抽动障碍临床特点与脑电图关系的研究进展

抽动障碍(Tic disorder,TD)是一种儿童期发病且主要侵犯神经系统的疾病。临床工作中发现部分患儿脑电图(electroencephalogram,EEG)明显异常,提示患儿脑功能障碍与疾病严重程度有关;TD患儿治疗后EEG变化特点也对临床医生选择何种治疗方式有指导意义。     

佐金平木联合健脾化痰法对多发性抽动症患儿肌肉功能、肾脏损害及血清GABA、NE的影响

摘要 目的：探讨佐金平木联合健脾化痰法对多发性抽动症（TS）患儿肌肉功能、肾脏损害及血清γ-氨基丁酸（GABA）、去甲肾上腺素（NE）的影响。方法：选取2017年2月~2019年2月期间我院收治的TS患儿83例,根据随机数字表法将患儿分为对照组（n=41）和研究组（n=42）,对照组患儿给予氟哌啶醇治疗,研究组在对照组的基础上给予佐金平木联合健脾化痰法治疗,比较两组患儿临床疗效、肌肉功能、肾脏损害及GABA、NE水平,记录两组治疗期间不良反应情况。结果：研究组治疗3个月后的总有效率为90.48%,高于对照组的73.17%（P<0.05）。两组治疗3个月后耶鲁综合抽动严重程度量表（YGTSS）评分均下降,且研究组低于对照组（P<0.05）。两组患儿治疗3个月后血清尿素氮（BUN）、血肌酐（Scr）水平均降低,但研究组高于对照组（P<0.05）。两组患儿治疗3个月后血清GABA、NE水平均升高,且研究组高于对照组（P<0.05）。研究组、对照组不良反应发生率分别为16.67%（7/42）、24.39%（10/41）,差异无统计学意义（P>0.05）。结论：佐金平木联合健脾化痰法治疗TS患儿,可有效改善患儿肌肉功能及血清GABA、NE水平,同时可减轻肾脏损害,用药安全性较好,临床应用价值较高。     

安神定志汤联合\"调肝熄风\"针法对多发性抽动症患儿下丘脑-垂体-肾上腺轴激素和行为心理的影响

摘要 目的：探讨安神定志汤联合\"调肝熄风\"针法对多发性抽动症（TS）患儿下丘脑-垂体-肾上腺轴激素和行为心理的影响。方法：研究对象选自2017年2月~2020年2月期间我院收治的98例TS患儿,将其按照信封抽签法分为对照组（n=49）和研究组（n=49）。其中对照组给予常规西医治疗,研究组在对照组的基础上加用安神定志汤联合\"调肝熄风\"针法治疗。对比两组疗效,耶鲁抽动严重程度综合量表（YGTSS）、儿童行为量表(CBCL)评分,皮质醇（COR）、促肾上腺皮质激素（ACTH）水平及复发率。结果：研究组的临床总有效率为87.76%（43/49）,高于对照组的65.31%（32/49）（P<0.05）。治疗6周后,两组患儿CBCL、YGTSS评分均明显降低,且研究组均低于对照组（P<0.05）。治疗6周后,两组患儿COR、ACTH水平均明显降低,且研究组低于对照组（P<0.05）。研究组患儿的复发率为10.20%（5/49）,低于对照组的32.65%（16/49）（P<0.05）。结论：安神定志汤联合\"调肝熄风\"针法治疗TS,能显著减轻患儿的抽动症状,改善行为心理状态和下丘脑-垂体-肾上腺轴功能,提高患儿治疗效果,降低复发率。     

不同状态下脑电图复杂性探索

Ｌｅｍｐｅｌ－Ｚｉｖ所定义的有限序列的复杂性反映了给定序列随其长度的增长出现新模式的速率,事实上它反映了序列接近随机的程度。将该复杂性度量运用于脑电分析,旨在克服分数维方法的缺陷。文中计算了八种实验条件下脑电图的复杂度,涉及看、听、休息和心算等基本的大脑功能状态,１３个被试的１６导数据被用于计算分析．结果显示了复杂度在不同电极位置及实验条件下都有变化,睁眼状态的复杂度高于闭眼,而施加任务时有额部大脑活动区域复杂度降低的现象。同时复杂度也提供了一些研究大脑高级认知活动的新思路。     

