Repetitive transcranial magnetic stimulation for post-stroke non-fluent aphasia: a systematic review and meta-analysis of randomized controlled trials.

Objective: To systematically evaluate the efficacy and safety of repetitive transcranial magnetic stimulation (rTMS) on language function in patients with non-fluent aphasia post-stroke. Methods: We selected randomized clinical trials (RCT) that involved stroke patients with non-fluent aphasia, whose intervention was rTMS vs. no therapy or other therapy. Two researchers autonomously reviewed the literature based on the specified criteria for inclusion and exclusion and completed the process of data extraction, data verification, and quality evaluation. Meta-analysis was performed using RevMan 5.4 and Stata MP 17, while the assessment of risk of bias was carried out utilizing the Risk of Bias version 2 tool (RoB2). Results: The meta-analysis involved 47 RCTs, encompassing 2,190 patients overall. The indexes indicated that rTMS has the potential to decrease the severity of non-fluent aphasia in stroke patients, including improvement of the capability of repetition, naming, and spontaneous language. The determination of BDNF in the serum of patients was also increased. In addition, rTMS reduced the likelihood of depression in stroke patients. Conclusion: To summarize the relevant studies, rTMS has significant effects on improving the language abilities of stroke patients suffering from non-fluent aphasia, including the abilities of repetition, naming, and spontaneous language.

[Visualization of research in treatment of vascular dementia by CiteSpace].

In light of the tremendous number of patients with vascular dementia in China, it is of great significance for the treatment of this disease to summarize related research focuses. In this study, articles on the treatment of vascular dementia, which were included in CNKI and Web of Science from January 1, 2012 to December 31, 2021, were analyzed. Specifically, CiteSpace 5.7.R2 was employed to visualize nationalities of authors, author affiliations, authors, keywords, and journals, and dissect the status quo and trend of research on the treatment of this disease. On this basis, the research focuses and evolution were elucidated. The findings are expected to serve as reference for the future research. Finally, 2 579 Chinese articles and 453 English articles were included. The annual number of published articles showed an upward trend. Authors from China published most papers and England had the highest centrality value. HU Yue-qiang and LIU Cun-zhi respectively published the most Chinese and English articles. Guangxi University of Chinese Medicine and Capital Medical University respectively topped the author affiliations in the number of published Chinese and English articles. Among the English journals, Anal Biochem and Stroke separately boasted the highest centrality value and the highest cited frequency. The analysis of keywords in the Chinese articles suggested that most studies on the treatment of vascular dementia focused on the observation of patients' mobility after treatment. Moreover, as for the therapeutic method, western medicine, as well as the Chinese medicine and acupuncture frequently attracted the attention of scholars. Basic research highlighted the oxidative stress, angiogenesis, and apoptosis. According to the analysis result of keywords in English articles on treatment of vascular dementia, the focus was the improvement of the memory function of patients with vascular dementia. As to the therapeutic method, drug therapy was frequently studied compared with other methods. The basic research focused on autophagy, nerve regeneration, and oxidative stress. This study concludes that the future research trend might be the combination of Chinese and western medicine in the treatment of vascular dementia.

Highly Sensitive Adsorption and Detection of Iodide in Aqueous Solution by a Post-Synthesized Zirconium-Organic Framework.

Effective methods of detection and removal of iodide ions (I-) from radioactive wastewater are urgently needed and developing them remains a great challenge. In this work, an Ag+ decorated stable nano-MOF UiO-66-(COOH)2 was developed for the I- to simultaneously capture and sense in aqueous solution. Due to the uncoordinated carboxylate groups on the UiO-66-(COOH)2 framework, Ag+ was successfully incorporated into the MOF and enhanced the intrinsic fluorescence of MOF. After adding iodide ions, Ag+ would be produced, following the formation of AgI. As a result, Ag+@UiO-66-(COOH)2 can be utilized for the removal of I- in aqueous solution, even in the presence of other common ionic ions (NO2-, NO3-, F-, SO42-). The removal capacity as high as 235.5 mg/g was calculated by Langmuir model; moreover, the fluorescence of Ag+@UiO-66-(COOH)2 gradually decreases with the deposition of AgI, which can be quantitatively depicted by a linear equation. The limit of detection toward I- is calculated to be 0.58 ppm.

