neurodegenerative disorders

神经退行性疾病
  • 文章类型: Journal Article
    各种形式的神经退行性疾病为当代医疗保健提供了相当大的挑战。人工智能的出现从根本上改变了诊断图景,提供了识别这些严重疾病的有效和早期手段。作为计算智能的一个子集,机器学习算法已经成为分析包括遗传在内的大型数据集的非常有效的工具,成像,和临床数据。此外,多模态数据集成,其中包括来自大脑成像的信息(MRI,PET扫描),遗传概况,和临床评估,通过计算智能变得更容易。通过这种合并方法,可以全面了解疾病的过程,这也有助于创建早期医学评估和结果预测的预测模型。此外,使用人工智能进行神经影像分析已经显示出很大的希望。复杂的图像处理方法与机器学习算法相结合,可以识别大脑中的功能和结构异常,它通常是神经退行性疾病的早期指标。本章探讨了计算智能如何在改善神经退行性疾病如帕金森氏症的诊断中发挥关键作用。老年痴呆症,等。总而言之,计算智能为改善神经退行性疾病的识别提供了一种革命性的方法。在与这些困难疾病的斗争中,接受和改进这些计算技术肯定会为更个性化的治疗和更多成功的治疗铺平道路。
    The numerous and varied forms of neurodegenerative illnesses provide a considerable challenge to contemporary healthcare. The emergence of artificial intelligence has fundamentally changed the diagnostic picture by providing effective and early means of identifying these crippling illnesses. As a subset of computational intelligence, machine-learning algorithms have become very effective tools for the analysis of large datasets that include genetic, imaging, and clinical data. Moreover, multi-modal data integration, which includes information from brain imaging (MRI, PET scans), genetic profiles, and clinical evaluations, is made easier by computational intelligence. A thorough knowledge of the course of the illness is made possible by this consolidative method, which also facilitates the creation of predictive models for early medical evaluation and outcome prediction. Furthermore, there has been a great deal of promise shown by the use of artificial intelligence to neuroimaging analysis. Sophisticated image processing methods combined with machine learning algorithms make it possible to identify functional and structural anomalies in the brain, which often act as early indicators of neurodegenerative diseases. This chapter examines how computational intelligence plays a critical role in improving the diagnosis of neurodegenerative diseases such as Parkinson\'s, Alzheimer\'s, etc. To sum up, computational intelligence provides a revolutionary approach for improving the identification of neurodegenerative illnesses. In the battle against these difficult disorders, embracing and improving these computational techniques will surely pave the path for more individualized therapy and more therapies that are successful.
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  • 文章类型: Journal Article
    线粒体是许多细胞功能所必需的单个细胞器,其中包括对压力的反应,调节钙水平,维持蛋白质稳态,协调细胞凋亡反应。细胞的活力,因此,取决于这些动态细胞器的最佳功能。线粒体质量控制机制(MQCM)在确保线粒体的完整性和功能性中起着关键作用。这些机制的干扰与帕金森病等神经退行性疾病的发病机制密切相关。老年痴呆症,亨廷顿病,和肌萎缩侧索硬化症.令人信服的证据表明,靶向MQCM内的特定途径可能为挽救线粒体完整性和减轻神经退行性疾病的进展提供治疗途径。细胞压力的复杂相互作用,蛋白质折叠错误,受损的质量控制机制提供了对潜在病理的细致理解。因此,解开神经退行性疾病中特定的MQCM失调对于制定有针对性的治疗策略至关重要。这篇综述深入研究了与神经退行性疾病有关的MQCM通路受损,并探讨了新兴的治疗干预措施。通过阐明旨在恢复MQCM效率的药物和遗传操作,该讨论旨在为改善神经退行性疾病进展的新策略提供见解。理解和解决线粒体质量控制机制不仅强调了它们在细胞健康中的重要性,而且为推进神经退行性疾病领域的治疗方法提供了有希望的前沿。
    Mitochondria are singular cell organelles essential for many cellular functions, which includes responding to stress, regulating calcium levels, maintaining protein homeostasis, and coordinating apoptosis response. The vitality of cells, therefore, hinges on the optimal functioning of these dynamic organelles. Mitochondrial Quality Control Mechanisms (MQCM) play a pivotal role in ensuring the integrity and functionality of mitochondria. Perturbations in these mechanisms have been closely associated with the pathogenesis of neurodegenerative disorders such as Parkinson\'s disease, Alzheimer\'s disease, Huntington\'s disease, and amyotrophic lateral sclerosis. Compelling evidence suggests that targeting specific pathways within the MQCM could potentially offer a therapeutic avenue for rescuing mitochondrial integrity and mitigating the progression of neurodegenerative diseases. The intricate interplay of cellular stress, protein misfolding, and impaired quality control mechanisms provides a nuanced understanding of the underlying pathology. Consequently, unravelling the specific MQCM dysregulation in neurodegenerative disorders becomes paramount for developing targeted therapeutic strategies. This review delves into the impaired MQCM pathways implicated in neurodegenerative disorders and explores emerging therapeutic interventions. By shedding light on pharmaceutical and genetic manipulations aimed at restoring MQCM efficiency, the discussion aims to provide insights into novel strategies for ameliorating the progression of neurodegenerative diseases. Understanding and addressing mitochondrial quality control mechanisms not only underscore their significance in cellular health but also offer a promising frontier for advancing therapeutic approaches in the realm of neurodegenerative disorders.