动态脑电图与常规脑电图应用于病毒性脑炎诊断的效果分析

目的:探讨动态脑电图与常规脑电图应用于病毒性脑炎的应用价值。方法:选取150例病毒性脑炎患者,随机分为两组,每组各75例,常规脑电图(REEG)组采用常规脑电图检查,动态脑电图(AEEG)组采用动态脑电图检查;观察并记录脑电图异常率,不同程度病情脑电图异常率的例数,评价动态脑电图与常规脑电图对病毒性脑炎的检测灵敏度和准确度。结果:AEEG组检出的脑电图异常率明显高于REEG组(P0.05)。不同程度病情脑电图检出的患者比例,两组相比,差异没有统计学意义(F=-0.085,P0.05)。REEG组中,轻度与中度病毒性脑炎检出率相比,差异没有统计学意义(P0.05),中度与重度病毒性脑炎检出率相比,差异没有统计学意义(P0.05),重度病毒性脑炎检出率明显高于轻度(P0.05)。AEEG组中,轻度与中度病毒性脑炎检出率相比,差异没有统计学意义(P0.05),重度病毒性脑炎检出率明显高于中度和轻度(P0.05),AEEG组重度病毒性脑炎检出率明显高于REEG组(P0.05)。结论:动态脑电图作为一种无创性检查,对于病毒性脑炎具有极好的检出率,灵敏度高,适用于病毒性脑膜炎的早期辅助诊断。     

多发性骨髓瘤遗传学的研究进展

多发性骨髓瘤起源于后生发中心的B细胞,是一种不可治愈的慢性进展性骨髓浆细胞恶性肿瘤,约占血液系统肿瘤的10%。多发性骨髓瘤存在明显的遗传学改变,其早期的遗传学改变是免疫球蛋白重链基因位点的易位,而这些易位常常导致11q13区域的cyclin D1、4p16.3区域的FGFR3/MMSET、16q23区域的c-maf、6p21区域的cyclin D3等癌基因的失调,同时还存在抑癌基因位点13q14的丢失以及13号染色单体的缺失,这些染色体异常与疾病的预后密切相关。并且N-RAS、K-RAS的突变,以及c-Myc改变等继发性的改变和癌基因的活化等也与疾病的进展密切关联。近年来,随着医学技术的不断进步,人们对该病的遗传学改变认识进一步加深。本文对多发性骨髓瘤的遗传学改变研究进展进行综述,旨在为指导临床有效治疗多发性骨髓瘤,有效评估预后提供参考。     

多发性硬化的MRI诊断

本文回顾性分析了经临床和随访确诊为MS的42例病人的MR表现,描述了MS的一般MR表现,重点讨论了MS较特异的MR表现,MS的鉴别诊断,以及评价了MR检查在MS诊断中的作用与不足。     

高原脱习服人群脑电图的变化

目的：探讨高原脱习服成人的脑电图变化规律。方法：117名健康成人（海拔≤4300m组有39人,〉4300m组有78人）在高原居住1年以上返回平原（海拔1380m）,3d内接受脑电图检查分析。结果：≤4300m组、〉4300m组脑电图异常率分别为30．8％和57．7％（P〈0．01）;背景脑电图少-中量θ波节律检出率分别为18．O％和37．2％（P〈O．05）;过度换气试验所检测到可疑波形的检出率分别为12例（30．8％）和43例（55．1％）（P〈O．05）。此外,与≤4300m组相比,〉4300m组的异常波、睁闭眼、闪光刺激未出现明显异常。结论：高原习服人群由高海拔低氧状态恢复至低海拔常氧状态下生活工作,机体需经历一个高原脱习服过程,高原脱习服人群脑电图易发生异常,海拔越高愈加明显;所记录的θ波表明高原脱习服成人的中枢神经系统常处于抑制状态。     

