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Yang N, Chen S, Liu S, Ling S, Chen L. Increased low frequency fluctuation in the brain after acupuncture treatment in CSVDCI patients: A randomized control trial study. Front Neurosci 2023; 17:1125418. [PMID: 36922926 PMCID: PMC10010105 DOI: 10.3389/fnins.2023.1125418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/02/2023] [Indexed: 03/02/2023] Open
Abstract
Background Cerebral small vessel disease (CSVD) is one of two cognition-impairing diseases. Acupuncture (Acu) is a flexible treatment with few adverse effects and is thus widely used to treat neurological problems. Methods We recruited a total of 60 patients and assigned them to two groups (n = 30 each group). During the study, some participants were excluded by quality control, and a total of 44 subjects (25 Acu and 19 controls) were completed to investigate the therapeutic efficacy of acupuncture on CSVD cognitive impairment (CSVDCI). The following demographic and clinical variables were compared between the two groups: gender, age, education, smoking, alcohol, Montreal cognitive assessment (MoCA), symbol digit modalities test (SDMT), verbal fluency test (VFT), digit span task (DST), Boston naming test (BNT) scores, and amplitude of low-frequency fluctuation (ALFF) under the typical band (0.01-0.08 Hz). Mixed effect analysis was utilized to test for differences between the two groups before and after the treatment. Results Following acupuncture treatment, the Acu group scored higher on MoCA, SDMT, VFT, DST, and BNT compared to controls (P < 0.05). The brain regions showing substantially greater ALFF values in the Acu group were the right inferior temporal gyrus, left middle occipital gyrus, left superior occipital gyrus, left insula, bilateral postcentral gyrus, right superior parietal gyrus, right cerebellum, right precuneus, and right precentral gyrus (P < 0.005, no correction). The ALFF values in the right inferior temporal gyrus (P = 0.027), left middle occipital gyrus (P = 0.005), left superior occipital gyrus (P = 0.011), and right superior parietal gyrus (P = 0.043) were positively associated with MoCA. Conclusion We found that acupuncture modulates the functional activity of temporal, occipital, and parietal regions of the brain in CSVDCI patients.
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Affiliation(s)
- Nan Yang
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China.,Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Sina Chen
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Shuxue Liu
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Shuiqiao Ling
- Zhongshan Hospital of Traditional Chinese Medicine, Zhongshan, Guangdong, China
| | - Lidian Chen
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
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Gibson E, Koh CL, Eames S, Bennett S, Scott AM, Hoffmann TC. Occupational therapy for cognitive impairment in stroke patients. Cochrane Database Syst Rev 2022; 3:CD006430. [PMID: 35349186 PMCID: PMC8962963 DOI: 10.1002/14651858.cd006430.pub3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Cognitive impairment is a frequent consequence of stroke and can impact on a person's ability to perform everyday activities. Occupational therapists use a range of interventions when working with people who have cognitive impairment poststroke. This is an update of a Cochrane Review published in 2010. OBJECTIVES To assess the impact of occupational therapy on activities of daily living (ADL), both basic and instrumental, global cognitive function, and specific cognitive abilities in people who have cognitive impairment following a stroke. SEARCH METHODS We searched the Cochrane Stroke Group Trials Register, CENTRAL, MEDLINE, Embase, four other databases (all last searched September 2020), trial registries, and reference lists. SELECTION CRITERIA We included randomised and quasi-randomised controlled trials that evaluated an intervention for adults with clinically defined stroke and confirmed cognitive impairment. The intervention needed either to be provided by an occupational therapist or considered within the scope of occupational therapy practice as defined in the review. We excluded studies focusing on apraxia or perceptual impairments or virtual reality interventions as these are covered by other Cochrane Reviews. The primary outcome was basic activities of daily living (BADL) such as dressing, feeding, and bathing. Secondary outcomes were instrumental ADL (IADL) (e.g. shopping and meal preparation), community integration and participation, global cognitive function and specific cognitive abilities (including attention, memory, executive function, or a combination of these), and subdomains of these abilities. We included both observed and self-reported outcome measures. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies that met the inclusion criteria, extracted data, and assessed the certainty of the evidence. A third review author moderated disagreements if consensus was not reached. We contacted trial authors for additional information and data, where available. We assessed the certainty of key outcomes using GRADE. MAIN RESULTS: We included 24 trials from 11 countries involving 1142 (analysed) participants (two weeks to eight years since stroke onset). This update includes 23 new trials in addition to the one study included in the previous version. Most were parallel randomised controlled trials except for one cross-over trial and one with a two-by-two factorial design. Most studies had sample sizes under 50 participants. Twenty studies involved a remediation approach to cognitive rehabilitation, particularly using computer-based interventions. The other four involved a compensatory and adaptive approach. The length of interventions ranged from 10 days to 18 weeks, with a mean total length of 19 hours. Control groups mostly received usual rehabilitation or occupational therapy care, with a few receiving an attention control that was comparable to usual care; two had no intervention (i.e. a waiting list). Apart from high risk of performance bias for all but one of the studies, the risk of bias for other aspects was mostly low or unclear. For the primary outcome of BADL, meta-analysis found a small effect on completion of the intervention with a mean difference (MD) of 2.26 on