An investigation on the changes of serum CCK-8, substance P, and 5-HT in patients with post-stroke insomnia.

BACKGROUND: At present, the pathogenesis of post-stroke insomnia (PSI) is still inconclusive. OBJECTIVE: To explore the changes and significance of serum cholecystokinin-8 (CCK-8), substance P (SP), and 5-hydroxytryptamine (5-HT) in patients with PSI. METHODS: Ninety-one patients with stroke were selected as the research subjects, and according to the score of the Athens Insomnia Scale (AIS), they were divided into the insomnia group and the non-insomnia group. The serum levels of CCK-8, SP, and 5-HT in the two groups were compared to explore their relationships with PSI. RESULTS: Among the 91 patients, 56 were in the insomnia group and 35 were in the non-insomnia group, and the incidence of insomnia was 61.5%. There was no significant difference in the serum levels of CCK-8, SP, and 5-HT between the two groups (P= 0.696, 0.980, and 0.809, respectively). One-way analysis of variance showed that there was no significant correlation between the serum levels of CCK-8, SP, 5-HT, and the AIS score (P= 0.7393, 0.9581, and 0.5952, respectively). CONCLUSION: The incidence of PSI was relatively high, but it could not be proved that CCK-8, SP, and 5-HT were involved in the pathogenesis of PSI. There might exist other neurotransmitters involved in the pathophysiological process of PSI, which should be further explored.

The Effect of Transcranial Direct Current Stimulation and Functional Electrical Stimulation on the Lower Limb Function of Stroke Patients.

Objective: This study aimed to research the effect of transcranial direct current stimulation (tDCS) and functional electrical stimulation (FES) on the lower limb function of post-convalescent stroke patients. Methods: A total of 122 patients in the stroke recovery stage who suffered from leg dysfunction were randomly divided into two groups: a tDCS group (n = 61) and a FES group (n = 61). All patients received same routine rehabilitation and equal treatment quality, the tDCS group was treated with tDCS, while the FES group received FES. The lower limb Fugl-Meyer assessment (FMA), modified Barthel index (MBI), functional ambulatory category (FAC), and somatosensory evoked potential (SEP) were used to assess the patients at three different stages: prior to treatment, 4 weeks after treatment, and 8 weeks after treatment. Results: The assessment scores for FMA, MBI, and FAC for the lower extremities after treatment (P > 0.05) were compared with those before treatment. The FMA, MBI, and FAC scores of the tDCS group were significantly higher than those of the FES group in all three stages (P < 0.05). The FMA, MBI, and FAC assessment scores of both groups were significantly higher after 4 weeks of treatment than that before treatment, and the scores after 8 weeks of treatment were significantly higher than those after 4 weeks after treatment (P < 0.05). The P40, N45 latencies decreased and the P40, N45 amplitudes increased, but there was no significant difference before treatment and after treatment (P >0.05), and there was no significant difference of the tDCS and FES groups before treatment and after treatment. Conclusion: In conclusion, FMA, MBI, and FAC indicate that both tDCS and FES can significantly promote the recovery of a patient's leg motor function and tDCS is more effective than FES in the stroke recovery stage. The application value of SEP in stroke patients remains to be further studied.

The Clinical Effect of Repetitive Transcranial Magnetic Stimulation on the Disturbance of Consciousness in Patients in a Vegetative State.

OBJECTIVE: To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) and conventional rehabilitation on the recovery of consciousness in patients in a persistent vegetative state (PVS). METHODS: A total of 48 patients in a PVS were randomly divided into a treatment and control group. Patients in the treatment group were treated with rTMS to stimulate the dorsolateral prefrontal cortex, and patients in the control group were treated with false stimulation. All patients were evaluated using scales and neuroelectrophysiological assessment before treatment, after 30 days of treatment, and following 60 days of treatment. RESULTS: Based on the Coma Recovery Scale-Revised (CRS-R) and electroencephalogram (EEG) grading indexes, the treatment group was significantly higher than those of the control group after 30 and 60 days of treatment. The average difference in the three measurements between the two groups before treatment, at 30 days, and 60 days was 0.04, 1.54, and 2.09 for CRS-R and 0.08, -0.83, and -0.62 for EEG indexes, respectively. The latency periods of each wave of the brainstem auditory evoked potentials (BAEPs) in the treatment group were shorter than those in the control group after 30 and 60 days of treatment. In both groups, the BAEP scores after 30 days of treatment were significantly higher than the scores before treatment, and the scores after 60 days of treatment were higher than the scores after 30 days. CONCLUSION: In patients in a PVS, rTMS assists in the recovery of consciousness function.