视频脑电图与常规脑电图在癫痫患儿诊断和定位中的应用价值对比研究

目的:比较视频脑电图(VEEG)与常规脑电图(REEG)在癫痫患儿诊断和定位中的应用价值,为癫痫诊断提供依据。方法:对2014年1月~2016年12月间本院收治的有临床症状拟诊断为癫痫的102例患儿的临床资料进行回顾性分析,比较VEEG与REEG两种方法痫样放电检出率、临床发作检出率、睡眠期检出率以及痫灶定位中的诊断价值。结果:102例患儿中,VEEG检测到痫样放电80例,痫样放电检出率为78.43%,REEG检测到痫样放电42例,痫样放电检出率为41.18%,VEEG痫样放电检出率显著高于REEG(P0.05)。VEEG临床发作检出率为48.75%,显著高于REEG临床发作检出率的14.29%(P0.05)。VEEG检测出睡眠期痫样放电检出率为46.25%,高于觉醒期痫样放电检出率的12.50%(P0.05)。VEEG睡眠期各电图时相痫样放电检出率比较,组间差异均有统计学意义(均P0.05)。根据VEEG确定39例癫痫患儿痫样放电起源部位为额区9例、颞区10例、额颞区9例、枕区4例、中央区4例、颞枕后区3例。结论:VEEG对癫痫患儿的脑部痫样放电检出率和临床发作检出率均明显优于REEG,同时定位诊断效果更优,值得临床推广应用。     

抽动秽语综合征遗传学研究

抽动秽语综合症(Gilles de la Tourette’s syndrome,GTS,TS)是一种慢性复杂性神经精神障碍,多起病于儿童期,以多发性运动性抽动伴不自主发声为主要临床表现,并伴多种并发症及神经行为障碍.目前已有大量关于TS遗传学研究报道,但其主要遗传学基础尚未鉴定.在此就抽动秽语综合征的遗传学研究做一介绍.     

The dynamics of EEG entropy

The scaling properties of human EEG have so far been analyzed predominantly in the framework of detrended fluctuation analysis (DFA). In particular, these studies suggested the existence of power-law correlations in EEG. In DFA, EEG time series are tacitly assumed to be made up of fluctuations, whose scaling behavior reflects neurophysiologically important information and polynomial trends. Even though these trends are physiologically irrelevant, they must be eliminated (detrended) to reliably estimate such measures as Hurst exponent or fractal dimension. Here, we employ the diffusion entropy method to study the scaling behavior of EEG. Unlike DFA, this method does not rely on the assumption of trends superposed on EEG fluctuations. We find that the growth of diffusion entropy of EEG increments of awake subjects with closed eyes is arrested only after approximately 0.5 s. We demonstrate that the salient features of diffusion entropy dynamics of EEG, such as the existence of short-term scaling, asymptotic saturation, and alpha wave modulation, may be faithfully reproduced using a dissipative, first-order, stochastic differential equation—an extension of the Langevin equation. The structure of such a model is utterly different from the “noise+trend” paradigm of DFA. Consequently, we argue that the existence of scaling properties for EEG dynamics is an open question that necessitates further studies.     

脑电信息处理

脑电信息处理是脑功能研究重要组成部分。本文介绍了脑电信息处理的前沿领域,包括诱发电位、事件相关电位（ＥＲＰ）、正弦调制光（声）诱发脑电、４０ＨｚＥＲＰ和脑电非线笥动力学研究,并论及了认知活动与分形维数的关系。     

Automatic EEG arousal detection for sleep apnea syndrome

Electroencephalographic (EEG) arousals are seen in EEG recordings as an awakening response of the human brain. Sleep apnea is a serious sleep disorder. Severe sleep apnea brings about EEG arousals and sleep for patients with sleep apnea syndrome (SAS) is thus frequently interrupted. The number of respiratory-related arousals during the whole night on PSG recordings is directly related to the quality of sleep. Detecting EEG arousals in the PSG record is thus a significant task for clinical diagnosis in sleep medicine. In this paper, a method for automatic detection of EEG arousals in SAS patients was proposed. To effectively detect respiratory-related arousals, threshold values were determined according to pathological events as sleep apnea and electromyogram (EMG). If resumption of ventilation (end of the apnea interval) was detected, much lower thresholds were adopted for detecting EEG arousals, including relatively doubtful arousals. Conversely, threshold was maintained high when pathological events were undetected. The proposed method was applied to polysomnographic (PSG) records of eight patients with SAS and accuracy of EEG arousal detection was verified by comparative visual inspection. Effectiveness of the proposed method in clinical diagnosis was also investigated.     