the Functional Independence Measure (FIM) (95% confidence interval (CI) 0.17 to 4.22; P = 0.03, I2 = 0%; 6 studies, 336 participants; low-certainty evidence). Therefore, on average, BADL improved by 2.26 points on the FIM that ranges from 18 (total assist) to 126 (complete independence). On follow-up, there was insufficient evidence of an effect at three months (MD 10.00, 95% CI -0.54 to 20.55; P = 0.06, I2 = 53%; 2 studies, 73 participants; low-certainty evidence), but evidence of an effect at six months (MD 11.38, 95% CI 1.62 to 21.14, I2 = 12%; 2 studies, 73 participants; low-certainty evidence). These differences are below 22 points which is the established minimal clinically important difference (MCID) for the FIM for people with stroke. For IADL, the evidence is very uncertain about an effect (standardised mean difference (SMD) 0.94, 95% CI 0.41 to 1.47; P = 0.0005, I2 = 98%; 2 studies, 88 participants). For community integration, we found insufficient evidence of an effect (SMD 0.09, 95% CI -0.35 to 0.54; P = 0.68, I2 = 0%; 2 studies, 78 participants). There was an improvement of clinical importance in global cognitive functional performance after the intervention (SMD 0.35, 95% CI 0.16 to 0.54; P = 0.0004, I2 = 0%; 9 studies, 432 participants; low-certainty evidence), equating to 1.63 points on the Montreal Cognitive Assessment (MoCA) (95% CI 0.75 to 2.52), which exceeds the anchor-based MCID of the MoCA for stroke rehabilitation patients of 1.22. We found some effect for attention overall (SMD -0.31, 95% CI -0.47 to -0.15; P = 0.0002, I2 = 20%; 13 studies, 620 participants; low-certainty evidence), equating to a difference of 17.31 seconds (95% CI 8.38 to 26.24), and for executive functional performance overall (SMD 0.49, 95% CI 0.31 to 0.66; P < 0.00001, I2 = 74%; 11 studies, 550 participants; very low-certainty evidence), equating to 1.41 points on the Frontal Assessment Battery (range: 0-18). Of the cognitive subdomains, we found evidence of effect of possible clinical importance, immediately after intervention, for sustained visual attention (moderate certainty) equating to 15.63 seconds, for working memory (low certainty) equating to 59.9 seconds, and thinking flexibly (low certainty), compared to control. AUTHORS' CONCLUSIONS The effectiveness of occupational therapy for cognitive impairment poststroke remains unclear. Occupational therapy may result in little to no clinical difference in BADL immediately after intervention and at three and six months' follow-up. Occupational therapy may slightly improve global cognitive performance of a clinically important difference immediately after intervention, likely improves sustained visual attention slightly, and may slightly increase working memory and flexible thinking after intervention. There is evidence of low or very low certainty or insufficient evidence for effect on other cognitive domains, IADL, and community integration and participation. Given the low certainty of much of the evidence in our review, more research is needed to support or refute the effectiveness of occupational therapy for cognitive impairment after stroke. Future trials need improved methodology to address issues including risk of bias and to better report the outcome measures and interventions used.
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Affiliation(s)
- Elizabeth Gibson
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Chia-Lin Koh
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Sally Eames
- Community and Oral Health Innovation and Research Centre, Metro North Hospital and Health Service, Brisbane, Australia
| | - Sally Bennett
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Anna Mae Scott
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Bond University, Gold Coast, Australia
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Zhang SH, Wang YL, Zhang CX, Zhang CP, Xiao P, Li QF, Liang WR, Pan XH, Zhou MC. Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function, Depression, and Anxiety: A Multicenter, Randomized, Controlled Trial. Chin J Integr Med 2021; 28:106-115. [PMID: 34874523 DOI: 10.1007/s11655-021-3338-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare the clinical effects of interactive dynamic scalp acupuncture (IDSA), simple combination therapy (SCT), and traditional scalp acupuncture (TSA) on cognitive function, depression and anxiety in patients with post-stroke cognitive impairment. METHODS A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA (218 cases), SCT (222 cases) and TSA groups (220 cases) according to a random number table. All the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation training. Scalp acupuncture and computer-based cognitive training (CBCT) were performed simultaneously in the IDSA group, but separately in the morning and in the afternoon in the SCT group. The patients in the TSA group underwent scalp acupuncture only. The course of treatment was 8 weeks. Before treatment (M0), 1 (M1) and 2 months (M2) after treatment, as well as follow-up at 1 (M3) and 2 months (M4), the cognitive function of patients was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) Scales; depression, anxiety, sleep quality, and self-care ability of patients were assessed using Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Pittsburgh Sleep Quality Index (PSQI), and Modified Barthel Index (MBI), respectively. During this trial, all adverse events (AEs) were accurately recorded. RESULTS There were no significant differences in the MMSE, MoCA, HAMD, HAMA, PSQI, and MBI scores among the 3 groups at M0 (all P>0.05). In the IDSA group, the MMSE, MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups, while the HAMD, HAMA and PSQI scores were significantly reduced (all P<0.01). The changes of all above scores (M2-M0, M4-M0) were significantly superior to those in the SCT and TSA groups (all P<0.01, except M4-M0 of HAMD). At M2, the severity of MMSE, HAMD, HAMA, PSQI and MBI in the IDSA group was significantly lower than that in the SCT and TSA groups (all P<0.01). There was no serious AE during this trial. CONCLUSIONS IDSA can not only significantly improve cognitive function, but also reduce depression, anxiety, which finally improves the patient's self-care ability. The effect of IDSA was significantly better than SCT and TSA. (Trial registration No. ChiCTR1900027206).
