Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascul...Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated.展开更多
Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in th...Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in the presentation of depressive symptoms in various types of cognitive impairment. Method: Retrospective chart review was conducted on 254 consecutive cases of community dwelling elderly newly diagnosed with mild Alzheimer’s Dementia (AD) n = 122, mild Vascular Dementia (VaD) n = 71 or Amnestic Mild Cognitive Impairment (aMCI) n = 32 and Non-Amnestic MCI (nMCI) n = 29. Results: Analysis revealed no significant differences (p 05). No statistically significant differences were found between VaD and nMCI or between the MCI groups. Conclusions: Support is provided for the use of GDS subscales in a wide range of cognitively impaired elderly. This study suggests in mild dementia the number and type of depressive symptoms vary significantly between AD and VaD. There are indications that aMCI patients are similar in their symptom endorsement to AD and nMCI are similar to VaD which is consistent with some of the notions regarding likely trajectories of the respective MCI groups.展开更多
Objective： To investigate functional connectivity within default mode network （DMN） and ex-ecutive control network （ECN） in vascular cognitive im-pairment, no dementia （VCIND）. Methods： Twenty-eight VCIND pati...Objective： To investigate functional connectivity within default mode network （DMN） and ex-ecutive control network （ECN） in vascular cognitive im-pairment, no dementia （VCIND）. Methods： Twenty-eight VCIND patients and sixteen healthy controls were recruit-ed. A seed-based connectivity analysis was performed us-ing data from resting-state functional magnetic resonance imaging （fMRI）. Based on previous fndings, posteriorcingulate cortex （PCC） and dorsolateral prefrontal cortex （DLPFC） were chosen as regions of interest to study these networks.One-sample t-test and two-sample t-test were used for statistical analysis. Results： Compared with thecontrols, the VCIND group exhibited increased functional activity in such DMN regions as the left inferior temporal gyrus, parahippocampal gyrus, and medial frontal gyrus. The VCIND group had decreased functional connectivity of DMN at right superior frontal gyrus, left mid-cingu-late area, the medial part of left superior frontal gyrus, and bilateral medial frontal gyrus. The VCIND group also showed decreased functional connectivity of ECN pri-marilyat left inferior parietal gyrus, right angular gyrus, right middle occipital gyrus, and right middle frontal cor-tex. Conclusions： Increased functional connectivity with-in DMN and decreased functional connectivity within ECN suggested dysfunction of these two networks, which mightbe associated with the cognitive defcitsin patients with VCIND. These fndingsmay help usunderstandthe pathogenesis and clinical characteristics of VCIND.展开更多
Introduction: Dementia is frequently associated with Parkinson’s disease, especially in later stages. Efficacy of cholinesterase inhibitors (ChI) in Alzheimer’s dementia is well established. However, treatment with ...Introduction: Dementia is frequently associated with Parkinson’s disease, especially in later stages. Efficacy of cholinesterase inhibitors (ChI) in Alzheimer’s dementia is well established. However, treatment with ChI in Parkinson’s disease dementia (PDD) remains controversial. The objective of this systematic review and meta-analysis was to assess the effects of ChI in PDD. Methods: A comprehensive literature search was performed in MEDLINE, EMBASE and Cochrane library up to March 2014 using the descriptors “Parkinson’s disease”, “dementia in Parkinson’s disease”, “cognition”, “acetylcholinesterase inhibitors”, “cholinesterase