Frontiers in Neurology最新文献

{"title":"Risk factors and clinical significance of refractory pain in patients with bone metastases: a comprehensive meta-analysis.","authors":"Qiju Li, Qingqing Liu, Liu Yang, Qin Li, Aimin Zhang","doi":"10.3389/fneur.2025.1517279","DOIUrl":"https://doi.org/10.3389/fneur.2025.1517279","url":null,"abstract":"<p><strong>Background: </strong>Refractory cancer pain, especially bone pain, presents a major clinical challenge that is difficult to manage despite the use of multimodal analgesic strategies. This meta-analysis aims to estimate the prevalence of refractory cancer pain in this patient population and to identify potential predictors that may increase the likelihood of developing such pain. In addition, we performed a systematic review of previous studies that delve into more effective pain strategies.</p><p><strong>Methods: </strong>This meta-analysis and systematic review were conducted in accordance with the PRISMA guidelines. A comprehensive search was performed using PubMed, Web of Science, Embase, and the Cochrane Library on risk factors for refractory metastatic bone pain. The inclusion criteria focused on studies reporting the incidence and/or risk factors associated with refractory cancer pain, providing relevant statistical measures such as odds ratios (OR), hazard ratios (HR), or relative risks (RR). The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS), and a random-effects meta-analysis was conducted using the R programming language.</p><p><strong>Results: </strong>The present study included eight studies with a cumulative sample size of 2,774 patients. The aggregated incidence of refractory cancer pain was found to be 70% [95% confidence interval (CI): 42 to 88%] using a random-effects model, highlighting a significant prevalence of pain that remains unresponsive to treatment. Notably, the heterogeneity among the included studies was considerable (<i>I</i> ² = 98%, <i>τ</i> ² = 2.7198). The analysis also identified several critical predictors of refractory cancer pain. The presence of multiple bone metastases was consistently linked to an increased likelihood of refractory cancer pain with an OR of 3.94 (95% CI: 2.64-5.87). Similarly, lytic bone metastases demonstrated a high OR of 5.99 (95% CI: 3.17-11.30). Furthermore, there was a strong correlation between the occurrence of refractory cancer pain with severe acute pain (OR = 219.20, 95% CI: 0.26-188127.63), breakthrough pain (OR = 16.44, 95% CI: 0.60-448.07), and psychological comorbidities such as depression (OR = 3.91, 95% CI: 1.22-2048.64) and anxiety (OR = 4.22, 95% CI: 1.22-2048.64).</p><p><strong>Conclusion: </strong>Refractory cancer pain, observed in approximately 70% of patients with bone metastases, poses a significant clinical challenge. Refractory cancer pain predictors include the presence of multiple and lytic bone metastases, severe acute pain, breakthrough pain, and psychological comorbidities. Collectively, our findings highlight the need for improved pain management strategies that address both the physical and psychological aspects of cancer pain.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1517279"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biological effect of acupuncture on peripheral facial paralysis.","authors":"Wenwen Duan, Dan Chen, Zubo Huang, Yue Zeng, Shanshan Liu, Chao Wang, Hao Zhou","doi":"10.3389/fneur.2025.1516904","DOIUrl":"https://doi.org/10.3389/fneur.2025.1516904","url":null,"abstract":"<p><p>Peripheral facial paralysis is the dominant treatment disease of acupuncture. A large number of studies have proved the effectiveness of acupuncture in the treatment of peripheral facial paralysis. However, the underlying biological effect remains in an exploratory phase. This article will sort out and summarize the existing research mechanisms from the following aspects: inflammatory response, immune regulation, neurotransmitters, immune response, facial microcirculation, oxidative stress, changes in nerve structure and function, specificity of acupoints, acupuncture intervention time, and other potential mechanisms aiming to provide a scientific foundation for the role of acupuncture in the treatment of peripheral facial paralysis. Furthermore, the review discusses future directions for mechanistic research based on existing findings.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1516904"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thiamine administration and in-hospital mortality in patients with traumatic brain injury: analysis of the MIMIC-IV database.","authors":"Shuangqi Gao, Zhendan Zhu, Wenhan Zheng","doi":"10.3389/fneur.2025.1448439","DOIUrl":"https://doi.org/10.3389/fneur.2025.1448439","url":null,"abstract":"<p><strong>Aim: </strong>Several studies have suggested the favorable impact of thiamine administration on the prognosis of diseases. However, the value of thiamine in patients with traumatic brain injury (TBI) admitted to the intensive care unit (ICU) remains unclear. The aim of this study was to investigate the association between the between thiamine administration and in-hospital mortality in TBI patients.