Helena Nunes CostaAna Raquel EstevesNuno EmpadinhasSandra Morais Cardoso...
113-124页
查看更多>>摘要：The way sporadic Parkinson's disease(PD)is perceived has undergone drastic changes in recent decades.For a long time,PD was considered a brain disease charac-terized by motor disturbances;however,the identification of several risk factors and the hypothesis that PD has a gastro-intestinal onset have shed additional light.Today,after rec-ognition of prodromal non-motor symptoms and the patho-logical processes driving their evolution,there is a greater understanding of the involvement of other organ systems.For this reason,PD is increasingly seen as a multiorgan and multisystemic pathology that arises from the interaction of susceptible genetic factors with a challenging environment during aging-related decline.
查看更多>>摘要：Accurate self-motion perception,which is criti-cal for organisms to survive,is a process involving multi-ple sensory cues.The two most powerful cues are visual(optic flow)and vestibular(inertial motion).Psychophysical studies have indicated that humans and nonhuman primates integrate the two cues to improve the estimation of self-motion direction,often in a statistically Bayesian-optimal way.In the last decade,single-unit recordings in awake,behaving animals have provided valuable neurophysiologi-cal data with a high spatial and temporal resolution,giving insight into possible neural mechanisms underlying multi-sensory self-motion perception.Here,we review these find-ings,along with new evidence from the most recent studies focusing on the temporal dynamics of signals in different modalities.We show that,in light of new data,conventional thoughts about the cortical mechanisms underlying visuo-vestibular integration for linear self-motion are challenged.We propose that different temporal component signals may mediate different functions,a possibility that requires future studies.
查看更多>>摘要：Major advances have been made over the past few decades in identifying and managing disorders of con-sciousness(DOC)in patients with acquired brain injury(ABI),bringing the transformation from a conceptualized definition to a complex clinical scenario worthy of scientific exploration.Given the continuously-evolving framework of precision medicine that integrates valuable behavioral assessment tools,sophisticated neuroimaging,and electro-physiological techniques,a considerably higher diagnostic accuracy rate of DOC may now be reached.During the treat-ment of patients with DOC,a variety of intervention meth-ods are available,including amantadine and transcranial direct current stimulation,which have both provided classⅡ evidence,zolpidem,which is also of high quality,and non-invasive stimulation,which appears to be more encour-aging than pharmacological therapy.However,heterogene-ity is profoundly ingrained in study designs,and only rare schemes have been recommended by authoritative institu-tions.There is still a lack of an effective clinical protocol for managing patients with DOC following ABI.To advance future clinical studies on DOC,we present a comprehensive review of the progress in clinical identification and manage-ment as well as some challenges in the pathophysiology of DOC.We propose a preliminary clinical decision protocol,which could serve as an ideal reference tool for many medi-cal institutions.
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