Dear Sir,I am Dr. Huijae Lee, from the Seoul Ire Eye Clinic,Seoul, Korea. I write to present a case report of esotropia after occlusion therapy.Amblyopia can be caused by
Background:Understanding the neurophysiological mechanisms of Amblyopia,a neurodevelopmental disorder of the visual cortex,will bring us closer to full recovery.Past findings have been contradictory.Results have shown...Background:Understanding the neurophysiological mechanisms of Amblyopia,a neurodevelopmental disorder of the visual cortex,will bring us closer to full recovery.Past findings have been contradictory.Results have shown that despite having severe acuity impairment,amblyopes can nonetheless perceive sharp edges.In this study,we explore the representation of blur through a series of image blur-discrimination and matching tasks,to understand more about the amblyopes’visual system.Methods:Monocular image blur-discrimination thresholds were measured in a spatial two-alternative forced-choice procedure whereby subjects had to decide which image was the blurriest.Subjects also had to interocularly match pictures that were identical to those used for the image blur discrimination task.Ten amblyopes,as well as a group of ten controls were under study.Results:Data on amblyopes and controls will be presented for both experiments.According to previous research that was done on blur-edge discrimination and matching,we predict that subjects’performance will follow a dipper function,that is,all observers will be better at discriminating between both images when a small amount of blur is applied rather than when the image is either sharp or very blurry.We also predict that amblyopes’blur discrimination will be noisier,but that they will paradoxically be able to match the sharpness of the images presented in the matching task.Conclusions:This would confirm our hypothesis about amblyopes’visual system,that they can represent blur levels defined by spatial frequencies that are beyond their resolution limit,and would also raise interesting questions about the visual system in general regarding the different perceptions driven by images versus edges.展开更多
AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)te...AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)technology based on clinical effectiveness.METHODS:Eighty children with anisometropic monocular amblyopia were randomly divided into two groups:control(40 cases,1 case of shedding)and acupuncture(40 cases,1 case of shedding)groups.The control group was treated with glasses,red flash,grating,and visual stimulations,with each procedure conducted for 5min per time.Based on routine treatment,the acupuncture group underwent acupuncture of“regulating qi and unblocking meridians to bright eyes”,Jingming(BL1),Cuanzhu(BL2),Guangming(GB37),Fengchi(GB20)acupoints were taken on both sides,with the needle kept for 30min each time.Both groups were treated once every other day,three times per week,for a total of 4wk.After the treatment,the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted.At the same time,nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rsfMRI before and after treatment.The differences in the brain regions between the two groups were compared and analyzed with VMHC.RESULTS:Chi-square test showed a notable difference in the total efficiency rate between the acupuncture(94.87%)and control groups(79.49%).Regarding the P100 wave latency and amplitude,the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group.Moreover,the VMHC values of the bilateral temporal lobe,superior temporal gyrus,and middle temporal gyrus were notably increased in the acupuncture group after treatment.CONCLUSION:Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia.Compared with the conventional treatment,the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.展开更多
Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5...Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5%). There are different treatment options for amblyopia based on its severity and age of the patient. Traditional treatments include patching or occlusion of the dominant eye and pharmacological penalisation using Atropine (1%). Recent developments in amblyopia management have found success with the use of binocular exercises and certain modifications of glasses and contact lenses. The critical age up to which amblyopia is treatable or reversible is also being pushed up with more research. With newer advancements in amblyopia therapy, the success rate is also improving with multimodal approach.展开更多
Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as cro...Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.展开更多
Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanism...Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanisms underlying strabismic amblyopia and anisometropic amblyopia may be different.Therefore,we performed a systematic review of magnetic resonance imaging studies investigating brain alterations in patients with these two subtypes of amblyopia;this study is registered with PROSPERO(registration ID:CRD42022349191).We searched three online databases(PubMed,EMBASE,and Web of Science) from inception to April 1,2022;39 studies with 633 patients(324patients with anisometropic amblyo pia and 309 patients with strabismic amblyopia) and 580 healthy controls met the inclusion criteria(e.g.,case-control designed,pee r-reviewed articles) and were included in this review.These studies highlighted that both strabismic amblyopia and anisometropic amblyopia patients showed reduced activation and distorted topological