DNAzyme recognition triggered cascade signal amplification for rapid and highly sensitive visual detection of uranyl ions.

This work presents a rapid and highly sensitive colorimetric assay using bifunctional DNA probe decorated agarose microbeads (MBs) coupled with a cascade signal amplification system, including rolling circle amplification (RCA) and the hemin/G-quadruplex-catalyzed colorimetric reaction, for visualized detection of uranyl ions. The DNA probe integrates the UO22+-specific DNAzyme/substrate as the target recognition unit and a DNA primer as the signal conversion unit. The presence of uranyl ions induces the efficient cleavage of the DNA substrates with the catalysis of DNAzyme. Then the conjugated primers are released from MBs, initiating the RCA reaction (the first amplification). The RCA product consists of repetitive G-quadruplexes that can lead to a second amplification by catalyzing the oxidation of ABTS2- with hemin binding, resulting in a coloration that is visible to the naked eye. The whole assay procedure could be finished within 40 min, including recognition of uranyl and DNA cleavage (5 min), the RCA reaction (30 min) and data readout either by eye or using a UV-vis spectrometer (5 min for each sample). In the optimal conditions, concentrations as low as 5 nM uranyl ions could be distinguished by the naked eye. With UV-vis spectrometric measurement, the visible absorbance had a linear relationship with the concentration of uranyl ions with a dynamic range from 1 nM to 50 nM, and a low detection limit of 0.48 nM (i.e. ∼0.12 ppb) was obtained. Excellent selectivity and anti-interference capability in water samples were also certified. This facile visualized assay could be applied in detecting trace-level uranium for on-site environmental analysis.

Efficacy and safety of traditional Chinese medicine rehabilitation program in the treatment of knee osteoarthritis: a randomized controlled trial protocol.

BACKGROUND: Knee osteoarthritis (KOA) is a common joint disease worldwide, and the main cause of pain and disability in the elderly. Due to increased aging and rates of obesity of the global population, the number of patients with KOA is expected to increase. To reduce the burden of KOA, effective and safe interventions should be developed to reduce pain and improve range of motion, functionality, and quality of life. The aim of the proposed randomized controlled study was to evaluate the efficacy and safety of a traditional Chinese medicine (TCM) rehabilitation therapy in the treatment of KOA. METHODS: This multicenter, randomized, double-blind, parallel group, placebo-controlled trial will include a total of 200 patients with KOA. The enrolled patients will be randomly divided into the experimental group (n=100) and control group (n=100). The experimental group will receive basic treatment plus TCM rehabilitation therapy, while the control group will receive basic treatment plus physiotherapy regimen. Primary endpoints will include clinical efficacy outcomes, visual analog scale, Western Ontario and McMaster Universities Osteoarthritis Index score, and Knee Outcome Survey Activities of Daily Living Scale score. The data will help determine whether TCM rehabilitation therapy is beneficial for the treatment of KOA. DISCUSSION: The results will provide high-quality guidance for the current clinical treatment of KOA, and provide patients with more options for symptom relief. The findings from this study may provide updated evidence concerning the efficacy and safety of TCM for patients with KOA.

Robot-Assisted Therapy for Upper Extremity Motor Impairment After Stroke: A Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this study was to review the effects of robot-assisted therapy (RT) for improving poststroke upper extremity motor impairment. METHODS: The PubMed, Embase, Medline, and Web of Science databases were searched from inception to April 8, 2020. Randomized controlled trials that were conducted to evaluate the effects of RT on upper extremity motor impairment poststroke and that used Fugl-Meyer assessment for upper extremity scores as an outcome were included. Two authors independently screened articles, extracted data, and assessed the methodological quality of the included studies using the Physiotherapy Evidence Database (PEDro) scale. A random-effects meta-analysis was performed to pool the effect sizes across the studies. RESULTS: Forty-one randomized controlled trials with 1916 stroke patients were included. Compared with dose-matched conventional rehabilitation, RT significantly improved the Fugl-Meyer assessment for upper extremity scores of the patients with stroke, with a small effect size (Hedges g = 0.25; 95% CI, 0.11-0.38; I2 = 45.9%). The subgroup analysis revealed that the effects of unilateral RT, but not that of bilateral RT, were superior to conventional rehabilitation (Hedges g = 0.32; 95% CI, 0.15-0.50; I2 = 55.9%). Regarding the type of robot devices, the effects of the end effector device (Hedges g = 0.22; 95% CI, 0.09-0.36; I2 = 35.4%), but not the exoskeleton device, were superior to conventional rehabilitation. Regarding the stroke stage, the between-group difference (ie, RT vs convention rehabilitation) was significant only for people with late subacute or chronic stroke (Hedges g = 0.33; 95% CI, 0.16-0.50; I2 = 34.2%). CONCLUSION: RT might be superior to conventional rehabilitation in improving upper extremity motor impairment in people after stroke with notable upper extremity hemiplegia and limited potential for spontaneous recovery.

