关键词： Neurophysiology   Sleep explorations   Sleep disorders   Comorbidity   Quality of care   PRACTICE PARAMETERS   NARCOLEPSY   PRIORITIES   APNEA  

摘要： Sleep disorders like sleep-related breathing disorders, sleep-related movement disorders, parasomnias, and central hypersomnia are frequently associated with psychiatric disorders. It is thus important to detect patients with comorbid sleep disorders and to refer them for an appropriate sleep exploration if necessary. Sleep explorations are noninvasive electrophysiological diagnostic tests to assess brain function and more generally to assess the cardiopulmonary, motor and behavioral functions that are major physiologic functions modified during sleep. Sleep explorations allow diagnosis of sleep disorders and the assessment of their severity. The objective of this article is: to provide basic knowledge to psychiatrists on the conduct, the interpretation, and the results of the main sleep explorations, and to highlight the principles of clinical screening of sleep disorders evaluated by the sleep explorations. Close collaboration between psychiatry and sleep medicine is needed to promote access to subjects suffering from mental disorder to sleep explorations with the aim to ensure quality of care. (C) 2015 Elsevier Masson SAS. All rights reserved.

关键词： brain stem   neurodegenerative disorders   vagus   whole cell patch clamp   DORSAL MOTOR NUCLEUS   NIGRA-PARS-COMPACTA   ASPARTATE GLUTAMATERGIC AGONIST   INTRACELLULAR T1-T1 INTERFACE   MITOCHONDRIAL OXIDANT STRESS   SUBSTANTIA-NIGRA   ALPHA-SYNUCLEIN   DOPAMINERGIC-NEURONS   L-DOPA   VAGAL NEURONS  

摘要： Parkinson's disease (PD) is predominantly idiopathic in origin, and a large body of evidence indicates that gastrointestinal (GI) dysfunctions are a significant comorbid clinical feature; these dysfunctions include dysphagia, nausea, delayed gastric emptying, and severe constipation, all of which occur commonly before the onset of the well-known motor symptoms of PD. Based on a distinct distribution pattern of Lewy bodies (LB) in the enteric nervous system (ENS) and in the preganglionic neurons of the dorsal motor nucleus of the vagus (DMV), and together with the early onset of GI symptoms, it was suggested that idiopathic PD begins in the ENS and spreads to the central nervous system (CNS), reaching the DMV and the substantia nigra pars compacta (SNpc). These two areas are connected by a recently discovered monosynaptic nigro-vagal pathway, which is dysfunctional in rodent models of PD. An alternative hypothesis downplays the role of LB transport through the vagus nerve and proposes that PD pathology is governed by regional or cell-restricted factors as the leading cause of nigral neuronal degeneration. The purpose of this brief review is to summarize the neuronal electrophysiological findings in the SNpc and DMV in PD.

摘要： Objective: Determine the time course and concentration dependent effects of oxaliplatin on the nerve action ***: Oxaliplatin is an important chemotherapy drug whose major dose limiting side effect is peripheral neuropathy. Understanding the effects of concentration and time of exposure of a nerve to oxaliplatin may help in developing strategies to reduce this ***/Methods: The in-vitro sciatic nerve model is used with rat sciatic nerve placed into a perfusion apparatus where the nerve microenvironment and the concentration of oxaliplatin can be carefully controlled. Paired stimuli are provided to each nerve at 5Hz, the averaged NAP is digitized and recorded every 4 seconds. The changes in the NAP over time in the absence of oxaliplatin and with three different infusions of oxaliplatin are determined and analyzed for statistically significant changes. Maximum oxaliplatin concentrations of 9.3uM, 93uM and 208uM are studied. At the end of the infusion the perfusate is replaced by a non-oxaliplatin containing ***: The most prominent changes in the NAP with the oxaliplatin infusion are prolongation in the duration of the NAP and prolonged NAP rise time as well as the loss in the amplitude the trough following the NAP peak. Smaller change in the amplitude of the NAP peak are noted. Changes in the NAP persist even after the oxaliplatin is removed from the perfusate. The first changes in the NAP can be seen at concentrations as low as 0.46uM but effects rapidly increase as the concentration increases over 100uM..Conclusions: The changes in the NAP with oxaliplatin concentration are consistent with an effect on sodium channels. The persistence of effects after oxaliplatin is removed from the perfusate suggests a strong interaction between oxaliplatin and sodium channels. The in-vitro sciatic nerve model may be useful in testing treatments that could ameliorate the effects of oxaliplatin on the peripheral nerve

