Association between depression and quality of life in stroke patients: The Korea National Health and Nutrition Examination Survey (KNHANES) IV-VII (2008-2018).

BACKGROUND: Stroke and depression are common diseases that affect quality of life (QoL). Although some recent studies have investigated the association between the two diseases, studies that examined the association between stroke, depression, and QoL are rare, with large-scale national-level studies lacking. We aimed to investigate the association between depression and QoL in stroke patients. METHODS: Data from the Korea National Health and Nutrition Examination Survey (KNHANES) IV-VII conducted in 2008-2018 were used, and 45,741 adults who were aged >40 years and had no missing data for stroke and depression were included in the analysis. The participants were first grouped by prevalence of stroke, and further divided by prevalence of depression. RESULTS: The overall prevalence of stroke was 3.2%, and the incidence was 9% higher in men than in women. Multiple logistic regression was performed after adjusting for demographic factors, health-related factors, and disease-related factors. The results confirmed that the stroke group with depression had a lower overall health-related quality of life, measured using EQ-5D, score compared to the stroke group without depression (-0.15). Moreover, the concurrent stroke and depression treatment group had the highest OR of 7.28 (95% CI 3.28-16.2) for the anxiety/depression domain. CONCLUSION: Depression was strongly associated with QoL in stroke patients. This association was more evident in stroke patients undergoing treatment for depression. Thus, clinical approaches that take QoL into consideration are needed for stroke patients with depression.

Efficacy of Acupuncture for Insomnia: A Systematic Review and Meta-Analysis.

Patients with insomnia frequently use acupuncture as an alternative treatment to pharmacotherapy globally. The aim of this paper is to assess the effect of acupuncture on insomnia. Seven medical databases, including MEDLINE, EMBASE, CENTRAL, CNKI, RISS, NDSL, and OASIS, were used to identify studies published through July 09, 2020. Twenty-four randomized controlled trials (RCTs) were included in this qualitative review comparing acupuncture to either pharmacotherapy or sham-acupuncture therapy. Methodological quality was assessed, using the Cochrane risk of bias (ROB). In the subsequent quantitative meta-analysis of studies comparing acupuncture versus pharmacotherapy, fifteen RCTs demonstrated that acupuncture had a significant effect on patients with insomnia as assessed by the Pittsburgh sleep quality index (PSQI) (RR: -0.74; 95% CI: -1.07 to -0.40; [Formula: see text] ¡0.0001; [Formula: see text] = 89%; [Formula: see text] = 1475). A subgroup analysis showed that there was no significant effect after weeks 1 and 2, but six studies found that acupuncture had a significant effect insomnia at week 3 (RR: -0.97; 95% CI: -1.65 to -0.28; [Formula: see text] = 0.006; [Formula: see text] = 91%; [Formula: see text] = 463) and nine studies demonstrated a significant effect at week 4 (RR: -0.70; 95% CI: -1.15 to -0.25; [Formula: see text] = 0.002; [Formula: see text] = 85%; [Formula: see text] = 594). These results suggest that insomnia patients may experience significant improvement in symptoms after more than three weeks of acupuncture treatment compared to pharmacological treatments.

Individual Variation and the Bilingual Advantage-Factors that Modulate the Effect of Bilingualism on Cognitive Control and Cognitive Reserve.

This editorial is an introduction to the special issue 'Individual variation and the bilingual advantage-factors that modulate the effect of bilingualism on cognitive control'[...].

The Relationship Between Linguistic Ability, Multilingualism, and Dementia.

In a recent article of the Journal of Alzheimer's Disease, Hack et al. (2019) argue that linguistic ability rather than multilingualism is a significant predictor of dementia. In their longitudinal study, they investigated 325 religious sisters who were older than 75 years of age. Self-reports were used in order to determine multilingualism. They found that speaking two or three languages did not delay the onset of dementia. However, they did find that individuals speaking four or more languages were less likely to suffer from dementia than those speaking only one language and concluded that having linguistic ability was a more significant predictor of dementia than being multilingual. However, more research is needed in order to identify the characteristics of multilingualism most salient for the risk of dementia. In this commentary, we raise several important methodological and statistical issues that are likely to have affected the findings of Hack et al.'s study. As a result, although their study makes an important contribution to the research field, drawing a conclusion at this time that linguistic ability is more a predictor of dementia than multilingualism would be premature; moreover, their preliminary results cannot be generalized to the general population.

Relationship Between Working Memory and Speech-in-Noise Recognition in Young and Older Adult Listeners With Age-Appropriate Hearing.

