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25 March 2017, Volume 13 Issue 1
    

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    Comment on Guideline
  • Interpretation on 2016 AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery
    ZHAN Qing, WANG Lijing
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 1-9. https://doi.org/10.12022/jnnr.2017-0008
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    In June 2016, American Heart Association (AHA)/American Stroke Association (ASA) released the first guideline for adult stroke rehabilitation—AHA/ASA Guidelines for Adult Stroke Rehabilitation and Recovery (2016 GASRR). This paper aims to compare the 2016 GASRR with Chinese Adult Stroke Rehabilitation Guideline in 2011 (2011 CASRG) and Consensus of Rehabilitation Experts on Acute Cerebral Infarction in 2016 (2016 CREACI) to provide references for rehabilitation therapy of stroke in China. The 2016 GASRR, 2011 CASRG and 2016 CREACI all suggest that early rehabilitation during acute stage is essential for optimal outcomes, but do not provide the specified timing of intervention. Suggestions on rehabilitation methods are mentioned given specific training programs can prevent pressure sore, joint contracture, deep venous thrombosis (DVT), lung infection and urinary tract infection. The 2016 GASRR gives more detailed information on rehabilitation methods, level of rehabilitation activities, rehabilitation schedule, and the interventions to prevent pro-stroke complications. Furthermore, different approaches are suggested in the 2016 GASRR, 2011 CASRG and 2016 CREACI on prevention of DVT and post-stroke central pain and the psychological intervention. The 2016 GASRR also has covered recommendations for improvement of activities of daily living (ADL) and instrumental activities of daily living (IDAL) which are specified to leisure activities and occupational treatments. As compared with the criteria of stroke rehabilitation abroad, there is still a long way to go for the development of stroke rehabilitation in China. In the future, more researches are needed to be done in China in order to standardize the post-stroke rehabilitation.
    • Original Research
  • Lianshen Fengxin Decoction in treatment of excessive salivation and frequent urination overnight in patients with motor neuron disease: An open randomized controlled trial
    GAO Penglin, LIAO Weilong, SUN Chuanhe, JIANG Wenfei, PAN Weidong
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 10-16. https://doi.org/10.12022/jnnr.2016-0068
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    Objective: To investigate the efficacy of Lianshen Fengxin Decoction, a formula of Traditional Chinese Medicine, in treatment of excessive salivation and frequent urination overnight in patients with motor neuron disease (MND). Methods: Fifty-two eligible patients with MND suffering with excessive salivation and frequent urination overnight who were outpatients or inpatients from Department of Neurology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine between June, 2014 and November, 2016 were recruited in this study. The patients were randomly divided into two groups: Lianshen Fengxin Decoction group (n = 26, receiving routine Western medicine in combination with Lianshen Fengxin Decoction for 6 weeks) and routine Western medicine group (n = 26, only receiving routine Western medicine for 6 weeks). The overnight activity, quantity of salivation (24 h) and frequency of urination overnight as the primary measurements, and the score of Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) as the secondary mesurement were used to evaluate the clinical efficacy of Lianshen Fengxin Decoction. Results: There were no significant differences in overnight activity, quantity of salivation (24 h), frequency of urination overnight and ALSFRS score before treatment between two groups (all P > 0.05). At the end of 6-week treatment, there were 4 patients and 5 patients dropped out or lost to follow-up in Lianshen Fengxin Decoction group and routine Western medicine group, respectively. The overnight activity, quantity of salivation (24 h) and the frequency of urination overnight were significantly decreased after treatment as compared with those before treatment in Lianshen Fengxin Decoction group (all P < 0.05), but there were no significant changes observed in routine Western medicine group (all P > 0.05). The ALSFRS score in two groups had no significant changes after treatment (both P > 0.05). No obvious liver and renal dysfunctions were observed in two groups. Conclusion: Traditional Chinese Medicine formula—Lianshen Fengxin Decoction, which has the function of tonifying the kidney and the astringent effect, can obviously decrease the quantity of salivation and frequency of urination overnight in patients with MND.
