Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness ...Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for s展开更多
Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acu...Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.展开更多
Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment f...Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(regi展开更多
Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that ph...Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that physical exercise is beneficial to cognitive function.The purpose of this meta-analysis was to critically assess the effect of Tai Chi exercise on global cognitive,executive,and memory functions in older adults.Methods:After a thorough electronic search and selection,eight studies were included in this meta-analysis with two cross-sectional and six intervention studies.Nine variables included in this meta-analysis were:mini mental status examination(MMSE),Alzheimer’s disease assessment scale-cognitive subscale(ADAS-cog),trailmaking test part A(TMA),trailmaking test part B(TMB),digit span test forward(DSF),digit span test backward(DSB),visual span test backward(VSB),verbal fluency test(VFT),and word delay recall test(WDR).The effect sizes and forest plots of these nine variables were generated.Results:Four(MMSE,DSB,VSB,and VFT)out of nine variables were significantly improved after Tai Chi exercise with the effect sizes ranged from 0.20 to 0.46(small to medium).MMSE represented global cognitive function,and DSB,VSB,and VFT represented memory function.Conclusion:Tai Chi as a mind-body exercise has the positive effects on global cognitive and memory functions,and more consistent positive effects were found on memory function,especially verbal working memory.展开更多
基金financial support from the National Natural Science Foundation of Chinafunded by the National Natural Science Foundation of China(81871854)。
文摘Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for s
基金supported by the National Natural Science Foundation of China,No.81173354the Natural Science Foundation of Guangdong Province,No.10451810101005862+1 种基金a grant from Guangdong Administration of Traditional Chinese Medicine,No.20111032,20132019the Science and Technology Plan Project of Baoan District,Shenzhen City,No.200902159
文摘Our previous ifndings have demonstrated that acupuncture at the Taixi （KI3） acupoint in healthy youths can activate neurons in cognitive-related cerebral cortex. Here, we investigated whether acupuncture at this acupoint in elderly patients with mild cognitive impairment can also activate neurons in these regions. Resting state and task-related functional magnetic resonance imaging showed that the pinprick senstation of acupuncture at the Taixi acupoint differed signiifcantly between elderly patients with mild cognitive impairment and healthy elderly controls. Results showed that 20 brain regions were activated in both groups of participants, including the bi-lateral anterior cingulate gyrus （Brodmann areas [BA] 32, 24）, left medial frontal cortex （BA 9, 10, 11）, left cuneus （BA 19）, left middle frontal gyrus （BA 11）, left lingual gyrus （BA 18）, right medial frontal gyrus （BA 11）, bilateral inferior frontal gyrus （BA 47）, left superior frontal gyrus （BA11）, right cuneus （BA 19, 18）, right superior temporal gyrus （BA 38）, left subcallosal gyrus （BA 47）, bilateral precuneus （BA 19）, right medial frontal gyrus （BA 10）, right superior frontal （BA 11）, left cingulate gyrus （BA 32）, left precentral gyrus （BA 6）, and right fusiform gyrus （BA 19）. These results suggest that acupuncture at the Taixi acupoint in elderly patients with mild cogni-tive impairment can also activate some brain regions.
基金This work was supported by the National Natural Science Foundation of China,No.81874032(to GZH)the Science and Technology Planning Project of Shenzhen of China,No.JCYJ20160427191726109(to FZ)+1 种基金the Science and Technology Planning Project of Guangdong Province of China,No.2016A020215202(to SHC)Shenzhen Health and Family Planning System Research Project of China,No.SZXJ2017069(to SHC).
