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Objective:To observe any effect of combining music exercise with transcranial direct current stimulation (tDCS) on the motor control, balance and cognition of persons with Parkinson′s disease (PD).Methods:A total of 120 PD patients were randomly divided into a control group, a music exercise group, a tDCS group and a combined group, each of 30. All received routine rehabilitation training, while the music exercise, tDCS and combined groups were additionally provided with music exercise therapy, tDCS treatment or both, respectively. Version three of the unified Parkinson′s disease scale (UPDRSIII), a 10m reentry movement test, the Berg balance scale (BBS), the Activity Balance Confidence scale (ABC) and Montreal cognitive assessments were applied before and after 4 weeks of the treatments.Results:After the treatment, the average UPDRSIII score and 10m reentry movement time of the music exercise group were significantly lower than in the control group, while the average BBS and ABC scores were significantly higher than the control group′s averages. The tDCS group′s average MoCA scores on all of the items and its total score were significantly higher than those of the music exercise and control groups. The average UPDRSIII score and 10m reentry movement time of the combined group were the lowest after the treatment, and that group′s average BBS, ABC, MoCA and total scores were the highest, significantly better than the other three groups.Conclusion:Combining music exercise training with tDCS can effectively improve the motor functioning, balance and cognition of persons with PD.
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Objective:To observe any effect of combining repetitive transcranial magnetic stimulation (rTMS) under the guidance of event related potentials (ERPs) with action observation therapy (AOT) on the cognitive and motor functioning of stroke survivors in the recovery period.Methods:Ninety stroke survivors were randomly divided into a control group, an rTMS group and an rTMS+ AOT group, each of 30. All three groups were given conventional rehabilitation treatment (including the training of waist, upper and lower limb function, balance, walking, memory, attention, orientation, spatial perception and executive ability). The rTMS group also received one session of ERP-based rTMS daily five times a week. The rTMS+ AOT group was given the same rTMS combined with AOT twice a day, five times a week. Before and after 4 weeks of treatment, the Mini-mental State Examination (MMSE), the Montreal Cognitive Assessment Scale (MOCA), the Fugl-Meyer assessment scale (FMA), the Berg Balance Scale (BBS) and the modified Barthel index (MBI) were used to evaluate each subject′s cognitive and motor ability and their skill in the activities of daily living.Results:After the treatment, the average MMSE, MOCA, FMA, BBS and MBI scores of all groups had improved significantly, but the average MMSE, MOCA, upper limb FMA and MBI scores of the rTMS group were then significantly higher than the control group′s averages. And the average scores of the rTMS+ AOT group were significantly better than those of the other two groups.Conclusion:Combining rTMS guided by ERPs with AOT can effectively improve the cognitive functioning, motor control and balance of stroke survivors, and improve their ability in the activities of daily living.
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Objective@#To observe the influence of transcranial direct current stimulation (tDCS) on rapid eye movement sleep disorders among Parkinson′s disease (PD) patients.@*Methods@#Fifty-four PD patients were randomly divided into a treatment group (n=28) and a control group (n=26). Both groups were given routine drug treatment and nursing, while the treatment group was additionally provided with tDCS therapy. Both groups were evaluated using polysomnography (PSG), the Hamilton depression scale (HAMD), the pediatric daytime sleepiness scale (PDSS), the Epworth sleeping scale (ESS) and PD quality of life questionnaire-39 (PDQ-39) before and after four months of treatment.@*Results@#There were no significant differences between the two groups before the treatment. After the treatment, significant improvement was observed in the total sleep time (TST), sleep latency (SL), sleep efficiency (SE), rapid eye movement sleep (REMS), arousal index (AI), and in the HAMD, ESS, PDSS and PDQ-39 scores among the treatment group. In the control group only the average TST and HAMD score improved significantly. After the treatment, all of the treatment group′s average results were significantly better than the control group′s averages.@*Conclusion@#tDCS can significantly improve the sleep quality of patients with PD and relieve any depression, bettering their life quality.
