Effect of acupuncture on learning and memory ability and hippocampal Ngb expression in rats with vascular cognitive impairment / 国际中医中药杂志

Objective:To discuss the effect of acupuncture on learning and memory ability and the expression of neuroglobin (Ngb) of the hippocampus of vascular cognitive impaired (VCI) rats.Methods:VCI rats model was established by repeated ligation of the carotid arteries of the two sides to induce ischemia-reperfusion injury. The successful modeled rats were divided into acupuncture group and a model group according to the random number table method, with 12 rats in each group, and 12 rats were selected as the normal group. The rats in the acupuncture group received acupuncture at "Baihui", "Fengfu" and "Yongquan", 10 times as a course of treatment, a total of 3 courses, and stop acupuncture treatment for 2 days during the courses of treatment. Neurobehavioral scores were measured on the 3rd day after the intervention. Morris water maze was conducted to detect the learning and memory ability of the rats in each group, and Western blot was used to detect the expression of Ngb in the hippocampus of the rats.Results:Compared with the model group, the behavioral score of the acupuncture group decreased after intervention ( P<0.05), the escape latency was significantly shortened ( P<0.05), the number of crossing platforms was increased ( P<0.05), and the hippocampal Ngb (1.18±0.06 vs.0.98±0.04) was significantly increased ( P<0.05). Conclusion:Acupuncture at "Baihui", "Fengfu" and "Yongquan" could promote the expression of Ngb in the hippocampus of rats and improve the learning and memory ability of VCI rats.

Dosimetry and Clinical Efficacy of Transcranial Photobiomodulation for Major Depression Disorder: Could they Guide Dosimetry for Alzheimer's Disease?

BACKGROUND: Major depressive disorder (MDD) is prevalent and has significant impact on individuals and society. Cognitive symptoms are frequent in MDD and insufficiently treated by antidepressant medications. Transcranial photobiomodulation (t-PBM) is a novel device therapy which shows promise as an antidepressant and pro-cognitive treatment. To date, despite the encouraging results, the optimal stimulation parameters of t-PBM to treat MDD are not established, and clinical studies are very heterogeneous in terms of these parameters. While the literature provides guidance on the appropriate fluence to achieve therapeutic results, little is known on the other parameters. OBJECTIVE: To evaluate the relationship between different parameters and the antidepressant effect of t-PBM. METHODS: We reviewed clinical studies on MDD and on depressive symptoms comorbid with other diseases. We calculated the standardized effect size of the change in symptoms severity before and after t-PBM and we performed a descriptive analysis of the reviewed papers. RESULTS: The greatest effect sizes for the antidepressant effect were found in studies using pulse-wave t-PBM with high peak irradiance (but low average irradiance) over large skin surface. One well-designed and sufficiently powered, double-blind, sham-controlled trial indicated that t-PBM with low irradiance over a small skin surface is ineffective to treat depression. CONCLUSION: The use of t-PBM for Alzheimer's disease and for dementia is still at its inception; these dosimetry lessons from the use of t-PBM for depression might serve as guidance.

Clinical study of acupuncture combined with repetitive transcranial magnetic stimulation in the treatment of cognitive impairment after traumatic brain injury / 国际中医中药杂志

Objective:To observe the efficacy of acupuncture combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of cognitive impairment after traumatic brain injury.Methods:A total of 40 patients were randomly divided into treatment group and control group with 20 cases each. The control group received routine basic therapy and cognitive function training, and the treatment group received rTMS combined with acupuncture based on the control group treatment. Both two groups were treated for 4 weeks. The MMSE, MoCA, latency and amplitude were used before and after treatment to compare the difference between the two groups.Results:The MMSE (23.60 ± 2.16 vs. 21.70 ± 2.87, t=-2.366) and MoCA (21.75 ± 3.35 vs. 19.05 ± 2.46, t=-2.903) scores in the treatment group were significantly higher than those in the control group ( P<0.05). There were no significant difference in latency and amplitude of motor evoked potential between both groups before and after treatment ( P>0.05). Conclusion:Acupuncture combined with rTMS can improve the cognitive function of patients with cognitive impairment after traumatic brain injury.

