Cognitive Disorders

认知障碍
  • 文章类型: Journal Article
    认知障碍是帕金森病(PD)中常见的非运动症状。传统上,拉丁裔背景的个人在PD研究中代表性不足。尽管拉丁美洲人占美国人口的18%,在PD研究中,它们通常占不到5%的样本。新出现的证据表明,患有PD的拉丁裔人在运动症状更严重方面可能与白人非拉丁裔人存在差异,更严重的抑郁症状,与健康相关的生活质量更差。本研究的目的是调查患有PD的拉丁裔和白人非拉丁裔个体之间认知表现的差异,并检查认知表现的相关性。
    数据来自帕金森进展标志物倡议。参与者包括60名患有PD的拉丁裔个人和1,009名患有PD的白人非拉丁裔个人,所有这些人每年随访5年.参与者完成了注意力和工作记忆的神经心理学测试,处理速度,视觉空间功能,口语流利,以及即时和延迟的记忆和回忆。
    相对于患有PD的白人非拉丁裔个人,患有PD的拉丁裔个体在认知功能的全球测量上得分明显较低,处理速度的测试,以及工作记忆和注意力的测试。在拉丁裔群体中,受教育年限与这三个认知领域的表现之间的相关性最强。
    这些发现提供了拉丁裔PD患者认知功能差异的初步证据。教育劣势可能是这些差异的潜在驱动因素之一。
    UNASSIGNED: Cognitive impairment is a common nonmotor symptom in Parkinson\'s disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance.
    UNASSIGNED: Data were obtained from the Parkinson\'s Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall.
    UNASSIGNED: Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group.
    UNASSIGNED: These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities.
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  • 文章类型: Journal Article
    神经纤维瘤病1型(NF1型)是一种常染色体显性疾病,具有典型的临床表现,如皮肤损伤,Lisch结节,视路胶质瘤,和神经纤维瘤,由NF1基因的突变引起的。视觉诱发电位(VEP)是视觉皮层对视觉刺激的电生理反应的量度。VEP在NF1型的病理生理学中的作用非常复杂,需要进一步的研究。
    我们检查了VEP正常和改变的NF1型患者之间的差异,并分析了P100潜伏期延长与疾病严重程度之间的相关性。
    两组:对照组和NF1型患者研究组。在对照组分析的基础上,获得了正常VEP发现116ms的阈值,并将研究组分为VEP正常和改变的亚组。我们继续研究亚组之间疾病临床表现的差异,之后,我们根据Riccardi量表检查P100潜伏期的延长与临床表现的严重程度之间是否存在相关性。在SPSS28.0程序中使用Pearson卡方检验和Spearman相关性检验进行统计分析,具有统计学意义的水平p=0.05和p=0.001。
    在VEP异常的组中,我们发现视神经胶质瘤的发生率有统计学意义(p=0.008),肿瘤(p=0.032),癫痫(p=0.043),和认知障碍(p=0.028),而其他临床体征在两组中的患病率相同.在P100潜伏期的延长与临床表现的严重程度之间观察到中度强相关性(rs=0.665)。
    我们的结果显示了VEP在NF1型临床表型描述中的重要作用。该研究的作者建议将VEP纳入为1型NF患者设计的诊断算法中。
    UNASSIGNED: Neurofibromatosis type 1 (NF type 1) is an autosomal dominant disease with typical clinical manifestations, such as skin lesions, Lisch nodules, optic pathway gliomas, and neurofibromas, caused by the mutation of the NF1 gene. Visual evoked potentials (VEP) present a measure of the electrophysiological response of visual cortex to a visual stimulus. The role of VEP in the pathophysiology of NF type 1 is very complex and requires additional research.
    UNASSIGNED: We examined the differences between NF type 1 patients with normal and altered VEP and analyzed the correlation between the prolongation of P100 latency and disease severity.
    UNASSIGNED: Two groups were formed: a control group and a study group with NF type 1 patients. Based on the control group analysis, a threshold value for a normal VEP finding of 116 ms was obtained, and it was used to divide the study group into subgroups with normal and altered VEP. We proceeded with examining the differences in clinical manifestations of the disease between the subgroups, after which we checked if there is a correlation between the prolongation of the P100 latency and the severity of the clinical picture according to the Riccardi scale. Statistical analysis was performed using the Pearson chi-square test and the Spearman correlation test in the program SPSS 28.0, with levels of statistical significance p = 0.05 and p = 0.001.
