Effects of Paroxetine on Motor and Cognitive Function Recovery in Patients with Non-Depressed Ischemic Stroke: An Open Randomized Controlled Study

2018 ◽  
Vol 19 (3) ◽  
pp. 228-234
Author(s):  
Xiao-Ling Pan ◽  
Hong-Fang Chen ◽  
Xing Cheng ◽  
Chuan-Chen Hu ◽  
Jian-Wei Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Function ◽  
Depression Scale ◽  
Controlled Study ◽  
Hamilton Depression Scale ◽  
Randomized Controlled ◽  
Function Recovery ◽  
Random Number Table ◽  
And Control

Introduction: To investigate the effects of paroxetine (PAR) on motor and cognitive function recovery in patients with non-depressed ischemic stroke (nD-AIS).Methods: One hundred sixty-seven patients hospitalized for non-depressed acute ischemic stroke were selected and divided into treatment (T) and control (C) groups using a random number table. All patients received conventional secondary ischemic stroke prevention and rehabilitation training; patients in Group T additionally received treatment with PAR (10 mg/day during week 1 and 20 mg/day thereafter) for 3 months. The follow-up observation lasted 6 months. The Fugl–Meyer motor scale (FMMS), Montreal cognitive assessment (MoCA), and Hamilton depression scale (HAMD) were used on D0, D15, D90, and D180 (T0, 1, 2, and 3, respectively; D180 = 90 days after treatment cessation) after study initiation, and scores were compared between the groups.Results: The FMMS and MoCA scores differed significantly between Groups T and C at T2 and T3 (p < .05); by contrast, these scores did not differ significantly between the groups at T1 (p > .05). Furthermore, the HAMD scores differed significantly between the two groups at T3 (p < .05), but not at T1 and T2 (p > .05).Conclusions: PAR treatment may improve motor and cognitive function recovery in patients with nD-AIS. Moreover, PAR may reduce the occurrence of depression after stroke.

scholarly journals Association Between Obesity and Post-stroke Anxiety in Patients With Acute Ischemic Stroke

2021 ◽  
Vol 8 ◽  
Author(s):  
Bei-Lei Zhu ◽  
Ai-Yi Hu ◽  
Gui-Qian Huang ◽  
Hui-Hua Qiu ◽  
Xian-Chai Hong ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Abdominal Obesity ◽  
Depression Scale ◽  
Elevated Risk ◽  
Hamilton Depression Scale ◽  
Post Stroke ◽  
Significant Difference ◽  
Clinical Measurements

Post-stroke anxiety (PSA) is serious psychosomatic comorbidity among patients with stroke, but whether obesity could be positively associated with PSA is currently unknown. The purpose of this study was to investigate the potential association between obesity and subsequent anxiety risk in patients with stroke. A total of 441 patients with acute ischemic stroke (AIS) onset were consecutively recruited within 7 days, and PSA and post-stroke depression (PSD) were evaluated by using a 14-item Hamilton anxiety scale (HAMA) and 17-item Hamilton depression scale (HAMD) at the end of 1-month follow-up. The odds ratio (OR) with 95% CI was estimated for the incidental PSA by using logistic regression analysis. The incidence of PSA was 25.85% at the end of 1-month follow-up, with a significant difference between patients with and without abdominal obesity. Relative fat mass (RFM) and abdominal obesity were significantly associated with an elevated risk of PSA, and the crude ORs were 1.04 (95% CI: 1.01–1.08) and 1.93 (95% CI: 1.11–3.34), respectively. Even after adjustment for obesity-related risk factors and PSA-related clinical measurements, the association remained to be pronounced with abdominal obesity. However, RFM (OR = 1.03, 95% CI: 0.99–1.06, P = 0.053) and abdominal obesity (OR = 1.31, 95% CI: 0.80–2.15, P = 0.280) were not significantly associated with an elevated risk of PSD. Abdominal obesity was independently associated with the PSA instead of PSD, which may help predict PSA risk in clinical practice. Further prospective clinical studies with a long follow-up duration are warranted to verify this finding.

scholarly journals The Potential Influence of Absence of Blinding Method: Secondary Analysis From Randomized Controlled Trials Concerned Acupuncture for Depression