</p><p><strong>Methods: </strong>A cohort of 1,755 individuals diagnosed with TBI from the Medical Information Mart for Intensive Care IV database were included in this retrospective cohort study. Thiamine administration is determined by the patient's usage during their stay in the ICU. The primary outcome was in-hospital mortality. Univariable and multivariable Cox regression analysis were used to investigate the relationship between thiamine administration and in-hospital mortality of patients with TBI. Subgroup analysis was also performed to determine if this association differed for subgroups classified using different variables including age (<65 years and ≥65 years), gender (male and female), and the severity of TBI (mild, moderate, and severe).</p><p><strong>Results: </strong>The median follow-up time was 6.77 (3.98, 12.94) days, and the in-hospital mortality rate for the population was approximately 14.1%. In the univariable Cox regression analysis, thiamine administration was significantly associated with the reduced risk of in-hospital mortality in TBI patients admitted to the ICU. performing the multivariable Cox regression analysis, the observed association of thiamine administration and in-hospital mortality remained significant, with the hazard ratios (HR) of 0.66 [95% confidence interval (CI) = 0.45-0.98]. In the subgroup analysis, the results demonstrated that thiamine administration resulted in a decreased risk of in-hospital mortality among TBI patients who aged 65 years or older (HR = 0.36, 95% CI: 0.19-0.69), as well as male individuals (HR = 0.36, 95% CI: 0.17-0.80) and those with severe TBI (HR = 0.16, 95% CI: 0.04-0.57).</p><p><strong>Conclusion: </strong>Thiamine administration may reduce in-hospital mortality for patients with TBI admitted to the ICU.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1448439"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12058809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of serum A20 levels with stroke-associated pneumonia, early neurological deterioration, and poor neurological prognosis following acute supratentorial intracerebral hemorrhage: a prospective cohort study.","authors":"Chao Tang, Wei Li, Suijun Zhu, Min Zhang, Gaofeng Xiong, Yijuan Lin","doi":"10.3389/fneur.2025.1546934","DOIUrl":"https://doi.org/10.3389/fneur.2025.1546934","url":null,"abstract":"<p><strong>Background: </strong>A20 is an endogenous protective protein. We quantified serum A20 levels following acute intracerebral hemorrhage (ICH) and assessed their association with the severity of illness and clinical outcomes of patients.</p><p><strong>Methods: </strong>In total, 243 patients with acute supratentorial ICH and 76 controls were included in this prospective cohort study. Serum A20 levels were measured at admission in all patients, at study entry in all controls, and on post-ICH days 1, 3, 5, 7, 10, and 14 in 76 patients. The National Institutes of Health Stroke Scale (NIHSS) scores and hematoma volume were used to estimate the severity. Stroke-associated pneumonia (SAP), early neurological deterioration (END), and post-ICH 6-month poor prognosis (modified Rankin Scale scores: 3-6) were considered as the three outcome variables of interest.</p><p><strong>Results: </strong>Patients, as opposed to controls, exhibited significantly heightened serum A20 levels from admission until 14 days following ICH, with a peak value at day 3. Serum A20 levels at all-time points after ICH, which were significantly correlated with NIHSS scores and hematoma volume, were significantly higher in patients with END, SAP, or poor prognosis than in those without the corresponding one. Serum A20 levels at admission possessed similar predictive ability of these clinical outcomes to those at other time points. Serum A20 levels at admission, along with initial NIHSS scores and hematoma volume, remained independent predictors of clinical outcomes among patients. As confirmed by numerous statistical approaches, their conjunctions comprised three prediction models: satisfactory stability, clinical validity, and discrimination efficiency.</p><p><strong>Conclusion: </strong>Serum A20 levels were significantly increased following ICH and may accurately reflect hemorrhagic severity and effectively predict END, SAP, and poor neurological prognosis, suggesting that serum A20 may be a promising prognostic biomarker for ICH.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1546934"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12059376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of exercise to treat postural orthostatic tachycardia syndrome: a systematic review.","authors":"Melissa M Cortez, Kayla Aikins, Amy C Arnold, Jeffrey R Boris, Todd E Davenport, Katie Johnson, Hagar S Kattaya, Laurence Kinsella, Mary M McFarland, Ryan Pelo, Clayton D Powers, Kelsi Schiltz, Lauren E Stiles, Lauren Ziaks, Tae Hwan Chung, Claudia Dal Molin","doi":"10.3389/fneur.2025.1567708","DOIUrl":"10.3389/fneur.2025.1567708","url":null,"abstract":"<p><strong>Background: </strong>Postural orthostatic tachycardia syndrome (POTS) is a chronic condition associated with a high symptom burden and decreased quality of life (QOL). Exercise is currently considered to be a first line non-pharmacological treatment for POTS. The purpose of this systematic review was to evaluate the impact of exercise on cardiovascular and patient-centered outcomes in patients with POTS.