  • Relationship between cognitive condition and neuroimaging features in patients with cerebral small vessel disease
    CAO Wenwei, ZHAO Wei, YU Ling, CHAI Wen, WANG Yao, XU Qun
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 17-24. https://doi.org/10.12022/jnnr.2016-0069
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Objective: The purpose of this study is to investigate the relationship between the cognitive state of patients with cerebral small vessel disease (CSVD) and the location and number of lacunar infarcts, the white matter lesion (WML) and medial temporal lobe atrophy (MTA). Methods: This study recruited 59 patients with CSVD who had a recent symptomatic ischemic stroke history > 3 months and were registered in the secondary prevention clinic of cerebrovascular disease in Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine. According to the detailed neuropsychological assessment results, 59 patients were divided into no cognitive impairment (NCI) group (n = 24), mild cognitive impairment (MCI) group (n = 22) and vascular dementia (VaD) group (n = 13). The magnetic resonance imaging (MRI) of brain with multiple sequences and oblique coronal reconstruction was used for counting the number of lacunar infarcts and grading WML and MTA. Results: Cognitive impairment in patients with CSVD was associated with the number of lacunar infarcts (P = 0.004), and the number of lacunar infarcts in the subcortical white matter parts was significantly different among three groups (P = 0.001). The patients had more lacunar infarcts in thalamus in MCI and VaD groups than in NCI group, but it did not reach significant difference (P = 0.058). The majority of WLMs were located in the frontal and parietal occipital lobes, and there were less lesions in the temporal lobes and basal ganglia. There were significant differences in WML score of bilateral frontal lobes (P = 0.003) and basal ganglia (P = 0.009) among three groups. Of the 59 patients, MRI oblique coronal reconstruction was performed in 43 patients. It showed that MTA almost developed synchronously in both sides, and there were statistically significant differences in left and right MTA scores among three groups (both P < 0.001). In 13 patients whose left MTA scores were ≥2, 11 patients were in NCI and MCI groups. All the patients in VaD group had MTA, and the average left and right MTA scores of 6 patients were ≥2. The result of multivariate analysis showed that the number of subcortical WML [odds ratio: 2.39 (95% confidence interval: 1.19-5.80), P = 0.005] and the left MTA score [odds ratio: 10.21 (95% confidence interval: 2.02-51.75), P = 0.003] were the independent risk factors of cognitive impairment of patients with CSVD. Conclusion: The degree of cognitive impairment in patients with CSVD is associated with the number of subcortical WML and left MTA score.
    • Review
  • Advances in severe hemorrhagic transformation after intravenous thrombolysis with recombinant tissue plasminogen activator for acute brain infarction
    WANG Qinying, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 25-31. https://doi.org/10.12022/jnnr.2017-0003
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Severe hemorrhagic transformation is a most dangerous complication during thrombolytic therapy for acute ischemic stroke. This paper summarizes the definition, clinical manifestations, imaging characteristics, and the related risk factors of thrombolysis-associated severe hemorrhagic transformation. In acute ischemic stroke patients with high risk of severe hemorrhagic transformation, thrombolytic therapy with a low dose of recombinant tissue plasminogen activator (rtPA) may reduce the risk of symptomatic intracerebral hemorrhage.
  • Progress in research on association of cognitive reserve with disease-related cognitive disorders
    JIANG Wenfei, GAO Penglin, SUN Chuanghe, LIAO Weilong, PAN Weidong
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 32-39. https://doi.org/10.12022/jnnr.2017-0002
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Cognitive reserve (CR) might be thought as an ability which can delay the occurrence and development of cognitive disorders. Although CR is not a symptom or an independent disease, it can help to understand the differences in cognitive function decline during the development process of different diseases. CR may have certain effects on the occurrence and development of some disease-related cognition functions and symptoms, such as memory loss, mild cognitive impairment, Alzheimer’s disease, Parkinson’s disease and multiple sclerosis; at the same time, it also has effects on the occurrence and development of cognitive dysfunction in hepatitis C, obesity, sleep disorders and brain trauma. Traditional Chinese medicine (TCM), especially with the effect of tonifying the liver and kidney, can improve the cognitive functions caused by various reasons, but it has not yet been introduced into the intervention for CR. In this paper, the relationship between CR and cognitive functions related to various diseases is reviewed and discussed.