A novel synthesis of graphene quantum dots via thermal treatment of crude graphite oxide in a dry and alkaline condition, and their application in uranyl detection.

In this article, a novel method to synthesize graphene quantum dots was developed via thermal treatment of crude graphite oxide (GO) in a dry and alkaline condition to cut the crude GO sheets into small graphene quantum dots (named as aGQDs). The aGQDs are nano-scale reduced graphene oxide pieces with the sizes around 5-10 nm. The aGQDs could disperse in water for their richment of oxygen-containing groups. The fluorescence properties were carefully investigated. The aGQDS aqueous solution shows a bright yellow-green fluorescence under the UV illumination. Besides, the uranyl ions show a strong fluorescence quenching effect on the a aGQD aqueous solution even at a low concentration (~10-7 M) compared with other common ions in natural water-body, which makes that these aGQDs could be applied as a chemosensor for detection of uranyl ions with good sensitivity and selectivity.

Graphene quantum dot electrochemiluminescence increase by bio-generated H2O2 and its application in direct biosensing.

In this study, a novel signal-increase electrochemiluminescence (ECL) biosensor has been developed for the detection of glucose based on graphene quantum dot/glucose oxidase (GQD/GOx) on Ti foil. The proposed GQD with excellent ECL ability is synthesized through a green one-step strategy by the electrochemical reduction of graphene oxide quantum dot. Upon the addition of glucose, GOx can catalytically oxidize glucose and the direct electron transfer between the redox centre of GOx and the modified electrode also has been realized, which results in the bio-generated H2O2 for ECL signal increase in GQD and realizes the direct ECL detection of glucose. The signal-increase ECL biosensor enables glucose detection with high sensitivity reaching 5 × 10-6 mol l-1 in a wide linear range from 5 × 10-6 to 1.5 × 10-3 mol l-1. Additionally, the fabrication process of such GQD-based ECL biosensor is also suitable to other biologically produced H2O2 system, suggesting the possible applications in the sensitive detection of other biologically important targets (e.g. small molecules, protein, DNA and so on).

Synthesis of sandwich-like Mn3O4@reduced graphene oxide nano-composites via modified Hummers' method and its application as uranyl adsorbents.

Efficient and sustainable remediation technologies for uranium have recently been gaining more and more interest. Adsorption techniques are facile, effective and universal for kinds of heavy metal ions. In this paper, sandwich-like Mn3O4@reduced graphene oxide (Mn3O4@G) nano-composites were prepared facilely and greenly by adding NaOH solution into crude graphite oxide suspension prepared via the Hummers' method to modify the pH. The Mn3O4@G nanocomposites possess a reasonable maximum equilibrium adsorption quantity 195.6 mg [U] g-1. Moreover, the magnetism of Mn3O4@G makes it easy to remove Mn3O4@G from water by strong magnet field.

The contribution of photoinduced charge-transfer enhancement to the SERS of uranyl(VI) in a uranyl-Ag2O complex.