Prevalence of psychiatric disorders among older adults in Jodhpur and stakeholders perspective on responsive health system.

BACKGROUND: Ageing is an inescapable reality of human existence. The elderly population of India is steadily increasing with growing mental health needs which pose many challenges for the health care system. The aim of this study is to assess anxiety, depression, and cognitive disorders among urban and rural elderly and to explore the availability of social support mechanisms and a responsive health system for elderly. METHODS: This study is a mixed-method approach. For a quantitative study, a community-based cross-sectional survey is conducted in Jodhpur, Rajasthan. A total of 330 elderly persons aged 60 years and above are randomly screened for depression (GDS), anxiety (GAD), and cognitive impairment (HMSE). Further for a qualitative study, in-depth interviews are conducted with 7 key informants including policy and program managers, service providers, and facilitators from the state. For quantitative data analysis, Excel and SPSS are used and for Qualitative data analysis, Thematic Framework Approach is used. RESULTS: The mean age of the respondents is 67.9 ± 7.8. The prevalence of severe depression is 17%, severe anxiety is 10.3%, and cognitive impairment is 51.2%. The prevalence of all the three is more in rural elderly as compared to urban elderly as well as more in female individuals as compared to males. Qualitative analysis revealed that there are challenges in early identification of mental disorders at both the levels: service providers and elderly. Psychological and financial issues are also seen in elderly who are not supported by their children. There are cases of fear for elder abuse and influence of western culture in the society. CONCLUSION: There is a sizeable prevalence of psychological issues in elderly population. Therefore, there is a need to adopt holistic and integrated psychogeriatric services for the improvement of quality of life in elderly.

Cognitive Impairment Along the Course of Depression: Non-Pharmacological Treatment Options.

Major Depressive Disorder (MDD) is one of the most common psychiatric disorders, with a large global impact on both the individual and the society. In this narrative review, we summarize neurocognitive deficits during acute and (partially) remitted states of depression. Furthermore, we outline the potential negative effect of cognitive impairment (CI) on functional recovery, and discuss the role of several variables in the development of CI for MDD patients. Though there is cumulating evidence regarding persistent CI in unipolar depression, research on treatment options specific for this patient group is still scarce. Hence the central aim of our review is to present non-pharmacological interventions, which are thought to reduce CI in affected MDD patients. We discuss cognitive remediation therapy (CRT), physical exercise, yoga, mindfulness-based therapy, and modern neuromodulation approaches like neurostimulation and neurofeedback training. In conclusion, we propose future directions for research on CI in depression. Looking further ahead, we suggest creative interventional designs that include a direct comparison of different non-pharmacological treatment approaches on neurocognition and functional outcome of MDD. Furthermore, additive and synergistic effects of CRT with other treatment approaches should be examined and compared to create multimodal and even personalized intervention programs.

Incidence and predictors of postoperative delirium after cytoreduction surgery-hyperthermic intraperitoneal chemotherapy.

BACKGROUND: Incidence of, and baseline characteristics associated with delirium in patients after cytoreduction surgery-hyperthermic intraperitoneal chemotherapy (CRS-HIPEC), were subject of investigation. METHODS: The study was conducted among a consecutive series of prospectively included patients who underwent CRS-HIPEC at the University Medical Center Groningen, Groningen, the Netherlands, between February 2006 and January 2015. A chart-based instrument for delirium during hospitalization was used to identify patients with symptoms of delirium who were not diagnosed by a psychiatrist during admission. Uni- and multivariate logistic regression analyses were performed. RESULTS: Data of 136 patients were included in the analysis. Median age was 60 years (range: 18-76) and 50 (37%) patients were male. During hospitalization, 38 (28%) patients were diagnosed with delirium. Factors that differed significantly between the patients with and without delirium by univariate analysis were included in multivariate analysis. Multivariate analysis showed that after adjustment for age and complications other than delirium, having three or more organs resected and the CRP serum levels were independent predictors for delirium (OR: 3.97; 95% 1.24-12.76; OR: 1.01; 95% 1-1.01, respectively). CONCLUSIONS: This report shows an incidence of 28% of delirium, occurring after CRS-HIPEC and suggests a role for systemic inflammation in the development of postoperative delirium.