Purpose The purpose of this study was to investigate the relationship between working memory (WM) capacity and speech recognition in noise in both a group of young adults and a group of older adults. Method Thirty-three older adults with a mean age of 71.0 (range: 60.4-82.7) years and 27 young adults with a mean age of 21.7 (range: 19.1-25.0) years participated in the study. All participants had age-appropriate hearing and no history of central nervous system dysfunction. WM capacity was measured using the van den Noort version of the Reading Span Test, and recognition of sentences in the presence of a stationary speech-shaped noise was measured as the speech reception threshold for 50% correct identification by using the Leuven Intelligibility Sentence Test. Results The older adults had significantly worse WM capacity scores, t(58) = 8.266, p < .001, and significantly more difficulty understanding sentences in noise than the younger adults, t(58) = -6.068, p < .001. In the group of older adults, a correlation was found (r = -.488, n = 33, p = .004) between the results of the WM capacity test (Reading Span Test) and the results of the speech-recognition-in-noise test (Leuven Intelligibility Sentence Test), meaning that the higher the WM performance was, the better was the speech recognition in noise. This correlation cannot be found in young normal-hearing listeners. Conclusions This study shows deleterious effects of age on both WM capacity and speech recognition in noise. Interestingly, only in the group of older adults was a significant relation found between WM capacity and speech recognition in noise. The current results caution against the assumption that WM necessarily supports speech-in-noise identification independently of the age and hearing status of the listener.

A Systematic Review on the Possible Relationship Between Bilingualism, Cognitive Decline, and the Onset of Dementia.

A systematic review was conducted to investigate whether bilingualism has a protective effect against cognitive decline in aging and can protect against dementia. We searched the Medline, ScienceDirect, Scopus, and ERIC databases with a cut-off date of 31 March, 2019, thereby following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Our search resulted in 34 eligible studies. Mixed results were found with respect to the protective effect of bilingualism against cognitive decline. Several studies showed a protective effect whereas other studies failed to find it. Moreover, evidence for a delay of the onset of dementia of between 4 and 5.5 years in bilingual individuals compared to monolinguals was found in several studies, but not in all. Methodological differences in the set-up of the studies seem to explain these mixed results. Lifelong bilingualism is a complex individual process, and many factors seem to influence this and need to be further investigated. This can be best achieved through large longitudinal studies with objective behavioral and neuroimaging measurements. In conclusion, although some evidence was found for a cognitive reserve-enhancing effect of lifelong bilingualism and protection against dementia, to date, no firm conclusions can be drawn.

Does the Bilingual Advantage in Cognitive Control Exist and If So, What Are Its Modulating Factors? A Systematic Review.

Recently, doubts were raised about the existence of the bilingual advantage in cognitive control. The aim of the present review was to investigate the bilingual advantage and its modulating factors. We searched the Medline, ScienceDirect, Scopus, and ERIC databases for all original data and reviewed studies on bilingualism and cognitive control, with a cut-off date of 31 October 2018, thereby following the guidelines of the preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol. The results of the 46 original studies show that indeed, the majority, 54.3%, reported beneficial effects of bilingualism on cognitive control tasks; however, 28.3% found mixed results and 17.4% found evidence against its existence. Methodological differences seem to explain these mixed results: Particularly, the varying selection of the bilingual participants, the use of nonstandardized tests, and the fact that individual differences were often neglected and that longitudinal designs were rare. Therefore, a serious risk for bias exists in both directions (i.e., in favor of and against the bilingual advantage). To conclude, we found some evidence for a bilingual advantage in cognitive control; however, if significant progress is to be made, better study designs, bigger data, and more longitudinal studies are needed.

A study of the effects of 8-week acupuncture treatment on patients with Parkinson's disease.

BACKGROUND: Parkinson's disease (PD) is a degenerative brain disorder, resulting in decreased neural responses in the supplementary motor area, putamen, and thalamus. Previous research showed that acupuncture was able to improve the motor dysfunction. The primary aim of this study is to assess the efficacy of longer acupuncture treatment for preventing brain degeneration in patients with PD. METHODS: Ten outpatients with PD were recruited from Kyung Hee Medical Hospital. Behavioral and neural responses were examined before and after 8 weeks of acupuncture treatment. A semi-individualized treatment approach was used; patients were treated for 15 minutes with 120-Hz electro-acupuncture at the right GB34 and Taechung (LR3), followed by manual acupuncture based on the individual symptoms of the patient. RESULTS: Immediately after 8 weeks of acupuncture treatment, the Unified Parkinson's Disease Rating Scale (UPDRS) sub-scores and the depression scores for the patients had statistically decreased compared to the scores before acupuncture treatment; moreover, 8 weeks later, these scores remained stable. Compared to the neural responses before the acupuncture stimulation, those after the acupuncture treatment were significantly higher in the thalamus, cingulate gyrus, anterior cingulate, lingual gyrus, parahippocampal gyrus, lateral globus pallidus, mammillary body, middle temporal gyrus, cuneus, and fusiform gyrus. Finally, a positive correlation was found between the UPDRS and the mean magnetic resonance signal change for the thalamus. CONCLUSION: This study found beneficial clinical effects of 8-week acupuncture treatment in the brains of patients with PD.