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  • 文章类型: Journal Article
    背景:根根大黄,在韩国药典中被列为“Daehwang”,富含各种蒽醌,以其抗炎和抗氧化特性而闻名。含有Daehwang的制剂传统上用于治疗神经病症。本研究旨在证实丹参根提取物(RTE)对三甲基锡(TMT)诱导的癫痫发作和海马神经变性的抗癫痫和神经保护功效。
    方法:采用超高效液相色谱法(UPLC)对RTE的成分进行鉴定。实验动物分为以下五类:对照,TMT,和三个TMT+RTE组,剂量为10、30和100mg/kg。每天评估癫痫发作的严重程度,以进行组间比较。使用组织学和分子生物学技术检查脑组织样品以确定神经变性和神经炎症的程度。网络药理学分析涉及从多个数据库中提取大王的草药靶标和癫痫的疾病靶标。使用用于检索相互作用基因/蛋白质(STRING)数据库的搜索工具建立了蛋白质-蛋白质相互作用网络,并通过拓扑分析确定关键目标。使用注释数据库进行富集分析,可视化,和集成发现(DAVID)工具来阐明底层机制。
    结果:发现RTE制剂中含有皂甙A,森诺赛德B,大黄酚,大黄素,physcion,(+)-儿茶素,和槲皮素-3-O-葡糖醛酸。RTE在10、30和100mg/kg剂量下有效抑制TMT诱导的癫痫发作,并在30和100mg/kg剂量下减轻海马神经元衰变和神经炎症。此外,RTE显著降低肿瘤坏死因子(TNF-α)的mRNA水平,胶质纤维酸性蛋白(GFAP),和海马组织中的c-fos。网络分析显示TNF,白细胞介素-1β(IL-1β),白细胞介素-6(IL-6),蛋白质c-fos(FOS),RAC-α丝氨酸/苏氨酸蛋白激酶(AKT1),以哺乳动物雷帕霉素靶蛋白(mTOR)为核心靶点。富集分析显示,唐古汀菌成分显著参与神经变性(p=4.35×10-5)和TNF信号通路(p=9.94×10-5)。
    结论:本研究中进行的体内和计算机模拟分析表明,RTE可以潜在地调节TMT诱导的癫痫发作和神经变性。因此,根根是一种有前途的草药治疗选择,用于抗癫痫和神经保护应用。
    BACKGROUND: Rheum tanguticum root, cataloged as \"Daehwang\" in the Korean Pharmacopeia, is rich in various anthraquinones known for their anti-inflammatory and antioxidant properties. Formulations containing Daehwang are traditionally employed for treating neurological conditions. This study aimed to substantiate the antiepileptic and neuroprotective efficacy of R. tanguticum root extract (RTE) against trimethyltin (TMT)-induced epileptic seizures and hippocampal neurodegeneration.