inhibitors”, “anticholinesterase agents”, “rivastigmine”, “donepezil” and “galantamine” (Pubmed search strategy). All randomized, doubleblinded, placebo-controlled trials that met the eligibility criteria and assessed the effects of ChI in PDD were considered for analysis. There were no restrictions regarding paper language. Summary effect-sizes were presented as standardized mean differences (SMD) and the pooled analysis was performed with a fixed-effects model. Outcomes considered for analysis were the Mini Mental Status Exam (MMSE) score and the cognition scale for evaluation of dementia ADAS-Cog. The degree of heterogeneity between included studies was assessed through the I2 test. Results: After a comprehensive search, 175 references were retrieved. From these, five randomized trials involving 946PDD subjects were included in the review. Four studies used donepezil and only one study used rivastigmine. The pooled analysis of five studies that assessed the effects of ChI in MMSE total score showed a SMD of 0.24 (CI 95% 0.11 - 0.38). Three studies considered the effects of ChI on Adas-Cog and the pooled results showed a SMD of 0.21 (CI 95% 0.07 - 0.35). There was no significant heterogeneity between the studies. Conclusions: The results of this systematic review and meta- analysis suggest that ChI improves cognitive impairment in PDD subjects. Despite statistically significant, the translation of these results into relevant clinical improvement should be taken with caution, as the studies did not address what would be considered a clinically significant result.展开更多
The research focuses on the effectiveness of transluminal laser revascularization of the brain in the treatment of atherosclerotic lesions accompanied by vascular dementia development. 1125 patients aged from 29 to 81...The research focuses on the effectiveness of transluminal laser revascularization of the brain in the treatment of atherosclerotic lesions accompanied by vascular dementia development. 1125 patients aged from 29 to 81 (average age 75) suffering from various kinds of atherosclerotic lesions of cerebral vessels were examined during the research. The examination plan included: computed tomography of the brain (CT), magnetic resonance imaging (MRI), scintigraphy of the brain (SG), rheoencephalography (REG), cerebral multi-gated angiography (MUGA). 665 (59.11%) patients suffered from diseases accompanied by the development of vascular dementia. To perform transcatheter treatment, 639 patients were selected: Group 1 (CDR-1)—352 patients, Group 2 (CDR-2)—184 patients, Group 3 (CDR-3)—103 patients. To conduct revascularization of main intracranial arteries high-energy laser systems were used;for revascularization of the distal intracranial branches low-energy laser systems were used. The clinical outcome depended on the severity of dementia and the timing of the intervention. A good clinical outcome in Group 1 was obtained in 281 (79.82%) cases, in Group 2 in 81 (44.02%) cases, in Group 3 in 9 (8.73%) cases. A satisfactory clinical outcome in Group 1 was obtained in 53 (15.34%) cases, in Group 2 in 62 (33.70%) cases, in Group 3 in 31 (30.09%) cases. A relatively satisfactory clinical outcome in Group 1 was obtained in 17 (4.83%) cases, in Group 2 in 41 (22.28%) cases, in Group 3 in 63 (61.16%) cases. No negative effect was observed after the intervention. Evaluating the data obtained it can be concluded that the method of transluminal laser revascularization of cerebral blood vessels is an effective one for the treatment of atherosclerotic lesions of the brain accompanied by dementia.展开更多