cortical activated maps in the striate and extrastriate co rtices during tas k-based functional magnetic resonance imaging with spatial-frequency stimulus and retinotopic representations,respectively;these may have arisen from abnormal visual experiences.Compensations for amblyopia that are reflected in enhanced spontaneous brain function have been reported in the early visual cortices in the resting state,as well as reduced functional connectivity in the dorsal pathway and structural connections in the ventral pathway in both anisometro pic amblyopia and strabismic amblyopia patients.The shared dysfunction of anisometro pic amblyopia and strabismic amblyopia patients,relative to controls,is also chara cterized by reduced spontaneous brain activity in the oculomotor co rtex,mainly involving the frontal and parietal eye fields and the cerebellu m;this may underlie the neural mechanisms of fixation instability and anomalous saccades in amblyopia.With regards to specific alterations of the two forms of amblyo pia,anisometropic amblyo pia patients suffer more microstructural impairments in the precortical pathway than strabismic amblyopia patients,as reflected by diffusion tensor imaging,and more significant dysfunction and structural loss in the ventral pathway.Strabismic amblyopia patients experience more attenuation of activation in the extrastriate co rtex than in the striate cortex when compared to anisometropic amblyopia patients.Finally,brain structural magnetic resonance imaging alterations tend to be lateralized in the adult anisometropic amblyopia patients,and the patterns of brain alterations are more limited in amblyopic adults than in childre n.In conclusion,magnetic resonance imaging studies provide important insights into the brain alterations underlying the pathophysiology of amblyopia and demonstrate common and specific alte rations in anisometropic amblyo pia and strabismic amblyopia patients;these alterations may improve our understanding of the neural mechanisms underlying amblyopia.展开更多
Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify ...Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.展开更多
Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography an...Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffu- sion-weighted imaging showed that the area of infarction core gradually increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initially in- creased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion co- efficient value in the infarction core and remote bilateral cerebellum both gradually decreased, and then slightly increased 3-24 hours after infarction. Apparent diffusion coefficient values at remote regions （cerebellum） varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coefficient values and diffusion weighted imaging can be used to detect early diaschisis.展开更多
BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct ...BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury.展开更多
The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of trauma...The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease.展开更多
Ferumoxytol, an iron replacement product, is a new type of superparamagnetic iron oxide ap- proved by the US Food and Drug Administration. Herein, we assessed the feasibility of tracking transplanted human adipose-der...Ferumoxytol, an iron replacement product, is a new type of superparamagnetic iron oxide ap- proved by the US Food and Drug Administration. Herein, we assessed the feasibility of tracking transplanted human adipose-derived stem cells labeled with ferumoxytol in middle cerebral artery occlusion-injured rats by 3.0 T MRI in vivo. 1 × 104 human adipose-derived stem cells labeled with ferumoxytol-heparin-protamine were transplanted into the brains of rats with middle cerebral artery occlusion. Neurologic impairment was scored at 1, 7, 14, and 28 days after transplantation. T2-weighted imaging and enhanced susceptibility-weighted angiography were used to observe transplanted cells. Results of imaging tests were compared with results of Prussian blue staining. The modified neurologic impairment scores were significantly lower in rats transplanted with cells at all time points except I day post-transplantation compared with rats without transplantation. Regions with hypointense signals on T2-weighted and enhanced susceptibility-weighted angiography images corresponded with areas stained by Prussian blue, suggesting the presence of superparamagnetic iron oxide particles within the engrafted cells. Enhanced susceptibility-weighted angiography image exhibited better sensitivity and contrast in tracing ferumoxytol-heparin-protamine-labeled human adipose-derived stem ceils compared with T2-weighted imaging in routine MRI.展开更多
Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the p...Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.展开更多
Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebr...Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging（DWI）. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and si RNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging（T2WI） and DWI gradually increased within 0.5–6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2 WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2 WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.展开更多
