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Transcranial direct current stimulation (tDCS), as an emerging non⁃invasive neuromodulation technology, has high safety and provides a choice for intractable epilepsy patients without surgical indications or unable to benefit from surgical treatment. Among them, negative electrode tDCS can reduce epileptic discharge and seizure frequency by inhibiting abnormal cortical excitation in epilepsy patients, restoring the balance of brain functional network. However, due to the heterogeneity among the results of various studies, its application in the treatment of epilepsy still needs further exploration. This article reviews the principle of tDCS, its potential mechanism in the treatment of epilepsy and its clinical application in intractable epilepsy in the past three years, providing evidence for the potential and safety of tDCS in the clinical treatment of intractable epilepsy.

Background DSA is an irreplaceable diagnostic method for cerebral vascular disease. It is sensitive to intracranial macrovascular disease, but not to distal blood perfusion. In order to quantitatively assess the perfusion area of the feeding artery, this study is the first to propose an imaging method of the internal carotid artery (ICA) perfusion area relying on deconvolution algorithm and cross⁃correlation (CC) algorithm. Methods Four patients with cerebral vascular disease and 2 healthy subjects who underwent DSA examination in Luwan Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from June 2020 to May 2021 were enrolled. The arterial input function (AIF) of the ICA was extracted, and a deconvolution algorithm was used to calculate the time to peak (Tmax) for each pixel. Then the CC algorithm was used to obtain the CC map related to the perfusion of the ICA at each pixel point of the whole brain. Area of interest (ROI) of AIF were randomly selected for 2 healthy subjects, calculated the root mean square error (RMSE) of the CC map for reliability analysis. The CC map was drawn for 4 patients with cerebral vascular disease for validity analysis. Results Reliability analysis showed that the RMSE values of Towne's and lateral views of the CC map and Tmax map of the left and right ICA in a healthy subject were 0.008±0.011, 0.022±0.002, 0.015±0.007, 0.004±0.008, and (0.108±0.181) s, (0.181±0.214) s, (0.301±0.230) s, (0.035±0.092) s; another healthy subject were 0.015±0.023, 0.007±0.011, 0.007±0.011, 0.005±0.012, and (0.172±0.275) s, (0.092±0.174) s, (0.087±0.156) s, (0.079±0.153) s. The averaged RMSE value of Tmax map was lower than the temporal resolution of DSA, indicating that the reliability of the CC map of the AIF value box in different ROIs of the ICA was high. Validity analysis showed that the CC map and Tmax map of the patient with acute ischemic stroke treated by intravenous thrombolysis bridging to mechanical thrombectomy can fully display the perfusion changes of the ICA after successful thrombectomy. Postoperative DSA in the patient with subacute ischemic stroke after endovascular therapy showed recanalization of the occluded artery, while the CC map showed no significant change in the perfusion of the ICA. The DSA of the patient with middle cerebral artery (MCA) stenosis without related ischemic events showed severe MCA stenosis, but the CC map showed that the ICA was well perfused, and no endovascular treatment was required. The DSA of the patient with acute ischemic stroke without MCA stenosis showed no MCA stenosis, but only sparse ICA⁃related perfusion was seen on the CC map. Conclusions The CC map and Tmax map based on DSA images have good reliability in different ROIs of AIF. The CC map can provide quantitative information on the perfusion area of the feeding arteries, which is helpful for accurate diagnosis and appropriate treatment decisions.

Alzheimer's disease (AD) is one of most common neurodegenerative diseases, which gradually begins and develops after 65 years old, presenting as progressive and irreversible memory loss and other cognitive decline, and finally causes dementia and disability. Therefore, early diagnosis, timely treatment and effective prevention of AD have been become important clinical and scientific problems. During the period of Twelfth Five-Year Plan for National Economic and Social Development, our team have engaged in AD diagnosis and treatment for a long time and carried out studies in the field of pathogenesis, epidemiology, screening of risk factors, neuropsychological tests, imaging, biomarkers and early intervention of AD. This paper has summarized these research achievements. [ABSTRACT FROM AUTHOR]

This article summarizes the clinical research highlights of Alzheimer's disease and other dementias in 2013. It includes epidemiology, risk factors, diagnostic biomarkers and therapy of these disorders. [ABSTRACT FROM AUTHOR]