Schizophrenia and Sleep Disorders: An Introduction.

This editorial is an introduction to the special issue 'Schizophrenia and Sleep Disorders'.[…].

Pharmacological Treatment for Long-Term Patients with Schizophrenia and Its Effects on Sleep in Daily Clinical Practice: A Pilot Study.

Background: Pharmacological treatment is still the key intervention in the disease management of long-term patients with schizophrenia; however, how it affects sleep and whether gender differences exist remains unclear. Methods: Forty-six long-term outpatients with schizophrenia entered the study. The numbers of antipsychotics, sleep medications, antidepressants, and anxiolytics were analyzed. Moreover, all patients were tested using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS). Correlation analyses were conducted between the medication used and the scores on the two subjective sleep inventories. Results: A large variability, ranging from 0 to 8, in the total number of psychiatric drugs per person was found between the patients. Despite ongoing pharmacological treatment, the patients scored high on the PSQI, but not on the ESS; this indicates that they report problems with sleep, but not with daytime sleepiness. A significant positive correlation between the use of antipsychotics and the ESS score, but not the PSQI score, was found; moreover, no gender differences were found. Conclusions: A large variability exists in the pharmacological treatment of long-term patients with schizophrenia. To date, patients' sleep problems have been insufficiently treated, and gender differences have not been adequately accounted for in the pharmacological treatment of schizophrenia. More and larger international clinical studies are warranted to verify the findings of the present preliminary pilot study before any firm conclusions can be drawn and before any changes to the drug treatment of male and female patients with schizophrenia can be recommended.

Decreased expression of serum- and glucocorticoid-inducible kinase 1 (SGK1) promotes alpha-synuclein increase related with down-regulation of dopaminergic cell in the Substantia Nigra of chronic MPTP-induced Parkinsonism mice and in SH-SY5Y cells.

Parkinson's disease (PD) is a chronically progressive neurodegenerative disease, with its main pathological hallmarks being a dramatic loss of dopaminergic neurons predominantly in the Substantia Nigra (SN), and the formations of intracytoplasmic Lewy bodies and dystrophic neurites. Alpha-synuclein (α-syn), widely recognized as the most prominent element of the Lewy body, is one of the representative hallmarks in PD. However, the mechanisms behind the increased α-syn expression and aggregation have not yet been clarified. To examine what causes α-syn expression to increase, we analyzed the pattern of gene expression in the SN of mice intoxicated with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), where down-regulation of dopaminergic cells occurred. We identified serum- and glucocorticoid-dependent kinase 1 (SGK1) as one of the genes that is evidently downregulated in chronic MPTP-intoxication. The results of Western blot analyses showed that, together with the down-regulation of dopaminergic cells, the decrease in SGK1 expression increased α-syn expression in the SN in a chronic MPTP-induced Parkinsonism mouse. For an examination of the expression correlation between SGK1 and α-syn, SH-5YSY cells were knocked down with SGK1 siRNA then, the downregulation of dopaminergic cells and the increase in the expression of α-syn were observed. These results suggest that decreased expression of SGK1 may play a critical role in increasing the expression of α-syn, which is related with dopaminergic cell death in the SN of chronic MPTP-induced Parkinsonism mice and in SH-SY5Y cells.

Gender Differences in Laser Acupuncture-Results of a Crossover Study with Green and Yellow Laser at the Ear Point Shenmen.