    METHODS: The constituents of RTE were identified by ultra-performance liquid chromatography (UPLC). Experimental animals were grouped into the following five categories: control, TMT, and three TMT+RTE groups with dosages of 10, 30, and 100 mg/kg. Seizure severity was assessed daily for comparison between the groups. Brain tissue samples were examined to determine the extent of neurodegeneration and neuroinflammation using histological and molecular biology techniques. Network pharmacology analysis involved extracting herbal targets for Daehwang and disease targets for epilepsy from multiple databases. A protein-protein interaction network was built using the Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database, and pivotal targets were determined by topological analysis. Enrichment analysis was performed using the Database for Annotation, Visualization, and Integrated Discovery (DAVID) tool to elucidate the underlying mechanisms.
    RESULTS: The RTE formulation was found to contain sennoside A, sennoside B, chrysophanol, emodin, physcion, (+)-catechin, and quercetin-3-O-glucuronoid. RTE effectively inhibited TMT-induced seizures at 10, 30, and 100 mg/kg dosages and attenuated hippocampal neuronal decay and neuroinflammation at 30 and 100 mg/kg dosages. Furthermore, RTE significantly reduced mRNA levels of tumor necrosis factor (TNF-α), glial fibrillary acidic protein (GFAP), and c-fos in hippocampal tissues. Network analysis revealed TNF, Interleukin-1 beta (IL-1β), Interleukin-6 (IL-6), Protein c-fos (FOS), RAC-alpha serine/threonine-protein kinase (AKT1), and Mammalian target of rapamycin (mTOR) as the core targets. Enrichment analysis demonstrated significant involvement of R. tanguticum components in neurodegeneration (p = 4.35 × 10-5) and TNF signaling pathway (p = 9.94 × 10-5).
    CONCLUSIONS: The in vivo and in silico analyses performed in this study suggests that RTE can potentially modulate TMT-induced epileptic seizures and neurodegeneration. Therefore, R. tanguticum root is a promising herbal treatment option for antiepileptic and neuroprotective applications.
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  • 文章类型: Journal Article
    哺乳动物的大脑完全依赖氧气来生产ATP,这使得它非常容易缺氧,在高海拔地区或临床情况下,包括贫血或肺部疾病。缺氧在各种脑部疾病的发展中起着至关重要的作用,比如阿尔茨海默氏症,帕金森,和其他与年龄相关的神经退行性疾病。另一方面,环境中氧气含量的降低,例如在高海拔地区长时间停留,可能对衰老过程和死亡可能性产生有益影响。此外,利用受控的缺氧暴露有可能成为治疗年龄相关性脑疾病的一种方法.最近的发现表明HIF-1α和NLRP3炎性体的参与在阿尔茨海默病的发展中具有重要意义。HIF-1α作为各种细胞缺氧反应的关键控制器,对许多生理机制如能量代谢和炎症反应的影响。NLRP3通过炎症小体复合物的组装协调炎症反应的启动,在先天免疫系统中起着至关重要的作用。这篇综述探讨了与缺氧对大脑的对比影响有关的信息,强调其积极和有害的影响,以及参与介导这些不同影响的分子途径。这项研究探索了治疗干预的潜在策略,专注于恢复细胞平衡和减少神经炎症,这是解决这种严重的神经退行性疾病的关键方面,并解决了需要进一步研究的关键询问。
    The mammalian brain\'s complete dependence on oxygen for ATP production makes it highly susceptible to hypoxia, at high altitudes or in clinical scenarios including anemia or pulmonary disease. Hypoxia plays a crucial role in the development of various brain disorders, such as Alzheimer\'s, Parkinson\'s, and other age-related neurodegenerative diseases. On the other hand, a decrease in environmental oxygen levels, such as prolonged stays at high elevations, may have beneficial impacts on the process of ageing and the likelihood of death. Additionally, the utilization of controlled hypoxia exposure could potentially serve as a therapeutic approach for age-related brain diseases. Recent findings indicate that the involvement of HIF-1α and the NLRP3 inflammasome is of significant importance in the development of Alzheimer\'s disease. HIF-1α serves as a pivotal controller of various cellular reactions to oxygen deprivation, exerting influence on a multitude of physiological mechanisms such as energy metabolism and inflammatory responses. The NLRP3 plays a crucial role in the innate immune system by coordinating the initiation of inflammatory reactions through the assembly of the inflammasome complex. This review examines the information pertaining to the contrasting effects of hypoxia on the brain, highlighting both its positive and deleterious effects and molecular pathways that are involved in mediating these different effects. This study explores potential strategies for therapeutic intervention that focus on restoring cellular balance and reducing neuroinflammation, which are critical aspects in addressing this severe neurodegenerative condition and addresses crucial inquiries that warrant further future investigations.