Background/Aims: As a suitable test to screen for Alzheimer's disease (AD) or mild cognitive impairment (MCI), studies to validate the Chinese version of Addenbrooke's Cognitive Examination-Revised (ACE-R) are rare. Methods: A total of 151 subjects were recruited and the neuropsychological assessments were employed. One-way analysis of variance and Bonferroni correction were used to compare scores of different psychometric scales. Intraclass correlation coefficient (ICC) and Cronbach's coefficient α were used to evaluate the reliability of psychometric scales. The validity of ACE-R to screen for mild AD and amnestic subtype of MCI (a-MCI) was assessed by receiver operating characteristic (ROC) curves. Results: The Chinese ACE-R had good reliability (inter-rater ICC = 0.994; test-retest ICC = 0.967) as well as reliable internal consistency (Cronbach's coefficient α = 0.859). With its cutoff of 67/68, the sensitivity (0.920) and specificity (0.857) were lower than for the Mini-Mental State Examination (MMSE) cutoff (sensitivity 1.000 and specificity 0.937) to screen for mild AD. However, the sensitivity of ACE-R to screen for a-MCI was superior to the MMSE with a cutoff of 85/86. The specificity of ACE-R was lower than that of the MMSE to screen for a-MCI. The area under the ROC curve of ACE-R was much larger than that of the MMSE (0.836 and 0.751) for detecting a-MCI rather than mild AD. Conclusion: The Chinese ACE-R is a reliable assessment tool for cognitive impairment. It is more sensitive and accurate in screening for a-MCI rather than for AD compared to the MMSE. © 2013 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The article presents a study on the GRB2-associated binding protein 2 (GAB2) as a risk factor for the development of Alzheimer's disease (AD) in the Chinese population. A case-control study was used to determine the prevalence of five single nucleotide polymorphisms (SNPs) of GAB2 gene and to investigate the risk factor for AD. The study concludes that the implications of the three SNPs with an association at SNP rs7101429 C allele might increase the risk factor for AD.

T-wave alternans (TWA) is a potent arrhythmia substrate under the conditions of acute myocardial ischemia. Abnormal intracellular calcium cycling contributes to the genesis of cardiac alternans. Ryanodine receptor (RyR) is a pivotal Ca 2+ cycling protein central to Ca 2+ signaling in the heart. Here, we investigated the potential role of RyR in cardiac alternans and ventricular arrhythmias in acute myocardial ischemia. Transmembrane action potentials were simultaneously recorded from epicardium and endocardium together with a transmural ECG and isometric contraction force in the arterially perfused left ventricular wedge preparations. Calcium alternans were induced by incremental frequency of field stimulation in rat ventricular myocytes. TWA, mechanical alternans and ventricular arrhythmias were reproducibly induced by rapid pacing in the acute ischemic wedge preparations. Compared with control group, calcium alternans ratio and spontaneous calcium release were increased in acute ischemic myocytes. Verapamil, a phenylalkylamine calcium channel blocker, can successfully abolish spontaneous calcium release, TWA, and ventricular arrhythmias. The inhibition effect of verapamil could be diminished by low concentration of ryanodine (10 nmol/L). However, nifedipine, a dihydropyridine calcium channel blocker, could not block TWA or arrhythmias. Moreover, verapamil, but not nifedipine, significantly decreased ROS production in ischemic myocytes. Collectively, our results indicate that verapamil can significantly inhibit the development of cardiac alternans and ventricular arrhythmias in acute myocardial ischemia, and the mechanism was related to the inhibition of RyR and the protective function to oxidative stress., Competing Interests: None.

Background: Transthyretin-related hereditary amyloidosis is an autosomal dominant inherited disease caused by mutations in the transthyretin (TTR) gene. Corresponding to the various transthyretin gene mutations and a wide range of geographical distribution, transthyretin-related hereditary amyloidosis presents diverse characteristics in genotype-phenotype correlation., Objective/method: Here, we identify the clinical characteristics of a Chinese family affected by transthyretin-related hereditary amyloidosis with TTR Tyr114Cys mutation., Results/conclusion: The pathogenic mechanism studies showed that the protein encoded by TTR Tyr114Cys is more easily depolymerized to form amyloid fibrils. Moreover, the cytotoxicity of the TTR Tyr114Cys may be attributed to its ability to persistently activate the extracellular-signal-regulated kinase 1/2 pathway., (Copyright © 2010 S. Karger AG, Basel.)