Neuromodulatory effects of high-definition theta transcranial alternating current stimulation on the parietal cortex: a pilot study of healthy males.

Introduction: Transcranial alternating current stimulation (tACS) can regulate brain functions by modulating endogenous brain rhythms. Theta-band neural oscillations are associated with memory function. In particular, theta neural oscillatory power evoked in the parietal cortex is closely related to memory retrieval processes. In this study, the immediate effects of high-definition theta transcranial alternating current stimulation (HDθ-tACS) on the human left parietal cortex were investigated using short-latency afferent inhibition (SAI) and electroencephalography (EEG). Methods: Ten subjects participated in this study. We used 6-Hz HD tACS to stimulate the left parietal cortex for 15 min. SAI was calculated, and non-linear dynamic analysis of the EEG was performed to analyze neuronal function after HD θ-tACS. Results: The results showed a significant decrease in SAI (p < 0.05), while the left frontoparietal network was reinforced, leading to brain lateralization after HD θ-tACS. During performance of a memory task, F3 signals showed a significant upward trend in approximate entropy following treatment (p < 0.05). There was also a significant decrease in cross-approximate entropy in the C3-C4 and P3-P4 connections following the intervention (p < 0.05) in a resting eyes-open condition and in the memory task condition. Discussion: In conclusion, HD θ-tACS could alter cholinergic transmission and cortical excitability between the parietal and motor cortices, as well as reinforcing the frontoparietal network and the left-lateralization phenomenon, which may facilitate memory formation, encoding, and consolidation.

Exploring the Therapeutic Effects and Mechanisms of Transcranial Alternating Current Stimulation on Improving Walking Ability in Stroke Patients via Modulating Cerebellar Gamma Frequency Band-a Narrative Review.

The cerebellum plays an important role in maintaining balance, posture control, muscle tone, and lower limb coordination in healthy individuals and stroke patients. At the same time, the relationship between cerebellum and motor learning has been widely concerned in recent years. Due to the relatively intact structure preservation and high plasticity after supratentorial stroke, non-invasive neuromodulation targeting the cerebellum is increasingly used to treat abnormal gait in stroke patients. The gamma frequency of transcranial alternating current stimulation (tACS) is commonly used to improve motor learning. It is an essential endogenous EEG oscillation in the gamma range during the swing phase, and rhythmic movement changes in the gait cycle. However, the effect of cerebellar tACS in the gamma frequency band on balance and walking after stroke remains unknown and requires further investigation.

[Applying Multiple Strategies to Enhance the Completion Rate of Critical Care in COVID-19 Patients].

BACKGROUND & PROBLEMS: Taiwan entered the community transmission stage of COVID-19 in May 2021, with numbers of locally confirmed cases and critical cases increasing sharply. Medical institutions deployed special units to treat patients. In our hospital, a special COVID-19 intensive care units staffed with nursing personnel across various specialties was established. The rate of COVID-19 critical care completion among nurses in this unit was 79.1%. The reasons for non-completion were found to include limited intensive care standards for COVID-19; inadequate training, teaching aids, and practice manuals; and the overwhelming amount of new COVID-19-related information and updates. PURPOSE: The aim of this project was to increase the team's COVID-19 critical care completion rate from 79.1% to 93.5%. RESOLUTIONS: Multiple strategies were implemented, including: (1) providing online education and training, (2) establishing a platform for sharing COVID-19-related updates, (3) creating a QR-code accessible COVID-19 reference database, (4) creating a COVID-19 practice manual, and (5) providing simulation training sessions on wearing personal protective equipment during critical care. RESULTS: The critical-care completion rate for patients with COVID-19 infection increased significantly in this unit from 79.1% to 98.2%, which exceeded the project goal. CONCLUSIONS: Implementing a multi-strategy intervention that includes both online and simulation training may be effective in improving the critical care completion rate for patients with COVID-19 infection.

Drug Therapy for Behavioral and Psychological Symptoms of Dementia.

Dementia, which can be induced by diverse factors, is a clinical syndrome characterized by the decline of cognitive function. Behavioral and psychological symptoms of dementia (BPSD) include depression, agitation, and aggression. Dementia causes a heavy burden on patients and their caregivers. Patients with BPSD should be assessed comprehensively by practitioners and offered appropriate non-pharmacologic and pharmacologic therapy. Nonpharmacologic therapy has been recommended as the basal treatment for BPSD; however, pharmacologic therapy is required under many situations. Medications, including antipsychotic agents, antidepressants, sedative and hypnotic agents, mood stabilizers, cholinesterase inhibitors, and amantadine, are extensively used in clinical practice. We have reviewed the progression of pharmacologic therapy for BPSD.