2020 ◽  
Author(s):  
Rui-Ting Wang ◽  
Ling-Jun Cui ◽  
Jian-Ping Liu ◽  
Mei Han ◽  
Yu-Tong Fei ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Depression Scale ◽  
Experimental Treatment ◽  
Controlled Trials ◽  
Hamilton Depression Scale ◽  
China National Knowledge Infrastructure ◽  
Detection Bias ◽  
Randomized Controlled ◽  
And Control

Abstract Background To evaluate the possibility and impact of performance and detection bias in randomized controlled trials due to lack of the blinding method. MethodsTrials assessing acupuncture for depression published by March 2020 were searched from China National Knowledge Infrastructure database. Through matching, we reassembled the trials of comparing experimental acupuncture and control acupuncture. Meta-analysis with post-treatment HAMD (Hamilton Depression Scale) of the newly reassembled trials was conducted. Changes of HAMD of all included groups were also analyzed, the between groups difference was then analyzed by t-test. All statistical analyses were performed using RevMan 5.3 software. ResultsThirteen pairs of studies were matched from 63 included trials. Re-analysis from the paired studies showed obvious difference of HAMD scales between the experimental and control acupuncture (Mean Difference was -2.95 for HAMD-17, -5.55 for HAMD-24). Re-analysis from all the included groups also showed the statistical difference between groups at four weeks of HAMD-17 (P=0.01), and four/six weeks of HAMD-24 (P<0.01).Conclusion Effectiveness of acupuncture for decreasing the severity of depression was superior in trials that considered acupuncture as experimental treatment, showing performance and detection bias caused by the absence of blinding method is of great significance in acupuncture trials.

scholarly journals Effect of Brain Gym ® exercises on cognitive function and brain-derived neurotrophic factor plasma level in elderly: a randomized controlled trial

2020 ◽  
Vol 39 (1) ◽  
pp. 34
Author(s):  
Donna Adriani Kusumadewi Muhammad ◽  
Yudhisman Imran ◽  
Martiem Mawi ◽  
Patwa Amani ◽  
Ermita I.I. Ilyas
Keyword(s):  
Cognitive Function ◽  
Treatment Group ◽  
Neurotrophic Factor ◽  
The Elderly ◽  
Brain Derived Neurotrophic Factor ◽  
Controlled Study ◽  
Control Group ◽  
Brain Gym ◽  
Randomized Controlled ◽  
And Control

<p><strong>Background</strong></p><p>Cognitive impairment and dementia are some of the major health concerns in the aging population. Many studies showed positive effects of physical exercise in delaying or preventing these conditions. Brain Gym ® exercises is a structured aerobic exercise involving head, eyes and crossing movements of the extremities in order to stimulate both brain hemispheres. This study was conducted to evaluate the effect of Brain Gym ® exercises sessions on cognitive function and plasma brain-derived neurotrophic factor (BDNF) in the elderly.</p><p><strong> </strong></p><p><strong>Methods</strong></p><p>A non-blinded randomized controlled study involving 64 healthy women aged &gt;60 years who were randomized into Brain Gym ® exercises treatment group (n=32) and control group (n=32). Treatment group joined 60 minutes of brain gym exercises sessions twice a week for 12 weeks. The measured outcomes were cognitive function (assessed by mini-mental state examination [MMSE] questionnaire) and plasma BDNF levels. The outcomes were measured at base-line and after the intervention. An independent t-test was used to analyze the data.</p><p><strong> </strong></p><p><strong>Results</strong></p><p>The BDNF levels were increased in both groups after 12 weeks, and there was a significant difference between treatment group (41.26 ± 6,82 ng/mL) and control group (37.10 ± 8.11 ng/mL)(p=0.040). However, the MMSE score was not significantly different between the two groups (p=0.200).</p><p><strong> </strong></p><p><strong>Conclusion</strong></p>Brain Gym ® exercises sessions significantly increase plasma BDNF level in the elderly population. In practical terms, we may suggest evaluation of the effects of Brain Gym ® exercises as a strategy in the treatment of disorders associated with central degenerative changes.<p class="email"> </p>

scholarly journals Effectiveness of Abdominal and Gluteus Medius Training in Lumbo-Pelvic Stability and Adductor Strength in Female Soccer Players. A Randomized Controlled Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1528
Author(s):  
Héctor Guerrero-Tapia ◽  
Rodrigo Martín-Baeza ◽  
Rubén Cuesta-Barriuso
Keyword(s):  
Repeated Measures ◽  
Gluteus Medius ◽  
Soccer Players ◽  
Controlled Study ◽  
Control Group ◽  
Extrinsic Factors ◽  
Randomized Controlled ◽  
Limb Injuries ◽  
Experimental Group

