Effects of vagus nerve stimulation on cognitive function in patients with epilepsy: a systematic review and meta-analysis.

Background: Previous studies showed that vagus nerve stimulation (VNS) can improve cognitive function in patients with epilepsy, but there is still great controversy about the effect of VNS on cognitive function in patients with epilepsy. Objective: To investigate the effect of VNS on the cognitive function of epilepsy patients. Methods: Clinical trials published in PubMed, The Cochrane Library, and Embase before September 20, 2022, were comprehensively searched. Primary outcomes were overall cognitive performance, executive function, attention, memory; Secondary outcomes were seizure frequency, mood, and quality of life (QOL). Random effects were used to calculate the pooled outcome. Results: Twenty clinical trials were included. There was no significant improvement in overall cognitive performance in patients with epilepsy after VNS treatment (SMD = 0.07; 95% CI: -0.12 to 0.26; I2 = 0.00%) compared to pre-treatment. Compared to pre-treatment, there was no significant difference in executive function (SMD = -0.50; 95% CI: -1.50 to 0.50; p = 0.32), attention (SMD = -0.17; 95% CI: -0.43 to 0.09; p = 0.21) and memory (SMD = 0.64; 95% CI: -0.11 to 1.39; p = 0.09), but there were significant differences in seizure frequency, mood, and quality of life in patients with epilepsy after VNS. Conclusion: This meta-analysis did not establish that VNS can significantly improve cognitive function in patients with epilepsy, but it shows that VNS can significantly improve the seizure frequency, mood and quality of life of patients with epilepsy. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42023384059.

Effects of whole-body vibration training on physical function, activities of daily living, and quality of life in patients with stroke: a systematic review and meta-analysis.

Purpose: This systematic review and meta-analysis aimed to evaluate the efficacy of whole-body vibration training (WBVT) in patients with stroke, specifically focusing on its effects on physical function, activities of daily living (ADL), and quality of life (QOL). Additionally, potential moderators influencing WBVT outcomes were explored. Methods: We conducted a systematic search of PubMed, Embase, and Cochrane Library from inception to September 2022. Eligible studies were randomized controlled trials employing WBVT in patients with stroke. Two investigators independently extracted the data and calculated the standardized mean difference (SMD) using random-effect models. Results: Twenty-five studies involving 991 patients were included in this meta-analysis. WBVT demonstrated significant reductions in spasticity (SMD = -0.33, 95% CI = -0.61 to -0.06, p = 0.02), improvements in motor function (SMD = 0.39, 95% CI = 0.16 to 0.61, p < 0.01), and enhancements in balance function (SMD = 0.28, 95% CI = 0.09 to 0.47, p < 0.01) in patients with stroke. However, no significant effects were observed for gait (SMD = -0.23, 95% CI = -0.50 to 0.04, p = 0.10), ADL (SMD = -0.01, 95% CI = -0.46 to 0.44, p = 0.97), or QOL (SMD = 0.12, 95% CI = -0.30 to 0.53, p = 0.59). Subgroup analyses revealed that variable frequency vibration and side-alternating vibration exhibited significant efficacy in reducing spasticity and improving motor and balance functions, while fixed frequency vibration and vertical vibration did not yield significant therapeutic benefits in these domains. Conclusion: Our findings indicate that WBVT may serve as a viable adjunct therapy for stroke patients to alleviate spasticity and enhance motor and balance functions. Variable frequency and side-alternating vibration appear to be crucial factors influencing the therapeutic effects of WBVT on these dysfunctions. Nonetheless, WBVT did not show significant effects on gait, ADL, or QOL in stroke patients. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD42022384319).