</p><p><strong>Purpose: </strong>To evaluate whether exercise benefits patients with POTS by synthesizing data from published clinical studies.</p><p><strong>Methods: </strong>Electronic databases, including Medline, Embase, CINAHL Complete, Cochrane CENTRAL, and others were searched and results were exported on May 2, 2023. Study inclusion: those that utilized an exercise program as an intervention for POTS and were conducted as experimental or quasi-experimental design. Exclusions: Non-English language papers and opinion-based/theoretical/non-empirical studies/case reports. Data extraction was based on Cochrane Handbook guidance and summarized according to Synthesis Without Meta-analysis (SWiM) guidelines; methodological quality and risk of bias was evaluated using the JBI Critical Appraisal tools. Standardized effects were calculated and summarized based on the direction of effect.</p><p><strong>Results: </strong>Seven studies included in the final review are described in the data summary and synthesis. Improvements in heart rate were reported across all studies reviewed, while stroke volume and QOL improvements were also found. Notably, not all studies reported on the latter two outcomes. Methodological variability across studies precluded meta-analysis, and risk of bias was considered moderate-high in all but a single study.</p><p><strong>Conclusion: </strong>While currently available evidence supports exercise as beneficial to QOL and cardiovascular features of POTS, we identified a major need for additional studies assessing the effect of exercise on symptom burden and daily function, including studies that consider patients with specific comorbidities that impact exercise tolerability and/or dosing.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1567708"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12071195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The safety and feasibility of a pilot randomized clinical trial using combined exercise and neurostimulation for post-stroke pain: the EXERT-Stroke study.","authors":"Chen Lin, Charity J Morgan, E Lane Schlitz Fortenberry, X Michelle Androulakis, Keith McGregor","doi":"10.3389/fneur.2025.1524004","DOIUrl":"https://doi.org/10.3389/fneur.2025.1524004","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain after stroke can occur between 10 and 50% of stroke survivors. Post-stroke pain (PSP) can lead to further complications in a stroke survivor's recovery. PSP is caused by the stroke itself and produces moderate or severe pain. It can manifest as new onset or worsening of prior headaches.</p><p><strong>Methods: </strong>EXERT-Stroke was a feasibility pilot 2-arm randomized sham-controlled, double-blind trial at a single center over a 30-day intervention period, followed by a month follow-up. Patients were recruited for this study from July 2022 through June 2024 at the Veterans Hospital. The study protocol was approved by the local institutional review board. The trial was registered with ClinicalTrials.gov (NCT04672044). All potential participants were screened for safety with a graded exercise stress test before randomization. Participants were randomized (1:1) to either active repetitive transcranial magnetic stimulation (rTMS) or sham rTMS. Both arms received the same exercise protocol. The intervention protocol consisted of 10 sessions over a 30-day period of rTMS (sham vs. active) + exercise, where rTMS was delivered prior to each exercise session on the same day. RTMS was aimed at the M1 of the contra-lesional hemisphere. Exercise was delivered on a recumbent bicycle targeting a participant's heart rate reserve. Primary outcomes were intervention feasibility (attendance and tolerance) and safety (adverse events).</p><p><strong>Results: </strong>Of those consented, one participant was a screen failure, and nine participants were randomized. The average age was 62 years old, 22.2% were female, and 44.4% were Black. For feasibility, five (55.5%) participants were randomized to active rTMS and four (44.4%) were randomized to sham rTMS. Four of the five (80%) active rTMS and two of the four (50.0%) of the sham rTMS completed the final assessment, suggesting that there was no association between treatment assignment and likelihood of completing the study. Importantly, there were no serious adverse events.</p><p><strong>Conclusion: </strong>This is the first feasibility trial to investigate paired intervention of exercise and rTMS in patients with post-stroke pain. The trial found that the intervention had few safety issues. There was overall positive feedback from participants.</p><p><strong>Clinical trial registration: </strong>https://clinicaltrials.gov/, identifier NCT04672044.