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  • 文章类型: Journal Article
    这篇手稿探讨了纳米结构壳聚糖用于鼻内药物递送的用途,靶向改善神经退行性疾病的治疗效果,精神病治疗,疼痛管理,疫苗接种,和糖尿病治疗。壳聚糖纳米颗粒被证明可以增强大脑传递,提高生物利用度,并通过促进药物穿过血脑屏障的运输来最大程度地减少全身副作用。尽管在靶向递送和疫苗功效方面取得了实质性进展,可扩展性方面仍然存在挑战,监管批准,从临床前研究过渡到临床应用。壳聚糖基纳米药物的未来取决于推进临床试验,促进跨学科合作,并在纳米粒子设计中进行创新,以克服这些障碍并实现其治疗潜力。
    This manuscript explores the use of nanostructured chitosan for intranasal drug delivery, targeting improved therapeutic outcomes in neurodegenerative diseases, psychiatric care, pain management, vaccination, and diabetes treatment. Chitosan nanoparticles are shown to enhance brain delivery, improve bioavailability, and minimize systemic side effects by facilitating drug transport across the blood-brain barrier. Despite substantial advancements in targeted delivery and vaccine efficacy, challenges remain in scalability, regulatory approval, and transitioning from preclinical studies to clinical applications. The future of chitosan-based nanomedicines hinges on advancing clinical trials, fostering interdisciplinary collaboration, and innovating in nanoparticle design to overcome these hurdles and realize their therapeutic potential.
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  • 文章类型: Journal Article
    可以选择性去除大脑中的流氓蛋白的抗体是治疗神经退行性疾病(ND)的明显选择,但是经过几十年的努力,只有两种治疗阿尔茨海默病的抗体被批准,几十个处于测试阶段,一个人被撤回,另一个停了下来,可能是由于功效问题。然而,这些结果应该是明显的,因为这些抗体由于血脑屏障(BBB)保护剂而不能充分进入大脑.然而,所有产品都可以通过与转铁蛋白结合来恢复活力,最好是较小的片段。该模型可以快速且低成本地进行测试,应应用于bapineuzumab,solanezumab,克雷珠单抗,gantenerumab,aducanumab,lecanemab,Donanemab,Cinpanemab,和Gantenerumab,和他们的碎片。本文证明与转铁蛋白缀合不会改变与脑蛋白如淀粉样蛋白-β(Aβ)和α-突触核蛋白的结合。我们还提出了缀合物设计的选择,其将允许在进入脑后裂解以防止其胞吐作用,同时保持片段连接以实现与蛋白质的最佳结合。所识别的产品可以容易地进行测试并以最低的监管成本和延迟返回给患者。这些工程抗体可以通过重组工程制造,优选通过mRNA技术,作为一种更实惠的解决方案,以满足有效治疗神经退行性疾病的迫切需要。
    Antibodies that can selectively remove rogue proteins in the brain are an obvious choice to treat neurodegenerative disorders (NDs), but after decades of efforts, only two antibodies to treat Alzheimer\'s disease are approved, dozens are in the testing phase, and one was withdrawn, and the other halted, likely due to efficacy issues. However, these outcomes should have been evident since these antibodies cannot enter the brain sufficiently due to the blood-brain barrier (BBB) protectant. However, all products can be rejuvenated by binding them with transferrin, preferably as smaller fragments. This model can be tested quickly and at a low cost and should be applied to bapineuzumab, solanezumab, crenezumab, gantenerumab, aducanumab, lecanemab, donanemab, cinpanemab, and gantenerumab, and their fragments. This paper demonstrates that conjugating with transferrin does not alter the binding to brain proteins such as amyloid-β (Aβ) and α-synuclein. We also present a selection of conjugate designs that will allow cleavage upon entering the brain to prevent their exocytosis while keeping the fragments connected to enable optimal binding to proteins. The identified products can be readily tested and returned to patients with the lowest regulatory cost and delays. These engineered antibodies can be manufactured by recombinant engineering, preferably by mRNA technology, as a more affordable solution to meet the dire need to treat neurodegenerative disorders effectively.
