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Acupuncture has a certain effect for the patients with post-stroke depression. In clinics, acupuncture treat this disease from the brain, liver and kidney, heart and spleen, and phlegm and blood stasis. Acupuncture plays a role in nourishing the bone of marrow, regulating the liver and kidney, nourishing the heart and mind, and invigorating the spleen and stomach. Acupuncture plays an antidepressant role by regulating neurotransmitters and receptors, promoting nerve function repair, inhibiting the secretion of inflammatory factors, reducing inflammatory response, inhibiting the hyperfunction of hypothalamic-pituitary-adrenal axis, and regulating the brain-gut axis.
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Objective To analyze the clinical efficacy of acupuncture combined with rehabilitation training in the treatment of post-stroke hemiplegia.Methods A retrospective study was conducted to select 121 cases of post-stroke hemiplegia patients who attended Haikou People's Hospital,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2021 to January 2023,and were divided into the control group and the acupuncture group according to whether acupuncture treatment was performed or not;59 cases in the control group were given conventional rehabilitation training methods of treatment,and 62 cases in the acupuncture group were added with acupuncture treatment on the basis of the conventional rehabilitation treatment.The course of treatment was 1 month.The changes in the traditional Chinese medicine(TCM)syndrome scores of the patients in the two groups were observed before and after treatment,as well as the cerebrovascular resistance values,including carotid artery mean blood flow(Qmean),mean velocity(Vmean),cerebrovascular bed characteristic impedance(Zc),and peripheral vascular resistance(R),and the changes in the Stroke Impact Scale(SIS),China Stroke Scale(CSS),and Fugl-Meyer Assessment(FMA)in the patients in the two groups were observed before and after treatment,and the clinical efficacy of the two groups was evaluated.Results(1)The total effective rate was 93.55%(58/62)in the acupuncture group and 79.66%(47/59)in the control group.The efficacy of the acupuncture group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,all TCM syndrome scores and total scores of patients in the two groups were significantly improved(P＜0.05),and the acupuncture group was significantly superior to the control group in improving TCM syndrome scores,with statistically significant differences(P＜0.05).(3)After treatment,the cerebral circulatory kinetic parameters of the patients in the two groups were significantly improved(P＜0.05),and the acupuncture group was significantly superior to the control group in improving the cerebral circulatory kinetic parameters,with a statistically significant difference(P＜0.05).(4)After treatment,the SIS,CSS,and FMA scores of patients in the two groups were significantly improved(P＜0.05),and the acupuncture group was significantly superior to the control group in improving the SIS,CSS,and FMA scores,and the differences were all statistically significant(P＜0.05).Conclusion The efficacy of acupuncture in the treatment of post-stroke hemiplegia is remarkable,and its efficacy is better than that of simple conventional rehabilitation training.
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Objective To observe the clinical efficacy of thumb-tack needling for subcutaeous embedding combined with joint mobilization in the treatment of post-stroke shoulder-hand syndrome.Methods A total of 80 patients with post-stroke shoulder-hand syndrome were randomly divided into a treatment group and a control group,with 40 patients in each group.Both groups were given arthrocentesis,the control group was given ordinary acupuncture on the basis of arthrocentesis,and the treatment group was combined with thumb-tack needling for subcutaeous embedding.One course of treatment was 4 weeks and a total of 4 weeks of treatment was given.After 1 month of treatment,the clinical efficacy of the two groups was evaluated.The changes of Visual Analogue Scale(VAS)of pain scores and simplified Fugl-Meyer Assessment(FMA)scores,as well as the pain-free passive forward flexion and abduction of the shoulder joint of the affected limb were observed before and after treatment.The Simple Quality of Life Scale(SF-36)scores of the patients in the two groups were compared after treatment.The safety and the occurrence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate was 95.00%(38/40)in the treatment group and 80.00%(32/40)in the control group.The efficacy of the treatment group was superior to that of the control group,and the difference was statistically significant(P＜0.05).(2)After treatment,the VAS scores and upper extremity FMA scores of the patients in the two groups were significantly improved(P＜0.05),and the treatment group was significantly superior to the control group in improving the VAS scores and upper extremity FMA scores,and the differences were statistically significant(P＜0.05).(3)After treatment,the joint mobility of patients in the two groups were significantly improved(P＜0.05),and the improvement of shoulder joint movement in the treatment group was superior to that in the control group,and the difference was statistically significant(P＜0.05).(4)After treatment,the SF-36 Quality of Life Scale scores of the treatment group were significantly superior to those of the control group in terms of physical function,psychological function,emotional health,and social function levels,and the difference was statistically significant(P＜0.05).(5)There was no significant difference in the incidence of adverse reactions between the treatment group and the control group(P＞0.05).Conclusion Thumb-tack needling for subcutaeous embedding combined with joint mobilization exert certain effect in the treatment of post-stroke shoulder-hand syndrome.It can significantly improve the pain symptoms of patients,thus improving their quality of life,and the clinical effect is remarkable.