    UNASSIGNED: In the group with the abnormal VEP we found a statistically significant more frequent occurrence of optic tract glioma (p = 0.008), tumors (p = 0.032), epilepsy (p = 0.043), and cognitive disorders (p = 0.028), while the other clinical signs had an equal prevalence in both groups. A moderately strong correlation (r s = 0.665) was observed between the prolongation of P100 latency and the severity of the clinical picture.
    UNASSIGNED: Our results showed the important role of VEP in the description of clinical phenotypes of NF type 1. The authors of the study propose VEP to be included in the diagnostic algorithms designed for patients with NF type 1.
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  • 文章类型: Journal Article
    术后认知功能障碍(POCD)是一个主要的问题,尤其是在老年人中。这项研究使用了老年小鼠的社会隔离(ISO)和多组学分析来研究POCD发展的潜在机制。将老年小鼠分为两组:ISO和配对住房(PH)。油酰胺和大麻素受体2型(CB2R)拮抗剂AM630腹膜内给药,而Foxq1腺相关病毒(AAV)载体直接注射到海马中。随后进行胫骨髓内手术以建立POCD模型。包括Y迷宫的行为测试,露天试验,术后2天进行新物体识别。评估海马和血清炎性细胞因子。手术后,ISO小鼠表现出增强的认知障碍和不断升级的炎症标志物。整合转录组和代谢组学分析显示,PH小鼠海马和血清中的油酰胺浓度升高,相关研究表明Foxq1基因与油酰胺水平之间存在密切关系。虽然油酰胺给药和Foxq1基因过表达显著改善了小鼠术后认知表现和全身炎症,CB2R拮抗剂AM630阻碍了这些增强。Foxq1基因和油酰胺可能对减轻POCD至关重要。虽然可能通过CB2R介导的途径起作用,这些因素可能会调节神经炎症并减弱海马内的促炎细胞因子水平,显著提高术后认知能力。这项研究为未来研究靶向Foxq1-油酰胺-CB2R轴的治疗方法奠定了基础。以预防或减轻POCD为最终目标。
    Postoperative cognitive dysfunction (POCD) is a major concern, particularly among older adults. This study used social isolation (ISO) and multiomics analyses in aged mice to investigate potential mechanisms underlying POCD development. Aged mice were divided into two groups: ISO and paired housing (PH). Oleamide and the cannabinoid receptor type 2 (CB2R) antagonist AM630 were administered intraperitoneally, while Foxq1 adeno-associated viral (AAV) vector was injected directly into the hippocampus. Intramedullary tibial surgeries were subsequently performed to establish the POCD models. Behavioral tests comprising the Y-maze, open field test, and novel object recognition were conducted 2 days after surgery. Hippocampal and serum inflammatory cytokines were assessed. Following surgery, ISO mice demonstrated intensified cognitive impairments and escalated inflammatory markers. Integrative transcriptomic and metabolomic analysis revealed elevated oleamide concentrations in the hippocampus and serum of PH mice, with associative investigations indicating a close relationship between the Foxq1 gene and oleamide levels. While oleamide administration and Foxq1 gene overexpression substantially ameliorated postoperative cognitive performance and systemic inflammation in mice, CB2R antagonist AM630 impeded these enhancements. The Foxq1 gene and oleamide may be crucial in alleviating POCD. While potentially acting through CB2R-mediated pathways, these factors may modulate neuroinflammation and attenuate proinflammatory cytokine levels within the hippocampus, substantially improving cognitive performance postsurgery. This study lays the groundwork for future research into therapeutic approaches targeting the Foxq1-oleamide-CB2R axis, with the ultimate goal of preventing or mitigating POCD.