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  • 文章类型: Journal Article
    微生物组研究中最具挑战性和争议的问题之一与肠道微生物代谢和神经心理障碍有关。精神生物学通过肠-脑轴影响人类行为和中枢神经系统过程,涉及神经元,免疫,和代谢途径。它们在治疗几种神经退行性和神经发育障碍如抑郁症方面具有治疗潜力,焦虑,自闭症,注意缺陷多动障碍,老年痴呆症,帕金森病,精神分裂症,亨廷顿病,神经性厌食症,和多发性硬化症。然而,精神生物学与上述疾病之间相互作用的潜在机制需要进一步探索。本文综述了肠道菌群之间的关系及其对神经和神经退行性疾病的影响。检查精神生物学作为预防和治疗方法的潜力,总结了最近关于肠-脑轴的研究和精神生物学的潜在有益作用,强调需要在这一领域进行进一步的研究和调查。
    One of the most challenging and controversial issues in microbiome research is related to gut microbial metabolism and neuropsychological disorders. Psychobiotics affect human behavior and central nervous system processes via the gut-brain axis, involving neuronal, immune, and metabolic pathways. They have therapeutic potential in the treatment of several neurodegenerative and neurodevelopmental disorders such as depression, anxiety, autism, attention deficit hyperactivity disorder, Alzheimer\'s disease, Parkinson\'s disease, schizophrenia, Huntington\'s disease, anorexia nervosa, and multiple sclerosis. However, the mechanisms underlying the interaction between psychobiotics and the abovementioned diseases need further exploration. This review focuses on the relationship between gut microbiota and its impact on neurological and neurodegenerative disorders, examining the potential of psychobiotics as a preventive and therapeutic approach, summarising recent research on the gut-brain axis and the potential beneficial effects of psychobiotics, highlighting the need for further research and investigation in this area.
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  • 文章类型: Journal Article
    背景:最近的研究表明,β淀粉样蛋白(Aβ)正电子发射断层扫描(PET)示踪剂在注射后不久(“早期阶段”)摄取反映了脑代谢和灌注。我们在主要为淀粉样蛋白阴性的神经退行性疾病中评估了这种模式,帕金森病(PD),并假设早期阶段的18F-氟贝他班(eFBB)摄取会重现与PD认知下降相关的特征性低代谢和低灌注模式。
    方法:150名认知功能障碍的PD患者接受了双相AβPET,结构和动脉自旋标记(ASL)磁共振成像(MRI),和神经心理学评估。多元线性回归模型将eFBB摄取与认知表现和ASLMRI灌注进行了比较。
    结果:降低的eFBB摄取与先前与PD的低代谢相关的认知下降有关的大脑区域的认知表现有关,独立于淀粉样蛋白状态。此外,eFBB摄取与广泛区域的脑灌注相关。
    结论:EFBB摄取是脑灌注/代谢的潜在替代指标。双相PET成像方法可以作为评估认知障碍的临床工具。
    在淀粉样蛋白β(Aβ)正电子发射断层扫描示踪剂注射时拍摄的图像可能反映了脑灌注和代谢。帕金森病(PD)是一种主要为淀粉样蛋白阴性的疾病。PD早期阶段氟倍他班(eFBB)与认知能力相关。eFBB摄取反映了PD中与代谢低相关的认知下降。eFBB与动脉自旋标记磁共振成像测量的脑灌注相关。eFBB将痴呆与正常认知和轻度认知损害区分开来。研究结果与后期Aβ负荷无关。因此,eFBB可以作为脑代谢/灌注的替代测量。
    BACKGROUND: Recent work suggests that amyloid beta (Aβ) positron emission tomography (PET) tracer uptake shortly after injection (\"early phase\") reflects brain metabolism and perfusion. We assessed this modality in a predominantly amyloid-negative neurodegenerative condition, Parkinson\'s disease (PD), and hypothesized that early-phase 18F-florbetaben (eFBB) uptake would reproduce characteristic hypometabolism and hypoperfusion patterns associated with cognitive decline in PD.