文摘Individuals with amnestic mild cognitive impairment(aMCI)have a high risk of developing Alzheimer’s disease.Although repetitive transcranial magnetic stimulation(rTMS)is considered a potentially effective treatment for cognitive impairment in patients with aMCI,the neuroimaging mechanisms are poorly understood.Therefore,we performed a double-blind randomized sham-controlled trial in which rTMS was applied to the left dorsolateral prefrontal cortex of aMCI patients recruited from a community near the Third Hospital Affiliated to Sun Yat-sen University,China.Twenty-four patients with aMCI were randomly assigned to receive true rTMS(treatment group,n=12,6 men and 6 women;age 65.08±4.89 years)or sham stimulation(sham group,n=12,5 men and 7 women;age 64.67±4.77 years).rTMS parameters included a stimulation frequency of 10 Hz,stimulation duration of 2 seconds,stimulation interval of 8 seconds,20 repetitions at 80%of the motor threshold,and 400 pulses per session.rTMS/sham stimulation was performed five times per week over a period of 4 consecutive weeks.Our results showed that compared with baseline,Montreal Cognitive Assessment scores were significantly increased and the value of the amplitude of low-frequency fluctuation(ALFF)was significantly increased at the end of treatment and 1 month after treatment.Compared with the sham group,the ALFF values in the right inferior frontal gyrus,triangular part of the inferior frontal gyrus,right precuneus,left angular gyrus,and right supramarginal gyrus were significantly increased,and the ALFF values in the right superior frontal gyrus were significantly decreased in the treatment group.These findings suggest that high-frequency rTMS can effectively improve cognitive function in aMCI patients and alter spontaneous brain activity in cognitive-related brain areas.This study was approved by the Ethics Committee of Shenzhen Baoan Hospital of Southern Medical University,China(approval No.BYL20190901)on September 3,2019 and registered in the Chinese Clinical Trials Registry(regi
文摘目的:探讨老年脑梗死患者25-羟基维生素D[25 hydroxyvitamin D,25(OH)D]水平与神经功能缺损程度和梗死后认知障碍(post-stroke cognitive impairment,PSCI)的关系。方法:选取2019年6月至2 0 2 0年1 2月安徽皖北煤电集团总医院神经内科收治的1 2 0例老年脑梗死患者,采用卒中量表(National Institute of Health Stroke Scale,NIHSS)评估神经功能缺损程度,采用蒙特利尔认知量表(Montreal Cognitive Scale,MoCA)评估认知功能。依据血清25(OH)D水平,分为维生素D正常组(≥20ng/m L,n=46)与缺乏组(<20ng/m L,n=74),比较两组临床资料特征,分析血清25(OH)D水平与NIHSS、MoCA评分的关系,采用多因素logistic回归模型分析患者PSCI的影响因素。结果:维生素D缺乏组NIHSS评分、PSCI发生率、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)、糖化血红蛋白(hemoglobin A1c,HbA1c)高于维生素正常组,MoCA评分、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)均低于维生素D正常组,差异均有统计学意义(均P<0.05),血清25(OH)D水平与NIHSS评分呈负相关(r=-0.723,P<0.05),与MoCA评分呈正相关(r=0.668,P<0.05)。老年脑梗死患者PSCI发生率为35.83%(43/120),logistic回归分析显示年龄、高血压史、饮酒史、NIHSS评分、25(OH)D和LDL-C水平均是PSCI发生的独立影响因素(P<0.05)。结论:老年脑梗死患者血清25(OH)D水平与神经功能缺损程度和认知功能有紧密相关性,较低25(OH)D水平增加PSCI发生风险。
文摘Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that physical exercise is beneficial to cognitive function.The purpose of this meta-analysis was to critically assess the effect of Tai Chi exercise on global cognitive,executive,and memory functions in older adults.Methods:After a thorough electronic search and selection,eight studies were included in this meta-analysis with two cross-sectional and six intervention studies.Nine variables included in this meta-analysis were:mini mental status examination(MMSE),Alzheimer’s disease assessment scale-cognitive subscale(ADAS-cog),trailmaking test part A(TMA),trailmaking test part B(TMB),digit span test forward(DSF),digit span test backward(DSB),visual span test backward(VSB),verbal fluency test(VFT),and word delay recall test(WDR).The effect sizes and forest plots of these nine variables were generated.Results:Four(MMSE,DSB,VSB,and VFT)out of nine variables were significantly improved after Tai Chi exercise with the effect sizes ranged from 0.20 to 0.46(small to medium).MMSE represented global cognitive function,and DSB,VSB,and VFT represented memory function.Conclusion:Tai Chi as a mind-body exercise has the positive effects on global cognitive and memory functions,and more consistent positive effects were found on memory function,especially verbal working memory.
