Vascular cognitive impairment with no dementia treated with auricular acupuncture and acupuncture:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To compare the clinical efficacy on vascular cognitive impairment with no dementia (VCIND) between the combined therapy of auricular acupuncture and acupuncture and the simple acupuncture.</p><p><b>METHODS</b>One hundred patients of VCIND were randomized into a combined therapy of auricular acupuncture and acupuncture group (a combined therapy group) and an acupuncture group, 50 cases in each one. The basic internal medicine treatment was applied in the two groups. Additionally, in the combined therapy group, auricular acupuncture and's three needling therapy were used. pizhixia (AT), xin (CO), shen (CO), gan (CO), erzhong (HX) were selected in auricular acupuncture, once every Monday, Wednesday and Friday;,andwere selected in's three needling therapy, once a day. In the acupuncture group,'s three needling therapy was just provided, once a day. The treatment was given for 4 weeks in the two groups. Montreal cognitive assessment (MoCA) and social function activities questionnaire (FAQ) were adopted for the evaluation comparison before treatment and in 2 weeks and 4 weeks after treatment in patients of the two groups.</p><p><b>RESULTS</b>Compared with those before treatment, the total scores of MoCA were improved in 2 and 4 weeks after treatment in the two groups (all<0.01). The score in the combined therapy group was improved more apparently as compared with that in the acupuncture group (<0.01). FAQ score was reduced in the two groups (all<0.05). The score in the combined therapy group was reduced more apparently as compared with that in the acupuncture group (<0.05). As compared with the result in 2 weeks of treatment, MoCA score was improved in the two groups in 4 weeks of treatment (both<0.01), the improvements in the combined therapygroup were more obvious than those in the acupuncture group (<0.05) and FAQ score was reduced in the two groups (<0.05), but the difference was not significant between the two groups (>0.05).</p><p><b>CONCLUSIONS</b>The combined therapy of auricular acupuncture and acupuncture effectively improve the cognitive function and social function, which are better than the effects of simple acupuncture in VCIND. The improvement of the combined therapy in social function is more advantageous in the treatment of the first two weeks.</p>

Genetic predisposition to higher production of interleukin-6 through -174 G > C polymorphism predicts global cognitive decline in oldest-old with cognitive impairment no dementia / Predisposição genética à maior produção de interleucina-6 por meio do polimorfismo -174 G > C prediz declínio cognitivo global em idosos muito idosos com comprometimento cognitivo não demência

Interleukin 6 (IL-6) is a pro-inflammatory cytokine upregulated in neurodegenerative contexts. The polymorphism IL-6 -174 G > C influences release levels of this cytokine. We aimed to evaluate the influence of IL-6 -174 G > C on global cognitive score of a group with cognitive impairment no dementia in one year of follow-up.Methods The subjects were categorized in two groups: short-term decline in global cognitive score and those with short-term stability or improvement. IL-6 174 G > C information were compared among these groups.Results We observed that individuals with cognitive impairment no dementia with GGlowergenotype were more frequent among global cognitive score non-decliners while carriers of at least one Chigherallele were more frequent in the group with global cognitive score decliners (p = 0.012; RR = 3.095 IC95%= 1.087-8.812).Conclusion These results suggest that the higher expression of IL-6 gene may be an independent risk factor for cognitive decline among individuals with cognitive impairment no dementia.

Interleucina 6 (IL-6) é uma citocina pró-inflamatória cuja produção acentua-se em contextos neurodegenerativos. O polimorfismo IL-6 -174 G > C influencia os níveis secretados deste mediador inflamatório. Nós objetivamos avaliar a influência de IL-6 -174 G > C sobre o escore cognitivo global de um grupo com comprometimento cognitivo não demência em um ano de seguimento.Métodos Os participantes foram categorizados em dois grupos: com declínio em escore cognitivo global em curto prazo e aqueles com melhora ou estabilidade do escore cognitivo global.Resultados Nós observamos que indivíduos com comprometimento cognitivo não demência carreadores do genótipo GGbaixa foram mais frequentes entre pacientes com escore cognitivo global não declinante, enquanto carreadores de no mínimo um alelo Caltaforam mais frequentes no grupo que apresentou declínio no escore cognitivo global (p = 0,012; RR = 3,095 IC95%= 1,087-8,812).Conclusão Estes resultados sugerem que a alta expressão do gene IL-6 pode ser um fator de risco independente para declínio cognitivo entre pacientes com comprometimento cognitivo não demência.