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Affiliation(s)
- Shao-Hua Zhang
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Yu-Long Wang
- Department of Rehabilitation Medicine, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, 518037, China.
| | - Chun-Xia Zhang
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Chun-Ping Zhang
- Department of Rehabilitation Medicine, Shenzhen Hospital of Guangzhou University of Chinese Medicine, Shenzhen, Guangdong Province, 518034, China
| | - Peng Xiao
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Qian-Feng Li
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Wei-Rong Liang
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Xiao-Hua Pan
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, Guangdong Province, 518121, China
| | - Ming-Chao Zhou
- Department of Rehabilitation Medicine, Shenzhen Second People's Hospital, Shenzhen, Guangdong Province, 518037, China
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Xue X, Jin XM, Luo KL, Liu XH, Zhang L, Hu J. Effectiveness of Yijinjing on cognitive functions in post-stroke patients with mild cognitive impairment: study protocol for a randomized controlled trial. Trials 2021; 22:265. [PMID: 33836807 PMCID: PMC8034135 DOI: 10.1186/s13063-021-05220-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 03/24/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Statistics show that every year, 5.4 million people in the world suffer a stroke. Post-stroke cognitive impairment (PSCI) is one of the most common complications after stroke with a rate of 75%, which leads to decreased functions for independent living and reduced quality of life (QOL). Exercise training has been reported to be useful to improve the cognitive functions of post-stroke patients. Yijinjing, a traditional Chinese Qigong exercise characterized by an integration of mind and body in moderate exercise intensity, can improve cognitive functions of PSCI patients. This study aims to explore the feasibility and effectiveness of the Yijinjing exercise in this regard. METHODS A single-blind, superiority, randomized controlled trial will be employed with evaluations at 3 and 6 months. Seventy-two PSCI patients will be recruited and randomly assigned to the Yijinjing exercise intervention group or the control group (1:1). Participants in the control group will receive routine rehabilitation therapies, including occupational therapy, physical therapy, acupuncture therapy, and health education 5 times a week for 3 months. The intervention group will receive a 12-week routine rehabilitation therapy combined with the Yijinjing exercise intervention for 40 min each session and 3 sessions a week. The primary outcome of cognition will be measured by the Montreal Cognitive Assessment scale (MoCA). Secondary outcomes include executive function, memory function, visuospatial function, sleep quality, gait and motor function, activity of daily living (ADL), and quality of life (QOL). DISCUSSION Current evidence has reported the effectiveness of traditional Chinese exercise in improving the post-stroke population's motor functions. This research is a randomized controlled trial that evaluates traditional Chinese exercise's effectiveness for PSCI patients. It is expected to expand the traditional Chinese exercise scope and provide a new treatment approach for stroke populations with cognitive impairments. TRIAL REGISTRATION Chinese Clinical Trial Registry ChiCTR1900026532 . Registered on 13 October 2019.
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Affiliation(s)
- Xin Xue
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China
| | - Xue-Ming Jin
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China
| | - Kai-Liang Luo
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China
| | - Xin-Hao Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China
| | - Li Zhang
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China
| | - Jun Hu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, No. 1200, Cai-Lun Road, Shanghai, China.
- Shanghai Second Rehabilitation Hospital, Shanghai, China.
