级功能的损伤,由神经精神疾病引起的认知功能损害对患者的生活质量和疾病转归造成严重影响。经颅交流电刺激(transcranial alternating current stimulation,tACS)通过调节特定频率的神经振荡、影响5-羟色胺和多巴胺...认知功能障碍是脑高级功能的损伤,由神经精神疾病引起的认知功能损害对患者的生活质量和疾病转归造成严重影响。经颅交流电刺激(transcranial alternating current stimulation,tACS)通过调节特定频率的神经振荡、影响5-羟色胺和多巴胺等神经递质的释放、增强脑网络局部与远端的同步,达到改善认知功能的效果。特定频率的tACS可以改善阿尔茨海默病(Alzheimer disease,AD)、精神分裂症、抑郁障碍引起的认知功能损害,其中以gamma和theta频率tACS对认知功能的影响最为显著。tACS安全性高,操作难度小,对改善神经精神疾病患者的认知功能具有巨大潜力。展开更多
Neuropsychiatric diseases, including ADHD, schizophrenia, and bipolar disorder, are increasingly prevalent but poorly understood at the molecular level. The complexities of diagnosing and treating these disorders emph...Neuropsychiatric diseases, including ADHD, schizophrenia, and bipolar disorder, are increasingly prevalent but poorly understood at the molecular level. The complexities of diagnosing and treating these disorders emphasize the need for objective, quantitative data to improve diagnostic accuracy and treatment efficacy. This study aims to explore the genetic underpinnings of neuropsychiatric diseases, contrasting them with well-characterized diseases like breast cancer, and discuss the role of specific genetic mutations and their implications for personalized treatment. The paper delves into the genetic and molecular insights of neuropsychiatric diseases, examining the role of specific genetic mutations and the potential for gene editing technologies like CRISPR. It contrasts the genetic underpinnings of neuropsychiatric diseases with well-characterized diseases like breast cancer, highlighting the potential for a shift towards molecular and genetic-based diagnostics and treatments. The study argues that a shift towards molecular and genetic-based diagnostics and treatments could revolutionize our approach to neuropsychiatric diseases, much like how biomarker tests have transformed breast cancer treatment. It concludes by advocating for a more personalized approach to healthcare, tailored to an individual’s unique genetic makeup, as the future of neuropsychiatric disease diagnosis and treatment.展开更多
文摘BACKGROUND: Postoperative cognitive dysfunction (POCD) is an adverse condition characterized by declined cognitive functions following surgeries and anesthesia. POCD has been associated with increased hospital stay and mortality. There are histological similarities to Alzheimer’s disease. Most early studies were conducted in patients receiving cardiac surgery. Since there is no information about POCD in liver transplant recipients, we measured the incidence of POCD in patients after liver transplantation and examined the correlation between neurological dysfunction and biological markers of dementia- based diseases. METHODS: We studied 25 patients who had a liver transplan- tation between July 2008 and February 2009. Patients with prior encephalopathy or risk factors associated with the development of POCD were excluded from the study. Five validated neuropsychiatric tests were used for diagnosis. The diagnosis was based on one standard deviation decline in two of the five neuropsychiatric tests. The correlation between patient variables and the development of POCD was examined. Serum levels of beta-amyloid and C-reactive protein were measured by standard ELISA and compared between patients with and without POCD. RESULTS: POCD was present in 11 (44%) of the 25 patients. Patients with POCD had significantly higher MELD scores, were more often Child-Pugh class C and received more blood transfusion during surgery. The serum beta-amyloid protein and C-reactive protein concentrations were significantly increased at 24 hours after surgery in the POCD group.CONCLUSIONS: The incidence of POCD in our group of liver transplant patients was greater than that reported in other surgical patients. The increase in the serum biomarkers of dementia in the POCD patients supports the hypothesis that chronic cognitive defects are due to a process similar to that seen in Alzheimer’s disease.
文摘认知功能障碍是脑高级功能的损伤,由神经精神疾病引起的认知功能损害对患者的生活质量和疾病转归造成严重影响。经颅交流电刺激(transcranial alternating current stimulation,tACS)通过调节特定频率的神经振荡、影响5-羟色胺和多巴胺等神经递质的释放、增强脑网络局部与远端的同步,达到改善认知功能的效果。特定频率的tACS可以改善阿尔茨海默病(Alzheimer disease,AD)、精神分裂症、抑郁障碍引起的认知功能损害,其中以gamma和theta频率tACS对认知功能的影响最为显著。tACS安全性高,操作难度小,对改善神经精神疾病患者的认知功能具有巨大潜力。
文摘Neuropsychiatric diseases, including ADHD, schizophrenia, and bipolar disorder, are increasingly prevalent but poorly understood at the molecular level. The complexities of diagnosing and treating these disorders emphasize the need for objective, quantitative data to improve diagnostic accuracy and treatment efficacy. This study aims to explore the genetic underpinnings of neuropsychiatric diseases, contrasting them with well-characterized diseases like breast cancer, and discuss the role of specific genetic mutations and their implications for personalized treatment. The paper delves into the genetic and molecular insights of neuropsychiatric diseases, examining the role of specific genetic mutations and the potential for gene editing technologies like CRISPR. It contrasts the genetic underpinnings of neuropsychiatric diseases with well-characterized diseases like breast cancer, highlighting the potential for a shift towards molecular and genetic-based diagnostics and treatments. The study argues that a shift towards molecular and genetic-based diagnostics and treatments could revolutionize our approach to neuropsychiatric diseases, much like how biomarker tests have transformed breast cancer treatment. It concludes by advocating for a more personalized approach to healthcare, tailored to an individual’s unique genetic makeup, as the future of neuropsychiatric disease diagnosis and treatment.