Inhibition of Notch1 signaling has been shown to promote astrocyte-derived neurogenesis after stroke.To investigate the regulatory role of Notch1 signaling in this process,in this study,we used a rat model of stroke b...Inhibition of Notch1 signaling has been shown to promote astrocyte-derived neurogenesis after stroke.To investigate the regulatory role of Notch1 signaling in this process,in this study,we used a rat model of stroke based on middle cerebral artery occlusion and assessed the behavior of reactive astrocytes post-stroke.We used theγ-secretase inhibitor N-[N-(3,5-diuorophenacetyl)-1-alanyl]-S-phenylglycine t-butylester(DAPT)to block Notch1 signaling at 1,4,and 7 days after injury.Our results showed that only administration of DAPT at 4 days after stroke promoted astrocyte-derived neurogenesis,as manifested by recovery of white matter fiber bundle integrity on magnetic resonance imaging,which is consistent with recovery of neurologic function.These findings suggest that inhibition of Notch1 signaling at the subacute stage post-stroke mediates neural repair by promoting astrocyte-derived neurogenesis.展开更多
文摘Dear Sir,I am Dr. Huijae Lee, from the Seoul Ire Eye Clinic,Seoul, Korea. I write to present a case report of esotropia after occlusion therapy.Amblyopia can be caused by
文摘Background:Understanding the neurophysiological mechanisms of Amblyopia,a neurodevelopmental disorder of the visual cortex,will bring us closer to full recovery.Past findings have been contradictory.Results have shown that despite having severe acuity impairment,amblyopes can nonetheless perceive sharp edges.In this study,we explore the representation of blur through a series of image blur-discrimination and matching tasks,to understand more about the amblyopes’visual system.Methods:Monocular image blur-discrimination thresholds were measured in a spatial two-alternative forced-choice procedure whereby subjects had to decide which image was the blurriest.Subjects also had to interocularly match pictures that were identical to those used for the image blur discrimination task.Ten amblyopes,as well as a group of ten controls were under study.Results:Data on amblyopes and controls will be presented for both experiments.According to previous research that was done on blur-edge discrimination and matching,we predict that subjects’performance will follow a dipper function,that is,all observers will be better at discriminating between both images when a small amount of blur is applied rather than when the image is either sharp or very blurry.We also predict that amblyopes’blur discrimination will be noisier,but that they will paradoxically be able to match the sharpness of the images presented in the matching task.Conclusions:This would confirm our hypothesis about amblyopes’visual system,that they can represent blur levels defined by spatial frequencies that are beyond their resolution limit,and would also raise interesting questions about the visual system in general regarding the different perceptions driven by images versus edges.
基金Supported by National Natural Science Foundation of China(No.82160935,No.82260965)Traditional Chinese Medicine Discipline“Qi Huang Ying Cai”Tutor Special Fund Doctoral Program(No.ZYXKBD-202208)+4 种基金Higher Education Innovation Fund Project of Gansu Province(No.2021A-087)Natural Science Foundation of Gansu Province(No.22JR5RA583)Traditional Chinese Medicine Discipline“Qi Huang Ying Cai”Tutor Special Fund Master’s Supervisor Program(No.ZYXKSD-202220)Youth Research Fund Project of Gansu University of Chinese Medicine(No.ZQ2017-9)Gansu Province 2023 Provincial Key Talent Project(No.2).
文摘AIM:To explore the brain mechanism of acupuncture for children with anisometropic amblyopia using the voxelmirror homotopic connectivity(VMHC)analysis method of resting functional magnetic resonance imaging(rs-fMRI)technology based on clinical effectiveness.METHODS:Eighty children with anisometropic monocular amblyopia were randomly divided into two groups:control(40 cases,1 case of shedding)and acupuncture(40 cases,1 case of shedding)groups.The control group was treated with glasses,red flash,grating,and visual stimulations,with each procedure conducted for 5min per time.Based on routine treatment,the acupuncture group underwent acupuncture of“regulating qi and unblocking meridians to bright eyes”,Jingming(BL1),Cuanzhu(BL2),Guangming(GB37),Fengchi(GB20)acupoints were taken on both sides,with the needle kept for 30min each time.Both groups were treated once every other day,three times per week,for a total of 4wk.After the treatment,the overall curative effect of the two groups and the latency and amplitude changes of P100 wave of pattern visual-evoked potential were counted.At the same time,nine children with left eye amblyopia were randomly selected from the two groups and were scanned with rsfMRI before and after treatment.The differences in the brain regions between the two groups were compared and analyzed with VMHC.RESULTS:Chi-square test showed a notable difference in the total efficiency rate between the acupuncture(94.87%)and control groups(79.49%).Regarding the P100 wave latency and amplitude,the acupuncture group had significantly shorter latency and higher amplitude of P100 wave than the control group.Moreover,the VMHC values of the bilateral temporal lobe,superior temporal gyrus,and middle temporal gyrus were notably increased in the acupuncture group after treatment.CONCLUSION:Acupuncture combined with conventional treatment can significantly improve the corrected visual acuity and optic nerve conduction in children with anisometropic amblyopia.Compared with the conventional treatment,the regulation of acupuncture on the functional activities of the relevant brain areas in the anterior cerebellum may be an effective acupuncture mechanism for anisometropic amblyopia.