Correlation analysis of ApoE gene polymorphism in patients with mild cognitive impairment / 中国医师杂志

Objective To investigate the association of apolipoprotein E (ApoE) gene polymorphism in patients with mild cognitive impairment.Methods The patients aged 60-85 years were randomly selected from the outpatient,hospital or community age of Xinjiang Medical University Affiliated Hospital of traditional Chinese medicine in January 2015-June 2016,and cognitive function assessment for the patients.A total of 100 cases of mild cognitive impairment (MCI) patients were selected as case group,and 139 cases with normal cognitive function were the control group.The polymorphism of ApoE gene was analyzed in all patients.The final data were analyzed by Pearson chi square test.Results Compared to the control group,the proportion of genotype T/T in the genotype distribution of rs429358 loci was lower than that of the control group,T/C and C/C were higher than those in the control group,Allele C was a risk factor for MCI disease (OR value =2.100).The epsilon 4 allele was significantly higher than that of the control group,and the epsilon 3 allele was significantly higher than that of the control group (P ＜ 0.05).Conclusions The polymorphism of the ApoE gene is associated with the pathogenesis of MCI,in which the ApoE-E4 allele may be a risk gene for MCI.This suggests that the detection of ApoE gene polymorphism may provide useful information for the early diagnosis of MCI.

Effects of electroacupuncture on cognitive function in vascular cognitive impairment rats / 国际中医中药杂志

Objective To investigate the effect of acupuncture at Baihui (DU20) and Zusanli (ST36) acupoints on the cognitive function and the oxidation protective mechanism of cortex in vascular cognitive impairment (VCI) rats, providing experimental evidence for the clinical treatment of VCI. Methods The VCI model was established by fluorescent microemboli injection through internal carotid artery. Randomly divided into the control group (n=12), the model group (n=12), the positive drug group (n=12), the acupuncture treatment group (n=12). Two weeks after modeling, the rats in the acupuncture treatment group were stimulated for 30 minutes with daily electroacupuncture at Baihui and Zusanli acupoints. The positive drug group was treated with donepezil hydrochloride 0.5206 mg/kg orally daily for 30 days. After the treatment, the water maze test was used to test the cognitive learning ability of rats. The content of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and hydrogen peroxide (H2O2) in the cortex of rats were detected by biochemical methods. Results Compared with the model group, the number of passing through the platform (7.5 ± 1.9, 6.8 ± 2.2 vs. 3.7 ± 1.0) of acupuncture treatment group and positive drug group were significantly higher (P<0.05), and the total distance in target quadrant (495.4 ± 89.4 cm, 487.6 ± 96.2 cm vs. 341.4 ± 67.3 cm) were significantly longer (P<0.05). In acupuncture treatment group and the positive drug group, the activity of SOD in the cortex (17.3 ± 3.3 U/mg, 15.1 ± 2.5 U/mg vs. 9.7 ± 4.9 U/mg) was significantly higher (P<0.05), but the MDA (9.1 ± 2.2 μmol/L, 8.4 ± 3.7 μmol/L vs. 15.2 ± 4.4μmol/L), and H2O2 (85.2 ± 16.2 μmol/L, 82.1 ± 13.2 μmol/L vs. 114.7 ± 24.8 μmol/L) were significantly lower (P<0.05). In acupuncture group, the activity of GSH-Px (14.5 ± 3.7 U/mg vs. 9.0 ± 2.5 U/mg) was significantly higher than that in control group (P<0.05). There was no significant difference between acupuncture group and positive drug (P>0.05). Conclusions Acupuncture at Baihui and Zusanli acupoints can improve the behavior scores of rats with VCI, increase the contents of total SOD and GSH-Px,decrease the content of MDA and H2O2 in brain,and enhance antioxidant effects, while inhibiting peroxidation, improve free radical metabolism.