Effects of computer assisted training combined with the actual environment training on vascular cognitive impairment with no dementia after stoke / 中华物理医学与康复杂志

Objective To observe the effects of computer assisted training combined with the actual environment training on vascular cognitive impairment with no dementia (VCIND) after stoke.Methods Sixty elderly patients with VCIND after stroke were randomly divided into a research group and a control group,each of 30.All patients were given routine medication and rehabilitation training,while the research group was additionally provided with computer assisted training and the actual environment training lasting two months.All patients' cognitive function and activities of daily life (ADL) in both groups were assessed using the Montreal cognitive assessment scale(MoCA) and modified Barthel index(MBI) before and after treatment.Results After two months of treatment,the total score of MoCA (22.80 ± 4.63) and the scores of seven subprojects including visual space (4.00 ± 0.93),naming (2.67±0.62),attention(4.13 ±0.74),language(2.33 ±0.62),abstract thinking(1.60± 0.83),delayed memory(2.93 ±0.70) and orientation(5.13 ± 1.19) in the research group were significantly higher than those before treatment and those of the control group.However,in the control group,only the total score and the scores of naming,language and delayed memory in the control group significantly were higher than those before treatment.After treatment,the scores of MBI in both group were significantly promoted,reaching (61.53 ± 7.13) and (52.20 ± 4.93) for the research and control group respectively,with the former improving more significantly than the latter.Conclusion The computer assisted training combined with the actual environment training helps to improve cognitive function and ADL for patients with VCIND after stoke.Such combined therapy is worth of promoting in clinical practice.

Effect of computer-assisted cognitive training on cognitive function and P300 in patients with vascular cognitive impairment no dementia / 中华物理医学与康复杂志

Objective To explore the effect of computer-aided cognitive training on cognitive function and auditory event-related potential P300 in patients with vascular cognitive impairment no dementia (VCIND).Methods Sixty VCIND patients were randomly divided into two groups namely a training group and a control group,each of 30.Both groups were given routine drug treatment and the traditional rehabilitation training.At the same time,the training group was additionally given 40min computer-aided cognitive training once a day,six times a week,lasing 4 weeks.Before and after four weeks of treatment,the cognitive function,the ability of daily life (ADL) and P300 of the two groups were assessed using mini-mental state examination(MMSE),the Montreal cognitive assessment (MoCA),Barthel Index (BI) and Motor evoked potential instrument respectively.Results Before treatment,no significant difference was found in the average MoCA,MMSE and BI scores of the two groups.After treatment,improvement was observed in the total MoCA scores (22.40 ± 4.38),as well as the average score,of visual space and executive function (3.27 ± 0.58),attention (4.30 ± 1.60),language (2.67 ± 0.48),delayed memory (3.67±0.80),MMSE (22.03 ±3.55) and BI (82.17±11.28) in the training group compared with the control group.Before treatment,there was no significant difference in the P300 latency and amplitude between the two groups.After treatment,however,the P300 latency of the training group decreased to(352.1 ± 30.68) ms,significently lower than the control group [(356.45 ± 40.30) ms] and that before treatment.Meanwhile,the amplitude rose to(8.65 ± 1.18)μV,significantly higher than the control group [(8.65 ± 1.18) μV] and that before treatment.Conclusion Computer-aided cognitive training can effectively improve the cognitive function of patients with VCIND and promote their ADL.

Curative Effect of Nimodipine on Vascular Cognitive Impairment no Dementia / 中国药师

Objective: To investigate the curative effect of nimodipine on vascular cognitive impairment no dementia. Methods:Totally 76 patients with vascular cognitive impairment no dementia were randomly divided into group A with 39 cases and group B with 37 cases. The two groups were given conventional treatment ( aspirin tablets, 100 mg · d-1 , and atorvastatin calcium tablets, 20 mg·d-1 , The patients in group A were treated with nimodipine additionally, 30 mg, po, tid. The course of treatment of the two groups was two weeks. The Montreal Cognitive Assessment ( MOCA) and mini-mental state examination ( MMSE) were used to evaluate the efficacy of the two groups before and after the treatment. Results:After the treatment, MMSE and MOCA scores in group A were increased significantly compared with those before the treatment (P 0. 05). The total efficacy in group A was notably higher than that in group B (P < 0. 05). No patient experienced adverse drug reactions in both groups. Conclusion: Nimodipine has preventive and therapeutic effects on vascular cognitive impairment no dementia.