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Objective To observe the clinical efficacy of Xingnao Kaiqiao Acupuncture(with the functions of awakening the brain and opening the orifices)combined with acupuncture at pericardium meridian points in the treatment of post-stroke sleep reversal(PSSR).Methods Sixty patients with PSSR were randomly divided into observation group and control group,30 patients in each group.Both groups were given conventional treatment,the control group was given oral use of Alprazolam,and the observation group was given the combination of acupuncture a at pericardial meridian points,and 10 days of treatment was one course of treatment.After 10 days of treatment,the clinical efficacy of the two groups was evaluated.The changes in the Pittsburgh Sleep Quality Index(PSQI)and Ascens Insomnia Scale(AIS)scores,as well as the Hamilton Depression Scale(HAMD)scores were observed before and after treatment in the two groups.The changes in cortisol levels at 0,8,and 16 o'clock were compared before and after treatment between the two groups.Results(1)After treatment,the PSQI scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving PSQI scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the AIS and HAMD scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the AIS and HAMD scores,and the difference was statistically significant(P＜0.05).(3)After treatment,the cortisol level of patients in the two groups at 0,8,and 16 o'clock was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the cortisol level at 0,8,and 16 o'clock was significantly superior to the control group,and the difference was statistically significant(P＜0.05).(4)The total effective rate was 86.67%(26/30)in the observation group and 80.00%(24/30)in the control group.The efficacy of the observation group was slightly superior to that of the control group,but the difference was not statistically significant(P＞0.05).Conclusion Xingnao Kaiqiao Acupuncture combined with acupuncture at pericardium meridian points for the treatment of PSSR can significantly improve the clinical symptoms of the patients,so as to improve the quality of life of the patients,and the therapeutic efficacy is remarkable.
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Based on FangNet platform,the data of the prescriptions for the effective cases of post-stroke sequelae treated by national renowned Chinese medical practitioner LIU Mao-Cai were collected for the analysis of medication frequency of the prescribed drugs as well as their properties,flavors and meridian tropism.The medication rules of LIU Mao-Cai for treating post-stroke sequelae was summarized by analyzing the weight scale,co-occurrence and mutual exclusivity of the prescribed drugs and by drug-symptom association rule analysis and drug clustering analysis.The results showed that a total of 105 prescriptions involving 95 Chinese medicines were obtained.The drugs in the prescriptions were mainly warm in nature,sweet in flavor and had the meridian tropism of liver meridian.There were 17 driver herbs,and they were Astragali Radix,Gastrodiae Rhizoma,Corni Fructus,Codonopsis Radix,Eucommiae Cortex,Achyranthis Bidentatae Radix,Chuanxiong Rhizoma,Polygalae Radix,Curcumae Longae Rhizoma,Acori Tatarinowii Rhizoma,Ophiopogonis Radix,Atractylodis Macrocephalae Rhizoma,Salviae Miltiorrhizae Radix et Rhizoma,Poria,Uncariae Ramulus cum Uncis,Pinelliae Rhizoma Praeparatum,and Ligustri Lucidi Fructus.The results of drug co-occurrence analysis yielded 12 drug pairs such as Achyranthis Bidentatae Radix-Eucommiae Cortex,drug-symptom association rule analysis yielded 9 groups of drug-symptom association combinations such as Gastrodiae Rhizoma-dizziness,and cluster analysis yielded 4 drug combinations.The results indicated that the drugs for post-stroke sequelae treated by LIU Mao-Cai are mild in nature and mainly have the actions of supporting healthy-qi and replenishing the deficient,and Astragali Radix and Codonopsis Radix are often used to replenish the vital energy,and Corni Fructus,Achyranthis Bidentatae Radix and Eucommiae Cortex are usually used to tonify the liver and kidney.Moreover,simultaneous treatment of phlegm and blood stasis,and simultaneous application of purging and nourishing therapeutics are also stressed.