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  • 文章类型: Journal Article
    有一种促进福祉的趋势,或者快乐和健康的状态,在医学界。历史上,住院医师在培训期间面临很高的困扰率。居住计划中的结构化福祉课程可能会将居民的心态从生存和韧性转变为以目的为中心的心态,订婚,和喜悦。
    每5周在一个机构亲自为居民提供约10个福利讲习班的原始福利课程,每学年总共有大约20个小时的课程曝光时间。幸福课程分为4个领域:认知扭曲和有问题的心态,正念和冥想,创意出口,和自我同情。接受至少1年福利课程的居民被要求回答匿名调查。对4个域中的每一个提出了4个问题。第一个和第二个问题询问了他们在研讨会之前和之后对主题的熟悉程度,熟悉程度为1-5。第三个和第四个问题询问了获得的知识对他们的职业和个人生活的影响程度,影响程度为1-5。
    在课程曝光之前,所有领域中等或更高水平知识的平均值为22.7%,课程完成后提高到77.3%。总的来说,58.6%的参与者认为该领域的知识在他们的职业生涯中具有中等或极高的影响力,在他们的个人生活中占83.6%。在健康研讨会之前和之后检查的任何领域,研究生2年级和研究生3年级居民之间都没有显着差异。
    在小组环境中实践的4域福祉课程对参与居民的个人和职业生活产生了积极影响。需要进行更大规模的进一步研究,以评估课程是否适合更广泛的医学界的需求。
    UNASSIGNED: There is a trend toward fostering well-being, or the state of being happy and healthy, within the medical community. Historically, resident physicians have faced high rates of distress during training. A structured well-being curriculum in residency programs may shift residents\' mindsets from survival and resilience to one centered on purpose, engagement, and joy.
    UNASSIGNED: An original well-being curriculum was administered to residents in person at a single institution every 5 weeks for approximately 10 well-being workshops, totaling around 20 hours of curriculum exposure during every academic year. The well-being curriculum was divided into 4 domains: cognitive distortions and problematic mindsets, mindfulness and meditation, creative outlets, and self-compassion.Residents exposed to at least 1 year of the well-being curriculum were asked to answer an anonymous survey. Four questions were asked for each of the 4 domains. The first and second questions asked how familiar they were with the topic before and after the workshops on a scale of 1-5 of familiarity. The third and fourth questions asked how much the knowledge acquired influenced their professional and personal life on a scale of 1-5 of influence.
    UNASSIGNED: Before curriculum exposure, the average for moderate or higher levels of knowledge across all domains was 22.7%, which improved to 77.3% after curriculum completion. Overall, 58.6% of participants felt the knowledge of the domains was moderately or extremely influential in their professional lives and 83.6% in their personal lives. There were no significant differences between post-graduate year 2 and post-graduate year 3 residents for any domains examined before and after the wellness workshops.
    UNASSIGNED: A 4-domain well-being curriculum practiced in a group setting positively impacted participating residents in their personal and professional lives. Further studies need to be performed on a larger scale to assess if the curriculum fits the needs of the broader medical community.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)是痴呆的一种重要形式。Embelin(EMB)是一种具有多种作用的天然化合物,可以帮助预防AD病理。在这里,我们研究了EMB对Aβ1-42诱导的大鼠神经毒性的神经保护潜力.在这个实验中,通过将Aβ1-42寡聚体直接注入脑室在大鼠中诱发阿尔茨海默样痴呆。随后,Aβ1-42中毒的大鼠接受不同剂量的EMB治疗(2.5,5和10mg/kg,腹膜内给药)超过2周。在不同的时间间隔评估动物的空间和非空间记忆,和各种生化,神经化学,并对大鼠海马脑组织的神经炎症参数进行分析。在大鼠脑中输注Aβ1-42引起认知障碍,并伴有乙酰胆碱酯酶活性增加,氧化应激,和促炎细胞因子水平升高(如TNF-α,IL-1β,和IL-6)在海马组织中。此外,还观察到单胺水平显着下降,GABA和谷氨酸水平失衡。EMB治疗可显着减轻Aβ1-42诱导的认知缺陷和其他生化变化,包括Aβ水平。EMB处理的大鼠表现出改善的学习和记忆巩固。EMB还减轻了Aβ诱导的氧化应激和神经炎症,并恢复了单胺的水平以及GABA和谷氨酸之间的平衡。在注入Aβ1-42的大鼠中EMB治疗后观察到的认知益处可能归因于其抗氧化和抗炎特性以及恢复海马神经化学和Aβ水平的能力。上述发现表明EMB在与认知衰退相关的神经退行性病变中的治疗潜力,如老年痴呆症。
    Alzheimer\'s disease (AD) is a significant form of dementia. Embelin (EMB) is a natural compound with varied actions that could help prevent AD pathology. Herein, we have investigated the neuroprotective potential of EMB against Aβ1-42-induced neurotoxicity in rats. In this experiment, Alzheimer-like dementia was induced in rats by infusing Aβ1-42 oligomers directly into the brain\'s ventricles. Subsequently, the Aβ1-42-intoxicated rats received treatment with varying doses of EMB (2.5, 5, and 10 mg/kg, administered intraperitoneally) over 2 weeks. The spatial and non-spatial memory of animals was assessed at different time intervals, and various biochemical, neurochemical, and neuroinflammatory parameters in the hippocampal brain tissue of the rats were analyzed. Infusion of Aβ1-42 in rat brain caused cognitive impairment and was accompanied by increased acetylcholinesterase activity, oxidative stress, and elevated levels of pro-inflammatory cytokines (such as TNF-α, IL-1β, and IL-6) in the hippocampal tissue. Moreover, a significant decline in the levels of monoamines and an imbalance of GABA and glutamate levels were also observed. EMB treatment significantly mitigated Aβ1-42-induced cognitive deficit and other biochemical changes, including Aβ levels. The EMB-treated rats showed improved learning and consolidation of memory. EMB also attenuated Aβ-induced oxidative stress and neuroinflammation and restored the levels of monoamines and the balance between GABA and glutamate. The observed cognitive benefits following EMB treatment in Aβ1-42-infused rats may be attributed to its antioxidant and anti-inflammatory properties and ability to restore hippocampal neurochemistry and Aβ levels. The above findings indicate the therapeutic potential of EMB in neurodegenerative pathologies associated with cognitive decline, such as Alzheimer\'s disease.