文摘Amblyopia is a neurodevelopmental disorder of the visual cortex arising from abnormal visual experience early in life. Amblyopia is a major cause of impaired vision in infants and young children (prevalence around 3.5%). There are different treatment options for amblyopia based on its severity and age of the patient. Traditional treatments include patching or occlusion of the dominant eye and pharmacological penalisation using Atropine (1%). Recent developments in amblyopia management have found success with the use of binocular exercises and certain modifications of glasses and contact lenses. The critical age up to which amblyopia is treatable or reversible is also being pushed up with more research. With newer advancements in amblyopia therapy, the success rate is also improving with multimodal approach.
基金Supported by the Ministry of Economy,Industry and Competitiveness of Spain within the program Ramón y Cajal(RYC-2016-20471)。
文摘Strabismic amblyopia is characterized by a distorted spatial perception.In this condition,the neurofunctional disorder occurring during first years of life provoke several monocular and binocular anomalies such as crowding,deficits in the accommodative response,contrast sensitivity,and ocular motility abilities.The inhibition of the binocular function of the brain by the misaligned amblyopic eye induces a binocular imbalance leading to interocular suppression and the reduction or lack of stereoacuity.Passive treatments such as occlusion,optical and/or pharmacological penalization,and Bangerter foils has been demonstrated to be potentially useful treatments for strabismic amblyopia.Recent researches have proved new pharmacological options to improve and maintain visual acuity af ter occlusion treatment in strabismic amblyopia.Likewise,the active vision therapy,in the last years,is becoming a very relevant therapeutic option in combination with passive treatments,especially during and after monocular therapy,in the attempt of recovering the imbalanced binocular vision.
文摘Amblyopia is the most common cause of vision loss in children and can persist into adulthood in the absence of effective intervention.Previous clinical and neuroimaging studies have suggested that the neural mechanisms underlying strabismic amblyopia and anisometropic amblyopia may be different.Therefore,we performed a systematic review of magnetic resonance imaging studies investigating brain alterations in patients with these two subtypes of amblyopia;this study is registered with PROSPERO(registration ID:CRD42022349191).We searched three online databases(PubMed,EMBASE,and Web of Science) from inception to April 1,2022;39 studies with 633 patients(324patients with anisometropic amblyo pia and 309 patients with strabismic amblyopia) and 580 healthy controls met the inclusion criteria(e.g.,case-control designed,pee r-reviewed articles) and were included in this review.These studies highlighted that both strabismic amblyopia and anisometropic amblyopia patients showed reduced activation and distorted topological cortical activated maps in the striate and extrastriate co rtices during tas k-based functional magnetic resonance imaging with spatial-frequency stimulus and retinotopic representations,respectively;these may have arisen from abnormal visual experiences.Compensations for amblyopia that are reflected in enhanced spontaneous brain function have been reported in the early visual cortices in the resting state,as well as reduced functional connectivity in the dorsal pathway and structural connections in the ventral pathway in both anisometro pic amblyopia and strabismic amblyopia patients.The shared dysfunction of anisometro pic amblyopia and strabismic amblyopia patients,relative to controls,is also chara cterized by reduced spontaneous brain activity in the oculomotor co rtex,mainly involving the frontal and parietal eye fields and the cerebellu m;this may underlie the neural mechanisms of fixation instability and anomalous saccades in amblyopia.With regards to specific alterations of the two forms of amblyo pia,anisometropic amblyo pia patients suffer more microstructural impairments in the precortical pathway than strabismic amblyopia patients,as reflected by diffusion tensor imaging,and more significant dysfunction and structural loss in the ventral pathway.Strabismic amblyopia patients experience more attenuation of activation in the extrastriate co rtex than in the striate cortex when compared to anisometropic amblyopia patients.Finally,brain structural magnetic resonance imaging alterations tend to be lateralized in the adult anisometropic amblyopia patients,and the patterns of brain alterations are more limited in amblyopic adults than in childre n.In conclusion,magnetic resonance imaging studies provide important insights into the brain alterations underlying the pathophysiology of amblyopia and demonstrate common and specific alte rations in anisometropic amblyo pia and strabismic amblyopia patients;these alterations may improve our understanding of the neural mechanisms underlying amblyopia.