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Objective We conduct a systematic review and meta-analysis to evaluate the efficacy and safety of Suanzaoren decoction for post-stroke insomnia.Methods We conducted a comprehensive literature search,including PubMed,EMbase,CNKI,WanFang Data and so on,from the database creating to September 15th 2023.Our systematic review only included randomized controlled trials(RCTs)concerning with Suanzaoren decoction in treating post-stroke insomnia.Two reviewers independently screened the literature,extracted the data,and assessed the risk of bias for included studies.We used RevMan 5.3 software to perform Meta-analysis.Results A total of 13 RCTs were included,involving 1002 patients.The meta-analysis results showed that the clinical effective rate of the Suanzaoren decoction group was higher than the control group(OR=4.25,95%CI 2.79 to 6.46,P<0.00001).The Suanzaoren decoction group(combined with other treatments)reduced the Pittsburgh sleep quality index(PSQI)score more significantly than the control group(MD=-2.78,95%CI-3.24 to-2.33,P<0.00001).The Suanzaoren Decoction group was better than the control group in reducing the score of the National Institute of Health Stroke Scale(NIHSS)and improving neurological impairment(MD=-1.58,95%CI-1.95 to-1.21,P<0.00001).The incidence of adverse events in Suanzaoren Decoction group was lower than that in the control group(OR=0.38,95%CI 0.20 to 0.71,P=0.003).Conclusion Suanzaoren decoction can enhance the clinical efficacy and improve the degree of neurological defect of post-stroke insomnia patients,Suanzaoren decoction(combined with other treatments)can improve the sleep quality.The incidence of adverse events is lower.However,the efficacy and safety of Suanzaoren decoction for post-stroke insomnia still need to be further verified by more high-quality RCTs.
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Objective To observe the protective effect of modified Baishile Decoction on hippocampal neuronal cells cultured in vitro;To explore its mechanism of treating post-stroke depression.Methods Hippocampal neuronal cells from mammary rats were isolated and cultured in vitro,cell injury was induced by oxygen glucose deprivation combined with lipopolysaccharide.The cells were divided into normal group,model group,blank serum group(10%)and modified Baishile Decoction containing serum group(10%).Invertedmicroscope was used to observe cell morphological changes,CCK-8 method was used to detect cell survival rate,Hoechst33342 staining was used to observe apoptosis,ELISA was used to detect Glu,5-HT,TNF-α,IL-1β,and IL-6 contents in cell supernatant,the expressions of purinergic P2X7 receptor(P2X7R)and NOD-like receptor protein 3(NLRP3)were detected by immunofluorescence staining.Results Compared with the normal group,the hippocampal neurons in the model group showed significant changes in cell morphology,the cell survival rate significantly decreased(P<0.01),the cell apoptosis increased(P<0.01);Glu,TNF-α,IL-1β,IL-6 contents in cell supernatant significantly increased(P<0.05,P<0.01),5-HT content significantly decreased(P<0.01),P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly increased(P<0.01).Compared with the model group,the morphology of hippocampal neurons in modified Baishile Decoction containing serum group was significantly improved,the cell survival rate significantly increased(P<0.01),the cell apoptosis reduced(P<0.01);Glu,TNF-α and IL-1β content in cell supernatant significantly reduced(P<0.05,P<0.01),5-HT content significantly increased(P<0.01),and P2X7R and NLRP3 expressions in hippocampal neuronal cells significantly decreased(P<0.01).Conclusion Modified Baishile Decoction may exert a protective effect on oxidative glucose deprivation combined with lipopolysaccharide induced hippocampal neuronal inflammation damage by inhibiting the P2X7R/NLRP3 signaling pathway,regulating neurotransmitter secretion,and inhibiting inflammatory factor release,thus treating post-stroke depression.
