Neuroplasticity in Post-Stroke Aphasia: A Systematic Review and                     Meta-Analysis of Functional Imaging Studies of Reorganization of Language                     Processing

Recovery from aphasia is thought to depend on neural plasticity, that is, the functional reorganization of surviving brain regions such that they take on new or expanded roles in language processing. We carried out a systematic review and meta-analysis of all articles published between 1995 and early 2020 that have described functional imaging studies of six or more individuals with post-stroke aphasia, and have reported analyses bearing on neuroplasticity of language processing. Each study was characterized and appraised in detail, with particular attention to three critically important methodological issues: task performance confounds, contrast validity, and correction for multiple comparisons. We identified 86 studies describing a total of 561 relevant analyses. We found that methodological limitations related to task performance confounds, contrast validity, and correction for multiple comparisons have been pervasive. Only a few claims about language processing in individuals with aphasia are strongly supported by the extant literature: First, left hemisphere language regions are less activated in individuals with aphasia than in neurologically normal controls; and second, in cohorts with aphasia, activity in left hemisphere language regions, and possibly a temporal lobe region in the right hemisphere, is positively correlated with language function. There is modest, equivocal evidence for the claim that individuals with aphasia differentially recruit right hemisphere homotopic regions, but no compelling evidence for differential recruitment of additional left hemisphere regions or domain-general networks. There is modest evidence that left hemisphere language regions return to function over time, but no compelling longitudinal evidence for dynamic reorganization of the language network.

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Acupuncture treatment for post-stroke insomnia: A systematic review and meta-analysis of randomized controlled trials

Complementary Therapies in Clinical Practice ◽

10.1016/j.ctcp.2021.101396 ◽

2021 ◽

Vol 44 ◽

pp. 101396

Author(s):

Jialei Yang

Keyword(s):

Systematic Review ◽

Randomized Controlled Trials ◽

Acupuncture Treatment ◽

Meta Analysis ◽

Controlled Trials ◽

Post Stroke ◽

Randomized Controlled

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Long-Term Efficacy of Extracorporeal Shock Wave Therapy on Lower Limb Post-Stroke Spasticity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm10010086 ◽

2020 ◽

Vol 10 (1) ◽

pp. 86

Author(s):

Emanuela Elena Mihai ◽

Luminita Dumitru ◽

Ilie Valentin Mihai ◽

Mihai Berteanu

Keyword(s):

Systematic Review ◽

Lower Limb ◽

Meta Analysis ◽

Extracorporeal Shock Wave Therapy ◽

Shock Wave Therapy ◽

Post Stroke ◽

Randomized Controlled ◽

Term Efficacy ◽

Extracorporeal Shock Wave

The purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults. A systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events. A total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD) = 0.53; 95% confidence interval (95% CI): (0.07–0.99); Modified Tardieu Scale (MTS): SMD = 0.56; 95% CI: (0.01–1.12); Visual Analogue Scale (VAS): SMD = 0.35; 95% CI: (−0.21–0.91); PROM: SMD = 0.69; 95% CI: (0.20–1.19). ESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile.

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Aquatic Therapy for improving Lower Limbs Function in Post-stroke Survivors: A Systematic Review with Meta-Analysis

Topics in Stroke Rehabilitation ◽

10.1080/10749357.2021.1929011 ◽

2021 ◽

pp. 1-17

Author(s):

Mahboubeh Ghayour Najafabadi ◽

Ardalan Shariat ◽

Jan Dommerholt ◽

Azadeh Hakakzadeh ◽

Amin Nakhostin-Ansari ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Lower Limbs ◽

Stroke Survivors ◽

Aquatic Therapy ◽

Post Stroke

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Association between insulin resistance and post-ischaemic stroke outcome in patients without diabetes: protocol for a systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2020-044771 ◽

2021 ◽

Vol 11 (3) ◽

pp. e044771

Author(s):

Jeremiah Hadwen ◽

Woojin Kim ◽

Brian Dewar ◽

Tim Ramsay ◽

Alexandra Davis ◽

...

Keyword(s):

Systematic Review ◽

Insulin Resistance ◽

Ischaemic Stroke ◽

Functional Outcome ◽

Recurrent Stroke ◽

Meta Analysis ◽

Secondary Outcome ◽

Stroke Outcome ◽

Post Stroke ◽

Meta Analyses

IntroductionInsulin resistance is an independent risk factor for atherosclerosis, coronary artery disease and ischaemic stroke. Currently, insulin resistance is not usually included in post-stroke risk stratification. This systematic review and meta-analysis intends to determine if available scientific knowledge supports an association between insulin resistance and post-stroke outcomes in patients without diabetes.Methods and analysisThe authors will conduct a literature search in Medline, Embase, Web of Science and Cochrane Central. The review will include studies that assess the association between elevated insulin homeostasis model of insulin resistance (HOMA-IR) and post-stroke outcome (functional outcome and recurrent stroke). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines will be used. The primary outcome will be post-stroke functional outcome (Modified Rankin Scale), and the secondary outcome will be recurrent ischaemic stroke. Comparison of outcome will be made between highest and lowest HOMA-IR range (as defined in each article included in this systematic review). Risk of bias will be assessed qualitatively. Meta-analysis will be performed if sufficient homogeneity exists between studies. Heterogeneity of outcomes will be assessed by I².Ethics and disseminationNo human or animal subjects or samples were/will be used. The results will be published in a peer-reviewed journal, and will be disseminated at local and international neurology conferences.PROSPERO registration numberCRD42020173608.

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