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Tyrosine Kinase Receptors Axl and MerTK Mediate the Beneficial Effect of Electroacupuncture in a Cuprizone-Induced Demyelinating Model. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3205176. [PMID: 32714402 PMCID: PMC7355344 DOI: 10.1155/2020/3205176] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/16/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
Electroacupuncture has been shown to promote remyelination in a demyelinating model of multiple sclerosis (MS) through enhanced microglial clearance of degraded myelin debris. However, the mechanisms involved in this process are yet to be clearly elucidated. It has been revealed that TAM receptor tyrosine kinases (Tyro3, Axl, and MerTK) play pivotal roles in regulating multiple features of microglia, including the phagocytic function and myelin clearance. Therefore, the aim of this study is to further confirm whether electroacupuncture improves functional recovery in this model and to characterise the involvement of the TAM receptor during this process. In addition to naive control mice, a cuprizone-induced demyelinating model was established, and long-term electroacupuncture treatment was administrated. To evaluate the efficiency of functional recovery following demyelination, we performed beam-walking test and rotarod performance test; to objectify the degree of remyelination, we performed transmission electron microscopy and protein quantification of mature oligodendrocyte markers. Oil Red O staining was used to evaluate the deposit of myelin debris. We confirmed that, in cuprizone-treated mice, electroacupuncture significantly ameliorates motor-coordinative dysfunction and counteracts demyelinating processes, with less deposit of myelin debris accumulating in the corpus callosum. Surprisingly, mRNA expression of TAM receptors was significantly upregulated after electroacupuncture treatment, and we further confirmed an increased protein expression of Axl and MerTK after electroacupuncture treatment, indicating their involvement during electroacupuncture treatment. Finally, LDC1267, a selective TAM kinase inhibitor, abolished the therapeutic effect of electroacupuncture on motor-coordinative dysfunction. Overall, our data demonstrate that electroacupuncture could mitigate the progression of demyelination by enhancing the TAM receptor expression to facilitate the clearance of myelin debris. Our results also suggest that electroacupuncture may be a potential curative treatment for MS patients.
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Cao N, Nguyen B, Li S, Lamba R, Hafner R, Li S. An overview of acupuncture in stroke recovery: A narrative review. THE JOURNAL OF THE INTERNATIONAL SOCIETY OF PHYSICAL AND REHABILITATION MEDICINE 2020. [DOI: 10.4103/jisprm.jisprm_19_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Hung CYF, Wu XY, Chung VCH, Tang ECH, Wu JCY, Lau AYL. Overview of systematic reviews with meta-analyses on acupuncture in post-stroke cognitive impairment and depression management. Integr Med Res 2019; 8:145-159. [PMID: 31304087 PMCID: PMC6600770 DOI: 10.1016/j.imr.2019.05.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/15/2019] [Accepted: 05/01/2019] [Indexed: 02/06/2023] Open
Abstract
Background: Acupuncture has been using as an alternative non-pharmacological therapy in the management of post stroke depression and cognitive impairment but its effectiveness and safety remain controversial. We conducted an overview of systematic reviews with meta-analyses to evaluate the evidence on the effect of acupuncture in the treatment of stroke with conventional medicine intervention. Methods: Systematic reviews summarized the treatment effects of acupuncture for post stroke cognitive impairment and post stroke depression were considered eligible. Methodological quality of included systematic reviews was assessed using A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2). Results: Four systematic reviews on post stroke cognitive impairment and ten systematic reviews on post stroke depression with good methodological quality were included. Meta-analyses revealed that acupuncture plus cognitive rehabilitation; and acupuncture or moxibustion plus cognitive rehabilitation, versus cognitive rehabilitation demonstrated statistically significant increase in Mini-Mental State Examination scores in compared to cognitive rehabilitation after 4 weeks treatment [Pooled weighted mean difference (WMD) = 3.14, 95% confidence interval (CI) = 2.06 to 4.21, I2 = 36%]; and (Pooled WMD = 3.22, 95% CI = 2.09 to 4.34, I2 = 0%). Furthermore, acupuncture versus antidepressant demonstrated statistically significant improve depression measured by increasing in 17-item Hamilton Depression Rating Scale in comparing to cognitive rehabilitation after 2 weeks treatment (Pooled WMD= -2.34, 95% CI= -3.46 to -1.22, I2 = 5%). Acupuncture usage was not associated with increased risk of adverse events. Conclusions: Acupuncture is safe and improves cognitive function and depressive disorder without obvious serious adverse events for post stroke patients.