Therapeutic effects of a traditional Chinese medicine decoction on cognitive impairment complicated with pulmonary infection after traumatic brain injury / 中华老年医学杂志

Objective To investigate the effects of a traditional Chinese medicine (TCM ) decoction on cognitive dysfunction complicated with pulmonary infection after traumatic brain injury . Methods From February 2016 to March 2017 ,80 patients with cognitive dysfunction after traumatic brain injury ,who also had lung infection at admission to our hospital ,were enrolled and randomly divided into a control group and an observation group ,with 40 cases in each. Patients in the control group received conventional treatment with antibiotics and donepezil ,and patients in the observation group were administered a TCM decoction in addition to what was given to the control group.Mini-mental state examination(MMSE)scores and pulmonary symptom scores before and after treatment as well as adverse reactions were compared between the two groups. Results After treatment ,MMSE scores were higher in the observation group than in the control group (23.88 ± 5.90 vs.20.11 ± 6.37 ,t=2.746 ,P=0.007) ,and pulmonary symptom scores were lower in the observation group than in the control group (4.39 ± 2.01 vs.6.13 ± 2.24 ,t = 3.656 ,P = 0.007 ). The total incidence of adverse reactions showed no significant difference between the two groups (P＞0.05). Conclusions The TCM decoction has clear benefits and high safety in treating cognitive impairment complicated with pulmonary infection after brain injury. It can improve cognitive ability and clinical symptoms of the lungs ,and should be recommended.

Effect analysis of Naokang Ⅱ combined with aniracetam for patients with vascular cognitive impairment of none dementia after cerebral infarction / 中国脑血管病杂志

Objective To observe the clinical efficacy of Naokang Ⅱ in patients with vascular cognitive impairment of none dementia after cerebral infarction.Methods A total of 100 consecutive patients with vascular cognitive impairment of none dementia after cerebral infarction diagnosed at the Neurology Clinic,Beijing Xuanwu Hospital,Capital Medical University from October 2012 to February 2014 were enrolled prospectively.Six of them did not complete a return visit because of not returning to the hospital in time,2 withdrew automatically,and finally,92 patients were enrolled in the study.According to the random number table method,they were divided into either an observation group (n=48) or a control group (n=44).The control group was treated with aniracetam,while the observation group was treated with aniracetam plus Naokang Ⅱ (Radix Polygoni Multiflori Preparata,Radix Rehmanniae Preparata,Radix Notoginseng,Acorus Calamus L.and Radix Polygalae) for 12 weeks.The differences of traditional Chinese medicine syndrome integral before and after treatment in both groups were compared.The effective rate and cognitive function improvement rate of traditional Chinese medicine syndromes before and after treatment in both groups were compared.Results The scores of traditional Chinese medicine syndrome integral before and after treatment in patients of the observation group were 28±5 and 15±4,respectively,those of the control group before and after treatment were 26±5 and 18±5,respectively.There were significant differences before and after treatment (the t values were 15.02 and 14.73,respectively,all P0.05).The total effective rate in the observation group (75.0% [36/48]) was higher than that in the control group (45.5% [20/44]).There was significant difference between two groups (χ2=7.023,P=0.008).The improvement rates of memory,orientation,judgment,and problem solving skills in the observation group (29.2% [14/48],27.1% [13/48],and 31.2% [15/48]) were higher than those in the control group (11.4% [5/44],9.1% [4/44],and 13.6% [6/44]).There were significant differences between the two groups (all P<0.05).No adverse reactions were observed in the two groups during the observation period.Conclusion Naokang Ⅱ combined with aniracetam for patients with vascular cognitive impairment of none dementia after cerebral infarction had a synergistic effect.