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Objective To explore the application low of stimulation parameters of transcutaneous electrical acupoint stimulation(TEAS)and transcranial direct current stimulation(tDCS)for post-stroke movement disorders based on data mining.Methods The relevant clinical research literature was retrieved from CNKI,Wanfang Data,VIP,CBM,PubMed and Web of Science from January 2000 to May 2023.A database was set up after quality assessment.Frequency analysis,association rules and complex network analysis were used to explore the application law of core acupoints and electrical stimulation parameters.Results A total of 79 articles were included and 128 groups of data were contained.For TEAS,the core acupoints included Waiguan(TE5),Shousanli(LI10),Zusanli(ST36),Hegu(LI4),Neiguan(PC6),Yanglingquan(GB34),etc.,while the most commonly used acupoint combinations of upper limb and lower limb were Shousanli(LI10)-Waiguan(TE5)and Yanglingquan(GB34)-Zusanli(ST36).Among the electrical stimulation parameters of TEAS,the frequencies used vary widely,and 100 Hz was most commonly used,while 2 Hz TEAS was also mainly used for stimulating acupoints located on upper limbs in the treatment of flaccid paralysis.The application of other electrical stimulation parameters was relatively consistent.The bidirectional symmetrical square-wave with 200-250 μs pulse-width was used in majority of studies.The stimulus intensity was mostly determined by patient tolerance.For tDCS,stimulation electrodes were often positioned on the projection of the primary M1,and the safe stimulus intensity was mostly set as 1 to 2 mA.Conclusion In the treatment of post-stroke movement disorders,appropriate acupoints and electrical stimulation parameters of TEAS should be determined on the muscle strength and muscle tension of stroke patients at different stages after stroke,particularly the selection of electric stimulating frequency.
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Objective To observe the effects of electroacupuncture on central inflammatory response and neurotransmitter release in rats with post stroke spasticity(PSS);To exploring the mechanism in treating PSS based on IL-6/JAK2/STAT3 signaling pathway.Methods Totally 30 male SD rats were randomly divided into sham-operation group,model group and electroacupuncture group,with 10 rats in each group.The PSS model was prepared by the method of suture and N-methyl-D-aspartic acid receptor injection into internal capsule.The rats in the electroacupuncture group were electroacupulated on the affected side of the body at"Quchi"and"Yanglingquan"for 30 min/d for consecutive 7 d.The sham-operation group and the model group were only fixed without any interventions.The Zea Longa neurological function score and the modified Ashworth muscle tension score were evaluated before and after treatment in each group;the pathological changes of the cortex on the ischemic side were observed by HE staining;the contents of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),and γ-aminobutyric acid(GABA)in cortex on the ischemic side were detected by ELISA;the content of glutamate(Glu)was detected by biochemical kit;Western blot was used to detect the expressions of tyrosine kinase 2(JAK2),p-JAK2,signal transduction and transcription activating factor 3(STAT3)and p-STAT3 protein in ischemic cortex;RT-PCR was used to detect the mRNA expressions of JAK2 and STAT3 in ischemic cortex.Results Compared with the sham-operation group,neurological function score and muscle tension score significantly increased in the model group(P<0.01),with disorganized neurons in cerebral cortex,nucleus accumbens,the contents of IL-6,TNF-α and Glu significantly increased,the content of GABA significantly decreased(P<0.01),and p-JAK2,p-STAT3 proteins and JAK2 and STAT3 mRNA expression significantly increased(P<0.01,P<0.05).Compared with the model group,the neurological function score and muscle tension score of rats in the electroacupuncture group were significantly decreased(P<0.05),the degree of neuronal damage in cerebral cortex was reduced,the cell contour was clear,the content of IL-6,TNF-α and Glu were significantly decreased,and the content of GABA significantly increased(P<0.05,P<0.01),p-JAK2,p-STAT3 protein and JAK2,STAT3 mRNA expression significantly decreased(P<0.01).Conclusion Electroacupuncture may alleviate central inflammatory response and improve limb spasticity of PSS model rats by inhibiting the IL-6/JAK2/STAT3 signaling pathway.