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1524004"},"PeriodicalIF":2.7,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-exertional malaise in Long COVID: subjective reporting versus objective assessment.","authors":"Barbara Stussman, Nathan Camarillo, Gayle McCrossin, Marybeth Stockman, Gina Norato, C Stephenie Vetter, Alenka Ferrufino, Ashade Adedamola, Nicholas Grayson, Avindra Nath, Leighton Chan, Brian Walitt, Lisa M K Chin","doi":"10.3389/fneur.2025.1534352","DOIUrl":"https://doi.org/10.3389/fneur.2025.1534352","url":null,"abstract":"<p><strong>Background: </strong>Post-exertional malaise (PEM) is a central feature of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and has emerged as a prominent feature of Long COVID. The optimal clinical approach to PEM is inconclusive, and studies of the impact of exercise have yielded contradictory results.</p><p><strong>Objective: </strong>The objective of this study was to examine PEM in Long COVID by assessing the prevalence of self-reported PEM across study cohorts and symptom responses of Long COVID patients to a standardized exercise stressor. Secondarily, Long COVID symptom responses to exercise were compared to those of ME/CFS and healthy volunteers.</p><p><strong>Methods: </strong>Data from three registered clinical trials comprised four cohorts in this study: Long COVID Questionnaire Cohort (QC; <i>n</i> = 244), Long COVID Exercise Cohort (EC; <i>n</i> = 34), ME/CFS cohort (<i>n</i> = 9), and healthy volunteers (HV; <i>n</i> = 9). All cohorts completed questionnaires related to physical function, fatigue, and/or PEM symptoms. EC also performed a standardized exercise test (cardiopulmonary exercise test, CPET), and the PEM response to CPET was assessed using visual analog scales and qualitative interviews (QIs) administered serially over 72 h. EC PEM measures were compared to ME/CFS and HV cohorts. A secondary analysis of QI explored positive responses to CPET among EC, ME/CFS and HV.</p><p><strong>Results: </strong>Self-reported PEM was 67% in QC and estimated at 27% in EC. Only 2 of 34 EC patients (5.9%) were observed to develop PEM after a CPET. In addition, PEM responses after CPET in Long COVID were not as severe and prolonged as those assessed in ME/CFS. Twenty-two of 34 EC patients (64.7%) expressed at least one of 7 positive themes after the CPET.</p><p><strong>Conclusion: </strong>Self-report of PEM is common in Long COVID. However, observable PEM following an exercise stressor was not frequent in this small cohort. When present, PEM descriptions during QI were less severe in Long COVID than in ME/CFS. Positive responses after an exercise stressor were common in Long COVID. Exercise testing to determine the presence of PEM may have utility for guiding clinical management of Long COVID.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1534352"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12055772/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The application of diffusion tensor imaging in patients with mild cognitive impairment: a systematic review and meta-analysis.","authors":"Xinle Zhao, Mengyue You, Wenyu Ren, Lixin Ji, Yongbo Liu, Meng Lu","doi":"10.3389/fneur.2025.1467578","DOIUrl":"https://doi.org/10.3389/fneur.2025.1467578","url":null,"abstract":"<p><strong>Objective: </strong>To systematically evaluate the diagnostic value of diffusion tensor imaging (DTI) for mild cognitive impairment (MCI) based on Meta-analysis.</p><p><strong>Materials and methods: </strong>Databases including PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang and VIP database were searched for literature on the use of DTI in studying MCI. The search was conducted from the inception of each database up to February 20, 2024. Literature was screened based on predefined inclusion and exclusion criteria, relevant data were extracted, and the quality of the included studies was assessed using the QUADAS-2 tool. Heterogeneity was evaluated using the Q-test and <i>I²</i> statistics. Fractional anisotropy (FA) values for different brain regions (frontal lobe, parietal lobe, temporal lobe, occipital lobe, fornix, hippocampus, parahippocampal gyrus, posterior cingulum, posterior limb of the internal capsule, uncinate fasciculus, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, inferior longitudinal fasciculus, genu and splenium of the corpus callosum) were extracted from the MCI and normal control (NC) groups. Meta-analysis software (Review Manager 5.4) was used to perform a pooled analysis of the eligible studies to obtain the weighted mean difference (WMD) and 95% confidence interval (95% CI).</p><p><strong>Results: </strong>A total of 76 studies were included (41 in English and 35 in Chinese). The overall pooled WMD and its 95% CI were -0.03 [-0.04, -0.03], with statistically significant differences in all brain regions except for the occipital lobe and the posterior limb of the internal capsule.</p><p><strong>Conclusion: </strong>DTI technology can identify microstructural damage in the brain white matter of MCI patients, which holds significant implications for early diagnosis and intervention.