EEG source identification: frequency analysis during sleep

This article deals with a new approach in sleep characterization that combines EEG source localisation methods with standard frequency analysis of multielectrode EEGs. First, we describe the theoretical methodology and the benefits that we get from a three-dimensional image (LORETA) of the cerebral activity related to a frequency band. Then, this new application is used as signal-processing technique on sleep EEG recordings obtained from young male adults using four frequency bands (delta 0.5-3.5 Hz, theta 4.0-7.5 Hz, alpha 8.0-12.5 Hz and beta 13.0-32.0 Hz) in different sleep stages. Finally, we show that the obtained results are highly consistent with other physiological assessments (standard EEG mapping, functional magnetic resonance imaging, etc.), but give us more realistic additional information on the generators of electromagnetic cerebral activity.     

30例急性血吸虫病的脑电图分析

本文报道了30例急性血吸虫病的脑电图(EEG）资料分析。其中25例异常(占83．3％),主要表现为a波慢化、不规则或基本节律消失。25例中22例(占88％)的慢波以低。中波幅不规则θ波为主,分布以双侧中央区为多,额、枕区次之。EEG异常者,与病情严重程度相关,病情严重者EEG异常程度相对高。12例经治疗后,11例EEG有所改善。     

基于PSoC的脑电信号采集系统的设计

脑电信号是一种很重要的生物医学信号,它是临床医学诊断和脑科学研究的一种重要手段。本文介绍了基于Cypress PSoC~(TM)可编程片上系统的脑电信号采集系统的整个设计过程,包括硬件组成和软件设计方法。通过PSoC芯片特有的可编程模拟系统和数字系统,可以把大量的外围器件集成到芯片的内部,从而提高了硬件系统的集成度和可靠性;加上功能强大的PSOC Designer集成开发环境,提高了开发效率,而且系统的软硬件升级也更加容易了。     

Improving N1 classification by grouping EEG trials with phases of pre-stimulus EEG oscillations

A reactive brain-computer interface using electroencephalography (EEG) relies on the classification of evoked ERP responses. As the trial-to-trial variation is evitable in EEG signals, it is a challenge to capture the consistent classification features distribution. Clustering EEG trials with similar features and utilizing a specific classifier adjusted to each cluster can improve EEG classification. In this paper, instead of measuring the similarity of ERP features, the brain states during image stimuli presentation that evoked N1 responses were used to group EEG trials. The correlation between momentary phases of pre-stimulus EEG oscillations and N1 amplitudes was analyzed. The results demonstrated that the phases of time–frequency points about 5.3 Hz and 0.3 s before the stimulus onset have significant effect on the ERP classification accuracy. Our findings revealed that N1 components in ERP fluctuated with momentary phases of EEG. We also further studied the influence of pre-stimulus momentary phases on classification of N1 features. Results showed that linear classifiers demonstrated outstanding classification performance when training and testing trials have close momentary phases. Therefore, this gave us a new direction to improve EEG classification by grouping EEG trials with similar pre-stimulus phases and using each to train unit classifiers respectively.     

Dynamics of EEG potentials at the beginning of a series of EEG-feedback sessions

We studied changes in the amplitudes of event-related EEG potentials (ERPs) and power spectra of background EEG in the course of a series of EEG-feedback sessions directed toward an increase in the ratio of powers of the α vs θ rhythms. The examined group included 70 volunteers divided into an experimental group (n = 37) and a control group (n = 33). The intensity of acoustic white noise overlapping the musical background served as a feedback signal; it became lower with increase in the above ratio, while in the control group it remained constant. The EEG potentials were recorded from C3 and C4 leads. The ERPs were recorded within a paradigm of measuring time intervals. Within a series of EEG-feedback sessions, the α/θ ratio decreased somewhat both in the control and experimental groups, but in subjects of the latter group this decrease was less significant, and the mean intragroup index became significantly greater than the respective value in the control group after the end of the third session. The EEG-feedback sessions also resulted in significant increases in the amplitudes of early components of the readiness potential in both hemispheres and in the amplitude of the contingent negative variation in the right hemisphere. We conclude that, in most healthy subjects, at least three sessions of α/θ training are necessary to form an effective series providing considerable changes in the pattern of EEG potentials. Neirofiziologiya/Neurophysiology, Vol. 39, No. 1, pp. 88–98, January–February, 2007.     

脑电与认知活动的相关性

本文简要介绍了认知活动与脑电（包括自发脑电、诱发脑电、脑电事件相关电位、４０ＨＺ脑电事件相关电位）的相关性及其应用前景。