Background: One of the most commonly used auricular acupuncture points selected for different pain treatment regimens is Shenmen. This point on the ear has been recognized as having a wide number of applications, as found by scientific investigation. Methods: Within this crossover study, the ear acupoint Shenmen was stimulated with two different kinds of laser (green, 532 nm and yellow, 589 nm) in 22 healthy volunteers (13 female, 9 male; mean age ± SD = 25.3 ± 4.1 years; range 21-36 years). Both green and yellow lasers were used for 15 min in the same volunteers in two different sessions. Results: The most prominent finding was that systolic blood pressure decreased significantly (p = 0.048) after yellow laser stimulation. Heart rate also decreased significantly (p < 0.001), whereas heart rate variability ratio low frequency (LF)/high frequency (HF) (p < 0.001) increased. The effects were significantly more pronounced in females than in males. In addition, the temperature was measured, and temperature increases were demonstrated at different locations on the ear using imaging methods. Conclusions: This study shows evidence of the effect of auricular laser acupuncture. However, a comparison with other publications was impossible because this is the first study using green and yellow laser stimulation on the ear.

Acupuncture as Add-On Treatment of the Positive, Negative, and Cognitive Symptoms of Patients with Schizophrenia: A Systematic Review.

Background: Schizophrenia is a severe psychiatric disorder that has a large impact on patients' lives. In addition to Western medicine, the use of additional treatments, such as acupuncture, in treating the positive, negative, and cognitive symptoms is increasing. Methods: We conducted a systematic review on the use of acupuncture as an add-on treatment for patients with schizophrenia that are in regular care, with a special focus on the treatment of the often accompanying sleep disorders. In this study, we searched the Medline, ScienceDirect, Cochrane Library, Scopus, and ERIC databases with a cut-off date of 31 December 2017, thereby following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocol. Results: Our search resulted in 26 eligible studies with 1181 patients with schizophrenia who received acupuncture treatment. Most studies showed limited evidence for the use of acupuncture as add-on therapy in the treatment of the positive, negative, and cognitive symptoms, but beneficial effects have been reported in the treatment of the accompanying sleep disorders. Conclusions: Limited evidence was found for the use of acupuncture as add-on therapy in the treatment of patients with schizophrenia; however, positive results were found in the treatment of sleep disorders, but this result needs to be confirmed in large, randomized, controlled trials.

Schizophrenia and depression: The relation between sleep quality and working memory.

Sleep is known to be markedly disturbed in patients with depression, but in patients with schizophrenia these problems are underestimated. This research aimed to determine if a relationship existed between sleep problems in patients with schizophrenia and with depression and their reduced working memory (WM) performance. Thirty outpatients with schizophrenia, 30 outpatients with depression, and 30 healthy control participants were enrolled in this study. All participants completed a sleep questionnaire (i.e., Pittsburgh Sleep Quality Index (PSQI)), two simple WM tasks tapping only its storage component (i.e., digit span forward and backward task), and two complex WM tasks tapping both its storage and processing components (i.e., letter-number sequencing and reading span task). The results showed that neither psychiatric group differed from the healthy controls on simple WM tasks. Patients with schizophrenia did not differ from those with depression in the performance of simple or complex WM tasks. However, patients with schizophrenia, and, to a lesser degree, patients with depression performed significantly worse than the healthy control participants on complex WM tasks, which was visible in lower WM scores for patients with depression and in slower information processing, as well, for patients with schizophrenia. Finally, a significant negative relationship was found between the PSQI score and the reading span task scores; thus, participants with worse performance tended to report more sleep problems. To conclude, sleep needs to receive more priority when treating patients with depression and especially patients with schizophrenia because better sleep improves (working) memory performance and daily functioning.

Sex differences in acupuncture effectiveness in animal models of Parkinson's disease: a systematic review.

BACKGROUND: Many animal experimental studies have been performed to investigate the efficacy of acupuncture in Parkinson's disease (PD). Sex differences are a major issue in all diseases including PD. However, to our knowledge, there have been no reviews investigating sex differences on the effectiveness of acupuncture treatment for animal PD models. The current study aimed to summarize and analyze past studies in order to evaluate these possible differences. METHOD: Each of 7 databases (MEDLINE, EMBASE, the Cochrane Library, 3 Korean medical databases, and the China National Knowledge Infrastructure) was searched from its inception through March 2015 without language restrictions. RESULTS: We included studies of the use of acupuncture treatment in animal models of PD. A total of 810 potentially relevant articles were identified, 57 of which met our inclusion criteria. C57/BL6 mice were used most frequently (42 %) in animal PD models. Most of the studies were carried out using only male animals (67 %); only 1 study (2 %) was performed using solely females. The further 31 % of the studies used a male/female mix or did not specify the sex. CONCLUSIONS: The results of our review suggest that acupuncture is an effective treatment for animal PD models, but there is insufficient evidence to determine whether sex differences exist. Future studies of acupuncture treatment for PD should use female animal models because they reflect the physiological characteristics of both males and females to fully evaluate the effect and the safety of the treatment for each sex.