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[Objective]To elaborate the significance of modulating the spirit and the mechanism of five elements music concrete hypnosis technique,so as to provide new ideas for the diagnosis and treatment of clinical post-stroke depression.[Methods]From the perspective of"modulating the spirit",this paper expounds the significance of five elements music concrete hypnosis technique in"modulating the spirit"by studying ancient and modern literature,explores its mechanism of action,and introduces five elements music concrete hypnosis technique in detail,and finally analyzes it combining with the clinical trial results.[Results]"Those who have the spirit prosper,those who are absent-minded die",modulating the spirit plays an important role in the treatment of clinical diseases,especially in the treatment of psychosomatic diseases.Five elements music concrete hypnosis technique plays a role in regulating the spirit by vibrating viscera,deducing concrete thinking,condensing breath and gathering Qi.The clinical application has achieved satisfactory results.[Conclusion]Five elements music concrete hypnosis technique in the treatment of post-stroke depression fully embodies the thought of"regulating the spirit"of traditional Chinese medicine,and its curative effect is considerable,which is worthy of further exploration and promotion.
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Post-stroke anxiety disorder （PSA） is a common psychiatric complication of stroke， which jeopardizes patients' recovery and their quality of life. Recent studies suggest that inflammation plays an important role in the pathogenesis of PSA. Therefore， this paper reviewed the related licture about the association between PSA and serum inflammatory biomarkers in order to provide references for the intervention of PSA. In this study， a comprehensive search was performed in China National knowledge Infrastructure （CNKI）， Wanfang Data， Web of Science and PubMed database to identify the well qualified literature focusing on the relationship between PSA occurrence and serum inflammatory biomarkers， and a total of 13 studies were retrieved. Analysis indicates a certain association between PSA occurrence and serum inflammatory biomarkers， and denotes that the elevation of inflammatory biomarkers may be a trigger for the disease occurrence and its progression， but the specific mechanism underlying this relationship requires further study.
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ObjectTo explore the risk factors related to the intensity of post-stroke depression in patients with cerebral infarction during hospitalization in the rehabilitation department. MethodsThe hospital consultation records of cerebral infarction patients in Beijing Bo'ai Hospital from December, 2019 to February, 2023 were reviewed from the hospital information system, and those who were diagnosed as depression visited the department of psychology were selected. It was collected including general information of sexes, ages, education levels, matrimony; medical features of course, location, affected side, sensory disorders, aphasia, agrypnia, dysphagia, hand-shoulder syndrome, constipation; functioning of muscle strength and Brunnstrom stages; and scores of Mini-Mental State Examination (MMSE), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Fugl-Meyer Assessment-Balance (FMA-B), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Patients with HAMD scores ≤ 20 were as the low group, and those > 20 were as the high group. ResultA total of 2 403 hospitalized stroke patients were included, out of which 269 patients with cerebral infarction were diagnosed as depression and visited the department of psychology; while 103 cases were in the low group and 166 cases were in the high group. The incidence of constipation was less, and the incidence of dysphagia and shoulder-hand syndrome was higher in the high group (χ2 > 5.379, P < 0.05), with weaker strength of iliopsoas muscle and quadriceps muscle, earlier of Brunnstrom stage of lower extremities and hands, and worse scores of NIHSS, MMSE, FMA, FMA-B and MBI (|Z| > 2.020, t > 2.171, P < 0.05). Logistic regression showed that constipation (OR = 0.435), quadriceps muscle strength (OR = 0.782) and dysphagia (OR = 2.602) related to the intensity of post-stroke depression in convalescent patients (P < 0.05). ConclusionPost-stroke dysphagia and poor quadriceps muscle strength may exacerbate post-stroke depression; however, constipation may not.