Correlation between neuropsychiatric symptoms and caregiver burden in a population-based sample from São Paulo, Brazil: a preliminary report / Correlação entre sintomas neuropsiquiátricos e sobrecarga do cuidador em uma amostra comunitária de São Paulo, Brasil: um relato preliminar

Neuropsychiatric symptoms and caregiver burden are highly prevalent in older adults with Alzheimer's disease (AD).OBJECTIVE: To evaluate the correlation between neuropsychiatric symptoms and caregiver burden in a community-based sample from São Paulo, Brazil. METHODS: A total of 1,563 randomly-selected subjects were assessed by the Mini-Mental State Examination, Fuld Object Memory Evaluation, Informant Questionnaire on Cognitive Decline in the Elderly and Bayer - Activities of Daily Living Scale. Subjects considered screen-positives were submitted to a dementia workup and diagnosis was determined according to ICD-10 criteria. The neuropsychiatric Inventory was applied to caregivers to evaluate neuropsychiatric symptoms and the Zarit Burden Interview was also applied to assess caregivers' burden. RESULTS: Sixty-one AD patients, 25 Cognitively Impaired Non Demented (CIND) and 79 healthy elderly subjects were evaluated. Zarit mean scores for controls, CIND and AD were 2.32, 3.92 and 20.11, respectively. There was strong positive correlation between total NPI and Zarit scores.

Sintomas neuropsiquiátricos e sobrecarga do cuidador apresentam alta prevalência em idosos com doença de Alzheimer (DA). OBJETIVO: Avaliar a correlação entre sintomas neuropsiquiátricos e sobrecarga do cuidador em uma amostra comunitária de São Paulo, Brasil. MÉTODOS: Um total de 1.563 indivíduos selecionados aleatóriamente foram avaliados através do Mini-Exame do Estado Mental, "Fuld Object Memory Evaluation", "Informant Questionnaire on Cognitive Decline in the Elderly" e da Escala Bayer - Atividades de Vida Diária. Indivíduos considerados suspeitos foram submetidos a uma investigação para demência, sendo o diagnóstico feito com os critérios da CID-10. Inventário Neuropsiquiátrico foi aplicado nos cuidadores para avaliar sintomas neuropsiquiátricos e a Escala Zarit de Sobrecarga no Cuidador para avaliar sobrecarga nos cuidadores. RESULTADOS: Sessenta e um pacientes com DA, 25 sujeitos com Comprometimento Cognitivo não Demência (CIND) e 79 idosos saudáveis foram avaliados. A média dos escores da Zarit para controles, CIND e DA foi, respectivamente, 2,32, 3,92 e 20,11 pontos. Houve correlação positiva boa entre os escores da NPI e da Zarit. CONCLUSÃO: Sintomas neuropsiquiátricos mostraram uma associação significativa com escores mais elevados de estresse do cuidador.

Vascular Cognitive Impairment (VCI) afternon-embolic ischemic stroke during a 12-month follow-up in Brazil / Comprometimento cognitivo vascular (CCV) após acidente vascular isquêmico não embólico, em seguimento de 12 meses no Brasil

VCI represents a spectrum of cognitive impairments associated with stroke, vascular brain injury, or subclinical disease ranging from the least to most severe manifestations. Few studies are available on the prevalence of post-stroke VCI and none have been conducted in Brazil. Objective: To determine the prevalence rates of VCI and associated risk factors in a sample of ischemic stroke patients. Methods: We evaluated 172 patients with ischemic stroke for cognitive impairment one year after ictus. Results: Patients comprised 81 women (47.1%) and had a mean age of 67.77 (7.86) years, schooling of 3.52 (2.99) years, and MMSE score of 24.94 (3.59) points. After cognitive evaluation, 4.6% were diagnosed as CIND(cognitive impairment no dementia) and 12.2% had a diagnosis of dementia (probable vascular dementia in 20 patients and one subject with cerebrovascular disease and Alzheimers disease). Conclusion: The prevalence of dementia was lower than previous reports but our sample had a lower age than others, while a 12 month-period of follow-up prevented interference from associated neurodegenerative disorders.

CCV representa um espectro de comprometimento cognitivo associado ao AVC, lesão cerebral vascular ou doença subclínica que vai desde as manifestações menos graves às mais graves. Há poucos estudos sobre a prevalência de CCV pós AVC e nenhum no Brasil. Objetivo: Determinar a prevalência de VCI em uma amostra de pacientes com AVC isquêmico e fatores de risco associados. Métodos: Foram avaliados 172 pacientes com AVC isquêmico após um ano do ictus, em relação ao comprometimento cognitivo. Resultados: Os pacientes foram compostos por 81 mulheres (47,1%) e tinham idade média de 67,77 (7,86) anos, a escolaridade de 3,52 (2,99) anos, a pontuação do MEEM de 24,94 (3,59)pontos. Após a avaliação cognitiva, 4,6% foram diagnosticados como CCSD (comprometimento cognitivo sem demência) e 12,2% tiveram diagnóstico de demência (demência vascular provável em 20 pacientes e um com doença cerebrovascular e doença de Alzheimer). Conclusão: A prevalência de demência na nossa população está entre as mais baixas, porém,nossos pacientes são mais jovens e foram acompanhados por um período de 12 meses, o que evita a contaminação por doenças neurodegenerativas associadas.

