scholarly journals Does Madopar Have a Role in the Treatment of Prolonged Disorders of Consciousness? A Call for Randomized Controlled Trials

2021 ◽  
pp. 781-788
Author(s):  
Christian Saleh ◽  
Agnieszka Andrykiewicz ◽  
Margret Hund-Georgiadis
Keyword(s):  
Randomized Controlled Trials ◽  
Motor Function ◽  
Disorders Of Consciousness ◽  
Controlled Trials ◽  
Disorder Of Consciousness ◽  
Dopaminergic Medication ◽  
Randomized Controlled

It is suggested that dopaminergic treatment may contribute to accelerated improvement in patients with a disorder of consciousness (DoC). Dopamine is an important stimulatory neurotransmitter, which plays a key role in alertness, arousal, behavior, emotion, cognition, and motor function. We discuss our experience with Madopar in 2 patients with DoC and review the literature on dopaminergic medication in patients with DoC.

scholarly journals The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

2021 ◽  
Vol 42 (4) ◽  
pp. 75-112
Author(s):  
Mikyung Kim ◽  
Chang-ho Han
Keyword(s):  
Randomized Controlled Trials ◽  
Motor Function ◽  
Upper Limb ◽  
Meta Analysis ◽  
Mean Difference ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Stroke Survivors ◽  
Randomized Controlled ◽  
Standard Mean Difference

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke.Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs.Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events.Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

scholarly journals Efficacy of Scalp Acupuncture in Patients With Post-stroke Hemiparesis: Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 12 ◽  
Author(s):  
Yuan-Ju Huang ◽  
Chih-Shan Huang ◽  
Kuo-Feng Leng ◽  
Jia-Ying Sung ◽  
Sheng-Wei Cheng
Keyword(s):  
Intracerebral Hemorrhage ◽  
Randomized Controlled Trials ◽  
Motor Function ◽  
Methodological Quality ◽  
Standard Treatment ◽  
Brain Infarction ◽  
Meta Analysis ◽  
Scalp Acupuncture ◽  
Controlled Trials ◽  
Randomized Controlled

Objectives: To conduct a meta-analysis to assess the efficacy of scalp acupuncture (SA) in patients with stroke and consequent hemiparesis regardless of brain infarction or intracerebral hemorrhage.Methods: A literature search of randomized controlled trials (RCTs) on SA for stroke was performed in five databases up to May 10, 2021. We investigated three types of outcome: motor function, sequelae of poststroke hemiparesis, and adverse effects. Methodological quality was assessed using the revised Cochrane risk of bias tool version 2.0.Results: Of 1,063 papers, 30 RCTs involving Fugl–Meyer Assessment were selected, among which 10 and four RCTs were selected for evaluation of courses lasting of 1 and 3 months, respectively. The meta-analysis of 1- and 3-month courses revealed significant differences in the motor function of the SA plus Western standard treatment group vs. Western standard treatment only (medication plus rehabilitation; P &lt; 0.001). A 3-month course tended to result in better outcomes than a 1-month course.Conclusions: Our meta-analysis results reveal that SA improves motor function in patients with acute to chronic stroke, regardless of brain infarction or intracerebral hemorrhage. However, because of a lack of methodological quality, thoroughly planned clinical studies are still required.

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