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ObjectiveTo explore the impact of autonomic nerve function on motor function in patients with post-stroke depression (PSD) from the perspective of regional homogeneity (ReHo). MethodsFrom January to December, 2020, a total of 60 inpatients and outpatients with cerebral infarction in the Affiliated Brain Hospital of Nanjing Medical University were divided into control group (n = 30) and PSD group (n = 30). Two groups were assessed using Fugl-Meyer Assessment (FMA), modified Barthel Index (MBI) and Hamilton Depression Scale (HAMD). Heart rate variability (HRV) was measured. Ten patients in each group were selected randomly to undergo resting state functional magnetic resonance imaging (rs-fMRI) to calculate ReHo. ResultsAll HRV indices were lower in PSD group than in the control group (|t| > 2.092, P < 0.05). In PSD group, FMA and MBI scores showed positive correlations with 24-hour standard deviation of normal-to-normal R-R intervals (SDNN), the root mean square of successive differences between normal heartbeats over 24 hours (RMSSD), the percentage of differences between adjacent normal R-R intervals over 24 hours that were greater than 50 ms (PNN50), total power (TP), very low frequency power (VLF) and low frequency power (LF) (r > 0.394, P < 0.05), and showed negative correlations with HAMD scores (|r| > 0.919, P < 0.001). HAMD scores in PSD group were negatively correlated with SDNN, RMSSD, PNN50, TP and VLF (|r| > 0.769, P < 0.001). Compared with the control group, the ReHo increased in PSD group in the right rectus gyrus (142 voxels, t = 6.575), the left medial and paracingulate gyri (204 voxels, t = 4.925) (GRF correction, P-Voxel < 0.005，P-Cluster < 0.05); and reduced in the right cerebellum (191 voxels, t = -6.487), the left middle temporal gyrus (140 voxels, t = -5.516), and the left precentral gyrus (119 voxels, t = -4.764) (GRF correction, P-Voxel < 0.005，P-Cluster < 0.05) in PSD group. ConclusionAutonomic nerve function is related to motor dysfunction in patients with PSD. The modulation of emotional, cognitive and motor brain regions by the autonomic nervous system may play a role in influencing the motor function in patients with PSD.
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Objective To explore the task-state electroencephalogram(EEG)characteristics of working memory in patients with post-stroke aphasia(PSA). Methods From September,2020 to February,2021,a total of eight patients with PSA(PSA group)and eight healthy adults(HC group)were recruited to collect EEG and memory scale data.The EEG data of working memory task-states were used to analyze the characteristics of the EEG frequency band indicators in time domain event-related potentials(ERP)and frequency;and the correlation with the items in the memory scale. Results Finally,five patients and five controls were included.N1 and P2 components were induced in the frontal area,and P300 components were induced in the parieto-occipital area.Compared with HC group,the activation of N1 and P2 increased in central prefrontal region,while the activity of P300 decreased in the right parieto-occipital re-gion in PSA group(|t|>2.193,P<0.05).The energy of theta band decreased in the right prefrontal region and the central parieto-occipital region,the energy of alpha1 band decreased in the left parieto-occipital region,and the energy of gamma band increased in the left central region(t>2.398,P<0.05).The energy of gamma band correlated with immediate recall(r = 0.914,P = 0.030)and correct recognition(r = 0.931,P = 0.022)of Auditory Verbal Learning Test,and inverting(r = 0.924,P = 0.025)and anterograde(r = 0.889,P = 0.044)of Digit Span Test. Conclusion Visual working memory task can activate the compensatory processing activity of memory related brain re-gions after PSA,which can be used as an objective indication for the evaluation of PSA working memory related research.There is close relationship between language impairment and working memory.
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Objective To systematically evaluate the efficacy and safety of the combination therapy of sodium valproate and edaravone in the treatment of post-stroke epilepsy(PSE).Methods The Cochrane Library,PubMed,Embase,Web of Science,CNKI,Wanfang database,and VIP databases were searched from the time of inception to May 2023.Randomized controlled trials of edaravone plus valproate versus valproate monotherapy for epilepsy were collected,the risk of bias of the included studies was assessed using the RoB 2 tool,and Meta-analyses were performed using RevMan 5.4 software.Results 13 studies with a total of 1 092 patients were included.The results showed that the response rate was significantly higher in the combination group than in the sodium valproate group[RR=0.18,95％CI(0.13 to 0.22),P＜0.01].The incidence of adverse reactions was lower[RR=0.73,95％CI(0.48 to 1.13),P=0.16].The seizure frequency[MD=-0.30,95％CI(-0.43,-0.11),P＜0.01]and duration of seizures[MD=-0.81,95％CI(-0.89,-0.72),P＜0.01]in the combined treatment group were significantly lower than those in the sodium valproate group.The inflammatory factors tumor necrosis factor-α[MD=-8.00,95％CI(-9.15,-6.84),P＜0.01],interleukin-2[MD=-10.19,95％CI(-14.61,-5.78),P＜0.01],interleukin-8[MD=-5.6,95％CI(-6.48,-4.73),P＜0.01]were significantly lower than those in the sodium valproate group.The neuron-specific enolase(NSE)level in patients with epilepsy in the combination treatment group was significantly better than that of the sodium valproate group at 1 month[MD=-4.73,95％CI(-4.99,-4.46),P＜0.01],3 months[MD=-2.10,95％CI(-3.26,-0.95),P＜0.01],and 6 months after treatment[MD=-1.31,95％CI(-2.35,-0.27),P＜0.01].There was no significant difference in NSE levels[MD=0.06,95％CI(-0.07,0.19),P=0.34]after 12 months.Conclusion Edaravone combined with sodium valproate in the treatment of post-stroke epilepsy can improve the epilepsy control rate of patients,shorten the frequency and duration of seizures,reduce the level of inflammatory factors in patients,promote the reduction of NSE levels,and improve their quality of life,which has a certain safety.