Study Objectives: Growing evidence suggests that sleep disturbances is common in vascular dementia (VaD). The goal of the current study is to assess the disturbance in sleep pattern in patients with VaD, and compare i...Study Objectives: Growing evidence suggests that sleep disturbances is common in vascular dementia (VaD). The goal of the current study is to assess the disturbance in sleep pattern in patients with VaD, and compare it to healthy normally cognitive elderly individuals. We next studied whether there are meaningful differences in the Subjective sleep assessment: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and sleep measurements by polysomnography (PSG) in VaD patients. Study design: Case control study. Subject and methods: Overnight PSG recordings and self-reported sleep measures were obtained from 20 healthy elderly subjects and 20 VaD patients at the sleep laboratory. Results: This study showed abnormal subjective sleep quality in all patients and revealed that the most common sleep complaints among VaD patients were: excessive daytime sleepiness (EDS), sleep disordered breathing (SDB), insomnia, restless leg syndrome (RLS), periodic limb movements (PLMS) and REM behavioral disordered (RBD) respectively. Moreover, patients spent more time in stage I sleep, but less time in slow wave sleep (SWS) and REM sleep compared to control populations, with delayed REML and less 1st REML. Also, increased sleep fragmentation;wakefulness after sleep onset (WASO) & sleep fragmentation index (SFI), increased arousal index (AI) & PLMS index were detected in VaD patients. Finally, VaD patients had significant high Apnea, Hypopnea and Respiratory Distress Index (RDI) score with high average SpO2 Desaturation. Conclusions: Sleep is significantly impaired in patients with VaD at both the objective and subjective level, which may be used as a diagnostic marker of VaD. SDB is a common feature of VaD and leads to fragmented sleep, increased nocturnal confusion, and excessive daytime sleepiness. Subjective sleep assessment questionnaire (ESS and PSQI) can be used in VaD patients when objective sleep assessment by PSG recordings is difficult to be done. The PSG study of sleep continuity, sleep architecture, and REM sleep may help in the prevention of progression of VaD.展开更多
目的研究丹红注射液联合吡拉西坦对血管性痴呆(vascular dementia,VD)患者的认知功能及血清胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、β-淀粉样蛋白1-42(amyloidβ-protein 1-42,Aβ1-42)表达的影响。方法选取2019年8...目的研究丹红注射液联合吡拉西坦对血管性痴呆(vascular dementia,VD)患者的认知功能及血清胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、β-淀粉样蛋白1-42(amyloidβ-protein 1-42,Aβ1-42)表达的影响。方法选取2019年8月~2020年8月期间收治的82例VD患者,采用随机数字表法分为对照组和观察组,每组41例。对照组给予吡拉西坦片1.6 g tid,观察组在对照组的基础上给予丹红注射液30 ml,qd,两组患者均治疗1个月后进行疗效及安全性评价。分别于治疗前后采用简易智力状态检查(Mini-mental State Examination,MMSE)评分量表、日常生活活动能力量表((Activities of Daily Living Scale,ADL)和美国国立卫生研究院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)对患者的认知功能、日常生活能力和神经功能缺损状况进行评价。分别于治疗前后检测患者血清中GFAP和Aβ1-42的表达水平。结果治疗后观察组总有效率高于对照组(P<0.05)。治疗后两组患者的MMSE评分显著提高,ADL评分、NIHSS评分均显著降低(P<0.05);与对照组相比,观察组的MMSE评分较高,ADL评分、NIHSS评分均较低(P<0.05)。治疗后两组患者血清GFAP和Aβ1-42的表达水平均显著降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者治疗期间均未见明显不良反应。结论丹红注射液联合吡拉西坦治疗VD具有良好的临床疗效,可有效改善患者的认知功能、日常生活能力和神经功能缺损状况,降低血清GFAP和Aβ1-42的表达,且未见明显不良反应。展开更多
目的探究重复经颅磁刺激联合认知训练对非痴呆型血管性认知障碍(vascular cognitive impairment no dementia,VCI-ND)患者认知功能、事件相关电位P300及生活能力的影响。方法选取我科2017年10月至2019年10月间107例VCI-ND患者,按随机数...目的探究重复经颅磁刺激联合认知训练对非痴呆型血管性认知障碍(vascular cognitive impairment no dementia,VCI-ND)患者认知功能、事件相关电位P300及生活能力的影响。方法选取我科2017年10月至2019年10月间107例VCI-ND患者,按随机数字表法分为对照组(53例)组和观察组(54例),对照组患者实行认知训练,观察组在对照组的基础上给予重复经颅磁刺激,治疗均进行2个疗程,为期1个月。观察两组患者在干预前后认知功能、事件相关电位P300检测、生活能力及并发症的发生情况。结果干预1个月后,观察组蒙特利尔认知评估量表、洛文斯顿认知评价箱的评分较对照组高(P<0.05);观察组事件相关电位P300的潜伏期N2、P3平均值低于对照组,但波幅P3和生活能力评分均高于对照组(P<0.05)。结论认知训练联合重复经颅磁刺激相较于单纯行认知训练的治疗方式,能够调节VCI-ND患者突触及神经传导功能,改善其认知障碍,提升患者大脑高级思维活动,纠正事件相关电位P300,并可有效增强患者日常生活能力。展开更多
基金supported by the Natural Science Foundation of Liaoning Province of China,No.20170541036(to HYL)