Effect of electroacupuncture on postoperative cognitive function in elderly patients undergoing carot-id endarterectomy / 中华麻醉学杂志

Objective To evaluate the effect of electroacupuncture on postoperative cognitive func?tion in elderly patients undergoing carotid endarterectomy. Methods Fifty patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ orⅢ, with the educational level≥ the level of primary school, scheduled for elective unilateral carotid endarterectomy, were divided into 2 groups ( n=25 each) using a random number table: control group ( group C) and electroacupuncture group ( group EA). In group EA, electroacupuncture (frequency 2∕100 Hz, intensity 5-12 mA) of Baihui (GV20), Neiguan (PC6) and Zusanli (ST36) was performed throughout surgery starting from 30 min before opera?tion, and then general anesthesia was performed. General anesthesia was performed directly in group C. Before operation ( T0 ) , at the end of operation ( T1 ) and at 24 h after operation ( T2 ) , blood samples were collected from the internal jugular vein for determination of plasma S?100βprotein, tumor necrosis factor?αand brain?derived neurotrophic factor ( BDNF) concentrations by enzyme?linked immunosorbent assay. The cognitive function was assessed using Montreal Cognitive Assessment at T0,2 and at 3 and 7 days after opera?tion ( T3,4 ) . Results Compared with group C, the Montreal Cognitive Assessment scores were significantly increased at T2?4 , the plasma S?100β protein and tumor necrosis factor?α concentrations were significantly decreased at T1,2 , and the plasma BDNF concentrations were significantly increased at T2 in group EA ( P promotion of BDNF production and reduction of brain injury.

Role of hippocampal AMPK signaling pathway in reduction of postoperative cognitive dysfunction by electroacupuncture preconditioning in aged rats / 中华麻醉学杂志

Objective To evaluate the role of hippocampal adenosine monophosphate-activated protein kinase (AMPK) signaling pathway in reduction of postoperative cognitive dysfunction by electroacupuncture (EA) preconditioning in aged rats.Methods A total of 150 healthy male Sprague-Dawley rats,aged 18-20 months,weighing 400-500 g,were randomly divided into 5 groups (n=30 each) using a random number table:control group (group C);splenectomy group (group O);preconditioning with EA at non-acupoint group (group NEA);preconditioning with EA at Baihui acupoint group (group EA);preconditioning with EA at Baihui acupoint + AMPK inhibitor group (group EAC).EA and EAC groups received EA at Baihui acupoints with a sparse-dense wave at an intensity of 1 mA and a frequency of 2 Hz/15 Hz for 30 nin,once a day,for 5 consecutive days,and splenectomy was performed at 24 h after the end of the last stimulation.Group NEA received EA at the points 2 mm lateral to the acupoints of Baihui,and the other treatments were similar to those previously described in group EA.Compound C 20 mg/kg was injected intraperitoneally at 5 min before operation in group EAC.Morris water maze test was performed at 1,3 and 5 days after operation,and the escape latency and swimming distance were recorded.The rats were then sacrificed,and brains were removed for examination of the pathological changes in the hippocampal CA3 region and for determination of the expression of AMPK,phosphorylated AMPK (p-AMPK),nuclear factor kappa B (NF-κB),interleukin-1beta (IL-1β),and tumor necrosis factor-alpha (TNF-α) by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,and the expression of AMPK,p-AMPK,NF-κB,IL-13,and TNF-α was significantly up-regulated in O,NEA,EA and EAC groups (P＜0.05).Compared with group O,the escape latency and swimming distance were significantly shortened,and the expression of AMPK,p-AMPK,NF-κB,IL-1β and TNF-α was significantly down-regulated in EA and EAC groups (P＜0.05),and no significant change was found in the parameters mentioned above in group NEA (P＞0.05).Compared with group EA,the escape latency and swimming distance were significantly prolonged,the expression of AMPK and p-AMPK was significantly down-regulated,and the expression of NF-κB,IL-1β and TNF-α was significantly up-regulated in group EAC (P＜0.05).Conclusion Activation of hippocampal AMPK signaling pathway is involved in EA preconditioning-induced improvement in postoperative cognitive dysfunction in aged rats.

