Effect of acupuncture on brain functional networks in patients with mild cognitive impairment: an activation likelihood estimation meta-analysis.

BACKGROUND: Prior research has shown that acupuncture, a traditional Chinese medical therapy, may have a certain therapeutic effect in patients with mild cognitive impairment (MCI). Furthermore, some studies have explored the effects of acupuncture on the brain functional networks of MCI patients to investigate the mechanism of action. Different studies have analysed the brain regions involved in acupuncture-induced changes, but (to our knowledge) these have not been summarized by a systematic review. METHODS: We searched PubMed, EMBASE, Cochrane Library, SinoMed, CNKI and other databases in Chinese and English to identify neuroimaging studies of acupuncture interventions in MCI patients. After two stages of literature screening, bias risk assessment and data extraction, brain regions with significant differences were input into GingerALE software. Based on the activation likelihood estimation algorithm, coordinate-based meta-analyses were conducted. RESULTS: The changes in functional activation of 95 different areas in 8 trials, including 212 MCI patients, were analysed. The three most commonly used traditional acupuncture point locations in acupuncture interventions for MCI were KI3 (Taixi), LR3 (Taichong) and LI4 (Hegu). The results of the ALE data analysis showed that, after acupuncture intervention, the degree of activation in the anterior cingulate, inferior frontal gyrus, medial frontal gyrus and cerebellar tonsil of MCI patients increased significantly. CONCLUSIONS: Acupuncture intervention for MCI appears to change the plasticity of brain function and improve the cognitive function of patients. Due to the small number and low quality of the included studies, the conclusion of this meta-analysis should be treated with caution. REGISTRATION: PROSPERO reference CRD42022301056 (http://www.crd.york.ac.uk/PROSPERO).

Different components of air pollutants and neurological disorders.

The harmful effects of air pollution can cause various diseases. Most research on the hazards of air pollution focuses on lung and cardiovascular diseases. In contrast, the impact of air pollution on neurological disorders is not widely recognized. Air pollution can cause various neurological conditions and diseases, such as neural inflammation, neurodegeneration, and cerebrovascular barrier disorder; however, the mechanisms underlying the neurological diseases induced by various components of air pollutants remain unclear. The present paper summarizes the effects of different components of air pollutants, including particulate matter, ozone, sulfur oxides, carbon oxides, nitrogen oxides, and heavy metals, on the nervous system and describes the impact of various air pollutants on neurological disorders, providing ideas for follow-up research.

The Prognostic Value of Domain-Specific Cognitive Abilities Assessed by Chinese Version of Oxford Cognitive Screen on Determining ADLs Recovery in Patients with Post-Stroke Cognitive Impairment.

Background: Poststroke cognitive impairment (PSCI) has been increasingly recognized in patients. However, it remains unclear whether ADLs recovery is more susceptible to domain-specific cognitive abilities after a stroke. Therefore, the study was designed to investigate the cognitive functions of patients with PSCI at admission by using the Chinese (Putonghua) Version of the Oxford Cognitive Screen (OCS-P) as well as to identify the prognostic value of domain-specific cognitive abilities on the recovery of ADLs when discharged. Methods: A total of 153 hospitalized stroke patients were included in this prospective study. Cognitive function was assessed by OCS-P when participants were admitted to the hospital. The ADLs were measured at admission and discharge, and recovery was estimated by the improvement between admission and discharge. A diagnostic model using logistic regression was constructed to identify the prognostic value of domain-specific cognitive abilities for ADLs. The efficacy and accuracy of the diagnostic model were assessed by receiver operating characteristic (ROC) and Hosmer-Lemeshow's goodness of fit test. The diagnostic model was validated by 10-fold cross-validation and presented as a nomogram. Results: The score of OCS-P was 60(49.75, 69). The most frequently impaired cognitive domain was number writing (60.8%), followed by verbal memory (52.9%). Multivariate logistic regression showed executive dysfunction was a risk prognostic factor of ADLs recovery (P < 0.001, OR = 3.176 [95% CI, 1.218∼8.278]). The ROC curve of the diagnostic model was 0.839, with a good diagnostic efficacy. Hosmer-Lemeshow test showed diagnostic model had good calibration ability (χ 2 = 8.939.3, P=0.347 > 0.05). The average error rate after adjustment of 10-fold cross-validation was 20.93%, within the acceptable range. Conclusions: Post-stroke patients generally suffered from multidimensional cognitive impairments. Executive dysfunction screened with OCS-P at clinical admission was a reliable and accessible predictive factor ADLs recovery in patients with PSCI. Early targeted rehabilitation programs are suggested to make them as earlier as possible, especially for those having executive dysfunction while hospitalized.