文摘Objective: To assess and compare the clinical efficacy and safety of cognitive enhancers(donepezil, galantamine, rivastigmine, and memantine) on cognition, behavior, function, and global status in patients with vascular cognitive impairment.Data sources: The initial literature search was performed with PubMed, EMBASE, the Cochrane Methodology Register, the Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing & Allied Health(CINAHL) from inception to January 2018 for studies regarding donepezil, galantamine, rivastigmine, and memantine for treatment of vascular cognitive impairment.Data selection: Randomized controlled trials on donepezil, galantamine, rivastigmine, and memantine as monotherapy in the treatment of vascular cognitive impairment were included. A Bayesian network meta-analysis was conducted. Outcome measures: Efficacy was assessed by changes in scores of the Alzheimer's Disease Assessment Scale, cognitive subscale, Mini-Mental State Examination, Neuropsychiatric Inventory scores and Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input, Activities of Daily Living, the Clinical Dementia Rating scale. Safety was evaluated by mortality, total adverse events(TAEs), serious adverse events(SAEs), nausea, vomiting. diarrhea, or cerebrovascular accidents(CVAs). Results: After screening 1717 citations, 12 randomized controlled trials were included. Donepezil and rivastigmine(mean difference(e) = –0.77, 95% confidence interval(CI): 0.25–1.32; MD = 1.05, 95% CI: 0.18–1.79) were significantly more effective than placebo in reducing Mini-Mental State Examination scores. Donepezil, galantamine, and memantine(MD = –1.30, 95% CI: –2.27 to –0.42; MD = –1.67, 95% CI: –3.36 to –0.06; MD = –2.27, 95% CI: –3.91 to –0.53) showed superior benefits on the Alzheimer's Disease Assessment Scale–cognitive scores compared with placebo. Memantine(MD = 2.71, 95% CI: 1.05–7.29) improved global status(Clinician's Interview-Based Impression of Change Scale Plus Caregiver's Input) more than the placebo. Safety results revealed that donepezil 10 mg(odds ratio(OR) = 3.04, 95% CI: 1.86–5.41) contributed to higer risk of adverse events than placebo. Galantamine(OR = 5.64, 95% CI: 1.31–26.71) increased the risk of nausea. Rivastigmine(OR = 16.80, 95% CI: 1.78–319.26) increased the risk of vomiting. No agents displayed a significant risk of serious adverse events, mortality, cerebrovascular accidents, or diarrhea.Conclusion: We found significant efficacy of donepezil, galantamine, and memantine on cognition. Memantine can provide significant efficacy in global status. They are all safe and well tolerated.
文摘Background: The Geriatric Depression Scale (GDS) is widely used to assess depressive symptoms in clinical and research settings. This study utilized a 4 factor solution for the 30-item GDS to explore differences in the presentation of depressive symptoms in various types of cognitive impairment. Method: Retrospective chart review was conducted on 254 consecutive cases of community dwelling elderly newly diagnosed with mild Alzheimer’s Dementia (AD) n = 122, mild Vascular Dementia (VaD) n = 71 or Amnestic Mild Cognitive Impairment (aMCI) n = 32 and Non-Amnestic MCI (nMCI) n = 29. Results: Analysis revealed no significant differences (p 05). No statistically significant differences were found between VaD and nMCI or between the MCI groups. Conclusions: Support is provided for the use of GDS subscales in a wide range of cognitively impaired elderly. This study suggests in mild dementia the number and type of depressive symptoms vary significantly between AD and VaD. There are indications that aMCI patients are similar in their symptom endorsement to AD and nMCI are similar to VaD which is consistent with some of the notions regarding likely trajectories of the respective MCI groups.