Protective effects of tenghuanglin against memory and sperm injury induced by microwave radiation in rats / 解放军医学杂志

Objective To observe the protective effects of Chinese herbal compound Tenghuanglin (THL) against memory and sperm damage induced by microwave radiation in rats. Methods Forty male SD rats were randomly divided into normal control group, radiation group, AduoLaFuzhenglin treatment (ADL) group and THL treatment (THL) group (10 in each). Before radiation, rats in ADL and THL groups were treated with AduoLaFuzhenglin (12g·kg-1·d-1) and THL (1g·kg-1·d-1) respectively by intragastric administration once per day for 7 days. Then, the rats in radiation, ADL and THL groups were exposed to 30mW/cm2 microwave once for 15min, and rats in normal group received sham-radiation. Morris water maze was adopted to detect the learning and memory function of rats 1-6 days after radiation, and the changes of sperm motility in rats were observed on day 7 post-radiation. Results Morris water maze tests showed that the escape latency was significantly shorter in ADL group and THL group than in RAD group on day 2-6 after withdrawal (P<0.05). On day 6 after withdrawal, the escape latency in THL group was significantly shorter than that in ADL group (P<0.05). The results of sperm motility assay showed that, compared with control group, the sperm motility in radiation group significantly decreased on day 7 after radiation, for instance, the proportion of sperm in grade A significantly decreased (P<0.05), while the proportion of sperm in grade D and grade C significantly increased (P<0.05). Compared with radiation and ADL group, the proportion of sperm in grade A significantly increased in THL group (P<0.05), while the proportion of sperm in grade D and grade C significantly decreased (P<0.05). Conclusions Microwave radiation can lead to the learning and memory injury and significant decrement in sperm activity in rats. The preventive administration of traditional Chinese medicine THL can significantly attenuate the injuries of learning and memory ability and sperm motility induced by microwave radiation in rats.

Effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with ;mild cognitive impairment in elderly care institution / 中国实用护理杂志

Objective To explore the effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with mild cognitive impairment in elderly care institution. Methods A total of 66 cases with mild cognitive impairment elderly that previously were screened out from two pension institutions in Taiyuan city as the research objects. According to the endowment institutions where the objects of study dwelled was divided into control group (34 cases) and intervention group (32 cases). The intervention group accepted nursing of Traditional Chinese Medicine plan for four months. The control group received the disease related knowledge health education. The cognitive function of the two groups were assessed using the Montreal Cognitive Scale (MoCA) before and after the intervention. Results Before the intervention, two groups had no statistical significance in each dimension score and total score of MoCA. After the intervention, four dimensions scores including ability of visual spatial and execute , attention , delayed recall , directional force and the total score of the intervention group respectively were (2.67±1.09) points, (4.07±1.08) points, (1.97±0.81) points, (4.83±0.99) points, (18.80±1.74) points while the control group were (2.15 ± 0.71) points, (3.30 ± 0.63) points, (1.39 ± 0.97) points, (4.24 ± 1.41) points, (15.06 ± 2.98) points, and the difference was statistically significant (t=1.91-6.06, P < 0.05 or 0.01) ;Before intervention the language score, delayed recall score and the total score of the intervention group were (1.43±0.77) points, (1.57±1.10) points, (17.27±1.99) points, respectively while after the intervention were (1.80 ± 0.66) points, (1.97 ± 0.81) points, (18.80 ± 1.74) points, there was statistically significant difference (t =-2.16,-2.11,- 4.34, P < 0.05 or 0.01). Conclusions Nursing of Traditional Chinese Medicine can delay the process of cognitive decline of mild cognitive impairment in the elderly, and have a certain effect on prevention and treatment of patients with mild cognitive impairment.

Therapeutic efficacy observation on electroacupuncture for Alzheimer’s disease / 针灸推拿医学（英文版）

Objective:To observe the effect of electroacupuncture (EA) for Alzheimer’s disease (AD). Methods:A total of 30 eligible cases were treated by needling Shenting (GV 24), Baihui (GV 20), Dazhui (GV 14), Fengfu (GV 16), Mingmen (GV 1) and Yongquan (KI 1). Upon arrival of qi, the G6805-II electric stimulator was connected to Shenting (GV 24) and Baihui (GV 20) (one pair), to Dazhui (GV 14) and Fengfu (GV 16) (one pair) and to bilateral Yongquan (KI 1) (one pair) for 25 min, using continuous wave at the frequency of 2-100 Hz and voltage of 2-4 V. With a tolerable intensity, the EA was conducted once a day for 10 d (one treatment course). There was a 3-day interval between two courses. After three courses, the therapeutic efficacies were evaluated using the mini-mental state examination (MMSE), revised Hasegawa dementia scale (HDS-R), activities of daily living (ADL) and neurological function defect scale (NFDS). Results:After EA treatment, the MMSE and HDS-R scores were significantly increased (P<0.01) and the ADL and NFDS scores were significantly decreased (P<0.01). Conclusion:EA is effective for AD and can improve the overall intelligence and repair neurologic deficits in AD patients.