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Objective:To observe the influence of transcranial direct current stimulation (tDCS) on rapid eye movement sleep disorders among Parkinson′s disease (PD) patients.Methods:Fifty-four PD patients were randomly divided into a treatment group ( n=28) and a control group ( n=26). Both groups were given routine drug treatment and nursing, while the treatment group was additionally provided with tDCS therapy. Both groups were evaluated using polysomnography (PSG), the Hamilton depression scale (HAMD), the pediatric daytime sleepiness scale (PDSS), the Epworth sleeping scale (ESS) and PD quality of life questionnaire-39 (PDQ-39) before and after four months of treatment. Results:There were no significant differences between the two groups before the treatment. After the treatment, significant improvement was observed in the total sleep time (TST), sleep latency (SL), sleep efficiency (SE), rapid eye movement sleep (REMS), arousal index (AI), and in the HAMD, ESS, PDSS and PDQ-39 scores among the treatment group. In the control group only the average TST and HAMD score improved significantly. After the treatment, all of the treatment group′s average results were significantly better than the control group′s averages.Conclusion:tDCS can significantly improve the sleep quality of patients with PD and relieve any depression, bettering their life quality.
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Objective:To investigate the effect of Donepezil treatment on the expression of high mobility group box 1 protein(HMGB1)in serum and cerebrospinal fluid in Alzheimer's disease patients.Methods:This is a single-center observational stady.A total of 120 Alzheimer's disease patients admitted in our hospital from March 2017 to may 2019 were randomly divided into the control group receiving the routine drug therapy(n=60)and the Donepezil group receiving Donepezil hydrochloride(5 mg/d)as an add-on to medicine of control group(n=60). The expression levels of HMGB1 in serum and cerebrospinal fluid, Alzheimer's disease assessment scale(ADAS-Cog), mini-mental state examination(MMSE)scores, activities of daily living(ADL)and neuropsychiatric inventory(NPI)were compared before versus after 1 month of treatment.Results:After the Donepezil treatment, the ADAS-Cog score was lower, MMSE score was higher, ADL score was higher and NPI score was lower in the Donepezil group than in the control group(25.2± 2.7 vs.33.4± 3.6, 23.3± 2.1 vs.19.4±1.9, 56.3±2.1 vs.46.9±1.6, 16.2±2.3 vs.22.3± 2.6, P<0.05). After the Donepezil treatment, the levels of HMGB1 in serum[(45.3±5.3)μg/L vs.(56.3±4.4)μg/L]and in cerebrospinal fluid[(39.2±3.3)μg/L vs.(47.1±3.9)μg/L]were lower in the Donepezil group than in the control group(all P<0.05). Conclusions:Donepezil treatment can downregulate the HMGB1 expression levels in serum and cerebrospinal fluid in Alzheimer's disease patients, which may related to the improvement of cognitive function in Alzheimer's disease patients.
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Objective To explore the effect of repeated transcranial magnetic stimulation ( rTMS) com-bined with rehabilitation training on the motor and non-motor symptoms of Parkinson's disease. Methods A total of 150 persons with Parkinson's disease were randomly divided into an rTMS group, a rehabilitation training group and an observation group, each of 50. The rTMS group received only repeated magnetic stimulation. The rehabilita-tion training group received only standard rehabilitation training. The observation group was given both for 4 weeks. The overall efficacy of each treatment was evaluated using the unified Parkinson's disease rating scale ( UPDRS) , while the motor symptoms were assessed using the 10 m back-and-forth run test, a simple test for evaluating hand function ( STEF) and Berg's balance scale. Non-motor symptoms were evaluated using a questionnaire ( NMSQ) , the mini-mental state examination ( MMSE) , the Hamilton depression scale ( HAMD) , the Hamilton anxiety scale ( HAMA) and the Parkinson's disease sleep scale ( PDSS) . Moreover, a comprehensive quality of life assessment questionnaire ( SF-36) was used to evaluate the life quality of patients before and after the treatment. Results Compared with before the treatment, the average UPDRS scores of all three groups were lower after the treatment. Moreover, the average UPDRS score of the observation group was significantly lower than those of the other two groups. Significant improvement was observed in the mean 10 m run time and in the average STEF and Berg scores of the rehabilitation training and observation groups, but not in the rTMS group's averages. After the treatment, the mean NMSQ, MMSE, HAMD, HAMA and PDSS results of the rTMS and observation groups were significantly bet-ter than those before treatment, with the observation group's averages significantly better than those of the rehabili-tation training group. The average PDSS and SF-36 scores of the observation group were also significantly better than those of the other groups. Conclusion rTMS combined with rehabilitation training can significantly improve the motor and non-motor symptoms of Parkinson's disease patients, and its efficacy is superior to that of rTMS or reha-bilitation training alone.