基金supported by Nanjing Jinling Hospital ( 2004082) Basic application grant supported by The Department ofEducation of Jiangsu Province
文摘Purpose: To research the mechanism of neurophysiological treatment of amblyopia by observing the visual cortex activation under rotating grating stimulus with functional magnetic resonance imaging (MRI), and identify the components of the activation. Methods: Nine healthy volunteers were examined using gradient-recalled echo and echo-planar imaging (GRE-EPI) pulse sequence performed at the 1.5 Tesla MRI scanner. In the block designing, rotating grating, stationary grating and luminance were plotted as task states, stationary grating, luminance and darkness as control states, respectively. The tasks of stimuli included 6 steps. Imaging processing and statistical analysis were carried out off-line using statistical parametric mapping (SPM99) software in single-subject. Results: Some individual areas of visual cortex were activated by various stimuli information supplied by rotating grating. The strong activation in the middle of occipital lobe related to the stimuli of luminance, bilateral activation of Brodmann’s 19th area related to visual motion perception, and the mild activation in the middle of occipital lobe related to form perception. Conclusion: The plotting of control state is important in bock design. The effective visual information of rotating grating includes components of luminance, visual motion perception and form perception. Functional MRI has potential as a tool for studying the physiological mechanism of visual cortex.
基金supported by Zhejiang Province Science and Technology Plan Project in China,No.2012C37029Public Welfare Technology Application Research Plan Project of Zhejiang Province in China,No.2011C23021
文摘Supratentorial cerebral infarction can cause functional inhibition of remote regions such as the cerebellum, which may be relevant to diaschisis. This phenomenon is often analyzed using positron emission tomography and single photon emission CT. However, these methods are expensive and radioactive. Thus, the present study quantified the changes of infarction core and remote regions after unilateral middle cerebral artery occlusion using apparent diffusion coefficient values. Diffu- sion-weighted imaging showed that the area of infarction core gradually increased to involve the cerebral cortex with increasing infarction time. Diffusion weighted imaging signals were initially in- creased and then stabilized by 24 hours. With increasing infarction time, the apparent diffusion co- efficient value in the infarction core and remote bilateral cerebellum both gradually decreased, and then slightly increased 3-24 hours after infarction. Apparent diffusion coefficient values at remote regions （cerebellum） varied along with the change of supratentorial infarction core, suggesting that the phenomenon of diaschisis existed at the remote regions. Thus, apparent diffusion coefficient values and diffusion weighted imaging can be used to detect early diaschisis.
文摘BACKGROUND Traumatic internal carotid artery(ICA)occlusion is a rare complication of skull base fractures,characterized by high mortality and disability rates,and poor prognosis.Therefore,timely discovery and correct management are crucial for saving the lives of such patients and improving their prognosis.This article retrospectively analyzed the imaging and clinical data of three patients,to explore the imaging characteristics and treatment strategies for carotid artery occlusion,combined with severe skull base fractures.CASE SUMMARY This case included three patients,all male,aged 21,63,and 16 years.They underwent plain film skull computed tomography(CT)examination at the onset of their illnesses,which revealed fractures at the bases of their skulls.Ultimately,these cases were definitively diagnosed through CT angiography(CTA)examinations.The first patient did not receive surgical treatment,only anticoagulation therapy,and recovered smoothly with no residual limb dysfunction(Case 1).The other two patients both developed intracranial hypertension and underwent decompressive craniectomy.One of these patients had high intracranial pressure and significant brain swelling postoperatively,leading the family to choose to take him home(Case 2).The other patient also underwent decompressive craniectomy and recovered well postoperatively with only mild limb motor dysfunction(Case 3).We retrieved literature from PubMed on skull base fractures causing ICA occlusion to determine the imaging characteristics and treatment strategies for this type of disease.CONCLUSION For patients with cranial trauma combined with skull base fractures,it is essential to complete a CTA examination as soon as possible,to screen for blunt cerebrovascular injury.
基金Supported by the Science and Technology Program of Nantong Health Committee,No.MA2019003 and No.MA2021017Science and Technology Program of Nantong City,No.Key003 and No.JCZ2022040Kangda College of Nanjing Medical University,No.KD2021JYYJYB025,No.KD2022KYJJZD019,and No.KD2022KYJJZD022.