Feasibility study of the Montreal cognitive assessment in detecting subcortcial vascular cognitive impairment-no dementia / 中华行为医学与脑科学杂志

ObjectiveTo explore feasibility study of the Montreal cognitive assessment (MoCA) in detecting subcortcial vascular cognitive impairment-no dementia(VaCIND-S).MethodsSeventy-five Chinese Han were assessed by the MoCA and MMSE.40 met criteria for VaCIND -S and 35 were considered cognitively normal.ROC curve analyses were performed to determine optimal sensitivity and specificity.ResultsNo differences were found between groups on age,gender,education degrees.According to their MoCA scores,cognitive impairments including memory,visuospatial,executive function,attention,language,and orientation sub-scores in VaCIND-S ( (0.43 ± 1.01),(2.21 ± 1.19),(2.11 ± 1.13),(4.66 ± 1.48),(4.42 ±1.31),(4.86 ± 1.12)) significantly decreased compared with those in controls( (2.93 ± 1.36),(3.29 ± 1.06),(3.53 ±0.93),(5.94 ±0.24),(5.44 ± 0.71 ),(5.80 ± 0.48 ) ) (P ＜ 0.05 ).The MMSE scale was insensitive to cognitive impairment as compared with MoCA scale.Using cut-off score of 23.5,the MoCA exhibited excellent sensitivity (0.971 ) and specificity (0.789).ConclusionMoCA is a more sensitive instrument than the MMSE for the detection of VaCIND-S and warrants further investigation regarding its applicability in large and varying ethnic population.

Feasibility study of the Montreal cognitive assessment of Chinese version for the detection of vascular cognitive impairment-no dementia in Han population / 中华行为医学与脑科学杂志

Objective To explore feasibility of the Chinese version of MoCA for the detection of vascular cognitive impairment-no dementia (VaCIND) and control in a cross-sectional study. Methods One hundred and three Chinese Han were assessed by the MoCA and MMSE. 64 met criteria for VaCIND and 39 were considered cognitively normal. Sensitivities and specificities were calculated using the recommended cut-off scores,and ROC curve analyses were performed to determine optimal sensitivity and specificity. Results No differences were found between groups on age,gender,education degrees. According to their MoCA scores,cognitive impairments including memory,visuospatial, executive function, attention, language, and orientation sub-scores in VaCIND ((0.44 ± 0.96), (2.13 ±1.40), (1.90 ±1.02), (4.61 ±1.41), (4.23 ±1.40), (5.38 ±1.15)) significantly decreased compared with that in controls((2.92 ± 1.42) ,(3.16 ± 1.08) ,(3.32 ± 1.07) ,(5. 87 ±0.41) ,(5.34 ±0.75), (5.79 ±0. 70)) (P<0. 05). The MMSE scale was insensitive to cognitive impairment as compared with MoCA scale. Using cut-off score of 24,the MoCA exhibited excellent sensitivity (0.923) and specificity (0.906). Conclusion MoCA is a more sensitive instrument than the MMSE for the detection of VaCIND and warrants further investigation regarding its applicability in large group and varying ethnic groups.

Comparison of Cognitive Functions in Patients with Amnestic Mild Cognitive Impairment and Vascular Cognitive Impairment-no Dementia / 中国心理卫生杂志

Objective: To investigate the cognitive impairment features in patients with amnestic mild cognitive impairment(aMCI) and vascular cognitive impairment-no dementia(VCI-ND).Methods:Sixteen normal elders,10 patients with aMCI and 12 patients with VCI-ND were recruited.The normal elders were selected from communities in Shanghai,while the aMCI and VCI-ND patients were selected from outpatient clinic.All participants ranged in age of 50～80 years,with education level of junior middle school or above,and they completed cranial CT or MRI and a series of neuropsychological tests.Results:In the three memory tests,aMCI group performed worst.The scores of both aMCI and VCI-ND groups were lower than that of the normal elders.For example,the delayed recall scores of the Rey-Osterrich complex figure test in the three groups were(18.8?9.5)(normal),(5.6?5.6)(aMCI) and(9.6?7.0)(VCI-ND)(P