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Chen G, Wu M, Chen J, Cai G, Liu Q, Zhao Y, Huang Z, Lan Y. Non-invasive brain stimulation effectively improves post-stroke sensory impairment: a systematic review and meta-analysis. J Neural Transm (Vienna) 2023; 130:1219-1230. [PMID: 37495840 DOI: 10.1007/s00702-023-02674-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 07/13/2023] [Indexed: 07/28/2023]
Abstract
More than half of stroke patients experience sensory dysfunction that affects their quality of life. Previous training modalities are ineffective in improving sensory function. In contrast, non-invasive brain stimulation (NIBS) is a new promising intervention for stroke rehabilitation. The aim of this meta-analysis was to summarize the current effectiveness of NIBS in the treatment of post-stroke sensory dysfunction. Articles published in PubMed, Web of Science, Embase, China National Knowledge Infrastructure (CNKI), Chinese scientific journals full-text database (VIP), and Wanfang database from the inception to March 8, 2023 were searched. There were no restrictions on language. A total of 14 RCTs were included (combined n = 804). Moderate-quality evidence suggested that NIBS significantly improved sensory function after stroke, and significant effects were observed up to 1 year after the intervention. In subgroup analysis, treatment with transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) was significantly more effective than controls for recovery of sensory function in stroke patients. Stimulation of the primary motor cortex (M1), primary somatosensory cortex (S1) or M1 + S1 stimulation sites significantly improved sensory function. NIBS for sensory dysfunction showed significant therapeutic potential in patients with different stages of stroke. No significant effects were observed in subjects with less than 10 NIBS stimulations. Significant therapeutic effects were observed with either high-frequency or low-frequency rTMS.
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Affiliation(s)
- Gengbin Chen
- Postgraduate Research Institute, Guangzhou Sport University, No. 1268, Guangzhou Avenue Middle, Tianhe District, Guangzhou, Guangdong, China
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1st Panfu Rd, Guangzhou, Guangdong, China
| | - Manfeng Wu
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1st Panfu Rd, Guangzhou, Guangdong, China
| | - Jialin Chen
- Postgraduate Research Institute, Guangzhou Sport University, No. 1268, Guangzhou Avenue Middle, Tianhe District, Guangzhou, Guangdong, China
| | - Guiyuan Cai
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1st Panfu Rd, Guangzhou, Guangdong, China
| | - Quan Liu
- Postgraduate Research Institute, Guangzhou Sport University, No. 1268, Guangzhou Avenue Middle, Tianhe District, Guangzhou, Guangdong, China
| | - Yinchun Zhao
- Postgraduate Research Institute, Guangzhou Sport University, No. 1268, Guangzhou Avenue Middle, Tianhe District, Guangzhou, Guangdong, China
| | - Zhiguan Huang
- Postgraduate Research Institute, Guangzhou Sport University, No. 1268, Guangzhou Avenue Middle, Tianhe District, Guangzhou, Guangdong, China.
- Engineering Technology Research Center for Sports Assistive Devices of Guangdong, School of Sport and Health, Guangzhou Sport University, Guangzhou, China.
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, 1st Panfu Rd, Guangzhou, Guangdong, China.
- Guangzhou Key Laboratory of Aging Frailty and Neurorehabilitation, Guangzhou, China.
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Chen G, Wu M, Chen J, Zhang C, Liu Q, Zhao Y, Xu G, Lan Y. Biomarkers associated with functional improvement after stroke rehabilitation: a systematic review and meta-analysis of randomized controlled trials. Front Neurol 2023; 14:1241521. [PMID: 37731856 PMCID: PMC10508962 DOI: 10.3389/fneur.2023.1241521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/25/2023] [Indexed: 09/22/2023] Open
Abstract
Objective This study aims to identify blood and cerebrospinal fluid biomarkers that are correlated to the functional improvement of stroke patients after rehabilitation therapy, and provide ideas for the treatment and evaluation of stroke patients. Methods The PubMed, Web of Science, and Embase databases were searched for articles published in the English language, from inception to December 8, 2022. Results A total of 9,810 independent records generated 50 high-quality randomized controlled trials on 119 biomarkers. Among these records, 37 articles were included for the meta-analysis (with a total of 2,567 stroke patients), and 101 peripheral blood and cerebrospinal fluid biomarkers were included for the qualitative analysis. The quantitative analysis results revealed a moderate quality evidence that stroke rehabilitation significantly increased the level of brain-derived neurotrophic factor (BDNF) in serum. Furthermore, the low-quality evidence revealed that stroke rehabilitation significantly increased the concentration of serum noradrenaline (NE), peripheral blood superoxide dismutase (SOD), peripheral blood albumin (ALB), peripheral blood hemoglobin (HB), and peripheral blood catalase (CAT), but significantly decreased the concentration of serum endothelin (ET) and glutamate. In addition, the changes in concentration of these biomarkers were associated with significant improvements in post-stroke function. The serum BNDF suggests that this can be used as a biomarker for non-invasive brain stimulation (NIBS) therapy, and to predict the improvement of stroke patients. Conclusion The concentration of serum BNDF, NE, ET and glutamate, and peripheral blood SOD, ALB, HB and CAT may suggest the function improvement of stroke patients.
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Affiliation(s)
- Gengbin Chen
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Manfeng Wu
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Jialin Chen
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Cailing Zhang
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
| | - Quan Liu
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Yinchun Zhao
- Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, China
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yue Lan
- Department of Rehabilitation Medicine, Guangzhou First People’s Hospital, School of Medicine, South China University of Technology, Guangzhou, China
- Guangzhou Key Laboratory of Aging Frailty and Neurorehabilitation, Guangzhou, China
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Kutlubaev MA, Akhmetova AI, Ozerova AI. [Emotional disorders after stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:30-35. [PMID: 38148695 DOI: 10.17116/jnevro202312312230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
Emotional disorders are common among patients after stroke. They include anger, fear, emotional expression control (uncontrollable crying, laughing), emotional indifference (apathy), disorders of emotion recognition and emotional empathy. They might develop independently or as a presentation of depression, anxiety, catastrophic reaction, posttraumatic stress disorder etc. Treatment of post-stroke emotional disorders include pharmacotherapy, psychotherapy, neuromodulation.
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Affiliation(s)
| | | | - A I Ozerova
- Bashkir State Medical University, Ufa, Russia
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