文摘The internal carotid artery occlusion caused by head and neck trauma,also known as traumatic intracranial artery occlusion,is relatively rare clinically.Traumatic skull base fracture is a common complication of traumatic brain injury.Traumatic skull base fracture is one of the causes of traumatic internal carotid artery occlusion.If not detected early and treated in time,the prognosis of patients is poor.This editorial makes a relevant analysis of this disease.
基金supported by the Science and Technology Plan Project of Dalian City in China,No.2014E14SF186
文摘Ferumoxytol, an iron replacement product, is a new type of superparamagnetic iron oxide ap- proved by the US Food and Drug Administration. Herein, we assessed the feasibility of tracking transplanted human adipose-derived stem cells labeled with ferumoxytol in middle cerebral artery occlusion-injured rats by 3.0 T MRI in vivo. 1 × 104 human adipose-derived stem cells labeled with ferumoxytol-heparin-protamine were transplanted into the brains of rats with middle cerebral artery occlusion. Neurologic impairment was scored at 1, 7, 14, and 28 days after transplantation. T2-weighted imaging and enhanced susceptibility-weighted angiography were used to observe transplanted cells. Results of imaging tests were compared with results of Prussian blue staining. The modified neurologic impairment scores were significantly lower in rats transplanted with cells at all time points except I day post-transplantation compared with rats without transplantation. Regions with hypointense signals on T2-weighted and enhanced susceptibility-weighted angiography images corresponded with areas stained by Prussian blue, suggesting the presence of superparamagnetic iron oxide particles within the engrafted cells. Enhanced susceptibility-weighted angiography image exhibited better sensitivity and contrast in tracing ferumoxytol-heparin-protamine-labeled human adipose-derived stem ceils compared with T2-weighted imaging in routine MRI.
基金supported by the National Natural Science Foundation of China,No.81371521
文摘Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.
基金supported by the National Natural Science Foundation of China,No.30960399a grant from Hainan Provincial International Cooperation Project of China,No.Qiongke(2012)65a grant from Hainan Provincial Health Department Project of China,No.2011-SWK-10-136/Qiongwei2011-65
文摘Aquaporin-4 regulates water molecule channels and is important in tissue regulation and water transportation in the brain. Upregulation of aquaporin-4 expression is closely related to cellular edema after early cerebral infarction. Cellular edema and aquaporin-4 expression can be determined by measuring cerebral infarct area and apparent diffusion coefficient using diffusion-weighted imaging（DWI）. We examined the effects of silencing aquaporin-4 on cerebral infarction. Rat models of cerebral infarction were established by occlusion of the right middle cerebral artery and si RNA-aquaporin-4 was immediately injected via the right basal ganglia. In control animals, the area of high signal intensity and relative apparent diffusion coefficient value on T2-weighted imaging（T2WI） and DWI gradually increased within 0.5–6 hours after cerebral infarction. After aquaporin-4 gene silencing, the area of high signal intensity on T2 WI and DWI reduced, relative apparent diffusion coefficient value was increased, and cellular edema was obviously alleviated. At 6 hours after cerebral infarction, the apparent diffusion coefficient value was similar between treatment and model groups, but angioedema was still obvious in the treatment group. These results indicate that aquaporin-4 gene silencing can effectively relieve cellular edema after early cerebral infarction; and when conducted accurately and on time, the diffusion coefficient value and the area of high signal intensity on T2 WI and DWI can reflect therapeutic effects of aquaporin-4 gene silencing on cellular edema.
基金supported by the National Natural Science Foundation of China,Nos.81801660(to XZH)and 81771788(to YMY)。
文摘Inhibition of Notch1 signaling has been shown to promote astrocyte-derived neurogenesis after stroke.To investigate the regulatory role of Notch1 signaling in this process,in this study,we used a rat model of stroke based on middle cerebral artery occlusion and assessed the behavior of reactive astrocytes post-stroke.We used theγ-secretase inhibitor N-[N-(3,5-diuorophenacetyl)-1-alanyl]-S-phenylglycine t-butylester(DAPT)to block Notch1 signaling at 1,4,and 7 days after injury.Our results showed that only administration of DAPT at 4 days after stroke promoted astrocyte-derived neurogenesis,as manifested by recovery of white matter fiber bundle integrity on magnetic resonance imaging,which is consistent with recovery of neurologic function.These findings suggest that inhibition of Notch1 signaling at the subacute stage post-stroke mediates neural repair by promoting astrocyte-derived neurogenesis.