Effects of vibration therapy for post-stroke spasticity: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: The efficacy of vibration therapy (VT) in people with post-stroke spasticity (PSS) remains uncertain. This study aims to conduct a comprehensive meta-analysis to assess the effectiveness of VT in PSS. METHODS: PubMed, Embase, Cochrane Library, Physiotherapy Evidence Database, and Web of Science were searched from inception to October 2022 for randomized controlled trials (RCTs) of VT in people with PSS. The primary outcome was spasticity, and secondary outcomes included pain, motor function, gait performance, and adverse events. A meta­analysis was performed by pooling the standardized mean difference (SMD) with 95% confidence intervals (CI). RESULTS: A total of 12 studies met the inclusion criteria. Overall, VT had significant effects on reducing spasticity (SMD = - 0.77, 95% CI - 1.17 to - 0.36, P < 0.01) and pain (SMD = - 1.09, 95% CI - 1.74 to - 0.45, P < 0.01), and improving motor function (SMD = 0.42, 95% CI 0.21 to 0.64, P < 0.01) in people with PSS. However, VT had no significant effect on gait performance (SMD = - 0.23, 95% CI - 0.56-0.10). In addition, subgroup differences in short-term anti-spasticity effects between different vibration subtypes, vibration frequencies, vibration durations, frequency of sessions, control therapy, spasticity distribution, and population classification were not significant. CONCLUSION: We found that VT significantly alleviated spasticity and pain in people with PSS and improved motor function, but its effect on gait performance was unclear. However, further studies are needed to validate these findings.

Impact of transcranial direct current stimulation combined with motor-cognitive intervention on post-stroke cognitive impairment.

OBJECTIVE: In this study, it was explored whether the efficacy on applying transcranial direct current stimulation (tDCS) combined with motor-cognitive intervention for post-stroke cognitive impairment (PSCI) was greater than that on applying each method alone. METHODS: A total of 90 patients with PSCI admitted to Zhejiang Provincial People's Hospital, China, from April 2021 to June 2022 were randomly divided into a tDCS group (n = 30), a motor-cognitive intervention group (n = 30), and a combination group (n = 30). All three groups received conventional rehabilitation therapy. The tDCS group was given tDCS therapy. The motor-cognitive intervention group received motor-cognitive intervention, whereas the combination group received tDCS combined with motor-cognitive intervention. The treatment duration was 4 weeks. The general data of patients were recorded before treatment. The Montreal Cognitive Assessment (MoCA) Scale and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) Scale were used to evaluate the cognitive function of patients in three groups before and after treatment. Further, within- and between-groups comparisons were performed to determine differences in cognitive function. RESULTS: Before treatment, there was no significant difference between the baseline scores of the three groups (P > 0.05). After 4 weeks of treatment, except for the score for the LOTCA motor praxis subtest of the tDCS group, the MoCA and LOTCA scores of the three groups significantly improved compared with the corresponding scores before treatment (P < 0.05), and there was no drop-out case. After treatment, the MoCA and LOTCA scores of the three groups were compared in pairs. The results showed that except for the attention domain in MoCA, the method used for the combination group had more efficacy than those used for the other two groups (P < 0.05). Further, there was no statistical difference in efficacy between the tDCS and the motor-cognitive intervention groups (P > 0.05). CONCLUSION: The combination of tDCS and motor-cognitive intervention is safe and can help improve the cognitive function of patients with PSCI.

Voice-Related Outcomes in Deep Brain Stimulation in Patients with Vocal Tremor: A Systematic Review and Meta-Analysis.

OBJECTIVES: The effectiveness of deep brain stimulation (DBS) in treating vocal tremors is currently a subject of debate. To assess the efficacy of DBS therapy in adults with vocal tremors (VT), we analyzed its impact on voice tremor severity, voice-related quality of life, fundamental frequency, voice intensity, and emotional state. METHODS: We conducted a systematic review with meta-analysis to investigate the impact of DBS therapy on voice tremor severity, voice-related quality of life, fundamental frequency, voice intensity, and emotional state in adults with vocal tremors (PROSPERO/CRD42023420272). The PubMed, Embase, Cochrane Library, Cochrane Central Register of Controlled Trials databases were searched up to September 20, 2022. Primary outcome measures included voice tremor severity and voice-related quality of life (V-RQOL), while fundamental frequency (F0) and voice intensity, along with emotional state, were selected as secondary outcome indicators. We employed the Cochrane Collaboration's tool for assessing bias risk in randomized trials. Meta-analysis (standardized difference of means and weighted mean differences) and heterogeneity analysis (I2) were performed. RESULTS: Our search identified 1186 studies, of which nine studies involving 61 patients met the inclusion criteria. The severity of voice tremor (SMD = -1.08; 95% CI: -1.80 to 0.35; P = 0.02) and V-RQOL (SMD = -1.39; 95% CI: -2.68 to -0.09; P = 0.04) in patients with vocal tremor significantly improved after DBS "on". Subgroup analyses revealed that the stimulation site may contribute to high heterogeneity. Specifically, Vim DBS showed significant improvement in voice tremor severity (SMD = -0.97; 95% CI: -1.84 to -0.09; I2 = 51.01%), while STN DBS did not demonstrate a clear benefit in addressing vocal tremor. There was no significant difference between DBS "on" and DBS "off" in terms of F0, voice intensity, or emotional status. CONCLUSION: DBS therapy is effective in enhancing voice quality and voice-related quality of life in patients with vocal tremors. Notably, Vim DBS demonstrates a significant improvement in voice tremor severity, particularly in VT patients with ET and SD.