Effect of hyperbaric oxygen in different intervention time,treatment of cognitive dysfunction after traumatic brain injury / 中国医师进修杂志

Objective To investigate the effect of hyperbaric oxygen treatment on course of different intervention time,cognitive impairment in patients with traumatic brain injury.Methods Ninety cases of cognitive dysfunction in patients with traumatic brain injury after hyperbaric oxygen in different intervention time were divided into group A,group B and group C,with 30 cases in each group.In 7-14 d,15-28 d,＞ 28 d after injury starting hyperbaric oxygen therapy,treatment 1 time a day,12 times for a course.The cognitive function of patients in three groups before and after 1,2,3 courses of treatment was evaluated by U.S.RLA cognition level classification standard evaluation form.Results Three groups after 1 course of treatment there was no statistically significant difference compared with before treatment RLA grading (P ＞ 0.05).Three groups after 2,3 courses of treatment compared with after 1 course of treatment RLA grading difference was statistically significant (P ＜ 0.05),three groups after 3 courses of treatment compared with after 2 courses of treatment RLA grading difference was statistically significant (P ＜ 0.05).Three groups after 1 course of treatment total effectiveness rate was no statistically significant difference(P ＞ 0.05).Group A and group B after 2,3 courses of treatment total effective rate was significantly higher than that in group C [73.33％ (22/30) and 66.67％ (20/30) vs.46.67 ％(14/30),93.33％ (28/30) and 86.67 ％(26/30) vs.60.00 ％ (18/30),P ＜ 0.05],group A was higher than group B,but there was no statistical significance (P ＞ 0.05).Conclusions Hyperbaric oxygen comprehensive therapy can effectively improve cognitive function in patients with traumatic brain injury cognitive impairment.After the injury,the earlier to start the hyperbaric oxygen therapy,the better effect it has,and the longer the course the better curative effect it has.

Effect of hyperbaric oxygen treatment on postoperative cognitive dysfunction in rats / 中华麻醉学杂志

Objective To evaluate the effect of hyperbaric oxygen (HBO) treatment on postoperative cognitive dysfunction (POCD) in rats.Methods Eighteen healthy male Sprague-Dawley rats,weighing 260-290 g,were anesthetized with intraperitoneal 10％ chloral hydrate 350 mg/kg.POCD was induced by injecting Aβ-40 2μl into the bilateral hippocampi by using a brain stereotaxic apparatus.The rats were randomly divided into 3 groups (n =6 each) using a random number table:normal sahne group (group NS),POCD group,and HBO treatment group(groupHBO).0.9％ normal saline 2 μl was injected into hippocampus in group NS.In group POCD,Aβ0 2 μl was injected into hippocampus.In group HBO,Aβ 2μl was injected into hippocampus,and then the rats received hyperbaric oxygen treatment lasting for 60 min once a day within 1-5 days after operation.Morris water maze test was performed on 7,14 and 21 days after operation in each group and the swimming distance and speed and escape latency were recorded.The animals were sacrificed after the end of test,the hippocampi were then removed to detect the activation of astrocytes (by immuno-histochemistry) and content of tumor necrosis factor-α (TNF-α) (by ELISA).Resets There were no significant differences in the parameters of behavior in Morris water maze test on 7 and 14 days after operation between the three groups.Compared with group NS,the swimming distance and escape latency were significantly prolonged,and the activation of astrocytes and TNF-α content were increased on 21 days after operation in group POCD,and the swimming distance and escape latency were significantly prolonged,the activation of astrocytes was increased,and no significant change was found in TNF-α content on 21 days after operation in group HBO.Compared with group POCD,the swimming distance and escape latency were significantly shortened,and the activation of astrocytes and TNF-α content were decreased in group HBO.There was no significant difference in the swimming speed at each time point among the three groups.Conclusion HBO treatment can alleviate POCD in rats,and the mechanism is related to inhibition of activation of astrocytes and inflammatory responses in hippocampi by HBO.

