目的探讨针灸对慢性头痛的治疗效果。方法在Medline(1966-2011),CINAHL,Cochrane Central Register ofControlled Trials与Scopus等数据库中检索所有关于针灸治疗头痛的随机对照研究。研究对象为慢性头痛的成年人,随机接受针灸治疗或者&...目的探讨针灸对慢性头痛的治疗效果。方法在Medline(1966-2011),CINAHL,Cochrane Central Register ofControlled Trials与Scopus等数据库中检索所有关于针灸治疗头痛的随机对照研究。研究对象为慢性头痛的成年人,随机接受针灸治疗或者"伪"针灸治疗。其监测指标包括头痛严重程度,头痛的发生频率及患者治疗好转率。结果共17例研究入选,大多数入选的研究显示了针灸治疗慢性头痛较"伪"针灸有效的趋势。荟萃分析显示无论是早期随访阶段还是晚期随访阶段,针灸治疗患者的好转率明显高于对照组:相对危险度(RR)分别为:1.19(95%CI:1.08,1.30)与1.22(95%CI:1.04,1.43)。结论同"伪"针灸相比,针灸可以提高患者的好转率,是一种有效的治疗方法。展开更多
目的:探讨发作性头痛与慢性头痛患者注意功能影响的临床表现及其可能的作用机制。方法:通过纳入18例发作性头痛(episodic headache,EH)患者、20例慢性头痛(chronic headache,CH)患者和21例健康对照人群,分别进行神经心理学评估,包括简...目的:探讨发作性头痛与慢性头痛患者注意功能影响的临床表现及其可能的作用机制。方法:通过纳入18例发作性头痛(episodic headache,EH)患者、20例慢性头痛(chronic headache,CH)患者和21例健康对照人群,分别进行神经心理学评估,包括简易精神状态评估量表(mini mental state exam,MMSE)、蒙特利尔认知评估量表中国北京版(Beijing Chinese version of Montreal Cognitive Assessment,Mo CA-C)、数字广度测试(digit span test,DS)、额叶功能评定量表(frontal assessment battery,FAB)、医院焦虑抑郁量表(hospital anxiety and depression subscales,HADS)和匹兹堡睡眠量表(Pittsburgh sleep quality index,PSQI)和注意力网络测试(attention networks test,ANT),并进行对比分析。结果:CH组的Mo CA-C(P值均<0.001)、DS(P=0.002或P=0.004)、HADS(焦虑:P<0.001或P=0.002;抑郁:P<0.001或P=0.001)、PSQI(P<0.001或P=0.001)评估结果均与健康对照组或EH组存在显著差异。CH组和健康对照组的FAB评估结果亦存在显著差异(P=0.021)。ANT测试结果显示3组间的警觉、定向效率和正确率无显著差异,但CH组的平均反应时间较健康对照组或EH组明显延长(P=0.002或P=0.035),执行控制效率较健康对照组明显降低(P=0.042)。结论:头痛损害注意功能,而CH组损害更明显,主要表现为CH患者执行注意力相关任务的平均反应时间延长、执行控制功能降低,提示CH损害了注意网络-执行功能,该功能的损害可能是头痛损害注意功能的关键机制之一。展开更多
Background: Chronic headache following traumatic brain injury(TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions, and it ma...Background: Chronic headache following traumatic brain injury(TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions, and it may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System(FNS), which involves minute pulses of electromagnetic energy stimulation of brainwave activity, has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS.Methods: Nine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington(in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache(BPI-HA), previous week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version(PCL-M), and an individual treatment session numerical rating scale(NRS) for the degree of cognitive dysfunction. Data analyses included beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS. Results: All beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced a reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing the virtual elimination of headaches. One participant obtained modest headache relief but no improvements in posttraumatic stress or cognitive dysfunction. Conclusions: FNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service. Further research is needed to investigate the e展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;">Stroke is the second highest cause of death globally and a leading cause of not only physical disability but also co...<div style="text-align:justify;"> <span style="font-family:Verdana;">Stroke is the second highest cause of death globally and a leading cause of not only physical disability but also cognitive. Approximately two-thirds of Ischemic Stroke patients, who represent the most common type of stroke are found to have mild deficits. Minor stroke, sometimes also referred to as “mild stroke”, is often defined in research studies as a National Institute of Health Stroke Scale (NIHSS) score of 5 or less, although, the cut point for NIHSS score or standardized criterion to define minor stroke has not been established. In the past, many studies have been focusing on the definition of the minor stroke to better stabilize the acute treatment guidelines, to predict the functional outcome, and also for early risk factors stratification. Different studies use different criteria or different cut-points of NIHSS scores to define minor stroke. Aside from indecision of acute management of minor stroke, many other questions have been raised regarding minor strokes, for example, the interaction of large vessel occlusion with minor stroke, the prevalence rate of depression, anxiety, cognitive dysfunction, chronic head after minor stroke, and so on. Finding a universal definition for minor stroke is the key to establish the guideline for management for this group of patients. However, the guidance of treatment of minor stroke is not the focus of this review. The review will focus on the deep comprehension of minor stroke characteristics, summarizing the new findings related to minor stroke, and highlight the essential points to consider for characterizing mild stroke symptoms for a new direction guide for future studies.</span> </div>展开更多