Ego-Resiliency and Perceived Social Support in Late Childhood: A Latent Growth Modeling Approach.

This study explored the change trajectory of schoolchildren's ego-resiliency and perceived social support and investigated the effect of perceived social support on ego-resiliency across four time points. A sample of 437 children aged 8-13 years (M = 10.99, SD = 0.70, 51.5% boys) completed assessments at four time points. The results indicated that ego-resiliency showed an increasing linear trend and perceived social support showed a declining linear trend. Perceived social support had a positive effect on ego-resiliency over time. In addition, the initial status of perceived social support negatively predicted the growth trend of ego-resiliency, and the initial status of ego-resiliency negatively predicted the declining trend of perceived social support. The implications for theory and practice are discussed.

How Leaders' Psychological Capital Influence Their Followers' Psychological Capital: Social Exchange or Emotional Contagion.

Using a sample of 32 work teams (32 work team leaders and their 321 followers) in Chinese cultural context, this study investigated the relationships between leaders' and their followers' psychological capital and the multilevel multiple mediation effects of social exchange and emotional contagion. PsyCap questionnaire (PCQ), leader-member exchange scale, and the positive affect scale in the positive and negative affect scale (PANAS) were adopted to measure variables. A total of 430 questionnaires were distributed in 2014 and the response rates were 90.2%. Structural equation model and hierarchical linear model were applied to analyze the survey data. The results revealed that leaders' psychological capital had a positive influence on their followers' psychological capital. Leader-member exchange was the cross-level mediator between leaders' psychological capital and their followers'. The cross-level mediating effect of leaders' positive emotions perceived by followers was not significant. The results of this study extended the social exchange theory and enriched researches on leadership. The implication was discussed in details.

Effects of Socioeconomic Status, Parent-Child Relationship, and Learning Motivation on Reading Ability.

Against the background of Chinese culture, we investigated the relationship between family socioeconomic status (SES) and children's reading ability. Participants included 2294 middle-school students in grade 8. SES was measured by parents' education level, parents' occupational prestige, and family property, and children's reading ability was estimated with item response theory. In addition, we adopted an 8-item parent-child relationship scale and a 22-item learning motivation scale that included four dimensions. We examined whether the parent-child relationship mediated the relationship between family SES and reading ability and whether this was moderated by learning motivation. The results indicated that the parent-child relationship played a mediating role in the relationship between SES and reading ability. This relationship was moderated by students' learning motivation. The direct effects of SES on reading ability at high, medium, and low levels of learning motivation were 0.24, 0.32, and 0.40, respectively.

Influence of Leaders' Psychological Capital on Their Followers: Multilevel Mediation Effect of Organizational Identification.

We investigated the relationships between leaders' and their followers' psychological capital and organizational identification in a Chinese community. Participants included 423 followers on 34 work teams, each with its respective team leader. Hierarchical linear models (HLM) were used in the analyses to delineate the relationships among participants' demographic background (gender, age, marital status, and educational level), human capital, and tenure. The results revealed that leaders' psychological capital positively influenced their followers' psychological capital through the mediation effect of enhancing followers' organizational identification. The implications of these findings, the study's limitations, and directions for future research are discussed.