Leveraging the glymphatic and meningeal lymphatic systems as therapeutic strategies in Alzheimer's disease: an updated overview of nonpharmacological therapies.

Understanding and treating Alzheimer's disease (AD) has been a remarkable challenge for both scientists and physicians. Although the amyloid-beta and tau protein hypothesis have largely explained the key pathological features of the disease, the mechanisms by which such proteins accumulate and lead to disease progression are still unknown. Such lack of understanding disrupts the development of disease-modifying interventions, leaving a therapeutic gap that remains unsolved. Nonetheless, the recent discoveries of the glymphatic pathway and the meningeal lymphatic system as key components driving central solute clearance revealed another mechanism underlying AD pathogenesis. In this regard, this narrative review integrates the glymphatic and meningeal lymphatic systems as essential components involved in AD pathogenesis. Moreover, it discusses the emerging evidence suggesting that nutritional supplementation, non-invasive brain stimulation, and traditional Chinese medicine can improve the pathophysiology of the disease by increasing glymphatic and/or meningeal lymphatic function. Given that physical exercise is a well-regarded preventive and pro-cognitive intervention for dementia, we summarize the evidence suggesting the glymphatic system as a mediating mechanism of the physical exercise therapeutic effects in AD. Targeting these central solute clearance systems holds the promise of more effective treatment strategies.

Effects of Swallowing Rehabilitation Training with a Balloon Dilation Therapy on the Deglutition Function and Quality of Life of Patients with Dysphagia after Radiotherapy for Nasopharyngeal Carcinoma.

Objective: The aim of this study is to investigate the effects of swallowing rehabilitation training with a balloon dilation therapy on the deglutition function and quality of life of patients with dysphagia after radiotherapy for nasopharyngeal carcinoma (NPC). Methods: The study was a retrospective study. The data of the 100 patients with dysphagia after NPC radiotherapy in our hospital between April 2021 and April 2022 were retrospectively analyzed. The patients were separated into the control group (n = 50) and experimental group (n = 50) according to their different treatments that were balloon dilation for the former and balloon dilation with swallowing rehabilitation training for the latter. The deglutition function, which was comprehensively evaluated by Kubota's water swallow test and assessments of penetration/aspiration and pharyngeal residue, and quality of life were compared between the two groups. Results: The scores of Kubota's water swallow test, penetration aspiration scale (PAS), and Yale pharyngeal residue severity rating scale (YPR-SRS) in the experimental group after treatment were (2.04 ± 0.66), (2.92 ± 1.07), and (2.42 ± 0.90), respectively, which were remarkably lower than (2.58 ± 0.78), (4.38 ± 1.51), and (2.78 ± 0.86) in the control group, with distinct differences in the data between both the groups (P < 0.05). The quality of life of patients in the experimental group was distinctly better than that in the control group (P < 0.001). Conclusion: Swallowing rehabilitation training in combination with a balloon dilation therapy can improve the deglutition function in patients with dysphagia after NPC radiotherapy as well as their quality of life, with a clinical application value.

The Effects of Transcranial Direct Current Stimulation Versus Electroacupuncture on Working Memory in Healthy Subjects.

Objective: Working memory (WM) can influence human thought processes through interactions with perception, long-term memory, and behavior. In recent years, transcranial direct current stimulation (tDCS) and electric acupuncture have been used to improve the performance of WM. Therefore, due to the n-back task as a continuous performance task that is commonly used to measure WM, the aim of this study is to investigate the differences in short-term efficacy between tDCS and electroacupuncture on WM under n-back task paradigm in healthy subjects. Methods: Forty-four college students (age: 23.70 ± 1.52 years; education: 16.93 ± 2.24 years) were recruited as experimental subjects and randomly divided into two groups by a random double-blind two-stage crossover experiment design. Group A received a tDCS intervention followed by at least 1 week of washout period and then the electroacupuncture intervention. Group B had the opposite sequence of interventions. The WM test under the n-back task paradigm was conducted before and after each intervention, and the changes in the accuracy (number of correct responses) and correct response time (RT) before and after the interventions were detected. The data were statistically analyzed using SPSS 24.0 to compare the short-term efficacy of tDCS and electroacupuncture on WM under different tasks. Results: In the 0-back task and 1-back tasks, there was no significant difference in the accuracy or RT before and after the interventions between tDCS and electroacupuncture stimulation. In the 2-back task, there was no significant difference in the accuracy before and after interventions between tDCS and electroacupuncture stimulation. However, there was a significant difference in RT (p < 0.05), which was lower after tDCS than after electroacupuncture in the 2-back task. Conclusion: The results show that tDCS with anodal stimulation on the left dorsolateral prefrontal cortex could increase the RT of the 2-back task performance in comparison with electroacupuncture stimulation of the Baihui (GV20) and Shenting (DU24) acupoints. The present results indicate that tDCS may have greater impact on WM in healthy subjects than electroacupuncture stimulation.