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Affiliation(s)
- Caroline Yik-fong Hung
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Xin-yin Wu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Vincent Chi-ho Chung
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, School of Public Health, Prince of Wales Hospital, Shatin, Hong Kong
| | - Endy Chun-hung Tang
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Justin Che-yuen Wu
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
| | - Alexander Yuk-lun Lau
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
- The Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong
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Xie G, Song C, Lin X, Yang M, Fan X, Liu W, Tao J, Chen L, Huang J. Electroacupuncture Regulates Hippocampal Synaptic Plasticity via Inhibiting Janus-Activated Kinase 2/Signal Transducer and Activator of Transcription 3 Signaling in Cerebral Ischemic Rats. J Stroke Cerebrovasc Dis 2019; 28:792-799. [DOI: 10.1016/j.jstrokecerebrovasdis.2018.11.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 10/18/2018] [Accepted: 11/22/2018] [Indexed: 01/16/2023] Open
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Zhang Q, Xu C, Lin S, Zhou H, Yao G, Liu H, Wang L, Pan X, Quan G, Wu C. Synergistic immunoreaction of acupuncture-like dissolving microneedles containing thymopentin at acupoints in immune-suppressed rats. Acta Pharm Sin B 2018; 8:449-457. [PMID: 29881684 PMCID: PMC5989831 DOI: 10.1016/j.apsb.2017.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 10/27/2017] [Accepted: 11/23/2017] [Indexed: 12/11/2022] Open
Abstract
Dissolving microneedles carried drug molecules can effectively penetrate the stratum corneum of skin to improve the transdermal drug delivery. The traditional Chinese medicine acupuncture is based on the needle stimulation at a specific location (acupoint) to generate and transmit biochemical and physiological signals which alter the pathophysiological state of patients. However, the pain associated with conventional acupuncture needles and the requirement of highly trained professionals limit the development of acupuncture in non-Asian countries. The purpose of this study is to investigate whether the dissolving microneedles can be utilized as a self-administered painless replacement for acupuncture and locally released drug molecules can achieve expected therapeutic outcomes. Immunosuppressive rats were treated with acupuncture at Zusanli (ST36) acupoint using microneedles containing thymopentin. The immune functions and psychological mood of the immunosuppressed animals were examined. The proliferation of splenocytes was examined by CCK-8 assay. CD4 and CD8 expression patterns in spleen cells were detected by flow cytometry. The current study showed that use of either microneedles containing thymopentin or conventional acupuncture both resulted in immune cell proliferation, which was confirmed by flow cytometry. Furthermore, either conventional acupuncture or microneedles were able to effectively mitigate the anxiety caused by immune-suppression when applied on the ST36.
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Dall'Agnol MS, Cechetti F. Kinesio Taping Associated with Acupuncture in the Treatment of the Paretic Upper Limb After Stroke. J Acupunct Meridian Stud 2018; 11:67-73. [DOI: 10.1016/j.jams.2017.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 12/21/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022] Open
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Huang J, You X, Liu W, Song C, Lin X, Zhang X, Tao J, Chen L. Electroacupuncture ameliorating post-stroke cognitive impairments via inhibition of peri-infarct astroglial and microglial/macrophage P2 purinoceptors-mediated neuroinflammation and hyperplasia. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 17:480. [PMID: 29017492 PMCID: PMC5635586 DOI: 10.1186/s12906-017-1974-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/12/2017] [Indexed: 12/21/2022]
Abstract
Background During ischemic stroke (IS), adenosine 5′-triphosphate (ATP) is released from damaged nerve cells of the infract core region to the extracellular space, invoking peri-infarct glial cellular P2 purinoceptors singling, and causing pro-inflammatory cytokine secretion, which is likely to initiate or aggravate motor and cognitive impairment. It has been proved that electroacupuncture (EA) is an effective and safe strategy used in anti-inflammation. However, EA for the role of purine receptors in the central nervous system has not yet been reported. Methods Ischemia-reperfusion injured rat model was induced by middle cerebral artery occlusion and reperfusion (MCAO/R). EA treatment at the DU 20 and DU 24 acupoints treatment were conducted to rats from the 12 h after MCAO/R injury for consecutive 7 days. The neurological outcomes, infarction volumes and the level of astroglial and microglial/macrophage hyperplasia, inflammatory cytokine and P2X7R and P2Y1R expression in the peri-infarct hippocampal CA1and sensorimotor cortex were investigated after IS to evaluate the MCAO/R model and therapeutic mechanism of EA treatment. Results EA effectively reduced the level of pro-inflammatory cytokine interleukin-1β (IL-1β) as evidenced by reduction in astroglial and microglial/macrophage hyperplasia and the levels of P2X7R and ED1, P2X7R and GFAP, P2Y1R and ED1, P2Y1R and GFAP co-expression in peri-infarct hippocampal CA1 and sensorimotor cortex compared with that of MCAO/R model and Non-EA treatment, accompanied by the improved neurological deficit and the motor and memory impairment outcomes. Therefore, our data support the hypothesis that EA could exert its anti-inflammatory effect via inhibiting the astroglial and microglial/macrophage P2 purinoceptors (P2X7R and P2Y1R)-mediated neuroinflammation after MCAO/R injury. Conclusion Astroglial and microglial/macrophage P2 purinoceptors-mediated neuroinflammation and hyperplasia in peri-infarct hippocampal CA1 and sensorimotor cortex were attenuated by EA treatment after ischemic stroke accompanied by the improved motor and memory behavior performance. Electronic supplementary material The online version of this article (10.1186/s12906-017-1974-y) contains supplementary material, which is available to authorized users.