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BACKGROUND:Although vitamin C has an anti-oxidation role and can promote cell proliferation, there is a lack of research about the promoting effect of vitamin C on the proliferation of adipose-derived stem cells under high glucose conditions and the related molecular mechanisms.OBJECTIVE:To explore the promoting effect of vitamin C on the proliferation adipose-derived stem cells treated by the high glucose and the related molecular mechanisms.METHODS:Passage 3 human adipose-derived stem cells were cultured under high glucose conditions and then treated with different concentrations of vitamin C (0, 100, 150, 200, 250, 300 μmol/L). Cells cultured under low glucose conditions acted as controls. The expression levels of p-ERK and p-AKT proteins were detected by western blot. MTT method was used to choose the optimal concentration and time of vitamin C for all the subsequent tests. Human adipose-derived stem cells cultured under high glucose conditions were divided into four groups, and cells in blank control group had no treatment. Cells in the other three groups were treated with the optimal concentration of vitamin C (vitamin C group), LY294002+the optimal concentration of vitamin C (LY294002 group), or U0126+the optimal concentration of vitamin C (U0126 group) for 48 hours.EdU staining assay was used to detect the cell proliferation of human adipose-derived stem cells.RESULTS AND CONCLUSION:(1) Cell counting kit detection:We found that high glucose reduced the proliferation of human adipose-derived stem cells, and vitamin C promoted the proliferation of these cells. The best concentration of vitamin C was 200 μmol/L and the optimal effect time was 48 hours. (2) Western blot detection:Compared with the 0 μmol/L vitamin C group, the level of p-ERK in the 200 μmol/L vitamin C group was upregulated significantly (P < 0.01),while no significant expression change in p-AKT protein was found in control, 0 and 200 μmol/L vitamin C groups.(3) EdU test:the number of EdU positive cells was significantly higher in the vitamin C, LY294002, and control groups compared with the blank control group (P < 0.01). Moreover, compared with the vitamin C group, the EdU positive cells in the U0126 group were decreased significantly in number (P < 0.01). In conclusion, the ERK/MAPK signaling pathway is involved in the promotion effect of vitamin C on the proliferation of human adipose-derived stem cells under high glucose conditions.
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Objective To investigate the effect of nerve growth factor ( NGF) combined with exercise train-ing on nerve protection, learning and memory. Methods Twenty-four six-month-old APP/PS1 mice were randomly divided into a control group, an NGF group, an exercise group and an NGF combined with exercise training group ( the combined group) , each of 6. The control group mice were given 50 μL of saline intra-nasally every day, while the NGF group were given 50 μL of NGF solution (0.1 mg/ml) intranasally. The exercise group was given 50μL of saline intra-nasally plus 30 minutes of treadmill exercise daily, while the combined group was given 50μL of the NGF solution and 30 minutes of exercise. The intervention lasted 21 days. Then Morris water maze test was conducted to e-valuate the memory of all groups, and all of the mice were sacrificed and immunohistochemical staining was used to check the levels of APP, Ki-67 expression in cortex and NeuN expression in hippocampus. Results In the place navigation test, significant differences in escape latency were observed among the 4 groups, with the NGF, exercise and combined groups showing average latencies significantly shorter than that of the control group The average latency of the combined group was also significantly shorter than that of the NGF and exercise groups. In the spatial probe, there were significant differences among the 4 groups in the percentage of time spent in the target quadrant. The com-bined group′s average was significantly larger than those of the NGF and exercises groups. The immunochemistry showed that the combined group had better-arranged neurons and more cells compared with the 3 other groups. The average APP protein expression of the combined group was significantly lower than that of the other groups, but their Ki-67-positive and NeuN-positive cells were found to be significantly more numerous. Conclusion NGF combined with exercise can improve learning and memory, at least in APP/ PS1 mice. This might be associated with its reduc-ing the expression of APP and promoting the expression of Ki-67 and NeuN.
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Objective To observe the effects of treadmill training and music therapy on freezing of gait among patients with Parkinson′s disease. Methods Fifty-six Parkinson′s disease patients with freezing of gait were randomly divided into a control group, a treadmill training group, a music group and a united group, each of fourteen. All groups received standard medication. The treadmill training group and the music group were also given treadmill training and music therapy respectively. The united group received both treadmill training and music therapy. All of the patients were assessed in terms of freezing score, time to start a first step, incidence of falls, UPDRS-Ⅲ scores and MBI scores before and after 8 weeks of intervention. Results There were no sig-nificant differences among the 4 groups before the training. Significant differences were observed in all of the measurements between the treadmill training and united groups after the treatment. In the music group, only the average UPDRS-Ⅲ and MBI results were significantly improved after the treatment. Compared with the treadmill training and music groups, the united group showed significant differences in all of the measurements. Conclu-sion Treadmill training combined with music therapy is more effective than either alone in relieving gait freezing among those with Parkinson′s disease. It decreases falling and improves their capacity in the activities of daily living life, thus their quality of life.