Charge-transfer (CT) is an important enhancement mechanism in the field of surface-enhanced Raman scattering (SERS) that typically increases the Raman intensity of molecules by as much as 10-100 times. Herein, a low-cost Ag2O aggregates substrate was prepared via a facile chemical precipitation method, and the calculated CT-based enhancement factor of the uranyl ions adsorbed on it reached as high as 105, a metal-comparable value. The efficient photoinduced CT process from the valence band of Ag2O to the LUMO of uranyl ions under appropriate excitation sources resulted in the repulsion of the axial oxygen atoms of the OUO bond, which enhanced its polarizability, creating a more intense Raman mode. To the best of our knowledge, this study firstly reports such a strong photoinduced CT enhancement of uranyl ions, with concentrations of 10-8 mol L-1 or lower being detected using this Ag2O substrate. Most importantly, this research has shown that the photoinduced CT enhancement also contributes to the SERS of uranyl ions on pure Ag substrates which have often been ascribed to the electromagnetic enhancement in previous studies. In addition, Ag2O can be used to selectively detect uranyl ions without interference from many other molecules or ions because of the energy matching rule of the photoinduced CT process, which was readily available for uranyl detection in the environmental aqueous solution.

Simplified Chinese translation of 13 adult item banks from the Quality of Life in Neurological Disorders (Neuro-QoL).

BACKGROUND: The Quality of Life in Neurological Disorders (Neuro-QoL) item banks evaluate and monitor the physical, mental, and social health of individuals with neurological conditions. Neuro-QoL items can be administered via short form or computerized adaptive testing. This paper describes the English-to-Simplified Chinese translation of 299 items from 13 adult item banks, which are publicly available. METHODS: Items were translated according to the Functional Assessment of Chronic Illness Therapy (FACIT) method, including forward and backward translation, reconciliation, expert reviews, and cognitive debriefing with both general and clinical populations in China. RESULTS: Most of the 299 Simplified Chinese items were well understood by the respondents. Revisions were made on a small number of items after cognitive debriefing. Although some difficulties were encountered in the translation process, all 13 item banks were linguistically validated with acceptable translations. CONCLUSION: All Chinese adult Neuro-QoL measures are linguistically equivalent to their English sources. Future work includes psychometric validation of these measures in order to create a final version of the item banks. The translation methodology used in this study can serve as a blueprint for researchers in other countries interested in translating the Neuro-QoL.

Electroacupuncture Inhibits Apoptosis of Peri-Ischemic Regions via Modulating p38, Extracellular Signal-Regulated Kinase (ERK1/2), and c-Jun N Terminal Kinases (JNK) in Cerebral Ischemia-Reperfusion-Injured Rats.

BACKGROUND Previous studies suggested that inhibition of apoptosis prevents the dysfunction of ischemia-reperfusion injury. In the pathogenesis of ischemia-reperfusion injury, JNK/ERK1/2 and p38 play an essential role in regulation of cell apoptosis. Electroacupuncture (EA), a form of acupuncture, has demonstrated superiority in preventing ischemia-reperfusion injury, but the underlying mechanism is unclear. In the present study, we explored the effects of electroacupuncture at Shenting (GV24) and Baihui (GV20) acupoints on focal cerebral ischemia-reperfusion (MCAO) rats, and explored whether JNK/ERK1/2- and p38-mediated cell apoptosis are involved. MATERIAL AND METHODS The rats were divided into a sham operation control group, an ischemia group, and an electroacupuncture group with acupuncture applied for 10 days (30 min per day). TTC staining was used to calculate the ischemic brain volume. TUNEL staining and transmission electron microscopy were used to detect cell apoptosis. Western blot analysis and Bio-Plex were used to detect JNK, p38, ERK1/2, Bcl-2, and Bax protein expression. RESULTS We found that electroacupuncture at day 10 significantly reduced cerebral infarction. In addition, electroacupuncture suppressed activation of JNK and p38, while enhancing the activation of ERK1/2 in the peri-ischemic regions. Consequently, the effect of electroacupuncture on these pathways resulted in the inhibition of apoptosis, which was demonstrated by TUNEL and transmission electron microscopy. We found that electroacupuncture upregulated the anti-apoptotic Bcl-2/Bax ratio in peri-ischemic regions. CONCLUSIONS Our findings suggest that inhibition of cell apoptosis via regulating multiple signaling pathways might be a mechanism whereby electroacupuncture has a positive therapeutic effect on post-stroke impairment.

Synergistic effect of acupuncture and mirror therapy on post-stroke upper limb dysfunction: a study protocol for a randomized controlled trial.

