As the most abundant excitatory neurotransmitter in the central nervous system, glutamate has been accepted to play a major role in the pathophysiology of migraine. The previous studies have reported the glutamate receptor ionotropic GRIA1 and GRIA3 genes variants associated with migraine. The project aims to investigate the polymorphisms in both genes for their association with migraine in the Chinese Han population. A Han-Chinese case-control population, including 331 unrelated female migraine patients and 330 matched controls, was studied. Variants in genes (GRIA1 and GRIA3) were genotyped by Multiplex SNaPshot assay. In the group of patients, the frequency of allele C was 84.1 % (557 C alleles) and allele T was 15.9 % (105 T alleles) for the GRIA1 (rs2195450) in migraineurs, this was significantly as compared with the controls (P = .001, OR = 1.786, 95 % CI: 1.28–2.49). And an association was also seen in the migraine with aura (MA) subtype (P = .012, OR = 2.092, 95 % CI: 1.17–3.76) and migraine without aura (MO) subtype (P = .002, OR = 1.737, 95 % CI: 1.23–2.45). However, no evidence was found that GRIA1 (rs548294) or GRIA3 (rs3761555) is associated with migraine. Our data of this study confirmed the association of GRIA1 (rs2195450) to female migraine (MA, MO) susceptibility in the Chinese Han population. The result provides evidence that the glutamatergic system is implicated in the pathophysiology of migraine.

Rationale: Osmotic demyelination syndrome (ODS) is a noninflammatory demyelinating disorder involving the pontis and other regions of the central nervous system. This article tries to enhance the understanding of ODS. Combined with clinical features, we use laboratory/imaging examination and literature review. Patient concerns: We report on 4 ODS cases and review the different etiologies, clinical manifestations, and possible pathophysiology. Diagnoses: We provide an update on the diagnosis and treatment of ODS, with a special focus on the prevention of ODS. Interventions: We corrected the hyponatremia appropriately and treated complications. Outcomes: The development of ODS is by association with a variety of clinical conditions. Also, the prognosis of ODS is heterogeneous, ranging from complete recovery to vegetative state, even death. However, there is no specific effective treatment, thus, it is more important to recognize the path mechanism of ODS and to avoid its occurrence. Lessons: It is essential to reduce the risk of suffering this potentially devastating disease through an appropriate rate of hyponatremia correction and the treatment of comorbid clinical conditions.

To investigate the clinical features, treatment, and outcomes in cerebral infarction (CI) patients with Sjögrens syndrome (pSS) for novel disease management strategies. A total of 27 patients diagnosed with CI with pSS were divided into the treatment group (12 patients) and non-treatment group (15 patients) according to whether they were treated for pSS in the acute and secondary prevention stage of CI. The related clinicopathological information including age, gender, medical history, experimental data, clinical manifestations, imaging data, treatment, functional recovery and recurrences were retrospectively analyzed. The clinical manifestations of 27 CI patients with pSS varied widely. There were also no significant differences in age, gender, traditional high-risk factors of CI, previous history, experimental data, and short-term nerve functional recovery between the two groups (p > 0.05). After 1 year of treatment, timely treatment of pSS can significantly improve the prognosis, the favorable prognosis (modified Rankin scale ≤ 2) of the treatment and non-treatment groups were 83.3% and 40.0% respectively. The recurrence rate of CI was 0% in the treatment group but 33.3% in the non-treatment group. Compared to the no treatment group. The odds of achieving a favorable prognosis in the treatment group were 7.5 times higher than in the non-treatment group (OR = 7.5, 95% CI: 1.195–47.1). the adjusted odds ratio was 0.113 (95% CI: 0.002–1.214). This indicates an 89% reduction in recurrence odds with treatment. PSS screening is necessary for CI patients. Moreover, prompt pSS treatment administered during the acute and secondary prevention stage of CI with pSS can promote neurologic functional independence and reduce the risk of CI recurrent.