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Objective To assess the characteristics and influencing factors of non-motor symptoms (non-motor symptoms) in untreated patients with Parkinson's disease (PD) at early stage.Methods A total of 106 untreated patients with PD at early stage and 108 healthy controls (HC) matched for age,gender,education status and occupation were investigated by non-motor symptoms questionnaire.And both of them were divided into two groups:aged group (≥60 years old) and nonaged group (＜60 years old).76 cases with an average of (66.8±6.6) years old were selected in the aged group,and 30 cases with an average of (57.3± 5.2) years old were selected in the non-aged group.The distribution of non-motor symptoms items was analyzed between two groups.The clinical characteristics of PD patients were also collected to assess the dominant influencing factors for the prevalence of non-motor symptoms.Results The total number of non-motor symptoms was significantly higher in aged PD patients and non aged PD patients than in age-matched control groups [(13±7) vs.(4±2),t=10.843; (11±4) vs.(2±1),t=12.145,both P＜0.001].The incidence of non-motor symptoms was significantly higher in aged PD patients (20 items) and non-aged PD patients (9 items) than in age-matched control groups (both P＜0.05).The constipation in aged PD patients and the olfactory disturbance in non-aged PD patients were the most frequent ones.The number of non motor symptoms was positively correlated with course of disease(r=0.413),age(r=0.385) and Hoehn-Yahr stage (r =0.318) in aged PD patients (all P ＜ 0.05).The number of non motor symptoms was positively correlated with Hoehn-Yahr stage in non-aged PD patients (r=0.306,P＜0.05).Conclusions non-motor symptoms are more frequently seen in aged and non-aged PD patients than in age-matched controls.non-motor symptoms are more common in PD patients at earl stage and the number of non-motor symptoms increases with the degree of disease severity and age.More attention should be paid to the diagnosis and rational treatment of the non-motor symptoms so as to increase treatment effectiveness.
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Objective To observe the effects of levodopa on verbal and spatial working memory in elderly patients with Parkinson's disease (PD).Methods The modified Smith working memory software were applied to study the verbal and spatial working memory in 32 PD patients before and 8 weeks after treatment with levodopa and benserazide hydrochloride tablets.The results of PD patients were compared with those in 32 normal controls matched for age,sex and education.Results The correct rates of phonological verbal and coordinate visuospatial working memory were significantly lower in the PD patients without treatment than in the normal controls (both P＜0.01).The correct rates of semantic verbal and categorical visuospatial working memory had no significant differences between the PD patients without treatment and the normal controls (both P＞0.05).The correct rates of phonological verbal working memory and coordinate visuospatial working memory were significantly higher in the PD patients after administration of levodopa and benserazide tablets than in PD patients without treatment [(88.6±6.5)％ vs.(82.1 ± 6.6)％,(84.2±8.8)％ vs.(75.2±8.9)％,respectively,both P＜0.01],but there were no significant differences in the correct rates of semantic verbal working memory and categorical visuospatial working memory between the above two groups (both P＞0.05).The correct rates of phonological verbal,semantic verbal,coordinate visuospatial and categorical visuospatial working memory were negatively correlated with the course of disease,and had no correlations with age and the degree of education.Conclusions Levodopa can improve the functions of phonological verbal working memory and the coordinate visuospatial working memory,but has no effect on the semantic verbal working memory and the categorical visuospatial working memory.It is postulated that dopamine replacement therapy may have double dissociable effects on the different working memories.
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Objective To characterize emotional memory impairment in untreated patients with Parkinson' s disease (PD) in the early stages of the disease. Methods Emotional memory tasks using standardized sets of emotional pictures including positive, neutral and negative valence were tested in 33 untreated patients with PD in the early stages and 31 healthy controls matched with age, sex, and education.Results Compared with the healthy adults (13.4 ± 1.4), PD patients had significant loss of negative valence picture memorizing ( 8. 9 ± 1.0; t = - 14. 87, P ＜ 0. 01 ).There was no significant difference between PD patients and normal controls in positive ( 11.8 ± 1.0 vs 12. 4 ± 2. 2 , t = - 0. 95 ) and neutral (7.9 ± 1.4 vs 8.2 ± 1.3, t = - 0. 89) valence picture memorizing ( both P ＞ 0. 05 ). ConclusionThe emotional memory for negative valence pictures is impaired but the emotional memory for positive and neutral is relatively spared in early PD patients without treatment.