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Effect of acupuncture plus conventional treatment on brain activity in ischemic stroke patients: a regional homogeneity analysis. J TRADIT CHIN MED 2017. [DOI: 10.1016/s0254-6272(17)30319-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Al-Nemr A, Abdelazeim F. Relationship of cognitive functions and gross motor abilities in children with spastic diplegic cerebral palsy. APPLIED NEUROPSYCHOLOGY-CHILD 2017; 7:268-276. [PMID: 28418729 DOI: 10.1080/21622965.2017.1312402] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Spastic diplegic cerebral palsy can be accompanied by a myriad of symptoms affecting other body systems including cognitive dysfunction. The purpose of this study was to determine whether a relationship exists between cognitive functions in the form of selective attention and figural memory domains with standing and walking motor abilities in children with diplegic cerebral palsy. The research design was a correlational study. Tasks assessing cognitive function and gross motor abilities were carried out with a sample of 50 children. The data demonstrated the presence of correlation between selective attention and figural memory domains of cognitive function with standing, walking running, and jumping subscales of the Gross Motor Function Measure (GMFM) scale at different ages, and this correlation was significant between selective attention domain and gross motor abilities. The outcome measurements of the current study provide original evidence based on the necessity of including cognitive and physical impairments in the examination and evaluation of children with diplegic cerebral palsy in research and clinical settings.
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Affiliation(s)
- Alaa Al-Nemr
- a Department of Physical Therapy for pediatric, Faculty of Physical Therapy , Cairo University , Cairo , Egypt
| | - Faten Abdelazeim
- a Department of Physical Therapy for pediatric, Faculty of Physical Therapy , Cairo University , Cairo , Egypt
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Zhu K, Sun J, Kang Z, Zou Z, Wu G, Wang J. Electroacupuncture Promotes Remyelination after Cuprizone Treatment by Enhancing Myelin Debris Clearance. Front Neurosci 2017; 10:613. [PMID: 28119561 PMCID: PMC5222794 DOI: 10.3389/fnins.2016.00613] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 12/26/2016] [Indexed: 12/13/2022] Open
Abstract
Promoting remyelination is crucial for patients with demyelinating diseases including multiple sclerosis. However, it is still a circuitous conundrum finding a practical remyelinating therapy. Electroacupuncture (EA), originating from traditional Chinese medicine (TCM), has been widely used to treat CNS diseases all over the world, but the role of EA in demyelinating diseases is barely known. In this study, we examined the remyelinating properties and mechanisms of EA in cuprizone-induced demyelinating model, a CNS demyelinating murine model of multiple sclerosis. By feeding C57BL/6 mice with chow containing 0.2% cuprizone for 5 weeks, we successfully induce demyelination as proved by weight change, beam test, pole test, histomorphology, and Western Blot. EA treatment significantly improves the neurobehavioral performance at week 7 (2 weeks after withdrawing cuprizone chow). RNA-seq and RT-PCR results reveal up-regulated expression of myelin-related genes, and the expression of myelin associated protein (MBP, CNPase, and O4) are also increased after EA treatment, indicating therapeutic effect of EA on cuprizone model. It is widely acknowledged that microglia exert phagocytic effect on degraded myelin debris and clear these detrimental debris, which is a necessary process for subsequent remyelination. We found the remyelinating effect of EA is associated with enhanced clearance of degraded myelin debris as detected by dMBP staining and red oil O staining. Our further studies suggest that more microglia assemble in demyelinating area (corpus callosum) during the process of EA treatment, and cells inside corpus callosum are mostly in a plump, ameboid, and phagocytic shape, quite different from the ramified cells outside corpus callosum. RNA-seq result also unravels that most genes relating to positive regulation of phagocytosis (GO:0050766) are up-regulated, indicating enhanced phagocytic process after EA treatment. During the process of myelin debris clearance, microglia tend to change their phenotype toward M2 phenotype. Thus, we also probed into the phenotype of microglia in our study. Immuno-staining results show increased expression of CD206 and Arg1, and the ratio of CD206/CD16/32 are also higher in EA group. In conclusion, these results demonstrate for the first time that EA enhances myelin debris removal from activated microglia after demyelination, and promotes remyelination.