文摘Objective： To investigate functional connectivity within default mode network （DMN） and ex-ecutive control network （ECN） in vascular cognitive im-pairment, no dementia （VCIND）. Methods： Twenty-eight VCIND patients and sixteen healthy controls were recruit-ed. A seed-based connectivity analysis was performed us-ing data from resting-state functional magnetic resonance imaging （fMRI）. Based on previous fndings, posteriorcingulate cortex （PCC） and dorsolateral prefrontal cortex （DLPFC） were chosen as regions of interest to study these networks.One-sample t-test and two-sample t-test were used for statistical analysis. Results： Compared with thecontrols, the VCIND group exhibited increased functional activity in such DMN regions as the left inferior temporal gyrus, parahippocampal gyrus, and medial frontal gyrus. The VCIND group had decreased functional connectivity of DMN at right superior frontal gyrus, left mid-cingu-late area, the medial part of left superior frontal gyrus, and bilateral medial frontal gyrus. The VCIND group also showed decreased functional connectivity of ECN pri-marilyat left inferior parietal gyrus, right angular gyrus, right middle occipital gyrus, and right middle frontal cor-tex. Conclusions： Increased functional connectivity with-in DMN and decreased functional connectivity within ECN suggested dysfunction of these two networks, which mightbe associated with the cognitive defcitsin patients with VCIND. These fndingsmay help usunderstandthe pathogenesis and clinical characteristics of VCIND.
文摘Introduction: Dementia is frequently associated with Parkinson’s disease, especially in later stages. Efficacy of cholinesterase inhibitors (ChI) in Alzheimer’s dementia is well established. However, treatment with ChI in Parkinson’s disease dementia (PDD) remains controversial. The objective of this systematic review and meta-analysis was to assess the effects of ChI in PDD. Methods: A comprehensive literature search was performed in MEDLINE, EMBASE and Cochrane library up to March 2014 using the descriptors “Parkinson’s disease”, “dementia in Parkinson’s disease”, “cognition”, “acetylcholinesterase inhibitors”, “cholinesterase inhibitors”, “anticholinesterase agents”, “rivastigmine”, “donepezil” and “galantamine” (Pubmed search strategy). All randomized, doubleblinded, placebo-controlled trials that met the eligibility criteria and assessed the effects of ChI in PDD were considered for analysis. There were no restrictions regarding paper language. Summary effect-sizes were presented as standardized mean differences (SMD) and the pooled analysis was performed with a fixed-effects model. Outcomes considered for analysis were the Mini Mental Status Exam (MMSE) score and the cognition scale for evaluation of dementia ADAS-Cog. The degree of heterogeneity between included studies was assessed through the I2 test. Results: After a comprehensive search, 175 references were retrieved. From these, five randomized trials involving 946PDD subjects were included in the review. Four studies used donepezil and only one study used rivastigmine. The pooled analysis of five studies that assessed the effects of ChI in MMSE total score showed a SMD of 0.24 (CI 95% 0.11 - 0.38). Three studies considered the effects of ChI on Adas-Cog and the pooled results showed a SMD of 0.21 (CI 95% 0.07 - 0.35). There was no significant heterogeneity between the studies. Conclusions: The results of this systematic review and meta- analysis suggest that ChI improves cognitive impairment in PDD subjects. Despite statistically significant, the translation of these results into relevant clinical improvement should be taken with caution, as the studies did not address what would be considered a clinically significant result.
文摘The research focuses on the effectiveness of transluminal laser revascularization of the brain in the treatment of atherosclerotic lesions accompanied by vascular dementia development. 1125 patients aged from 29 to 81 (average age 75) suffering from various kinds of atherosclerotic lesions of cerebral vessels were examined during the research. The examination plan included: computed tomography of the brain (CT), magnetic resonance imaging (MRI), scintigraphy of the brain (SG), rheoencephalography (REG), cerebral multi-gated angiography (MUGA). 665 (59.11%) patients suffered from diseases accompanied by the development of vascular dementia. To perform transcatheter treatment, 639 patients were selected: Group 1 (CDR-1)—352 patients, Group 2 (CDR-2)—184 patients, Group 3 (CDR-3)—103 patients. To conduct revascularization of main intracranial arteries high-energy laser systems were used;for revascularization of the distal intracranial branches low-energy laser systems were used. The clinical outcome depended on the severity of dementia and the timing of the intervention. A good clinical outcome in Group 1 was obtained in 281 (79.82%) cases, in Group 2 in 81 (44.02%) cases, in Group 3 in 9 (8.73%) cases. A satisfactory clinical outcome in Group 1 was obtained in 53 (15.34%) cases, in Group 2 in 62 (33.70%) cases, in Group 3 in 31 (30.09%) cases. A relatively satisfactory clinical outcome in Group 1 was obtained in 17 (4.83%) cases, in Group 2 in 41 (22.28%) cases, in Group 3 in 63 (61.16%) cases. No negative effect was observed after the intervention. Evaluating the data obtained it can be concluded that the method of transluminal laser revascularization of cerebral blood vessels is an effective one for the treatment of atherosclerotic lesions of the brain accompanied by dementia.
