Objective
To assess abnormal default mode network (DMN) and its potential mechanisms in insomnia patients with varying depression symptom via resting state functional magnetic resonance imaging (fMRI).
Methods
We recruited 15 cases of primary insomnia (PI) without depression symptom, 40 cases of insomnia patients with varying depressions, including mild depression (n=20) and moderate depression (n=20), and 40 cases of healthy controls (HC) with age and gender matched. We set bilateral posterior cingulate cortex and precuneus (PCC/PC) as seed regions, and compared the DMN changes between HC group and PI with depression symptoms group. We then compared the DMN changes between PI with mild and moderate depression groups. Finally, we extracted right cingulate cortex and parahippocampal signals and made Pearson correlation coefficient analysis with the Hamilton Depression Scale (HAMD) scores.
Results
The connectivity of PI with depression symptoms group was increased in brain regions including bilateral precuneus, left middle occipital gyrus, superior parietal lobe, superior frontal lobe, and was decreased in brain regions including left anterior cingulate cortex, compared with HC group. Compared with PI without depression symptoms group, the connectivity of PI with mild depression symptoms group was decreased in brain regions including bilateral middle frontal gyrus, right middle occipital gyrus/precuneus, and was not increased in brain regions in insomnia with mild group. Compared with PI with mild depression symptoms group, the connectivity of PI with moderate depression symptoms group was increased in brain regions including right cerebellum posterior lobe, middle cingulate cortex, left insular lobe/inferior frontal lobe, extra nuclear and inferior parietal lobe, and was decreased in brain regions in insomnia with moderate depression symptoms group including left superior temporal lobe and right parahippocampal gyrus. Pearson correlation coefficient analysis showed significant correlation between signals of right parahippocampal gyrus and HAMD scores (r=-0.697, P=0.006), while not between signals of right middle cingulate cortex and HAMD scores (r=0.224, P=0.441).
Conclusions
There were abnormal DMN in PI with depression symptoms group, and in PI with varying degrees of depression symptoms groups. Our results revealed specified brain regions of cognitive dysfunction and neural pathological mechanisms which were affected by PI with depression symptom.
Key words:
Sleep initiation and maintenance disorders; Depression; Nerve net; Magnetic resonance imaging
Objective To explore clinical significance in patients with acute myocardial infarction with or without ST segment depression. Methods A total of 65 AMI patients were enrolled in this study. Among them,29 patients were suffered from AMI with depression of ST seg-ment,and 36 were AMI without depression of ST segment. The number of impaired branches of coronary artery in these two groups had been com-pared. Levels of cardiac troponin I( cTnI) and creatine kinase-MB( CK-MB),erythrocyte sedimentation rate( ESR),and C-reactive protein( CRP) were also compared. Results AMI patients with STD were displayed more severe in impairment of coronary artery and more stronger in-flammatory reaction with higher serum levels of cTnI,CK-MB,ESR and CRP than those of patients without depression of ST segment. Conclu-sion AMI patients with STD were more likely to suffer from severe myocardium damage and more attention should be paid to this situation.
Data on the impact of metabolic syndrome (MetS) and systemic inflammation on endothelial function remains scarce. In this study, we aimed to investigate the combined effects of MetS and systemic inflammation on endothelial function in postmenopausal women.We identified 423 postmenopausal women from February 2019 through July 2020. MetS was diagnosed according to the International Diabetes Federation (IDF) criteria, and high sensitivity C-reaction protein (hs-CRP) was measured to assess the degree of underlying inflammation. The measurement of endothelial function was using digital arterial tonometry by assessing reactive hyperemia-induced vasodilation in one arm and adjusting for changes in the contralateral arm (reactive hyperemia index, RHI).There were 156 patients with MetS and 267 without MetS. Compared to the group without MetS, patients with MetS had significantly lower natural logarithmic RHI (0.66±0.29 versus 0.91±0.31; p<0.001), but higher levels of hs-CRP (0.98 [0.31, 3.54] versus 0.53 [0.20, 2.14]; p<0.001). In sequential multivariable analysis, the presence of hs-CRP (ΔR2=0.047, p=0.004) had a significant and independent influence on natural logarithmic RHI. Furthermore, the interaction of hs-CRP*MetS was synergistically associated with endothelial dysfunction even in the fully adjusted model (β=-0.107, 95% CI [-0.161~-0.053], p=0.009).MetS and systemic inflammation are synergistically associated with endothelial dysfunction in postmenopausal women. Postmenopausal women with both these conditions appear to be at a significantly higher risk for adverse cardiovascular events.
Preexcitation cardiomyopathy is a rare cardiac anomaly but it can be life threatening. It may occur in type B preexcitation syndrome. A patients with this condition typically has an enlarged left ventricle and reduced systolic function without tachycardia-associated cardiomyopathy. Echocardiography plays an important role in diagnosis in identifying this condition by revealing the "rebounce" movement of the inter-ventricular septum (IVS). We report echocardiographic findings of five pediatric patients with preexcitation cardiomyopathy. All of them had a radiofrequency catheter ablation (RFCA) and recovered during the follow-up.
Abernethy malformation, also known as congenital extrahepatic shunt, is a rare anomaly, which is characterized by partial or complete diversion of the portal blood into the systemic venous circulation. The clinical manifestations of Abernethy malformation during childhood include neonatal cholestasis, failure to thrive, mental retardation, and other congenital defects. We report a case of Abernethy malformation Type II in a 9-year-old boy, whose left ventricle was slightly enlarged because of several major aortopulmonary collateral arteries (MAPCAs) but laboratory examinations were normal 5 years earlier. The characteristics of congenital heart disease in patients with Abernethy malformation are discussed. We propose that physicians should be aware of the possibility of Abernethy malformation in children with enlargement of the left ventricular due to systemic-pulmonary collateral circulation.
Background: Hypertrophic cardiomyopathy (HCM) is a clinically heterogeneous disease with a diverse prognosis. Recent studies suggest that inflammatory response may play a significant role in the ph...
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