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  • 文章类型: Journal Article
    最近,针灸对不同疾病神经回路失调的影响越来越受到重视。这导致了对针灸工作原理的新理解。这篇综述提出了一个全面的分析研究,检查了针灸对疼痛相关的异常神经回路的影响,焦虑,帕金森病,成瘾症,认知问题,和胃肠道疾病。这些研究表明,针灸的治疗作用是由参与神经回路机制的特定脑区和神经元介导的,强调其广泛的影响。针灸的积极影响可以归因于其在各种生理条件下改变神经回路功能的能力。然而,当代关于针灸神经回路的研究经常忽视包括外围在内的综合回路机制,中枢神经系统,目标器官。此外,研究的疾病范围受到限制。未来的研究应集中于扩大研究的疾病范围,并深入探索这些疾病的神经回路机制,以提高我们对针灸神经生物学影响的认识。
    Recently, there has been increasing attention on the impact of acupuncture on the dysregulated neural circuits in different disease. This has led to new understandings of how acupuncture works. This review presents a comprehensive analysis of research that have examined the impact of acupuncture on abnormal neural circuits associated with pain, anxiety, Parkinson\'s disease, addiction disorders, cognitive problems, and gastrointestinal disorders. These studies have shown that acupuncture\'s therapeutic effects are mediated by specific brain areas and neurons involved in neural circuit mechanisms, emphasising its wide-ranging influence. The positive impacts of acupuncture can be ascribed to its ability to modify the functioning of neurocircuits in various physiological conditions. Nevertheless, contemporary studies on acupuncture neural circuits frequently overlook the comprehensive circuit mechanism including the periphery, central nervous system, and target organ. Additionally, the scope of diseases studied is restricted. Future study should focus on broadening the range of diseases studied and exploring the neural circuit mechanisms of these diseases in depth in order to enhance our understanding of acupuncture\'s neurobiological impacts.
