Objective To systematically review the efficacy and safety of acupuncture for the treatment of tumor-related cognitive dysfunction. Methods The PubMed, The Cochrane Library, EMbase, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on acupuncture for the treatment of tumor-related cognitive dysfunction from the establishment of the database to February 13th, 2022. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4.1 software. Results A total of 16 studies involving 1 361 patients were included. The results of meta-analysis showed that the mini-mental state examination (MD=1.82, 95%CI 1.49 to 2.15, P<0.000 01) and Montreal cognitive assessment (MD=1.56, 95%CI 0.83 to 2.29, P<0.0001) scores of the acupuncture treatment group were superior to those in the control group. Furthermore, the acupuncture treatment group showed a reduced incidence of postoperative cognitive dysfunction (RR=0.50, 95%CI 0.39 to 0.63, P<0.000 01) and decreased levels of interleukin-6 (MD=−10.43, 95%CI −14.91 to −5.95, P<0.000 01), interleukin-1β (MD=−47.14, 95%CI −63.92 to −30.36, P<0.000 01), and tumor necrosis factor-α (MD=−9.13, 95%CI −12.38 to −5.89, P<0.000 01). In contrast, the visual analog scale score of the acupuncture treatment group (MD=−1.26, 95%CI −2.06 to −0.47, P=0.002) was better than that of the control group. No significant difference was found in the level of central nervous system-specific protein (S100β) (MD=−0.06, 95%CI −0.13 to 0.01, P=0.12) between the two groups. Conclusion Acupuncture therapy can improve tumor-related cognitive function in patients. Its curative effect is better than that of non-acupuncture therapy; however, its ability to reduce S100β levels is not significantly different from that of non-acupuncture therapy. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
Atrial fibrillation, as the most common arrhythmia currently, can lead to secondary post-stroke cognitive dysfunction and chronic brain damage through various pathways, increasing the risk of cognitive dysfunction and affecting patient prognosis. The prevention and treatment drugs for cognitive dysfunction associated with atrial fibrillation mainly include anticoagulants, heart rhythm and heart rate control drugs, statins, and antihypertensive drugs. At present, there is still some controversy over the medication for cognitive dysfunction associated with atrial fibrillation, lacking guidelines and expert consensus. It is urgent and necessary to find safe, economical, and effective drugs to improve the cognitive function of atrial fibrillation patients. This article summarizes the recent advances in drug therapy for cognitive dysfunction associated with atrial fibrillation, in order to provide a reference for the treatment of cognitive dysfunction associated with atrial fibrillation in clinical practice.
ObjectiveTo systematically review the factors for cognitive impairment in hypertensive patients. MethodsPubMed, Web of Science, Embase, Cochrane Library, Ovid, Scopus, EBSCO, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect studies on factors for cognitive impairment in hypertensive patients from inception to March 2023. Two reviewers independently screened literature, extracted data and evaluated the risk of bias of the included studies. Meta-analysis was then performed by using RevMan 5.3 and Stata 14.0 software. ResultsA total of 26 articles involving 13 464 patients were included. The results of meta-analysis showed that antihypertensive drug use (OR=0.22, 95%CI 0.09 to 0.59, P=0.002), blood pressure was well controlled (OR=0.48, 95%CI 0.37 to 0.623, P<0.001), and social support (OR=0.94, 95%CI 0.90 to 0.97, P<0.001) were protective factors for CI in hypertensive patients. And age (OR=1.17, 95%CI 1.12 to 1.22, P<0.001), age ≥60 (OR=2.10, 95%CI 1.71 to 2.57, P<0.001), female (OR=1.55, 95%CI 1.25 to 1.93, P<0.001), single (OR=2.39, 95%CI 1.89 to 3.03, P<0.001), smoking (OR=3.40, 95%CI 2.40 to 4.82, P < 0.001), educational level (<college） (OR=3.46, 95%CI 2.73 to 4.39, P<0.001), education years (≥12 years) (OR=2.10, 95%CI 1.43 to 3.07, P<0.001), diabetes (OR=2.82, 95%CI 2.22 to 3.58, P<0.001), hyperlipidemia (OR=1.48, 95%CI 1.10 to 2.00, P=0.01), total cholesterol (OR=1.11, 95%CI 1.01 to 1.22, P=0.02), CVHI anomalies (OR=6.24, 95%CI 3.75 to 10.37, P<0.001), sleep disorder (OR=2.92, 95%CI 1.93 to 4.42, P<0.001), systolic blood pressure (OR=1.04, 95%CI 1.02 to 1.06, P<0.001), orthostatic hypotension (OR=1.39, 95%CI 1.20 to 1.62, P<0.001, grade 2 hypertension (OR=2.62,95%CI 1.83 to 3.73, P<0.001), grade 3 hypertension (OR=3.15, 95%CI 1.90 to 5.22, P<0.001), stress history (OR=4.57, 95%CI 2.86 to 7.30, P<0.001) were all risk factors. ConclusionThe current evidence shows that there are many factors affecting the incidence of CI in hypertensive patients, and the assessment of the factors affecting the incidence of cognitive dysfunction in hypertensive patients should be more comprehensive in the future.