Randomized, Sham-Controlled, Feasibility Trial of Hyperbaric Oxygen for Service Members With Postconcussion Syndrome: Cognitive and Psychomotor Outcomes 1 Week Postintervention.

Background Mild traumatic brain injury (mTBI) and residual postconcussion syndrome (PCS) are common among combatants of the recent military conflicts in Iraq and Afghanistan. Hyperbaric oxygen (HBO2) is a proposed treatment but has not been rigorously studied for this condition. Objectives In a secondary analysis, examine for possible effects on psychomotor (balance and fine motor) and cognitive performance 1 week after an HBO2 intervention in service members with PCS after mTBI. Methods A randomized, double-blind, sham control, feasibility trial comparing pretreatment and posttreatment was conducted in 60 male active-duty marines with combat-related mTBI and PCS persisting for 3 to 36 months. Participants were randomized to 1 of 3 preassigned oxygen fractions (10.5%, 75%, or 100%) at 2.0 atmospheres absolute (ATA), resulting in respective groups with an oxygen exposure equivalent to (1) breathing surface air (Sham Air), (2) 100% oxygen at 1.5 ATA (1.5 ATAO2), and (3) 100% oxygen at 2.0 ATA (2.0 ATAO2). Over a 10-week period, participants received 40 hyperbaric chamber sessions of 60 minutes each. Outcome measures, including computerized posturography (balance), grooved pegboard (fine motor speed/dexterity), and multiple neuropsychological tests of cognitive performance, were collected preintervention and 1-week postintervention. Results Despite the multiple sensitive cognitive and psychomotor measures analyzed at an unadjusted 5% significance level, this study demonstrated no immediate postintervention beneficial effect of exposure to either 1.5 ATAO2 or 2.0 ATAO2 compared with the Sham Air intervention. Conclusions These results do not support the use of HBO2 to treat cognitive, balance, or fine motor deficits associated with mTBI and PCS.

Effect of computer-assisted cognitive training on the cognitive function and depression in patients with brain injury / 中国脑血管病杂志

Objective: To observe the effect of computer-assisted cognitive training on the cognitive function and depression in patients with brain injury. Methods: Forty-six patients with cognitive impairment and depressive symptoms from 18 days to 1 year after brain injury were selected using single-blind method. The patients were divided into a computer-assisted training group (n = 26) and a traditional rehabilitation training group (n = 20). All patients received traditional rehabilitation training such as Bobath and Brunnstrom neurodevelopmental techniques, for 30 to 40 minutes twice a day, and drug therapy. At the same time, the computer-assisted training group received computer-assisted cognitive training for 30 minutes, twice a day. The training period was 5 weeks for both groups. The neurobehavioral cognitive status examination (NCSE) scale, clock drawing test and clinical judgment were used to identify the cognitive function; the Hamilton depression (HAMD, > 8) scale was used to assess the depressive state. Results: Before the training, there were no significant differences in the abilities of orientation, focus, language, memory, calculation, reasoning ability, and structure organizational skill scores of the NCSE scale, clock drawing test scores and HAMD scores between the computer-assisted training group and the traditional rehabilitation training group (P > 0.05). Circled digit oneAfter the training, all the scores of the NCSE scale and the scores of the clock drawing test were higher than those before training in both groups (P < 0.05 or P < 0.01); compared with the traditional rehabilitation training group, apart from the structure organizational skills, all other NCSE scale scores and the clock drawing test scores increased in the computer-assisted training group (P < 0.05 or P < 0.01). Circled digit twoAfter the training, the HAMD score in the computer-assisted training group was significantly lower than that before training (P < 0.01), and there was no significant change in the traditional rehabilitation training group. The HAMD score in the computer-assisted training group was lower than that in the traditional rehabilitation training group (P < 0.05). Conclusion: The computer-assisted cognitive training may improve cognitive impairment and depressive symptoms in patients with brain injury.