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1467578"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of transcutaneous electrical nerve stimulation in improving cognitive function in older adults with cognitive impairment: a systematic review and meta-analysis.","authors":"Nga Huen Chan, Shamay S M Ng","doi":"10.3389/fneur.2025.1556506","DOIUrl":"https://doi.org/10.3389/fneur.2025.1556506","url":null,"abstract":"<p><strong>Background: </strong>Transcutaneous electrical nerve stimulation (TENS), which involves the application of electrical stimulation to peripheral nerves, is used to improve or maintain cognitive function. Although many studies have examined the effect of TENS on cognition over the past 20 years, a comprehensive review and meta-analysis on this topic is lacking. This study aimed to evaluate the efficacy of TENS in improving cognitive function in older adults with cognitive impairment.</p><p><strong>Methods: </strong>A systematic search was performed in six electronic databases (CINAHL, Cochrane Library, Embase, Medline, PubMed, and Web of Science) to identify relevant studies published until May 2024. Moreover, the registered clinical trials, forward citation searches, and reference lists of identified publications were reviewed to identify additional relevant studies. Randomised controlled trials investigating the effect of TENS on cognitive function in older adults with cognitive impairment were included.</p><p><strong>Results: </strong>Seven studies including 247 older adults with cognitive impairment were included. The findings revealed a trend towards positive effects of TENS on face recognition memory [mean difference (MD) = 1.19, 95% confidence interval (CI) = -0.13 to 2.52] and verbal fluency [standardised MD (SMD) = 0.29, 95% CI = -0.01 to 0.59] when compared with placebo stimulation (control condition). TENS demonstrated a significant positive delayed effect on visual memory (SMD = 0.55, 95% CI = 0.11 to 0.98). Subgroup analysis indicated that TENS applied on the concha was more effective than that applied on the spinal column and earlobe in improving verbal memory in the delayed condition.</p><p><strong>Conclusion: </strong>A positive trend of immediate effect and a significant long-term effect on some cognitive domains were found after applying TENS in in older adults with cognitive impairment. Future studies with robust experimental designs and adequate sample sizes are warranted to investigate the efficacy of TENS in improving cognitive function.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42023408611, PROSPERO: CRD42023408611.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1556506"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global, regional, and national burden and trends of intracerebral hemorrhage among adolescents and young adults aged 15-39 years from 1990 to 2021: a comprehensive trend analysis based on the global burden of disease study 2021.","authors":"Xuanchen Liu, Xiaoxiong Yang, Yaoju Meng, Boyang Wen, Kun Yan, Qiyi Zhang, Junhao Wang, Yifei Su, Xiaochen Niu, Yingda Song, Rui Cheng, Hongming Ji, Guijun Jia, Chunhong Wang","doi":"10.3389/fneur.2025.1538413","DOIUrl":"https://doi.org/10.3389/fneur.2025.1538413","url":null,"abstract":"<p><strong>Background: </strong>Intracerebral hemorrhage (ICH) poses a significant health challenge, notably affecting adolescents and young adults (AYAs) aged 15-39 years. Despite advancements in medical technology, the global burden of ICH remains substantial, influenced by lifestyle factors, socioeconomic conditions, and disparities in healthcare access. This study leverages data from the 2021 Global Burden of Disease (GBD) to conduct a comprehensive analysis of ICH trends and burdens at global, regional, and national levels, emphasizing the role of the Social Development Index (SDI).</p><p><strong>Methods: </strong>We utilized data from the GBD 2021 to assess the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) associated with ICH from 1990 to 2021, covering 204 countries and regions. Age-standardized rates were calculated to ensure comparability. Temporal trends were evaluated using Joinpoint regression analysis, and future projections were made using a Bayesian Age-Period-Cohort model.</p><p><strong>Results: </strong>In 2021, ~246,938 new cases of ICH were reported among the global AYAs population, reflecting a decline in age-standardized incidence rates from 11.85 per 100,000 in 1990 to 8.14 in 2021. Prevalence rates also decreased from 124.44 to 94.58 per 100,000. Mortality rates and DALYs exhibited similar downward trends. Significant regional disparities were observed, with high SDI regions experiencing lower ICH burdens than low SDI regions, highlighting the influence of socioeconomic factors and healthcare access.</p><p><strong>Conclusion: </strong>While the global burden of ICH among AYAs has declined, significant disparities persist, particularly in regions with lower SDI. To further mitigate the impact of ICH, public health initiatives should focus on enhancing healthcare infrastructure, promoting health education, and addressing socioeconomic inequalities.</p>","PeriodicalId":12575,"journal":{"name":"Frontiers in Neurology","volume":"16 ","pages":"1538413"},"PeriodicalIF":2.7,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056743/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}