Noninvasive Brain Stimulation for Poststroke Dysphagia: A Meta-Analysis for Randomized Controlled Trials

2021 ◽  
pp. 1-8
Author(s):  
Yixin Zhu ◽  
Lihua Gu
Keyword(s):  
Motor Cortex ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Swallowing Function ◽  
Swallowing Therapy ◽  
Randomized Controlled ◽  
Therapy Effect

<b><i>Background:</i></b> Past research has indicated that repetitive transcranial magnetic stimulation (rTMS) on the pharyngeal motor cortex may be beneficial to poststroke dysphagic patients. In addition, some studies have supported that transcranial direct current stimulation (tDCS) over the pharyngeal motor cortex can improve swallowing function in poststroke dysphagia. However, some studies showed that rTMS and tDCS show no effect on poststroke dysphagia. This study aims to make a meta-analysis to investigate the therapy effect of rTMS and tDCS on poststroke dysphagia in randomized controlled trials (RCTs). <b><i>Methods:</i></b> We searched for studies published before March 2021 in databases (PubMed, Web of Science, MEDLINE, EMBASE, and Google Scholar). Meta-analysis was made to compute the results of included studies using STATA 12.0 software. <b><i>Results:</i></b> The present study shows a significant increase in the swallowing function in poststroke dysphagia given rTMS compared to those given sham rTMS (standardized mean difference [SMD] = 1.08, 95% confidence interval [CI] = 0.37–1.80, <i>I</i><sup>2</sup> = 81.2%, <i>p</i> &#x3c; 0.001). In addition, the study shows a significant increase in the swallowing function in poststroke dysphagia given tDCS (combined or not combined with conventional swallowing therapy), compared to those given sham tDCS (combined or not combined with conventional swallowing therapy) (SMD = 1.43, 95% CI = 0.73–2.13, <i>I</i><sup>2</sup> = 77.6%, <i>p</i> &#x3c; 0.001). <b><i>Conclusions:</i></b> The study demonstrates that rTMS and tDCS over the pharyngeal motor cortex show therapy effects on poststroke dysphagia. Many more large-scale, blinded RCTs are essential to investigate the effect of rTMS and tDCS on poststroke dysphagia.

scholarly journals The Effect of Acupuncture in Breast Cancer–Related Lymphoedema (BCRL): A Systematic Review and Meta-Analysis

2019 ◽  
Vol 18 ◽  
pp. 153473541986691 ◽  
Author(s):  
Tsai-Ju Chien ◽  
Chia-Yu Liu ◽  
Ching-Ju Fang
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Lymphatic Drainage ◽  
Controlled Trials ◽  
Breast Cancer Patients ◽  
Eligibility Criteria ◽  
Randomized Controlled

Background: Breast cancer–related lymphedema (BCRL) is hard to control. Management may include lymphatic drainage, skin care, bandaging, or even surgery. Since acupuncture has been proven to affect the neurophysiology and neuroendocrine systems, it has the potential to control BCRL. Aim: To evaluate the effect of acupuncture in BCRL in randomized controlled trials. Design: A literature search was performed, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement and without language restrictions. Data Sources: Five databases were searched from inception tthrough September 2018. Only studies that fulfilled the eligibility criteria of evaluating the effect of acupuncture on lymphedema in breast cancer were included. The methodological quality of these trials was assessed using the Cochrane criteria, and meta-analysis software (RevMan 5.3) was used for analysis. Results: We examined 178 breast cancer patients from 6 trials. All included randomized controlled trials had medium to high quality, based on the modified Jadad scale. The systematic review showed that acupuncture is safe and has a trend to improve symptoms, but trials did not consistently measure outcomes. The meta-analysis showed that acupuncture produced no significant improvement in the extent of lymphedema as compared with the control intervention (−1.90; 95% confidence interval = −5.39 to 1.59, P = .29). None of the studies reported severe adverse events. Conclusions: Acupuncture is safe and has a trend to improve the lymphedema related to breast cancer, yet it did not significantly change arm circumference in BCRL. Future studies should include both subjective and objective measurements and large-scale studies are warranted.

scholarly journals Systematic Review and Meta-Analysis of Randomized Controlled Trials of Xingnaojing Treatment for Stroke

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Weijun Peng ◽  
Jingjing Yang ◽  
Yang Wang ◽  
Weihao Wang ◽  
Jianxia Xu ◽  
...  
Keyword(s):  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Conventional Treatment ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Study Selection ◽  
Mild Impairment

Objective. Xingnaojing injection (XNJ) is a well-known traditional Chinese patent medicine (TCPM) for stroke. The aim of this study is to assess the efficacy of XNJ for stroke including ischemic stroke, intracerebral hemorrhage (ICH), and subarachnoid hemorrhage (SAH).Methods. An extensive search was performed within using eight databases up to November 2013. Randomized controlled trials (RCTs) on XNJ for treatment of stroke were collected. Study selection, data extraction, quality assessment, and meta-analysis were conducted according to the Cochrane standards, and RevMan5.0 was used for meta-analysis.Results. This review included 13 RCTs and a total of 1,514 subjects. The overall methodological quality was poor. The meta-analysis showed that XNJ combined with conventional treatment was more effective for total efficacy, neurological deficit improvement, and reduction of TNF-αlevels compared with those of conventional treatment alone. Three trials reported adverse events, of these one trial reported mild impairment of kidney and liver function, whereas the other two studies failed to report specific adverse events.Conclusion. Despite the limitations of this review, we suggest that XNJ in combination with conventional medicines might be beneficial for the treatment of stroke. Currently there are various methodological problems in the studies. Therefore, high-quality, large-scale RCTs are urgently needed.