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In recent years, post-stroke depression (PSD) and post-stroke cognitive impairment (PSCI) have gradually attracted the attention of scholars as common stroke-related non-motor symptoms. As an emerging non-invasive neuroimaging tool, functional near-infrared spectroscopy (fNIRS) has been widely used in the study of neurological diseases, which can evaluate the functional status and recovery of these patients by monitoring changes in cerebral blood circulation and oxygenation signals; fNIRS is now being increasingly used in PSD and PSCI studies. This review mainly focuses on the research progress of fNIRS in identifying PSD and PSCI, exploring their neural mechanisms, and evaluating treatment effects, as well as advantages, disadvantages and future development prospects of fNIRS in clinical application, so as to provide some references for research on rehabilitation of affective disorders and cognitive disorders in stroke patients.
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The corpus callosum is a large commissural fiber connecting the two hemispheres. The anterior communicating artery, pericallosal artery, and posterior pericallosal artery supply it. Stroke in this area is indeed rare, with an incidence rate of 0.9% to 2.8% per year. There were no documented seizure cases as a manifestation of corpus callosum stroke. We report a case of a 42-year-old right-handed male with a history of hypertension and heart failure who presented with focal motor seizure with intact awareness, alien hand syndrome, and hemianesthesia. His cranial magnetic resonance imaging (MRI) showed a corpus callosum stroke and focal delta slowing on electroencephalography (EEG). This study showed that the corpus callosum is a possible epileptogenic focus.
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Post-stroke depression (PSD) is a serious and common complication of stroke, which seriously affects the rehabilitation of stroke patients. To date, the pathogenesis of PSD is unclear and effective treatments remain unavailable. Here, we established a mouse model of PSD through photothrombosis-induced focal ischemia. By using a combination of brain imaging, transcriptome sequencing, and bioinformatics analysis, we found that the hippocampus of PSD mice had a significantly lower metabolic level than other brain regions. RNA sequencing revealed a significant reduction of miR34b-3p, which was expressed in hippocampal neurons and inhibited the translation of eukaryotic translation initiation factor 4E (eIF4E). Furthermore, silencing eIF4E inactivated microglia, inhibited neuroinflammation, and abolished the depression-like behaviors in PSD mice. Together, our data demonstrated that insufficient miR34b-3p after stroke cannot inhibit eIF4E translation, which causes PSD by the activation of microglia in the hippocampus. Therefore, miR34b-3p and eIF4E may serve as potential therapeutic targets for the treatment of PSD.