Background. Abdominal and lumbo-pelvic stability alterations may be the origin of lower limb injuries, such as adductor pathology in soccer players. Imbalance can be caused by both intrinsic and extrinsic factors. Methods: In this randomized controlled trial over 8 weeks, 25 female footballers were randomly allocated to an experimental group (isometric abdominal training and gluteus medius-specific training) or a control group (isometric abdominal training). Evaluations were performed at baseline, at the end of the intervention and after a 4-week follow-up period. The exercise protocol in common for both groups included three exercises: Plank, Lateral plank and Bird dog. Specific exercises for the gluteus medius were: Pelvic drop and Stabilization of the gluteus medius in knee valgus. Outcome measures were lumbar-pelvic stability and adductor strength. Results: After the intervention, there was an increase in lumbo-pelvic stability in both groups, being greater in the control group than in the experimental group (mean differences [MD]: 4.84 vs. MD: 9.58; p < 0.01) with differences in the analysis of repeated measures (p < 0.001), but not in group interaction (p = 0.26). Changes were found in adductor strength in the experimental group (MD: −2.48; p < 0.001 in the left adductor; MD: −1.48; p < 0.01 in right adductor) and control group (MD: −1.68; p < 0.001 in the left adductor; MD: −2.05; p < 0.001 in the right adductor) after the intervention, with differences in the analysis of repeated measures in left (p < 0.001) and right (p < 0.001) adductor strength. Conclusions: An abdominal and gluteal training protocol shows no advantage over a protocol of abdominal training alone for lumbo-pelvic stability and adductor strength, while improvements in both variables are maintained at four weeks follow-up.

scholarly journals Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial

2021 ◽  
pp. 088626052110041
Author(s):  
Roos Ruijne ◽  
Cornelis Mulder ◽  
Milan Zarchev ◽  
Kylee Trevillion ◽  
Roel van Est ◽  
...  
Keyword(s):  
Mental Health ◽  
Domestic Violence ◽  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Referral Rates ◽  
Randomized Controlled ◽  
Cluster Randomized ◽  
And Control ◽  
Domestic Violence And Abuse

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.

scholarly journals Transconjunctival versus Transcutaneous Injection of Botulinum Toxin into the Lacrimal Gland to Reduce Lacrimal Production: A Randomized Controlled Trial

Toxins ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 77
Author(s):  
Andrew G. Lee ◽  
Shin-Hyo Lee ◽  
Minsu Jang ◽  
Sang Jae Lee ◽  
Hyun Jin Shin
Keyword(s):  
Botulinum Toxin ◽  
Lacrimal Gland ◽  
Botulinum Toxin A ◽  
Controlled Trial ◽  
Clinical Effectiveness ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Delivery Routes ◽  
Tear Meniscus Height

The purpose of this study was to determine and compare the effects between injecting botulinum toxin A (BTX-A) transconjunctivally into the palpebral lobe and transcutaneously into the orbital lobe of the lacrimal gland in patients with epiphora due to lacrimal outflow obstruction. This randomized controlled study included 53 eyes of 31 patients with unilateral or bilateral epiphora. Patients were randomly allocated to receive an injection of BTX-A (3 units) either transconjunctivally (n = 15, 25 eyes) or transcutaneously (n = 16, 28 eyes). For objective assessments, the tear meniscus height and Schirmer’s I test with topical anesthesia were measured at baseline and after 2, 6, 12, and 24 weeks of follow-up. Subjective evaluations were performed using the Munk score. After BTX-A injection, patients in both groups experienced significant objective and subjective reductions in tearing at all follow-up times compared to pre-injection (success rate 86.8%), and the effect lasted for a mean duration of 5.63 months. The two delivery routes showed similar clinical effectiveness for a single injected dose of BTX-A. In conclusion, injecting BTX-A via either a transconjunctival or transcutaneous route helps to reduce normal tear production and results in significant improvements in the symptoms in patients with epiphora.