    METHODS: One hundred fifteen PD patients across the spectrum of cognitive impairment underwent dual-phase Aβ PET, structural and arterial spin labeling (ASL) magnetic resonance imaging (MRI), and neuropsychological assessments. Multiple linear regression models compared eFBB uptake to cognitive performance and ASL MRI perfusion.
    RESULTS: Reduced eFBB uptake was associated with cognitive performance in brain regions previously linked to hypometabolism-associated cognitive decline in PD, independent of amyloid status. Furthermore, eFBB uptake correlated with cerebral perfusion across widespread regions.
    CONCLUSIONS: EFBB uptake is a potential surrogate measure for cerebral perfusion/metabolism. A dual-phase PET imaging approach may serve as a clinical tool for assessing cognitive impairment.
    UNASSIGNED: Images taken at amyloid beta (Aβ) positron emission tomography tracer injection may reflect brain perfusion and metabolism.Parkinson\'s disease (PD) is a predominantly amyloid-negative condition.Early-phase florbetaben (eFBB) in PD was associated with cognitive performance.eFBB uptake reflects hypometabolism-related cognitive decline in PD.eFBB correlated with arterial spin labeling magnetic resonance imaging measured cerebral perfusion.eFBB distinguished dementia from normal cognition and mild cognitive impairment.Findings were independent of late-phase Aβ burden.Thus, eFBB may serve as a surrogate measure for brain metabolism/perfusion.
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  • 文章类型: Journal Article
    DDHD2(含DDHD结构域2)基因突变导致常染色体隐性遗传性痉挛性截瘫54型(SPG54),一种罕见的神经退行性疾病,其特征是儿童早期进行性痉挛性截瘫。据报道,DDHD2是主要的脑三酰甘油(TAG)脂肪酶,其功能障碍会导致SPG54患者大脑中大量脂滴(LD)积累。然而,DDHD2在调节LD分解代谢中的确切功能尚未完全了解。在最近的一项研究中,我们证明DDHD2与Atg8家族蛋白的多个成员(MAP1LC3/LC3s,GABARAP),在吸脂症中起着至关重要的作用。DDHD2具有两个LC3相互作用区(LIR)基序,这些基序有助于其LD消除活性。此外,DDHD2增强LC3B和LD之间的共定位以促进脂质吞噬。LD·ATTEC,一种将LC3束缚到LD以增强其大自噬/自噬清除的化合物,有效地抵消DDHD2缺乏诱导的LD积累。这些发现为DDHD2作为TAG脂肪酶和货物受体在神经元LD分解代谢中吸脂的双重功能提供了见解,并提出了治疗SPG54患者的潜在治疗方法。
    Mutations in the DDHD2 (DDHD domain containing 2) gene cause autosomal recessive spastic paraplegia type 54 (SPG54), a rare neurodegenerative disorder characterized by the early childhood onset of progressive spastic paraplegia. DDHD2 is reported as the principal brain triacylglycerol (TAG) lipase whose dysfunction causes massive lipid droplet (LD) accumulation in the brains of SPG54 patients. However, the precise functions of DDHD2 in regulating LD catabolism are not yet fully understood. In a recent study, we demonstrate that DDHD2 interacts with multiple members of the Atg8-family proteins (MAP1LC3/LC3s, GABARAPs), which play crucial roles in lipophagy. DDHD2 possesses two LC3-interacting region (LIR) motifs that contribute to its LD-eliminating activity. Moreover, DDHD2 enhances the colocalization between LC3B and LDs to promote lipophagy. LD·ATTEC, a compound that tethers LC3 to LDs to enhance their macroautophagic/autophagic clearance, effectively counteracts DDHD2 deficiency-induced LD accumulation. These findings provide insights into the dual functions of DDHD2 as a TAG lipase and cargo receptor for lipophagy in neuronal LD catabolism, and also suggest a potential therapeutic approach for treating SPG54 patients.
