The neural effects of acupuncture for stroke: a protocol for systematic review and meta-analysis based on fMRI.

Background: Stroke is one of the most common causes of death and is the main cause of persistent and acquired disability in adults worldwide. Acupuncture is recommended by the World Health Organization as an alternative and complementary strategy for stroke treatment. However, the mechanism of the neural effects of acupuncture on stroke is still lacking a uniform conclusion. The purpose of this study is to clarify the neural effects of acupuncture for stroke from the perspective of neuroimaging. Methods: Seven databases, including PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Data, and Chinese Biomedical Database, will be searched comprehensively according to the search strategy. All of them will be retrieved from the date of database establishment to December 31, 2023. All randomized controlled trials and observational studies will be considered for inclusion. The risk of bias will be assessed by the Cochrane Risk of Bias tool. Functional imaging of the whole brain in the resting functional state will be the primary outcome. A meta-analysis of primary outcome will be performed using Seed-based D Mapping with Permutation of Subject Images software. The data will be synthesized using a random effects model. Meta-analysis of other clinical data will be performed using RevMan 5.3 software. Publication bias will be assessed through funnel plots. Reports will adhere to the Preferred Reporting Items for Systematic Review and Meta-Analysis. Conclusion: This study will aggregate the results of independent studies to provide overall evidence for the neural effects of acupuncture for stroke. Clinical Trial Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=500306, Identifier CRD42024500306.

Neural effects of acupuncture on stroke patients with motor dysfunction: an activation likelihood estimation meta-analysis.

Background: Functional magnetic resonance imaging has been used in many studies to explore the neural mechanism of acupuncture in patients with post-stroke motor dysfunction. Inconsistent results have been found in these studies, however. This activation likelihood estimation (ALE) meta-analysis was designed to quantitatively integrate changes in brain activity and the neurological effects of acupuncture on patients with motor dysfunction after stroke. Methods: We searched PubMed, Embase, Web of Science, the Cochrane Library, China Science and Technology Journal Database, the China Biology Medicine, the China National Knowledge Infrastructure, and Wanfang Data Knowledge Service Platform for literature from the establishment of the database until March 21, 2024. Research papers were selected, data extracted, and quality assessment was done independently by two researchers. The GingerALE software was used for meta-analysis, and Jackknife sensitivity analysis was employed to assess result robustness. Results: We ended up analyzing 14 studies that included 235 patients and 100 healthy people. ALE meta-analysis showed that Compared with healthy people, the enhanced brain region in poststroke patients with motor dysfunction was located in the left posterior lobe of the cerebellum, the left inferior frontal gyrus, and the left precuneus (p < 0.001). After acupuncture, the activated regions were mainly located in the left posterior lobe of the cerebellum, the right lentiform nucleus putamen, the right medial frontal gyrus, the right inferior frontal gyrus, the left precuneus, the right middle temporal gyrus, the left claustrum, the left cerebellar tonsil, the right superior marginal gyrus, the inactivated area is located in the right medial frontal gyrus the left precentral gyrus and the right precuneus (p < 0.001). Conclusion: Acupuncture can reestablish motor function by causing extensive changes in the brain function of patients with stroke, which may be the neurological effect of acupuncture therapy on stroke patients. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42024526263.

Efficacy of electrical stimulation for post-stroke motor dysfunction: A protocol for systematic review and network meta-analysis.

OBJECTIVE: This study aims to analyze the efficacy and safety of different electrical stimulation treatments for post-stroke motor dysfunction, and to quantitatively analyze the advantages between them and their possible benefits for patients. METHODS: We will systematically search seven databases. All of them will be retrieved from inception to 15, April 2024. Two reviewers will evaluation the risk of bias in all included studies with the version 2 of the Cochrane risk-of-bias assessment tool. Data synthesis will be performed using a random-effects model of network meta-analysis to compare the efficacy and safety of different electrical stimulation therapies. The surface under the cumulative ranking curve was used to indicate the possibility of the pros and cons of the intervention. The strength of evidence will be assessed by the Grading of Recommendations, Assessment, Development, and Evaluation framework. DISCUSSION: This study will provide evidence that electrical stimulation therapy can effectively improve motor function in stroke patients and will also provide some valuable references for clinical decision-making and treatment guidelines. TRIAL REGISTRATION: PROSPERO registration number: CRD42023459102.

Autophagy­regulating miRNAs: Novel therapeutic targets for Parkinson's disease (Review).

Parkinson's disease (PD) is a neurodegenerative disorder that has a high incidence during the aging process and is characterized by the loss of dopaminergic neurons in the substantia nigra, leading to motor dysfunctions and non­motor symptoms. Impaired clearance and excessive accumulation of aberrantly modified proteins or damaged organelles, such as aggregated α­synuclein and dysfunctional mitochondria, are regarded as the main causes of nigrostriatal neurodegeneration. As one of the major degradation pathways, autophagy can recycle these useless or toxic substances to maintain cellular homeostasis and it plays a crucial role in PD progression. MicroRNAs (miRNAs) are a group of small non­coding RNA molecules that regulate gene expression by silencing targeted mRNAs. Recent studies have illustrated that autophagy­regulating miRNA has been implicated in pathological processes of PD, including α­synuclein accumulation, mitochondrial damage, neuroinflammation and neuronal apoptosis, which suggests that targeting autophagy­regulating miRNAs may provide novel therapeutic strategies for this disease. The present review summarizes the role of autophagy in PD and emphasizes the role of miRNA­mediated autophagy in PD, for the development of promising interventions in this disease.