  • Advances in music therapy and cognitive rehabilitation in patients with stroke
    WU Donghuan, FENG Jiayi, GU Yaping, ZHANG Yanwen, CAO Feng
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 40-43. https://doi.org/10.12022/jnnr.2017-0005
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    In recent years, with the continuous improvement of the level of medical technology, the mortality of stroke has decreased with years. However, the prevalence rate and disability rate of stroke have increased. Cognitive dysfunction after stroke is one of the common complications of stroke, and the cognitive dysfunction significantly affects the prognosis of stroke. Music therapy is one of the new techniques of rehabilitation therapy. It aims to regulate the nerve excitability and the inner circulation of the human body by music, so as to help the recovery of cognitive function. In this paper, the mechanism of music affecting cognitive function, the development of music therapy in china and abroad, the clinical application of music therapy in the rehabilitation of stroke patients and the existing problems are reviewed.
  • Advances in application of rehabilitation robots for upper limb dysfunction in patients with stroke
    GU Teng, LI Chuanjiang, ZHAN Qing
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 44-50. https://doi.org/10.12022/jnnr.2016-0060
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Motor dysfunction after stroke is a major problem for neurologists, and it is of important clinical significance that the stroke patients with upper limb dysfunction should need rehabilitation treatment, while the upper limb rehabilitation robots are important tools to solve this problem. This paper introduces the structures of ontology of upper limb rehabilitation robots, human-computer interaction technology of rehabilitation robots based on biological signals including myoelectric signal and electroencephalogram, the control system of rehabilitation robot technology based on the position and force, and the evaluation methods for the efficacy of upper limb rehabilitation training, in order to explore the developing prospects of upper limb rehabilitation robots.
    • Case Report
  • Empty sella secondary to cerebral venous sinus thrombosis: two case reports and literature review
    YAO Xiaoying, DAI Ruolian, GUAN Yangtai
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 51-57. https://doi.org/10.12022/jnnr.2016-0064
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    Objective: Empty sella has been defined as the herniation of the subarachnoid space into the sella turcica through the defected sellar diaphragm. Primary empty sella (PES) is not related to any known previous diseases of pituitary gland, but is considered to be caused by increased intracranial pressure (ICP), in association with defects of the sellar diaphragm. This case report aims to report the empty sella induced by chronic ICP. Methods: Two cases of empty sella related to chronic intracranial hypertension caused by cerebral venous sinus thrombosis (CVST) were reported. Results: In the present two cases, headache was the main clinical symptom; increased ICP was revealed by lumbar puncture; head magnetic resonance venography (MRV) showed the filling defects of the venous sinuses which implied CVST. The headache in the two cases was relieved gradually after the anticoagulant therapy. The degree of empty sella was aggravated on the head magnetic resonance imaging (MRI) images in one case during follow-up; in another case, the empty sella appeared during follow-up. Conclusion: The empty sella can be caused and aggravated by chronic ICP.
    • Teaching Research
  • Job fitness and interprofessional education in teaching of clinical neurology
    ZHAN Qing, YU Min, SHEN Jiankang, ZHAO Jiangmin
    Journal of Neurology and Neurorehabilitation. 2017, 13(1): 58-60. https://doi.org/10.12022/jnnr.2017-0006
    Abstract ( ) Download PDF ( )   Knowledge map   Save
    Starting from the interprofessional education pattern and the present situation of clinical teaching of modern neurology, this paper discusses the new mode of clinical teaching of neurology with competency-oriented. With the interprofessional teaching mode and early organ-based integrated teaching mode, a new teaching mode which is interprofessional, integrated and comprehensive is put forward, in order to develop the ability of practical skills, communication skills and teamwork ability, helping to develop clinicians of neurology with professional skills and morality in line with the requirements of modern social development.
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