Objective To analyze a possible association of -A930G and C242T polymorphism with cognitive dysfunction in obstructive sleep apnea (OSA) patients, and assess potential interactions of CYBA alleles in OSA patients with cognitive dysfunction. Methods A total of 157 OSA patients with cognitive dysfunction were recruited as an experimental group, and 526 matched OSA patients without cognitive dysfunction as an control group. The neurocognitive assessment, polysomnography, genetic analyses, NADHP oxidase (NOX) activity, determination of urinary 8-OH-dG were completed in all subjects. Results Frequencies of the -930G allele carriers were not significantly different between two groups (P>0.05). Frequencies of the TT/CT genotypes were significantly higher in the OSA patients without cognitive dysfunction (P<0.05). NOX activity was assessed and found to be increased in the OSA patients with cognitive dysfunction (P<0.01). NOX activity was significantly higher in whom the allelic T variant was absent (P<0.05). The level of urinary 8-OH-dG was higher in the OSA patients with cognitive dysfunction (P<0.05). The level of urinary 8-OH-dG was significantly higher in whom the allelic T variant was absent (P<0.05). Conclusion The p22phox C242T polymorphism may be involved in the development of oxidative stress reaction in OSA patients with cognitive dysfunction.
Objective To investigate the effects of dexmedetomidine combined with subanesthetic doses of ketamine on cognitive function after surgery for elderly patients with femoral neck fractures. Methods A total of 78 elderly patients with femoral neck fracture who were admitted to hospital between January 2015 and June 2016 were divided into the control group (n=38) and the study group (n=40) according to the admitting time. The cases in the control group were treated with dexmedetomidine given anesthesia and the cases in the study group received dexmedetomidine combined with subanesthetic dose of ketamine. The incidences of postoperative cognitive dysfunction (POCD) and the scores of Mini-mental State Examination (MMSE) and Ramsay scores were compaired, and serum levels of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected. Results There was no difference in operation time, blood loss, blood pressure and oxygen partial pressure between the two groups (P>0.05). The 1-, 3-day postoperative incidences of POCD in the study group were significantly lower than those in the control group (P<0.05). The 1-, 3-, 7-day postoperative MMSE scores and Ramsay sedation scores 1 hour, 3 and 6 hours after stopping anaesthetic drugs in the study group were significantly higher than those in the control group (P<0.05). The 1-, 3-day postoperative serum levels of IL-6 and TNF-α in the study group were significantly lower than those in the control group (P<0.05). Conclusion For elderly patients with femoral neck fracture after surgery, taking dexmedetomidine flax composite drunk dose of ketamine anesthesia method helps to reduce the incidence of postoperative cognitive dysfunction.
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) in the elderly. MethodsThe CNKI, WanFang Data, VIP, CBM, PubMed, Web of Science, Embase, and Cochrane Library databases were electronically searched for studies on the relationship between overweight, obesity/abdominal obesity, and CI in the elderly from their inception to July 2024. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed using Stata 15.0 software. ResultsA total of 38 studies involving 1 783 087 subjects were included. Meta-analysis results showed that compared with normal-weight individuals, overweight (OR=0.96, 95%CI 0.91 to 1.02, P=0.201) was not statistically significant in the risk of CI in the elderly. Obesity (OR=1.14, 95%CI 1.02 to 1.28, P=0.03) and abdominal obesity (OR=1.16, 95%CI 1.11 to 1.21, P<0.001) may be risk factors for CI in the elderly. Subgroup analysis was conducted based on study type, BMI standards, cognitive diagnostic standards, national development level, abdominal obesity diagnostic standards, and follow-up time. Among the subgroups analyzing the correlation between overweight and CI in the elderly, follow-up time ≤5 years (OR=0.68, 95%CI 0.58 to 0.80) showed a lower proportion of CI compared to other follow-up periods. In the subgroups analyzing the correlation between obesity and CI in the elderly, follow-up time ≤5 years (OR=0.71, 95%CI 0.50 to 1.01) was not statistically significant compared to other follow-up periods. For abdominal obesity, a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years (OR=1.21, 95%CI 1.15 to 1.27), compared with other follow-up periods. ConclusionCurrent evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly. Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.