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  • 文章类型: Journal Article
    背景:在许多病理中观察到认知功能受损,包括神经退行性疾病,如阿尔茨海默病。目前,可用来对抗认知衰退的药物治疗只有适度的效果,有明显的副作用。一种受到相当关注的非药物治疗是计算机化认知训练(CCT),旨在通过标准化练习中的反复练习来维持或改善认知功能。CCT可以直接在家中对认知功能进行更定期和彻底的训练,这代表了预防和对抗认知能力下降的重要机会。然而,训练期间的帮助似乎是提高患者积极性和治疗依从性的重要参数。为了弥补在家CCT期间治疗师的缺席,一个相关的选择可能是包括一个虚拟助手,在患者的整个训练过程中陪伴他们。
    目的:这项探索性研究的目的是评估在CCT期间包括虚拟助手来陪伴患者的兴趣。我们调查了各种个体因素之间的关系(例如,年龄,心理情感功能,个性,个人动机,和认知技能)以及CCT期间虚拟助手的欣赏和有用性。这项研究是THERADIA(TherrapiesDigitalesAuggmentéesparl\'IntelligenceArtificielle)项目的一部分,旨在开发一个善解人意的虚拟助手。
    方法:共招募了104名参与者,包括52名(50%)年轻人(平均年龄21.2岁,范围18~27岁,SD2.9岁)和52名(50%)老年人(平均年龄67.9岁,范围60~79岁,SD5.1岁).所有参与者都被邀请到实验室回答几个问卷,并进行1个CCT会议,其中包括4个认知练习,由人类飞行员通过绿野仙踪方法制作动画的虚拟助手监督。参与者在会话结束时评估虚拟助理和CCT。
    结果:使用贝叶斯框架进行分析。结果表明,在两个年龄段的CCT期间,虚拟助手都受到赞赏并被认为是有用的。然而,老年人对助手和CCT的总体评价比年轻人更积极。用户的某些特征,尤其是他们当前的情感状态(即,唤醒,内在相关性,目标传导性,和焦虑状态),似乎与他们对会议的评价有关。
    结论:这项研究提供了,第一次,深入了解年轻人和老年人在CCT期间如何看待虚拟助手。结果表明,这样的助手可能会对用户的动机产生有益的影响,只要它能处理不同的情况,尤其是他们的情绪状态。我们项目的下一步将是评估我们的设备与患有轻度认知障碍的患者,并测试其在长期认知训练中的有效性。
    BACKGROUND: Impaired cognitive function is observed in many pathologies, including neurodegenerative diseases such as Alzheimer disease. At present, the pharmaceutical treatments available to counter cognitive decline have only modest effects, with significant side effects. A nonpharmacological treatment that has received considerable attention is computerized cognitive training (CCT), which aims to maintain or improve cognitive functioning through repeated practice in standardized exercises. CCT allows for more regular and thorough training of cognitive functions directly at home, which represents a significant opportunity to prevent and fight cognitive decline. However, the presence of assistance during training seems to be an important parameter to improve patients\' motivation and adherence to treatment. To compensate for the absence of a therapist during at-home CCT, a relevant option could be to include a virtual assistant to accompany patients throughout their training.
    OBJECTIVE: The objective of this exploratory study was to evaluate the interest of including a virtual assistant to accompany patients during CCT. We investigated the relationship between various individual factors (eg, age, psycho-affective functioning, personality, personal motivations, and cognitive skills) and the appreciation and usefulness of a virtual assistant during CCT. This study is part of the THERADIA (Thérapies Digitales Augmentées par l\'Intelligence Artificielle) project, which aims to develop an empathetic virtual assistant.
    METHODS: A total of 104 participants were recruited, including 52 (50%) young adults (mean age 21.2, range 18 to 27, SD 2.9 years) and 52 (50%) older adults (mean age 67.9, range 60 to 79, SD 5.1 years). All participants were invited to the laboratory to answer several questionnaires and perform 1 CCT session, which consisted of 4 cognitive exercises supervised by a virtual assistant animated by a human pilot via the Wizard of Oz method. The participants evaluated the virtual assistant and CCT at the end of the session.
    RESULTS: Analyses were performed using the Bayesian framework. The results suggest that the virtual assistant was appreciated and perceived as useful during CCT in both age groups. However, older adults rated the assistant and CCT more positively overall than young adults. Certain characteristics of users, especially their current affective state (ie, arousal, intrinsic relevance, goal conduciveness, and anxiety state), appeared to be related to their evaluation of the session.
    CONCLUSIONS: This study provides, for the first time, insight into how young and older adults perceive a virtual assistant during CCT. The results suggest that such an assistant could have a beneficial influence on users\' motivation, provided that it can handle different situations, particularly their emotional state. The next step of our project will be to evaluate our device with patients experiencing mild cognitive impairment and to test its effectiveness in long-term cognitive training.