BACKGROUND: Upper limb dysfunction is common after stroke, posing an important challenge for post-stroke rehabilitation. The clinical efficacy of acupuncture for the recovery of post-stroke upper limb function has been previously demonstrated. Mirror therapy (MT) has also been found to be effective. However, the effects of acupuncture and MT have not been systematically compared. This trial aims to elucidate the synergistic effects of acupuncture and MT on upper limb dysfunction after stroke. METHODS: A 2 × 2 factorial randomized controlled trial will be conducted at the rehabilitation hospitals affiliated with Fujian University of Traditional Chinese Medicine. A total of 136 eligible subjects will be randomly divided into acupuncture treatment (AT), MT, combined treatment, and control groups in a 1:1:1:1 ratio. All subjects will receive conventional treatment. The interventions will be performed 5 days per week for 4 weeks. AT, MT, and combined treatment will be performed for 30 min per day (combined treatment: AT 15 min + MT 15 min). The primary outcomes in this study will be the mean change in scores on both the FMA and WMFT from baseline to 4 weeks intervention and at 12 weeks follow-up between the two groups and within groups. The secondary outcomes are the mean change in the scores on the Visual Analogue Scale, Stroke Impact Scale, and modified Barthel index. Medical abstraction of adverse events will be assessed at each visit. DISCUSSION: The results of this trial will demonstrate the synergistic effect of acupuncture and MT on upper limb motor dysfunction after stroke. In addition, whether AT and MT, either combined or alone, are more effective than the conventional treatment in the management of post-stroke upper limb dysfunction will also be determined. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-IOR-17011118 . Registered on April 11, 2017. Version number: 01.2016.09.1.

Psychometric Properties of the Chinese (Putonghua) Version of the Oxford Cognitive Screen (OCS-P) in Subacute Poststroke Patients without Neglect.

BACKGROUND: Oxford Cognitive Screen is designed for assessing cognitive functions of poststroke patients. This study was aimed to assess the psychometric properties of the Chinese (Putonghua) version of the Oxford Cognitive Screen-Putonghua (OCS-P) for use among poststroke patients without neglect. METHODS: Expert review panel evaluated content validity of the Chinese-translated items. After pilot tested the translated items, the patients and healthy participants completed the OCS-P as well as the Montreal Cognitive Assessment (MoCA-ChiB) and Goldenberg's test. A group of patients completed OCS-P for the second time within seven days. Data analyses included confirmatory factor analysis, item difficulty and item-total correlation, inter- and intrarater reliability, internal consistency, and between-group discrimination. RESULTS: One hundred patients and 120 younger (n = 60) or older (n = 60) healthy participants completed all the tests. Modifications were required for items in the "Picture Naming", "Orientation", and "Sentence Reading" subscales. Confirmatory factor analysis revealed a three-factor structure for the OCS-P subscales. The internal consistency coefficients for the three identified test dimensions were 0.30 to 0.52 (Cronbach's alpha). Construct validity coefficients between the OCS-P and MoCA-ChiB subscales were 0.45 < r < 0.79 (p < 0.001) and the "Praxis" subscale of OCS-P and Goldenberg's test was r = 0.72 (p < 0.001). The interrater reliability coefficients for the subscales were in general higher than the intrarater reliability coefficients. The "Picture Naming" and "Numerical Cognition" subscales were the most significant (p = 0.003) for differentiating patient participants from their older healthy counterpart. CONCLUSION: This study generated satisfactory evidence on the content validity, substantive validity, construct validity, inter- and intrarater reliability, and known-group discrimination of the OCS-P. They support its application among poststroke patients who speak Putonghua. Future studies could review the existing five-dimension domains for improving its structural validity and internal consistency as well as generate evidence of the OCS-P for use among the poststroke patients with neglect.

Advances in the use of carbonaceous materials for the electrochemical determination of persistent organic pollutants. A review.

