脑出血中医药临床研究的困境与对策

脑出血为临床上的急危重症,目前缺乏有效的中医药治疗。本文从中药汤刺、中药注射剂及针灸三个方面阐述中医药治疗脑出血的临床现状,分析中医药治疗脑出血的优势与不足,从脑出血中医病名的确定、中医病机的多样性及中医重经验、轻理论,重哲学、轻医理等方面剖析中医药治疗脑出血临床困境的原因,并根据所述原因从脑出血相关中医病名研究、脑出血病机研究、中医药新型制弃】研究等方面探讨如何走出中医药治疗脑出血的临床研究困境。     

Are postural adjustments during reaching related to walking development in typically developing infants and infants at risk of cerebral palsy?

BackgroundIn typical development, postural adjustments during reaching change in the second half of infancy, including increasing rates of direction-specific adjustments. These changes are absent or different in infants at risk of cerebral palsy (CP). To discover whether these changes are related to acquisition of independent walking, we studied postural adjustments during reaching in infants before and after they learned to walk.MethodsTen typically developing (TD) infants and 11 infants at very high risk (VHR) of CP were assessed before and after they learned to walk. Reaching movements were elicited during supported sitting, while surface electromyography was recorded of arm, neck, and trunk muscles. Percentages of direction-specific adjustments (first level of control), and recruitment patterns and anticipatory activation (second level of control) were calculated.ResultsIn both groups, postural adjustments during reaching were similar before and after acquisition of independent walking. Direction-specificity increased with age in typically developing infants but not in VHR-infants.ConclusionIncreasing age rather than the transition to independent walking is associated with increasing direction-specificity of TD-infants during reaching while sitting, while infants at very high risk of CP show no increase in direction-specificity, suggesting that they gradually grow into a postural deficit.     

A Clinical Comparative Study Evaluating the Effect of Epilepsy Versus Adhd on Timed Cognitive Tasks in Children

Both children with epilepsy and children with ADHD may be characterized by slowing on reaction-time measurement. This is of particular interest, as neuropsychological assessment is often requested in the differential diagnosis between children with short non-convulsive epileptic seizures and children with ADHD. In this study we attempt to identify patterns of impairment on timed tasks that are specific for epilepsy, relative to ADHD. This study was an open, controlled parallel-group clinical investigation which included two groups of patients: 60 children with ADHD and 60 children with epilepsy. These children were compared with a control group (n =30) on two types of timed cognitive tasks: tasks with low information load (simple reaction-time measurement) and tasks with high information load (multiple decision reaction-time measurement). The simple reaction-time measurements show significant differences between ADHD and controls (all except for visual RT non-dominant hand) and between epilepsy and controls (only one test). No significant differences were found between epilepsy and ADHD. The two tests with high information load show significant slowing compared with the controls for epilepsy on the Binary Choice Reaction-Time Test and for ADHD on the Visual Searching Test. On both tests also the differences between epilepsy and ADHD are significant. The two tests in combination have a relatively satisfactory potential to classify the children with ADHD (75% correct classification) and the children with epilepsy (55% correct classification). We may conclude that complex reaction-time tests (i.e., timed tasks with high information load) have potential for assessing the differential impact of ADHD and epilepsy on attentional function. These tasks specifically reveal general slowing for children with epilepsy and slowing as an effect of failures of inhibitory self control on unstructured tasks for ADHD.     

Attention and social functioning in children with malformations of cortical development and stroke

Attention and social functioning and their interrelationships have not been routinely examined in children with early brain insult (EBI). This study aimed to describe attention and social functioning in children with two types of EBI: malformations of cortical development (MCD) and stroke. Children diagnosed with MCD (n?=?14, 6 males) or stroke (n?=?14, 8 males) aged 8 to 14 years (M?=?12 years 11 months) completed neuropsychological assessments to examine attention processes. Primary caregivers completed a questionnaire to assess executive components of children's attention and teachers completed a questionnaire to measure children's social functioning. Brain scans (MRI or CT) were coded by a pediatric neuroradiologist. Higher rates of impairments in attention and social function were found in children with EBI compared with normative expectations. Children with MCD experienced more global and clinically significant levels of impairment than children with stroke; though impairments were present in both groups. A strong association between executive components of attention and social function was observed. In addition, complex attention processes were associated with social function. The findings emphasize the reciprocity between attention, behavior and social outcomes, and the vulnerability of social function following EBI.     

Age-related changes in visual pseudoneglect

Pseudoneglect is a slight but consistent leftward attentional bias commonly observed in healthy young populations, purportedly explained by right hemispheric dominance. It has been suggested that normal aging might be associated with a decline of the right hemisphere. According to this hypothesis, a few studies have shown that elderly tend to exhibit a rightward attentional bias in line bisection. In the present study, we tested this hypothesis in young and older participants using a perceptual landmark task. Results yield evidence for an age-related shift, from a strong attentional leftward bias in young adults toward a suppressed or even a reversed bias in the elderly. Right hemisphere impairment coupled to a left hemispheric compensation might explain the perceptual shift observed in older adults. However, a decline in corpus callosum function cannot be excluded. Alternatively, these results may be in agreement with the hypothesis of an age-related specific inhibition of return dysfunction, an overt attentional orienting mechanism, and/or a decrease of dopamine.     

语义启动效应的脑机制研究综述

文章主要介绍了语义启动的过程及其脑机制的研究进展。启动效应是内隐记忆的研究焦点,而语义启动是通过刺激的语义特征来研究启动效应的。语义启动的脑机制研究一般是通过脑损伤、脑成像和ERPs等方法实现的。研究表明,大脑的广泛区域都参与着语义启动过程,尤其是脑前区和大脑的左半球。     

Resource-dependent effects during sex categorization

The limited capacity of face perception resources in the left cerebral hemisphere was examined using a sex categorization task. One study tested the hypothesis that sex categorization is impeded whenever feature extraction resources in the left hemisphere are simultaneously being utilized by another task. This hypothesis was tested by presenting prime faces for either 32 ms or 320 ms to either the left or right visual-field just before centrally presented target faces were categorized by sex. Results showed that sex categorization was slower after prime faces were presented for 32 ms in the right visual-field compared to the left visual-field. This difference was not found after the 320 ms prime length. The results are interpreted in the context of a neurocognitive model of social perception and suggest that efficient sex categorization depends, in part, on the availability of facial feature extraction resources in the left hemisphere.     

Does degree of asymmetry relate to performance? An investigation of word recognition and reading in consistent and mixed handers

Is it advantageous to be strongly lateralized? The current study investigated this question by examining the relationship between visual field asymmetries for lexical tasks and reading performance in a sample of 200 young adults. Larger visual field asymmetries were associated with better reading performance, but this relationship was obtained primarily in those with strong and consistent hand preferences. Among mixed handers, variation in visual field asymmetry accounted for little or no variance in reading skill. In addition, correlations between visual field asymmetry and reading performance were observed for word recognition tasks, but not for tasks requiring controlled semantic retrieval. The results are consistent with the idea that consistent and mixed handers may represent differing neurobehavioral populations. Because greater lateralization was associated with better reading skill only for consistent handers, reduced behavioral asymmetry cannot be assumed to be a risk factor for reading dysfunction in the population as a whole.     

The nucleus premammillaris ventralis (pmv) and aggressive behavior in the rat

Small bilateral electrolytic lesions placed just posterior of the ventromedial hypothalamic nucleus cause a strong increase in offensive behavior. The histology suggests that damage to the ventral premammillary nucleus is responsible for this effect. A summary of the neuroanatomical literature shows that this structure is connected to most other brain structures reported to be involved in offensive behavior.