Alterations in Corticocortical Vestibular Network Functional Connectivity Are Associated with Decreased Balance Ability in Elderly Individuals with Mild Cognitive Impairment.

The corticocortical vestibular network (CVN) plays an important role in maintaining balance and stability. In order to clarify the specific relationship between the CVN and the balance ability of patients with mild cognitive impairment (MCI), we recruited 30 MCI patients in the community. According to age and sex, they were 1:1 matched to 30 older adults with normal cognitive function. We evaluated balance ability and performed MRI scanning in the two groups of participants. We analyzed functional connectivity within the CVN based on the region of interest. Then, we performed a Pearson correlation analysis between the functional connection and the Berg Balance Scale scores. The research results show that compared with the control group, there were three pairs of functional connections (hMST_R−Premotor_R, PFcm_R−SMA_L, and hMST_L−VIP_R) that were significantly decreased in the CVNs of the MCI group (p < 0.05). Further correlation analysis showed that there was a significant positive correlation between hMST_R−Premotor_R functional connectivity and BBS score (r = 0.364, p = 0.004). The decline in balance ability and increase in fall risk in patients with MCI may be closely related to the change in the internal connection mode of the corticocortical vestibular network.

A Mobile Health App for the Collection of Functional Outcomes After Inpatient Stroke Rehabilitation: Pilot Randomized Controlled Trial.

BACKGROUND: Monitoring the functional status of poststroke patients after they transition home is significant for rehabilitation. Mobile health (mHealth) technologies may provide an opportunity to reach and follow patients post discharge. However, the feasibility and validity of functional assessments administered by mHealth technologies are unknown. OBJECTIVE: This study aimed to evaluate the feasibility, validity, and reliability of functional assessments administered through the videoconference function of a mobile phone-based app compared with administration through the telephone function in poststroke patients after rehabilitation hospitalization. METHODS: A randomized controlled trial was conducted in a rehabilitation hospital in Southeast China. Participants were randomly assigned to either a videoconference follow-up (n=60) or a telephone follow-up (n=60) group. We measured the functional status of participants in each group at 2-week and 3-month follow-up periods. Half the participants in each group were followed by face-to-face home visit assessments as the gold standard. Validity was assessed by comparing any score differences between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Reliability was assessed by computing agreements between videoconference follow-up and home visit assessments, as well as telephone follow-up and home visit assessments. Feasibility was evaluated by the levels of completion, satisfaction, comfort, and confidence in the 2 groups. RESULTS: Scores obtained from the videoconference follow-up were similar to those of the home visit assessment. However, most scores collected from telephone administration were higher than those of the home visit assessment. The agreement between videoconference follow-up and home visit assessments was higher than that between telephone follow-up and home visit assessments at all follow-up periods. In the telephone follow-up group, completion rates were 95% and 82% at 2-week and 3-month follow-up points, respectively. In the videoconference follow-up group, completion rates were 95% and 80% at 2-week and 3-month follow-up points, respectively. There were no differences in the completion rates between the 2 groups at all follow-up periods (X21=1.6, P=.21 for 2-week follow-up; X21=1.9, P=.17 for 3-month follow-up). Patients in the videoconference follow-up group perceived higher confidence than those in the telephone follow-up group at both 2-week and 3-month follow-up periods (X23=6.7, P=.04 for 2-week follow-up; X23=8.0, P=.04 for 3-month follow-up). The videoconference follow-up group demonstrated higher satisfaction than the telephone follow-up group at 3-month follow-up (X23=13.9; P=.03). CONCLUSIONS: The videoconference follow-up assessment of functional status demonstrates higher validity and reliability, as well as higher confidence and satisfaction perceived by patients, than the telephone assessment. The videoconference assessment provides an efficient means of assessing functional outcomes of patients after hospital discharge. This method provides a novel solution for clinical trials requiring longitudinal assessments. TRIAL REGISTRATION: chictr.org.cn: ChiCTR1900027626; http://www.chictr.org.cn/edit.aspx?pid=44831&htm=4.