摘要： Objective: Examine the perceived effects of Epilepsy, Neuromuscular Medicine (NMM), and Sleep Medicine (SM) fellowships on the Clinical Neurophysiology (CNP) fellowships in terms of their structure, number of applicants, and future ***: Clinical Neurophysiology is the first and largest ABPN-approved neurology subspecialty. CNP continues to encompass electromyography (EMG), electroencephalography, and sleep studies, among others, despite the advent of NMM (2008), SM (2009), and Epilepsy (2010) subspecialties. Since 2014, however, there has been a steady decline in the number of CNP fellows, while there has been a rise in the number of fellows in Epilepsy, especially. Given this, questions have been raised about the future of CNP ***/Methods: Surveys were sent to program directors (PDs) of all ACGME-accredited CNP fellowships, both with and without other co-existing fellowships, to inquire about changes seen in CNP fellowships as a result of these newer ***: Eighty-nine PDs were surveyed and 20 (22.5%) responded. Epilepsy was identified as the main new fellowship responsible for contributing to a decline in the number of CNP applications, both in Epilepsy+CNP programs (54.5%) and in CNP-only programs (57.1%). Among Epilepsy+CNP programs, 63.6% of PDs have changed structure by increasing elective exposure, decreasing epilepsy exposure, and decreasing CNP positions. In CNP+NMM programs, 50% of PDs believed the NMM program led to a decline in CNP applications, 100% changed their CNP fellowship structure to decrease EMG exposure, and 100% decreased the size of their CNP fellowship. Despite concerns, 100% of PDs plan to continue their CNP ***: Despite CNP continuing to be the most populous neurology fellowship, Epilepsy and NMM fellowships may be contributing to a decline in CNP applications and structural changes, although no programs are planning to discontinue their CNP fellowships as a result.

摘要： Objective: To present data on the 25-year development of CNP as an ABPN/ACGME recognized ***: The first CNP examination administered by the ABPN was held in 1992, and the ACGME approved the training requirements for a one-year fellowship in ***/Methods: ABPN and ACGME data on programs, trainees, and certificates awarded were reviewed. A survey related to percentage of practice time devoted to performing CNP procedures was administered to all CNP diplomates (currently and previously certified) with current email addresses in the ABPN ***: In 1990, there were 51 non-ACGME-accredited programs with about 60 trainees. In AY 2001–02 there were 85 programs with 156 trainees, and a decade later (AY 2011–12), the numbers had increased to 94 and 217, respectively. Currently (AY 2018–19), there are 89 programs and 167 *** of 2017, 3,035 certificates had been issued to: 2,638 neurologists; 368 child neurologists; 3 double-boarded neurologists/child neurologists; 8 psychiatrists; and 18 double-boarded neurologists/*** survey response rate was 28% (690/2,487). Of the respondents, 32.1% spent 1–25% of time performing CNP procedures; 42.5% spent 26–50%; 15.4% spent 51–75%; and 9.9% spent 76–100%. Most of the respondents (80.2%) performed EEGs; 54.1% performed EMGs, and 34.0% performed evoked potentials. Smaller percentages performed intraoperative monitoring (23.5%), sleep studies (19.5%), and autonomic testing (7.6%). These results were similar to those found on practice surveys conducted in 1992 and ***: In the 25 years since the first examination was administered, CNP has developed a robust number of training programs, but the advent of subspecialty certification in neuromuscular medicine, epilepsy, and sleep medicine may be affecting these programs as evidenced by a decrease in the numbers of programs and trainees in recent years. The survey results indicate that a majority of diplomates spend more than

关键词： 逆商   挫折承受力   心理神经免疫学   科学理论体系   现实生活   认知心理学   神经生理学   Reach  

摘要： 人的一生大多是在逆境中度过的,当我们遭遇各种困境、失败和挫折时,逆商(AQ )的高低将起到决定性的作用。逆商表示挫折承受力的指标,反映的是人们面对逆境和挫折时的心理状态和应变能力,认知心理学、心理神经免疫学和神经生理学是逆商这一科学理论体系的三大支柱。作者在阐述逆商CORE—Control (掌控感)、Ownership (担当力)、Reach(影响度)、Endurance (持续性)四个纬度,以及如何使用LEAD工具(L= Listen,倾听自己的逆境反应;E=Explore,探究自己对结果的担当;A=Analyze,分析证据;D=Do,做点事情)的同时,例举了现实生活中大量的案例,为读者全面展示了如何应对逆境的方法、如何重塑生活,从而向上攀登、超越自我、掌控我们未来前行的方向。