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Affiliation(s)
- Keying Zhu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
| | - Jingxian Sun
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
| | - Zheng Kang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
| | - Zaofeng Zou
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
| | - Gencheng Wu
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
| | - Jun Wang
- Department of Integrative Medicine and Neurobiology, School of Basic Medical Sciences, Shanghai Medical College, Fudan UniversityShanghai, China; State Key Laboratory of Medical Neurobiology, Collaborative Innovation Center for Brain Science, Institutes of Brain Science, Fudan UniversityShanghai, China; Academy of Integrative Medicine, Fudan UniversityShanghai, China
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15
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Jiang C, Yang S, Tao J, Huang J, Li Y, Ye H, Chen S, Hong W, Chen L. Clinical Efficacy of Acupuncture Treatment in Combination With RehaCom Cognitive Training for Improving Cognitive Function in Stroke: A 2 × 2 Factorial Design Randomized Controlled Trial. J Am Med Dir Assoc 2016; 17:1114-1122. [DOI: 10.1016/j.jamda.2016.07.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 07/15/2016] [Accepted: 07/21/2016] [Indexed: 10/21/2022]
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16
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das Nair R, Cogger H, Worthington E, Lincoln NB. Cognitive rehabilitation for memory deficits after stroke. Cochrane Database Syst Rev 2016; 9:CD002293. [PMID: 27581994 PMCID: PMC6457594 DOI: 10.1002/14651858.cd002293.pub3] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Memory problems are a common cognitive complaint following stroke and can potentially affect ability to complete functional activities. Cognitive rehabilitation programmes either attempt to retrain lost or poor memory functions, or teach patients strategies to cope with them.Some studies have reported positive results of cognitive rehabilitation for memory problems, but the results obtained from previous systematic reviews have been less positive and they have reported inconclusive evidence. This is an update of a Cochrane review first published in 2000 and most recently updated in 2007. OBJECTIVES To determine whether participants who have received cognitive rehabilitation for memory problems following a stroke have better outcomes than those given no treatment or a placebo control.The outcomes of interest were subjective and objective assessments of memory function, functional ability, mood, and quality of life. We considered the immediate and long-term outcomes of memory rehabilitation. SEARCH METHODS We used a comprehensive electronic search strategy to identify controlled studies indexed in the Cochrane Stroke Group Trials Register (last searched 19 May 2016) and in the Cochrane Central Register of Controlled Trials (CENTRAL2016, Issue 5), MEDLINE (2005 to 7 March 2016), EMBASE 2005 to 7 March 2016), CINAHL (2005 to 5 February 2016), AMED (2005 to 7 March 2016), PsycINFO (2005 to 7 March 2016), and nine other databases and registries. Start dates for the electronic databases coincided with the last search for the previous review. We handsearched reference lists of primary studies meeting the inclusion criteria and review articles to identify further eligible studies. SELECTION CRITERIA We selected randomised controlled trials in which cognitive rehabilitation for memory problems was compared to a control condition. We included studies where more than 75% of the participants had experienced a stroke, or if separate data were available from those with stroke in mixed aetiology studies. Two review authors independently selected trials for inclusion, which was then confirmed through group discussion. DATA COLLECTION AND ANALYSIS We assessed study risk of bias and extracted data. We contacted the investigators of primary studies for further information where required. We conducted data analysis and synthesis in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. We performed a 'best evidence' synthesis based on the risk of bias of the primary studies included. Where there were sufficient numbers of similar outcomes, we calculated and reported standardised mean differences (SMD) using meta-analysis. MAIN RESULTS We included 13 trials involving 514 participants. There was a significant effect of treatment on subjective reports of memory in the short term (standard mean difference (SMD) 0.36, 95% confidence interval (CI) 0.08 to 0.64, P = 0.01, moderate quality of evidence), but not the long term (SMD 0.31, 95% CI -0.02 to 0.64, P = 0.06, low quality of evidence). The SMD for the subjective reports of memory had small to moderate effect sizes.The results do not show any significant effect of memory rehabilitation on performance in objective memory tests, mood, functional abilities, or quality of life.No information was available on adverse events. AUTHORS' CONCLUSIONS Participants who received cognitive rehabilitation for memory problems following a stroke reported benefits from the intervention on subjective measures of memory in the short term (i.e. the first assessment point after the intervention, which was a minimum of four weeks). This effect was not, however, observed in the longer term (i.e. the second assessment point after the intervention, which was a minimum of three months). There was, therefore, limited evidence to support or refute the effectiveness of memory rehabilitation. The evidence was limited due to the poor quality of reporting in many studies, lack of consistency in the choice of outcome measures, and small sample sizes. There is a need for more robust, well-designed, adequately powered, and better-reported trials of memory rehabilitation using common standardised outcome measures.
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Affiliation(s)
- Roshan das Nair
- University of NottinghamDivision of Rehabilitation and AgeingB98, B Floor Medical SchoolQueen's Medical CentreNottinghamUKNG7 2UH
| | - Heather Cogger
- University of NottinghamDivision of Rehabilitation and AgeingB98, B Floor Medical SchoolQueen's Medical CentreNottinghamUKNG7 2UH
| | | | - Nadina B Lincoln
- University of NottinghamDivision of Rehabilitation and AgeingB98, B Floor Medical SchoolQueen's Medical CentreNottinghamUKNG7 2UH
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Lin R, Yu K, Li X, Tao J, Lin Y, Zhao C, Li C, Chen LD. Electroacupuncture ameliorates post-stroke learning and memory through minimizing ultrastructural brain damage and inhibiting the expression of MMP-2 and MMP-9 in cerebral ischemia-reperfusion injured rats. Mol Med Rep 2016; 14:225-33. [PMID: 27177163 PMCID: PMC4918523 DOI: 10.3892/mmr.2016.5227] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 04/19/2016] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to investigate the potential neuroprotective effects of electroacupuncture (EA) in the treatment of cerebral ischemia/reperfusion (I/R) injury, and to elucidate the association between this neuroprotective effect and brain ultrastructure and expression of matrix metalloproteinase (MMP)-2 and 9. Rats underwent focal cerebral I/R injury by arterial ligation and received in vivo therapeutic EA at the Baihui (DU20) and Shenting (DU24) acupoints. The therapeutic efficacy was then evaluated following the surgery. The results of the current study demonstrated that EA treatment significantly ameliorated neurological deficits and reduced cerebral infarct volume compared with I/R injured rats. Furthermore, EA improved the learning and memory ability of rats following I/R injury, inhibited blood brain barrier breakdown and reduced neuronal damage in the ischemic penumbra. Furthermore, EA attenuated ultrastructural changes in the brain tissue following ischemia and inhibited MMP-2/MMP-9 expression in cerebral I/R injured rats. The results suggest that EA ameliorates anatomical deterioration, and learning and memory deficits in rats with cerebral I/R injury.