Persistent organic pollutants (POPs) are key pollutants due to their persistence, refractory biodegradation, high toxicity and bioaccumulation in the food chain. This review (with 93 refs.) covers the progress made in the past decades in the application of carbonaceous materials for electrochemical detection of POPs as listed in the Stockholm Convention. Following an introduction into the field, typical carbonaceous materials for use in electrodes are discussed, with subsection on carbon nanotubes, graphene, reduced graphene oxide, graphitic carbon nitride and carbon dots. This is followed by a section on application of carbonaceous materials in electrochemical detection, with subsections on the use of carbon nanotubes, of (doped-) graphene, of reduced graphene oxide, of graphitic carbon nitride, and of carbon dots. The review concludes with conclusions and future perspectives. The detection mechanisms of POPs are also discussed. Graphical abstract Advanced carbonaceous materials for the electrochemical determination of persistent organic pollutants.

Visualized analysis of developing trends and hot topics in natural disaster research.

This study visualized and analyzed the developing trends and hot topics in natural disaster research. 19694 natural disaster-related articles (January 1900 to June 2015) are indexed in the Web of Science database. The first step in this study is using complex networks to visualize and analyze these articles. CiteSpace and Gephi were employed to generate a countries collaboration network and a disciplines collaboration network, and then attached hot topics to countries and disciplines, respectively. The results show that USA, China, and Italy are the three major contributors to natural disaster research. "Prediction model", "social vulnerability", and "landslide inventory map" are three hot topics in recent years. They have attracted attention not only from large countries like China but also from small countries like Panama and Turkey. Comparing two hybrid networks provides details of natural disaster research. Scientists from USA and China use image data to research earthquakes. Indonesia and Germany collaboratively study tsunamis in the Indian Ocean. However, Indonesian studies focus on modeling and simulations, while German research focuses on early warning technology. This study also introduces an activity index (AI) and an attractive index (AAI) to generate time evolution trajectories of some major countries from 2000 to 2013 and evaluate their trends and performance. Four patterns of evolution are visible during this 14-year period. China and India show steadily rising contributions and impacts, USA and England show relatively decreasing research efforts and impacts, Japan and Australia show fluctuating activities and stable attraction, and Spain and Germany show fluctuating activities and increasing impacts.

Influence of macroscopic defects on the corrosion behavior of U-0.79 wt%Ti alloy in sodium chloride solution.

Uranium alloys containing a low concentration of titanium have received wide attention due to their greatly enhanced corrosion resistance and outstanding mechanical performances. Herein, we investigated the effect of macroscopic defects on the corrosion behavior of U-0.79 wt%Ti (denoted as U-Ti) alloy in 0.01 M NaCl solution using traditional electrochemical testing technologies and a novel scanning electrochemical composite probe (SECP). The results demonstrate that pitting corrosion occurs rapidly on the alloy surface due to macroscopic defects. Moreover, macroscopic defects led to a decrease in corrosion potential and polarization resistance, and an increase in corrosion current density. Furthermore, the potential and pH value distributions were detected in the same region using the composite probe. The results show that the region around the macroscopic defects become corrosion-active positions and the potential difference (vs. the average potential of the alloy surface) in this area is significantly higher than that at positions without macroscopic defects, while the opposite was observed for the pH value distribution. In addition, the distribution of the vertical direction (Z) potential at the active point was clearly different from that at the inactive point. A possible reason for this could lie in the difference in the electric field distribution and electrode reaction type between the active point and inactive point on the alloy surface.

Altered functional connectivity in patients with post-stroke memory impairment: A resting fMRI study.

Post-stroke memory dysfunction (PMD) is one of the most common forms of cognitive impairment among stroke survivors. However, only a limited number of studies have directly investigated the neural mechanisms associated with memory decline. The aim of the present study was to identify dynamic changes in the functional organization of the default mode network (DMN) and the dorsal attention network of patients with PMD. A total of 27 patients with PMD who experienced a stroke in the right hemisphere were enrolled in the current study, along with 27 healthy control subjects matched by age, sex, and educational level. A behavioral examination and functional magnetic resonance imaging scan were performed. The data were analyzed using an independent component analysis method. The results revealed a significantly increased functional connectivity between the DMN and prefrontal cortex (left middle/inferior frontal and left precentral gyri), temporal regions (left superior temporal gyrus), and bilateral and posterior cingulate gyri/precuneus (P<0.001). There was also a significantly decreased functional connectivity between the DMN and right middle temporal gyrus, left uvula, and right inferior parietal lobule, and between the dorsal attention network and prefrontal cortex (left precentral/inferior and right inferior/middle frontal gyri), right inferior parietal gyrus, and right insula (P<0.001). These results suggest that the stroke affected both the lesioned and contralesional hemispheres. The prefrontal cortex, temporal regions, insula, and posterior cingulate gyrus/precuneus serve a crucial role in memory processing.