关键词： 自闭症谱系障碍   抑制控制   任务模式   神经影像学   神经生理学   神经生物学  

摘要： 抑制控制作为执行功能的核心成分,是自闭症研究的热点,研究者们使用了传统的心理学测试和影像学、生理学、生物学等多种现代科学技术进行分析,取得了有价值的成果:通过Go/no-go、Stop-Signal、Stroop、Flanker、Windows等任务模式进行研究发现,自闭症儿童青少年在行为、情绪认知、优势刺激、注意选择、诱导-隐瞒等方面存在抑制控制缺陷;影像学和生理学研究表明,自闭症儿童青少年抑制控制受损可能与前额叶、前扣带皮层、额-顶网络功能连接、壳核、楔前叶和顶下小叶的激活异常、前额叶的含氧血红蛋白含量下降、θ/β的比值提高、P3潜伏期更长有关;生物学研究发现,5-羟色胺的转变和多巴胺D2受体rs2283265多态性是导致自闭症抑制控制缺陷的重要原因。上述研究结果对于自闭症儿童青少年的研究、教育、评估和干预具有一定的参考价值。传统心理学和现代科学技术相结合对自闭症儿童青少年的抑制控制能力加以研究,成为未来值得期待的方向。

关键词： Memory   Inhibition   Emotion   ERP   Late positive potential   Old/new effect   EMOTION REGULATION ABNORMALITIES   STRATEGIES FAIL   WORKING-MEMORY   INHIBITION   FMRI   ERP   UNPLEASANT   WORDS   METAANALYSIS   POTENTIALS  

摘要： Numerous studies have shown dysfunctional mechanism of interaction between bottom-up emotional and top down cognitive processes in persons with schizophrenia (SCZ). During the emotional directed forgetting (DF) paradigm participants have to apply volitional mechanisms to resist automatic emotional enhancement of the memory. Here we sought to compare mechanisms underlying emotional DF in SCZ and in healthy persons (HC). Eighteen SCZ and eighteen HC completed a DF paradigm with neutral and negative pictures. EEG was recorded during study and test phase of the task. We analyzed both the behavioral outcomes and event-related potential components, indicating emotional enhancement of memory (Late Positive Potential elicited by pictures) and DF strategies (N2/P3 elicited by forget/remember cues during study-phase; "old/new" and "reversed old/new" effects during test-phase of the task). Directed forgetting effects and emotional enhancement of memory were observed in both groups, even despite overall lower recognition rates in SCZ. Furthermore, cue presentation elicited similar pattern of N2/P3s in SCZ and in HC. However, "reversed old/new" effect was observed only in HC for negative stimuli. Patients may show similar reaction to affective stimuli as healthy controls during the emotional DF task. However, further investigation is needed to elicit the specific mechanisms underlying the DF strategies in SCZ.

关键词： Cortical plasticity   EEG   Movement disorders   Neurofeedback   TMS   STIMULATION  

关键词： COGNITIVE REMEDIATION   VERBAL MEMORY   RATING-SCALE   METAANALYSIS   DEFICITS   INDIVIDUALS   COMPETENCE   RECOVERY   THERAPY  

摘要： Objective: Cognitive remediation is an efficacious treatment for schizophrenia. However, different theoretical approaches have developed without any studies to directly compare them. This is the first study to compare the two dominant approaches to cognitive remediation (training of executive skills and training of perceptual skills) and employed the broadest assessment battery in the literature to date. Methods: Outpatients with schizophrenia spectrum disorders were randomly assigned to receive either executive training or perceptual training. Etectrophysiotogical activity, neurocognition, functional competence, case managerrated community functioning, clinical symptoms, and self-report measures were assessed at baseline, immediately after treatment, and at a 12-week posttreatment follow-up assessment. Results: Perceptual training improved the EEG mismatch negativity significantly more than executive training immediately after treatment, although the effect did not persist at the 12-week follow-up. At the follow-up, executive training improved theta power during an n-back task, neurocognition, functional competence, and case managerrated community functioning to a greater extent than perceptual training. These effects were not observed immediately after treatment. Conclusions: Both perceptual training and executive training improved neurophysiological mechanisms specific to their domains of intervention, although only executive training resulted in improvement in neurocognition and functioning. Improvements in favor of executive training did not appear immediately after treatment but emerged 12 weeks after the end of active treatment. Thus, short-term intervention targeting higher-order cognitive functions may prime further cognitive and functional improvement.