Intensive Statin Therapy for Acute Ischemic Stroke to Reduce the Number of Microemboli: A Preliminary, Randomized Controlled Study

2018 ◽  
Vol 80 (3-4) ◽  
pp. 163-170 ◽  
Author(s):  
Xingyu Chen ◽  
Xiaorong Zhuang ◽  
Zhongwei Peng ◽  
Huili Yang ◽  
Liangyi Chen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Statin Therapy ◽  
High Sensitivity ◽  
Controlled Study ◽  
Statin Group ◽  
Pre Treatment ◽  
Hs Crp ◽  
And Control ◽  
Intensive Statin Therapy

Background: To assess whether intensive statin therapy reduces the occurrence of microemboli in patients with acute ischemic stroke. Methods: Patients with acute ischemic stroke within 72 h of onset were randomized to the intensive statin (atorvastatin 60 mg/day, adjusted to 20 mg/day after 7 days) and control (atorvastatin 20 mg/day) groups. Combined aspirin and clopidogrel were used for antiplatelet therapy. Microemboli were monitored by transcranial Doppler on days 1 (pre-treatment), 3, and 7. Metalloproteinase-9 (MMP-9), high-sensitivity C-reactive protein (hs-CRP), and National Institutes of Health Stroke Scale (NIHSS) score were assessed on days 1 and 7. The modified Rankin scale (mRS) was used on day 90. The primary outcome was the proportion of patients with microemboli on day 3. Results: There were 35 (58.3%) and 30 (52.6%) patients with microemboli in the intensive statin (n = 60) and control (n = 57) groups, respectively, on day 1 (p = 0.342). On day 3, there were significantly less microemboli in the intensive statin group (n = 9; 15.0%) compared with controls (n = 16; 28.1%; p = 0.002). No difference was observed in MMP-9 and hs-CRP levels on day 1, but on day 7, MMP-9 (median 79.3 vs. 95.9 μg/L; p = 0.004) and hs-CRP (median 2.01 vs. 3.60 mg/L; p = 0.020) levels were lower in the intensive statin group compared with controls. There were no differences in NIHSS scores on days 1 and 7. There was no difference in mRS on day 90. Conclusion: Intensive atorvastatin therapy in patients with acute ischemic stroke reduces the occurrence of microemboli and inflammation, with no overt adverse events.

scholarly journals A Prospective Randomized Controlled Study of Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: Study Protocol

2019 ◽  
Author(s):  
Chao Hsing Yeh ◽  
Cuicui Li ◽  
Ronald Glick ◽  
Elizabeth A. Schlenk ◽  
Kathryn Albers ◽  
...  
Keyword(s):  
Older Adults ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Comparison Group ◽  
Controlled Study ◽  
Low Back ◽  
Randomized Controlled ◽  
Auricular Point

Abstract Background: Chronic low back pain (cLBP) is a major health problem and the most common pain condition among those 60 years of age or older in the US. Despite the development of pharmacological and nonpharmacological interventions, cLBP outcomes have not improved and disability rates continue to rise. This study aims to test auricular point acupressure (APA) as a non-invasive, nonpharmacological self-management strategy to manage cLBP and to address current shortcomings of cLBP treatment. Methods: For this prospective randomized controlled study, participants will be randomly assigned into three groups: (1) APA (active points related to cLBP), (2) Comparison Group -1 (non-active points, unrelated to cLBP), (3) Comparison Group-2 (enhanced educational control, an educational booklet on cLBP will be given and the treatment used by participants for their cLBP will be recorded). The ecological momentary assessment smartphone app will be used to collect real-time cLBP outcomes and adherence to APA practice. Treatment and nonspecific psychological placebo effects will be measured via questionnaires for all participants. This proposed trial will evaluate the APA sustained effects for cLBP at 12-month follow-up. Monthly phone follow-up will be used to collect study outcomes. Blood will be collected during study visits at baseline, post-APA treatment, and follow-up study visits at 1-, 3-, 6-, 9- and 12-months post-completion of treatment for a total of 7 assessments. Appointments will start between 9 and 11 am to control for circadian variation in cytokine levels. Discussion: This study is expected to provide vital information on the efficacy, sustainability, and underlying mechanism of APA on cLBP necessary for APA to gain acceptance from both healthcare providers and patients, which would provide a strong impetus for including APA as part of cLBP management in clinical and home settings. Trial registration: NCT03589703, Registered on May 22, 2018 Keywords: Chronic low back pain, auricular point acupressure, older adults, cytokines

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