文摘目的探讨针灸对慢性头痛的治疗效果。方法在Medline(1966-2011),CINAHL,Cochrane Central Register ofControlled Trials与Scopus等数据库中检索所有关于针灸治疗头痛的随机对照研究。研究对象为慢性头痛的成年人,随机接受针灸治疗或者"伪"针灸治疗。其监测指标包括头痛严重程度,头痛的发生频率及患者治疗好转率。结果共17例研究入选,大多数入选的研究显示了针灸治疗慢性头痛较"伪"针灸有效的趋势。荟萃分析显示无论是早期随访阶段还是晚期随访阶段,针灸治疗患者的好转率明显高于对照组:相对危险度(RR)分别为:1.19(95%CI:1.08,1.30)与1.22(95%CI:1.04,1.43)。结论同"伪"针灸相比,针灸可以提高患者的好转率,是一种有效的治疗方法。
文摘目的:探讨发作性头痛与慢性头痛患者注意功能影响的临床表现及其可能的作用机制。方法:通过纳入18例发作性头痛(episodic headache,EH)患者、20例慢性头痛(chronic headache,CH)患者和21例健康对照人群,分别进行神经心理学评估,包括简易精神状态评估量表(mini mental state exam,MMSE)、蒙特利尔认知评估量表中国北京版(Beijing Chinese version of Montreal Cognitive Assessment,Mo CA-C)、数字广度测试(digit span test,DS)、额叶功能评定量表(frontal assessment battery,FAB)、医院焦虑抑郁量表(hospital anxiety and depression subscales,HADS)和匹兹堡睡眠量表(Pittsburgh sleep quality index,PSQI)和注意力网络测试(attention networks test,ANT),并进行对比分析。结果:CH组的Mo CA-C(P值均<0.001)、DS(P=0.002或P=0.004)、HADS(焦虑:P<0.001或P=0.002;抑郁:P<0.001或P=0.001)、PSQI(P<0.001或P=0.001)评估结果均与健康对照组或EH组存在显著差异。CH组和健康对照组的FAB评估结果亦存在显著差异(P=0.021)。ANT测试结果显示3组间的警觉、定向效率和正确率无显著差异,但CH组的平均反应时间较健康对照组或EH组明显延长(P=0.002或P=0.035),执行控制效率较健康对照组明显降低(P=0.042)。结论:头痛损害注意功能,而CH组损害更明显,主要表现为CH患者执行注意力相关任务的平均反应时间延长、执行控制功能降低,提示CH损害了注意网络-执行功能,该功能的损害可能是头痛损害注意功能的关键机制之一。
文摘Background: Chronic headache following traumatic brain injury(TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions, and it may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System(FNS), which involves minute pulses of electromagnetic energy stimulation of brainwave activity, has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS.Methods: Nine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington(in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache(BPI-HA), previous week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version(PCL-M), and an individual treatment session numerical rating scale(NRS) for the degree of cognitive dysfunction. Data analyses included beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS. Results: All beginning-to-end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced a reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing the virtual elimination of headaches. One participant obtained modest headache relief but no improvements in posttraumatic stress or cognitive dysfunction. Conclusions: FNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service. Further research is needed to investigate the e
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;">Stroke is the second highest cause of death globally and a leading cause of not only physical disability but also cognitive. Approximately two-thirds of Ischemic Stroke patients, who represent the most common type of stroke are found to have mild deficits. Minor stroke, sometimes also referred to as “mild stroke”, is often defined in research studies as a National Institute of Health Stroke Scale (NIHSS) score of 5 or less, although, the cut point for NIHSS score or standardized criterion to define minor stroke has not been established. In the past, many studies have been focusing on the definition of the minor stroke to better stabilize the acute treatment guidelines, to predict the functional outcome, and also for early risk factors stratification. Different studies use different criteria or different cut-points of NIHSS scores to define minor stroke. Aside from indecision of acute management of minor stroke, many other questions have been raised regarding minor strokes, for example, the interaction of large vessel occlusion with minor stroke, the prevalence rate of depression, anxiety, cognitive dysfunction, chronic head after minor stroke, and so on. Finding a universal definition for minor stroke is the key to establish the guideline for management for this group of patients. However, the guidance of treatment of minor stroke is not the focus of this review. The review will focus on the deep comprehension of minor stroke characteristics, summarizing the new findings related to minor stroke, and highlight the essential points to consider for characterizing mild stroke symptoms for a new direction guide for future studies.</span> </div>