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Animals , Mice , Depression , Eukaryotic Initiation Factor-4E/metabolism , MicroRNAs/metabolism , Neurons/metabolism , Stroke/metabolismABSTRACT
ObjectiveTo investigate the effects of different acupuncture schemes on behaviors, neurotransmitters and inflammation-related factors in post-stroke depressed (PSD) rats. MethodsA total of 72 healthy male Sprague-Dawley rats were randomly divided into normal group, model group, drug control group, scalp acupuncture group, abdominal acupuncture group and combined acupuncture group, 12 rats in each group. The PSD model was prepared using a combination of middle cerebral artery occlusion and chronic unpredictable mild stimulation (CUMS) for the model and each intervention groups. The drug control group was administered fluoxetine, the scalp acupuncture group accepted acupuncture at Baihui (DU 20) and Yintang (EX-HN3), while the abdominal acupuncture group at Zhongwan (RN 12) and Guanyuan (RN 4), the combined acupuncture group at all the four acupoints, for 21 days. They were assessed with Longa neurological function score, body mass, open-field test and sugar-water preference test on the 0 (before modeling), the seventh (before CUMS), the 14th (before treatment) and the 35th day (after treatment). The levels of 5-hydroxytryptamine (5-HT), dopamine (DA), norepinephrine (NE), interferon-γ (INF-γ), tumor necrosis factor⁃α (TNF⁃α) and macrophage migration inhibitory factor (MIF) in the serum were determined with ELISA on the 35th day. Results The neurological function score was lower in the drug control group and the combined acupuncture group thanin the model group (P < 0.01) on the 35th day; while the body mass was higher in the drug control group, the abdominal acupuncture group and the combined acupuncture group than in the model group (P < 0.01); and the number of horizontal span frames, the number of uprightness and the sugar water consumption were higher in the drug control group, the scalp acupuncture group, the abdominal acupuncture group and the combined acupuncture group than in the model group (P < 0.05). There was no significant difference among the four intervention groups (P > 0.05). The levels of 5-HT, DA and NE were higher in the four intervention groups than in the model group (P < 0.01), and the levels of IFN-γ, TNF⁃α and MIF were lower (P < 0.01). 5-HT level was higher in the combined acupuncture group than in the scalp acupuncture group and the abdominal acupuncture group, and the levels of IFN-γ, TNF⁃α and MIF were lower (P < 0.01); the levels of DA and NE was higher in the combined acupuncture group than in the abdominal acupuncture group (P < 0.01). ConclusionThe combination of scalp acupuncture and abdominal acupuncture can improve behavior, neurotransmitters and inflammatory factors of PSD rats, like fluoxetine. Scalp or abdominal acupuncture alone is still effecive, and can be used secondarily.
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OBJECTIVE@#To compare the clinical efficacy between Tiaoshen Jieyu acupuncture (acupuncture for regulating mind and relieving depression) combined with sertraline hydrochloride tablet and simple sertraline hydrochloride tablet for post-stroke depression (PSD).@*METHODS@#A total of 76 patients with PSD were randomized into an observation group (38 cases, 6 cases dropped off) and a control group (38 cases, 4 cases dropped off). Both groups were treated with conventional treatment i.e. controlling blood pressure and anti-inflammation. Sertraline hydrochloride tablet was given orally in the control group, 20 mg a time, once a day. On the basis of the treatment in the control group, Tiaoshen Jieyu acupuncture was applied at Baihui (GV 20), Yintang (GV 24+), Neiguan (PC 6), Taichong (LR 3), etc. in the observation group, Baihui (GV 20) and Yintang (GV 24+) were connected to electroacupuncture, with disperse-dense wave, 2 Hz/100 Hz in frequency, 30 min a time, once a day, 6 times a week. Treatment of 8 weeks was required in both groups. Before and after treatment, the scores of Hamilton depression scale (HAMD), National Institutes of Health stroke scale (NIHSS), Barthel index (BI) and Pittsburgh sleep quality index (PSQI) were observed respectively, the therapeutic efficacy and rate of adverse reactions were evaluated in the two groups.@*RESULTS@#After treatment, the scores of HAMD, NIHSS and PSQI were lower while BI scores were higher than those before treatment in both groups (P<0.05); the scores of HAMD, NIHSS and PSQI in the observation group were lower while BI score was higher than those in the control group (P<0.05). The total effective rate was 93.8% (30/32) in the observation group, which was higher than 70.6% (24/34) in the control group (P<0.05). The rate of adverse reactions was 9.4% (3/32) in the observation group, which was lower than 32.4% (11/34) in the control group (P<0.05).@*CONCLUSION@#Tiaoshen Jieyu acupuncture combined with sertraline hydrochloride tablet can improve the depression degree, neurological function, activity of daily living and sleep quality in patients with post-stroke depression, the clinical efficacy is superior to simple sertraline hydrochloride, and can alleviate the adverse reactions caused by medication.