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  • 文章类型: Journal Article
    在Leamna肺病医院进行的这项研究调查了认知之间的相互关系,情感,和100名被诊断患有慢性呼吸系统疾病的患者中的呼吸变量,利用复杂的基于机器学习的聚类技术。从2022年10月到2023年2月,确诊患有哮喘或COPD的住院患者使用mMRC量表等标准化工具进行了广泛的评估。CAT测试,和肺活量测定。使用MMSE进行补充认知和情感评估,MoCA,汉密尔顿焦虑和抑郁量表,提供患者健康状况的整体观点。分析描绘了三个不同的集群:中度认知呼吸,重度认知呼吸,和稳定的认知呼吸,每个特征都具有独特的概况,强调了定制治疗策略的必要性。这些聚类在呼吸道症状的严重程度与其对认知和情感状况的影响之间表现出显着的相关性。结果突出了COPD和哮喘的综合治疗方法的益处,基于通过聚类识别的复杂模式进行个性化。这种战略有望加强对这些疾病的管理,可能会提高患者的生活质量和日常功能。这些发现主张根据认知之间的特定相互作用进行治疗定制,情感,和呼吸尺寸,为临床发展提供了广阔的前景,并开拓了慢性呼吸系统疾病管理领域研究的新途径。
    This study conducted at Leamna Pulmonology Hospital investigated the interrelations among cognitive, affective, and respiratory variables within a cohort of 100 patients diagnosed with chronic respiratory conditions, utilizing sophisticated machine learning-based clustering techniques. Spanning from October 2022 to February 2023, hospitalized individuals confirmed to have asthma or COPD underwent extensive evaluations using standardized instruments such as the mMRC scale, the CAT test, and spirometry. Complementary cognitive and affective assessments were performed employing the MMSE, MoCA, and the Hamilton Anxiety and Depression Scale, furnishing a holistic view of patient health statuses. The analysis delineated three distinct clusters: Moderate Cognitive Respiratory, Severe Cognitive Respiratory, and Stable Cognitive Respiratory, each characterized by unique profiles that underscore the necessity for tailored therapeutic strategies. These clusters exhibited significant correlations between the severity of respiratory symptoms and their effects on cognitive and affective conditions. The results highlight the benefits of an integrated treatment approach for COPD and asthma, which is personalized based on the intricate patterns identified through clustering. Such a strategy promises to enhance the management of these diseases, potentially elevating the quality of life and everyday functionality of the patients. These findings advocate for treatment customization according to the specific interplays among cognitive, affective, and respiratory dimensions, presenting substantial prospects for clinical advancement and pioneering new avenues for research in the domain of chronic respiratory disease management.
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  • 文章类型: Journal Article
    白细胞介素(IL)6在抑郁症合并类风湿关节炎(RA)的发病机制中起重要作用,用于治疗RA患者的IL-6抑制剂可能具有抗抑郁作用。该研究的目的是评估俄罗斯iIL-6olokizumab(OKZ)在减轻中度/高度RA活动患者抑郁症状方面的有效性。迄今为止,已纳入49例RA患者,其中43人(87.7%)是女性,平均年龄为47.8±12.8岁;根据DAS28(CRP)指数(89.8%),RA的活性明显较高,SDAI(79.6%)和CDAI(75.5%),且稳定的12周治疗无效。在所有患者中,一个精神病医生,根据ICD-10,在半结构化访谈中诊断出不同严重程度的抑郁症(慢性或复发性)。在第0周,所有患者均按顺序编号的方法以1:1:1的比例随机分配到三个研究组之一:第1组-cDMARDsOKZ64mg皮下每4周一次(n=18);第2组-cDMARDsOKZ64mg皮下每4周一次+药物治疗(PPT)(n=26);第3-cDMDs组(n=5PPT)。研究的持续时间为24周。在PHQ-9,MADRS量表上评估抑郁严重程度的动态;焦虑,在HAM-A上;还使用了实验心理投射技术。经过12周和24周的治疗,所有组患者的抑郁和焦虑严重程度均显著降低.然而,在接受PPT的患者组中,所有量表的最终值与初始值之间的差异在统计学上显着较大(p<0.05):cDMARDsOKZPPT(ΔPHQ-924-0=-6.75±3.91;ΔMADRS24-0=-22.5±4.83;ΔHAM-A24-0=-14.6±5.37)和cDMARDs-53-M24-5.0=与cDMARDs+OKZ组相比(ΔPHQ-924-0=-4.00±3.89;ΔMADRS24-0=-5.75±8.29;ΔHAM-A24-0=-8.50±8.21)。根据对精神科医生的半结构化访谈和设计实验心理技术,在接受PPT的患者组中,治疗24周后无抑郁的患者比例明显更高:cDMARDs+OKZ+PPT和100%-cDMARDs+PPT组中的90%,在cDMARDs+OKZ组中,这一比例为25%。OKZ疗法有助于夜间睡眠正常化,但并未导致认知障碍(CD)的频率和严重程度降低。OKZ有抗抑郁作用,导致睡眠障碍的频率降低。然而,只有在25%的RA患者中,当OKZ处方没有PPT时,抑郁症状完全消退是可能的,主要是轻度抑郁症患者。OKZ和PPT的组合对于抑郁和焦虑的完全消退以及CD的频率和严重程度的降低是最佳的。