Objective To explore the correlation of protein and mRNA levels of monocyte chemotactic protein-1 (MCP-1) and serum amyloid A protein (SAA) with cognitive function in chronic obstructive pulmonary disease (COPD) patients with or without hypoxemia, in order to identify the serum indexes of early cognitive impairment in patients with COPD, and investigate the effect of hypoxemia on cognitive impairment. Methods Sixty-two COPD patients admitted in the respiratory department of Affiliated Hospital of North China University of Science and Technology from January 2013 to January 2017 were included in the study. The COPD patients were divided into a hypoxemia group (25 cases) and a non-hypoxemia group (37 cases) according to blood gas analysis. Meanwhile 30 healthy subjects were recruited as control. ELISA was used to measure the concentration of serum MCP-1 and SAA in all subjects, and RT-PCR was used to detect the mRNA expression of MCP-1 and SAA in peripheral blood mononuclear cells. Montreal cognitive assessment scale (MoCA scale) was used to determine cognitive function. The expression levels of MCP-1 and SAA were compared between three groups, and the correlations with cognitive dysfunction were analyzed. Results The expression levels of serum MCP-1 and SAA had the same trend as those of MCP-1 mRNA and SAA mRNA in peripheral blood in the COPD patients. The protein and mRNA levels of MCP-1 and SAA were higher than those in the healthy control group (all P<0.05). The COPD hypoxemia group and the COPD non-hypoxemia group were lower than the control group in MoCA score, and the MoCA score of the COPD hypoxemia group decreased more obviously (allP<0.05). The protein and mRNA levels of SAA and MCP-1 were negatively correlated with MoCA score (allP<0.05). Conclusion The protein and mRNA levels of MCP-1 and SAA in peripheral blood increase in COPD patients, and hypoxemia may be involved in cognitive dysfunction in COPD patients.
ObjectiveTo systematically review the influence of dexmedetomidine on early postoperative cognitive dysfunction (POCD) and serum inflammatory factors in elderly patients.MethodsWe searched PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP databases from inception to April 2017, to collect randomized controlled trials (RCTs) about dexmedetomidine for early POCD in elderly patients. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by RevMan 5.3 software.ResultsA total of 23 RCTs, including 2 026 patients were enrolled. The results of meta-analysis showed that, the incidence of POCD in the dexmedetomidine group was lower than that in the control group (the first day: RR=0.40, 95%CI 0.30 to 0.53, P<0.000 01; the third day: RR=0.33, 95%CI 0.23 to 0.48,P<0.000 01; the seventh day: RR=0.42, 95%CI 0.22 to 0.78,P=0.006). Meanwhile, compared with the control group, the dexmedetomidine group significantly decreased the serum levels of TNF-α (immediately after operation: MD=–5.43, 95%CI –7.44 to –3.42, P<0.000 01; 1 h after operation: MD=–4.64, 95%CI –6.92 to –2.36,P<0.000 1; 24 h after operation: MD=–3.27, 95%CI –4.92 to –1.63,P<0.000 1) and IL-6 (immediately after operation: MD=–30.69, 95%CI –41.39 to –20.00,P<0.000 01; 1h after operation: MD=–20.84, 95%CI –28.87 to –12.80,P<0.000 01; 24 h after operation: MD=–13.42, 95%CI –19.90 to –6.94,P<0.000 1).ConclusionCurrent evidence indicates that dexmedetomidine could relief early POCD in elderly patients, in which the reduction of serum inflammatory factors alleviate inflammation response may play a vital role. Due to the limited quality and quantity of included studies, more high quality RCTs are required to verify the above conclusion.
ObjectiveTo systematically review the efficacy of virtual reality technology on cognitive dysfunction in patients with cerebral vascular accident (CVA).MethodsEMbase, Web of Science, PubMed, The Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect the randomized controlled trials (RCTs) on virtual reality technology on cognitive dysfunction in patients with CVA from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 25 RCTs involving 1 113 patients were included. The results of the meta-analysis showed that the scores of MBI (MD=9.24, 95%CI 1.91 to 16.56, P=0.01), MMSE (MD=3.02, 95%CI 1.11 to 4.93, P=0.002) and RBMT-2 (MD=2.74, 95%CI 1.97 to 3.51, P<0.000 01) in VR group were superior to the control group. However, there were no significant differences between the two groups in scores of BI, MOCA, and VCPT.ConclusionsCurrent evidence shows that virtual reality technology may have positively influence on cognitive function and participation in the daily life activities of patients with CVA. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.