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  • 文章类型: Journal Article
    创伤性脑损伤(TBI)可导致长期的认知障碍,一些幸存者在康复后认知能力下降。及早发现下降对护理计划很重要,了解下降的风险因素可以阐明预防目标。虽然神经心理学测试是表征认知功能的黄金标准方法,需要简短的,能够检测TBI后认知的临床显著变化的可扩展工具。这项研究检查了在慢性TBI患者样本中使用成人电话认知简短测试(BTACT)是否可以检测到临床上显着的变化,并调查了潜在的可改变因素是否与认知下降有关。90名年龄在40岁或以上的患有复杂的轻度至重度TBI的参与者参加了两次基于电话的研究访问,间隔约一年。人口统计,头部外伤暴露,并存的医疗条件,身体和心理社会功能数据通过自我报告收集.BTACT,全球认知功能的简要测量,用于评估六个领域的认知表现。计算用于量化BTACT表现的临床显著变化的可靠变化指数(RCI)。结果显示,不同认知领域的参与者中有10%至27%的认知能力下降。更具体地说,只有抑郁症状,包括抑郁情绪和快感缺失,在使用FDR校正多重比较后,与认知能力下降显著相关。其他因素,例如头部的打击次数,男性,呼吸困难,焦虑症状增加,癫痫发作,非法药物使用,更少的心血管合并症应该被认为是产生假设的。重要的是,年龄不是认知能力下降的显著预测因子,这挑战了认知能力下降仅与自然衰老过程有关的假设。这表明与TBI相关的独特因素会影响认知功能,这些因素会影响个体的寿命。BTACT是一个简短而敏感的工具,用于在相对短暂的时间内识别认知功能的临床意义变化(即,一年)在TBI慢性阶段的个体样本中(即,X=TBI后6.7年)。因此,BTACT可能在旨在理解和检测下降的监测工作中有用,特别是在面对面认知筛查不切实际或不可行的情况下。我们还确定了预防TBI后认知下降的潜在可修改的目标。这些发现可以为有认知能力下降风险的个人提供有关治疗目标和预防策略的见解。以及有助于促进早期识别工作。
    Traumatic brain injuries (TBIs) can lead to long-lasting cognitive impairments, and some survivors experience cognitive decline post-recovery. Early detection of decline is important for care planning, and understanding risk factors for decline can elucidate targets for prevention. While neuropsychological testing is the gold standard approach to characterizing cognitive function, there is a need for brief, scalable tools that are capable of detecting clinically significant changes in post-TBI cognition. This study examines whether clinically significant change can be detected using the Brief Test of Adult Cognition by Telephone (BTACT) in a sample of individuals with chronic TBI and investigates whether potentially modifiable factors are associated with cognitive decline. Ninety participants aged 40 or older with complicated mild to severe TBI participated in two telephone-based study visits approximately one year apart. Demographic, head trauma exposure, comorbid medical conditions, physical and psychosocial functioning data were collected via self-report. The BTACT, a brief measure of global cognitive function, was used to assess cognitive performance across six domains. A Reliable Change Index (RCI) for quantifying clinically significant changes in BTACT performance was calculated. Results revealed cognitive decline in 10% to 27% of participants across various cognitive domains. More specifically, only depressive symptoms, including depressed affect and anhedonia, were significantly associated with cognitive decline after correcting for multiple comparisons using FDR. Other factors such as the number of blows to the head, male gender, dyspnea, increased anxiety symptoms, seizures, illicit drug use, and fewer cardiovascular comorbidities should be considered hypothesis-generating. Importantly, age was not a significant predictor of cognitive decline, which challenges the assumption that cognitive decline is solely related to the natural aging process. It suggests that there are unique factors associated with TBI that impact cognitive function, and these factors can affect individuals across the lifespan. The BTACT is a brief and sensitive tool for identifying clinically meaningful changes in cognitive function over a relatively brief period (i.e., one year) in a sample of individuals in the chronic stages of TBI (i.e., x̅=6.7 years post-TBI). Thus, the BTACT may be useful in surveillance efforts aimed at understanding and detecting decline, particularly in situations where in-person cognitive screening is impractical or unfeasible. We also identified potentially modifiable targets for the prevention of post-TBI cognitive decline. These findings can offer insights into treatment goals and preventive strategies for individuals at risk for cognitive decline, as well as help to facilitate early identification efforts.
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