scholarly journals Auricular Plaster Therapy for Comorbid Insomnia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Huimin Zhao ◽  
Dan Li ◽  
Ying Yang ◽  
Yueting Liu ◽  
Jie Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Large Scale ◽  
Meta Analysis ◽  
Effective Rate ◽  
Sensitivity Analyses ◽  
Controlled Trials ◽  
Comorbid Insomnia ◽  
Randomized Controlled ◽  
Significant Difference

Background. Although the effectiveness of auricular plaster therapy (APT) on primary insomnia has been systematically reviewed, no systematic review of studies has focused on the effect on comorbid insomnia. Objective. To evaluate the efficacy and safety of APT for comorbid insomnia. Methods. Fifteen databases were searched from inception to July 2018. Randomized controlled trials (RCTs) of APT as an exclusive intervention for comorbid insomnia against Western medications, sham APT or no treatment were identified. Results. Fourteen studies involving 928 participants were identified. The pooled outcomes revealed that APT was superior to control conditions for the global score on PSQI (SMD = -1.13, and 95% CI = -1.48—-0.78) and the effective rate (RR = 1.24, 95% CI = 1.13—1.36, NNT = 5, and 95% CI =4—7). Furthermore, the results of subgroup analyses were similar to the pooled results. Additionally, the pooled results were verified to be stable by sensitivity analyses. Regarding safety, no significant difference was identified between APT and Western medications. Conclusions. APT appears to be an effective and safe treatment for comorbid insomnia. However, the benefits of APT for comorbid insomnia could not be ascertained due to the paucity of the quantity and quality of the included studies. Large-scale studies using proper methodology are needed to yield a firm conclusion.

scholarly journals Sanqi Panax Notoginseng Injection for Angina Pectoris

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Xiaochen Yang ◽  
Xingjiang Xiong ◽  
Jie Wang
Keyword(s):  
Randomized Controlled Trials ◽  
Large Scale ◽  
Clinical Symptoms ◽  
Meta Analysis ◽  
Panax Notoginseng ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Alternative And Complementary Medicine ◽  
Knowledge Infrastructure

Objective. To evaluate the clinical curative effects of SPN injection on AP.Methods. Six databases were systematically searched including Cochrane Central, PubMed, EMBASE, CBM, Chinese National Knowledge Infrastructure (CNKI), and VIP to identify randomized controlled trials (RCTs). We assessed the quality of included studies, extracted valid data, and undertook meta-analysis following the steps of systematic review recommended by the Cochrane group.Results. Ten moderate-to-low quality randomized controlled trials involving 969 patients were included. There was no evidence that SPN alone had better or worse effects than conventional drugs on improving clinical symptoms (RR 1.09, 95% CI 0.85 to 1.39) and ECG (RR 1.17, 95% CI 0.84 to 1.63). However, there was an evidence that SPN combined with western medications was a better treatment option than conventional drugs alone in improving clinical symptoms (RR 1.28, 95% CI 1.19 to 1.33) and ECG (RR 1.27, 95% CI 1.12 to 1.45). No serious adverse effects were reported.Conclusion. Compared with conventional treatment, SPN may show the potential of optimizing symptomatic outcomes. As a kind of alternative and complementary medicine, SPN may provide another choice for AP patients and further large-scale high-quality trials are needed to confirm this efficacy.

scholarly journals Effectiveness of Exercise Programs on Patients with Dementia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Xudong Li ◽  
Rui Guo ◽  
Zhenhong Wei ◽  
Jing Jia ◽  
Chaojun Wei
Keyword(s):  
Randomized Controlled Trials ◽  
Usual Care ◽  
Large Scale ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Exercise Programs ◽  
Randomized Controlled ◽  
Dementia Patients ◽  
Mean Differences

Exercise programs have been introduced to improve cognitive function, whereas studies showed inconsistent results regarding the effectiveness of exercise programs on patients with dementia. This study aimed to summarize randomized controlled trials (RCTs) to assess the effect of exercise programs on cognition, activities of daily living (ADL), and depression in elderly with dementia. We systematically screened PubMed, Embase, and the Cochrane library for relevant studies throughout November 21, 2018. The pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were employed to calculate cognition, ADL, and depression by using random-effects model. A total of 20 RCTs with 2,051 dementia patients were included in final quantitative meta-analysis. There were no significant differences between exercise programs and control regarding cognition (SMD: 0.44; 95% CI: −0.21–1.09; P=0.183), ADL (SMD: 0.50; 95% CI: −0.03–1.02; P=0.066), and depression (SMD: −0.43; 95% CI: −0.90–0.05; P=0.077). Sensitivity analysis results indicated that exercise programs might play an important role in cognition and ADL, whereas the depression level was unaltered by the exclusion of any particular study. Subgroup analyses indicated that exercise programs were associated with increased cognitive levels if the mean age of patients was <80.0 years when compared with usual care and studies with low quality. Moreover, the ADL level was significantly increased in patients receiving exercise programs versus usual care. These results suggested that exercise programs might play an important role in cognition and ADL in patients with dementia. These results required further verification by large-scale RCTs, especially for depression outcomes.

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