    Interleukin (IL) 6 plays an important role in the pathogenesis of depression comorbid with rheumatoid arthritis (RA), and IL-6 inhibitors used to treat patients with RA may have an antidepressant effect. The objective of the study was to evaluate the effectiveness of Russian iIL-6 olokizumab (OKZ) in reducing symptoms of depression in patients with moderate/high RA activity. To date, 49 RA patients have been included, of which 43 (87.7%) are women, with an average age of 47.8 ± 12.8 years; with a predominant high activity of RA according to DAS28 (CRP) indices (89.8%), SDAI (79.6%) and CDAI (75.5%) and inefficacy of stable 12-week therapy with сDMARDs. In all patients, a psychiatrist, in accordance with ICD-10, diagnosed depression (chronic or recurrent) of varying severity during a semi-structured interview. At week 0, all patients were randomized by the method of sequential numbers in a ratio of 1 : 1 : 1 to one of the three study groups: group 1-cDMARDs + OKZ 64 mg subcutaneously once every 4 weeks (n = 18); group 2-cDMARDs + OKZ 64 mg subcutaneously once every 4 weeks + psychopharmacotherapy (PPT) (n = 26); group 3-cDMARDs + PPT (n = 5). The duration of the study is 24 weeks. The dynamics of depression severity was assessed on the PHQ-9, MADRS scales; anxiety, on HAM-A; experimental psychological projective techniques were also used. After 12 and 24 weeks of therapy, there was a significant decrease in the severity of depression and anxiety in all groups of patients. However, the difference between the final and initial values of all scales was statistically significantly greater (p <0.05) in the groups of patients receiving PPT: cDMARDs + OKZ + PPT (ΔPHQ-9 24-0 = -6.75 ± 3.91; ΔMADRS 24-0 = -22.5 ± 4.83; ΔHAM-A 24-0 = -14.6 ± 5.37) and cDMARDs + PPT (ΔPHQ-9 24-0 = -15.5 ± 3.53; ΔMADRS 24-0 = -25.0 ± 1.41; ΔHAM-A 24-0 = -18.5 ± 3.53), compared with the cDMARDs + OKZ group (ΔPHQ-9 24-0 = -4.00 ± 3.89; ΔMADRS 24-0 = -5.75 ± 8.29; ΔHAM-A 24-0 = -8.50 ± 8.21). According to a semi-structured interview with a psychiatrist and design experimental psychological techniques, the proportion of patients without depression after 24 weeks of therapy was significantly higher in the groups of patients receiving PPT: 90% in the group of cDMARDs + OKZ + PPT and 100%-cDMARDs + PPT, as opposed to 25% in the group of cDMARDs + OKZ. OKZ therapy contributed to the normalization of night sleep but did not lead to a decrease in the frequency and severity of cognitive disorders (CDs). OKZ has an antidepressant effect, leads to a decrease in the frequency of sleep disorders. However, a complete regression of depression symptoms when OKZ is prescribed without PPT is possible only in 25% of RA patients, mainly in the patients with mild depression. A combination of OKZ and PPT is optimal for the complete regression of depression and anxiety and a decrease in the frequency and severity of CDs.
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  • 文章类型: Introductory Journal Article
    我们在皇家学会举行的关于“长期增强:50年后”的讨论会议上介绍并总结了演讲者的评论和研究论文,伦敦,2023年11月20日至21日会议是在较早的讨论会议之后举行的,这标志着长期增强发现的30周年和40周年。这些新的贡献概述了神经科学充满活力的分支中的当前研究和争议,对我们理解许多形式的学习和记忆以及广泛的神经和认知障碍的神经生物学基础具有重要意义。本文是讨论会议问题“长期增强:50年后”的一部分。
    We introduce and summarize reviews and research papers by speakers at a discussion meeting on \'Long-term potentiation: 50 years on\' held at the Royal Society, London, on 20-21 November 2023. The meeting followed earlier discussion meetings marking the 30th and 40th anniversaries of the discovery of long-term potentiation. These new contributions give an overview of current research and controversies in a vibrant branch of neuroscience with important implications for our understanding of the neurobiological basis of many forms of learning and memory and a wide spectrum of neurological and cognitive disorders.This article is part of a discussion meeting issue \'Long-term potentiation: 50 years on\'.
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