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Affiliation(s)
- Ruhui Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Kunqiang Yu
- TCM Rehabilitation Research Center of SATCM, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Xiaojie Li
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Yukun Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Congkuai Zhao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Chunyan Li
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
| | - Li-Dian Chen
- Fujian Key Laboratory of Exercise Rehabilitation, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350122, P.R. China
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18
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Rezapour T, DeVito EE, Sofuoglu M, Ekhtiari H. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders. PROGRESS IN BRAIN RESEARCH 2016; 224:345-69. [DOI: 10.1016/bs.pbr.2015.07.022] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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19
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Chen CX, Mao RH, Li SX, Zhao YN, Zhang M. Effect of visual training on cognitive function in stroke patients. Int J Nurs Sci 2015. [DOI: 10.1016/j.ijnss.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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20
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Huang J, Lin Z, Wang Q, Liu F, Liu J, Fang Y, Chen S, Zhou X, Hong W, Wu J, Madrigal-Mora N, Zheng G, Yang S, Tao J, Chen L. The effect of a therapeutic regimen of Traditional Chinese Medicine rehabilitation for post-stroke cognitive impairment: study protocol for a randomized controlled trial. Trials 2015; 16:272. [PMID: 26077459 PMCID: PMC4485558 DOI: 10.1186/s13063-015-0795-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2015] [Accepted: 06/05/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Post-stroke cognitive impairment (PSCI) lessens quality of life, restricts the rehabilitation of stroke, and increases the social and economic burden stroke imposes on patients and their families. Therefore effective treatment is of paramount importance. However, the treatment of PSCI is very limited. The primary aim of this protocol is to propose a lower cost and more effective therapy, and to confirm the long-term effectiveness of a therapeutic regimen of Traditional Chinese Medicine (TCM) rehabilitation for PSCI. METHODS/DESIGN A prospective, multicenter, large sample, randomized controlled trial will be conducted. A total of 416 eligible patients will be recruited from seven inpatient and outpatient stroke rehabilitation units and randomly allocated into a therapeutic regimen of TCM rehabilitation group or cognitive training (CT) control group. The intervention period of both groups will last 12 weeks (30 minutes per day, five days per week). Primary and secondary outcomes will be measured at baseline, 12 weeks (at the end of the intervention), and 36 weeks (after the 24-week follow-up period). DISCUSSION This protocol presents an objective design of a multicenter, large sample, randomized controlled trial that aims to put forward a lower cost and more effective therapy, and confirm the long-term effectiveness of a therapeutic regimen of TCM rehabilitation for PSCI through subjective and objective assessments, as well as highlight its economic advantages. TRIAL REGISTRATION This trial was registered with the Chinese Clinical Trial Registry (identifier: ChiCTR-TRC-14004872 ) on 23 June 2014.
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Affiliation(s)
- Jia Huang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China. .,Fujian Key Laboratory of Exercise Rehabilitation, No. 282 WUSI Road, Gulou, Fuzhou, 350003, China. .,National Rehabilitation Research Center of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Zhengkun Lin
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Qin Wang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Feiwen Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Jiao Liu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Yunhua Fang
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Shanjia Chen
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Xiaoxuan Zhou
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Wenjun Hong
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Jinsong Wu
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Natalia Madrigal-Mora
- Friedrich-Alexander University Erlangen-Nuremberg, Schlossplatz 4, 91054, Erlangen, Germany.
| | - Guohua Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Shanli Yang
- Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital, No. 282 WUSI Road, Gulou, Fuzhou, 350003, China.
| | - Jing Tao
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China. .,Fujian Key Laboratory of Exercise Rehabilitation, No. 282 WUSI Road, Gulou, Fuzhou, 350003, China. .,National Rehabilitation Research Center of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
| | - Lidian Chen
- Fujian Key Laboratory of Exercise Rehabilitation, No. 282 WUSI Road, Gulou, Fuzhou, 350003, China. .,National Rehabilitation Research Center of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China. .,Fujian University of Traditional Chinese Medicine, No. 1 Huatuo Road Shangjie Minhou, Fuzhou, 350122, China.
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