Electro-acupuncture ameliorates cognitive impairment via improvement of brain-derived neurotropic factor-mediated hippocampal synaptic plasticity in cerebral ischemia-reperfusion injured rats.

A previous study by our group found that electro-acupuncture (EA) at the Shenting (DU24) and Baihui (DU20) acupoints ameliorates cognitive impairment in rats with cerebral ischemia-reperfusion (I/R) injury. However, the precise mechanism of action has remained largely unknown. The present study investigated whether brain-derived neurotropic factor (BDNF) mediates hippocampal synaptic plasticity as the underlying mechanism. Rats were randomly divided into three groups: The sham operation control (Sham) group, the focal cerebral ischemia-reperfusion (I/R) group, and the I/R with EA treatment (I/R+EA) group. The I/R+EA group received EA treatment at the Shenting (DU24) and Baihui (DU20) acupoints after the operation. EA treatment was found to ameliorate neurological deficits (P<0.05) and reduce the cerebral infarct volume (P<0.01). In addition, EA improved cognitive function in cerebral I/R-injured rats (P<0.05). Furthermore, EA treatment promoted synaptic plasticity. Simultaneously, EA increased the hippocampal expression of BDNF, its high-affinity tropomyosin receptor kinase B (TrkB) and post-synaptic density protein-95 (PSD-95) in the rats with cerebral I/R injury. Collectively, the findings suggested that BDNF-mediated hippocampal synaptic plasticity may be one mechanism via which EA treatment at the Shenting (DU24) and Baihui (DU20) acupoints improves cognitive function in cerebral I/R injured rats.

Clinical Efficacy of Acupuncture Treatment in Combination With RehaCom Cognitive Training for Improving Cognitive Function in Stroke: A 2 × 2 Factorial Design Randomized Controlled Trial.

OBJECTIVE: The aim of this study was to identify the clinical efficacy of acupuncture in combination with RehaCom cognitive training in poststroke patients with cognitive dysfunction. METHODS/DESIGN: This study was a 2 × 2 factorial design randomized controlled trial comparing acupuncture, computer-assisted cognitive rehabilitation, and the usual treatment by per-protocol analysis. The trial was completed by 204 stroke patients, including 49 patients in a control group, 52 patients in an acupuncture treatment group, 51 patients in a RehaCom training group, and 52 patients in an acupuncture combined with RehaCom group. All of the patients accepted basic treatment and health education. The interventions continued for 12 weeks (30 minutes per day, 5 days per week). The relative cognitive and functional outcomes were measured at baseline and 12 weeks (at the end of intervention) using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Functional Independence Measure (FIM) scales. RESULTS: After 12 weeks of treatment, the functional statuses of the patients in each of the 4 groups showed varying degrees of improvement. Multiple comparisons of the changes in the MMSE, MoCA, and FIM scores indicated that acupuncture combined with RehaCom cognitive training (ACR) had enhanced therapeutic effects on the functional statuses of the stroke patients (P < .05). In addition, ACR had similar therapeutic effects on the functional statuses of the stroke patients according to each of the assessment scales applied (P△change value MMSE = 0.399, P△MoCA = 0.794, P△FIM = 0.862). The interaction effect values between acupuncture and RehaCom training (acceptance or nonacceptance) were as follows: △MMSE: F = 6.251, P = .013; △MoCA: F = 4.991, P = .027; and △FIM: F = 6.317, P = .013. Further, the main effect values for acupuncture and RehaCom training were both significant (P < .05). CONCLUSIONS: There is an interaction effect in the treatment of stroke patients using ACR. The use of acupuncture in combination with RehaCom training has better therapeutic effects on the functional statuses of poststroke patients than the use of either treatment alone, demonstrating the clinical significance of this combination therapy.