文摘Study Objectives: Growing evidence suggests that sleep disturbances is common in vascular dementia (VaD). The goal of the current study is to assess the disturbance in sleep pattern in patients with VaD, and compare it to healthy normally cognitive elderly individuals. We next studied whether there are meaningful differences in the Subjective sleep assessment: Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI) and sleep measurements by polysomnography (PSG) in VaD patients. Study design: Case control study. Subject and methods: Overnight PSG recordings and self-reported sleep measures were obtained from 20 healthy elderly subjects and 20 VaD patients at the sleep laboratory. Results: This study showed abnormal subjective sleep quality in all patients and revealed that the most common sleep complaints among VaD patients were: excessive daytime sleepiness (EDS), sleep disordered breathing (SDB), insomnia, restless leg syndrome (RLS), periodic limb movements (PLMS) and REM behavioral disordered (RBD) respectively. Moreover, patients spent more time in stage I sleep, but less time in slow wave sleep (SWS) and REM sleep compared to control populations, with delayed REML and less 1st REML. Also, increased sleep fragmentation;wakefulness after sleep onset (WASO) & sleep fragmentation index (SFI), increased arousal index (AI) & PLMS index were detected in VaD patients. Finally, VaD patients had significant high Apnea, Hypopnea and Respiratory Distress Index (RDI) score with high average SpO2 Desaturation. Conclusions: Sleep is significantly impaired in patients with VaD at both the objective and subjective level, which may be used as a diagnostic marker of VaD. SDB is a common feature of VaD and leads to fragmented sleep, increased nocturnal confusion, and excessive daytime sleepiness. Subjective sleep assessment questionnaire (ESS and PSQI) can be used in VaD patients when objective sleep assessment by PSG recordings is difficult to be done. The PSG study of sleep continuity, sleep architecture, and REM sleep may help in the prevention of progression of VaD.
文摘目的研究丹红注射液联合吡拉西坦对血管性痴呆(vascular dementia,VD)患者的认知功能及血清胶质纤维酸性蛋白(glial fibrillary acidic protein,GFAP)、β-淀粉样蛋白1-42(amyloidβ-protein 1-42,Aβ1-42)表达的影响。方法选取2019年8月~2020年8月期间收治的82例VD患者,采用随机数字表法分为对照组和观察组,每组41例。对照组给予吡拉西坦片1.6 g tid,观察组在对照组的基础上给予丹红注射液30 ml,qd,两组患者均治疗1个月后进行疗效及安全性评价。分别于治疗前后采用简易智力状态检查(Mini-mental State Examination,MMSE)评分量表、日常生活活动能力量表((Activities of Daily Living Scale,ADL)和美国国立卫生研究院脑卒中量表(National Institutes of Health Stroke Scale,NIHSS)对患者的认知功能、日常生活能力和神经功能缺损状况进行评价。分别于治疗前后检测患者血清中GFAP和Aβ1-42的表达水平。结果治疗后观察组总有效率高于对照组(P<0.05)。治疗后两组患者的MMSE评分显著提高,ADL评分、NIHSS评分均显著降低(P<0.05);与对照组相比,观察组的MMSE评分较高,ADL评分、NIHSS评分均较低(P<0.05)。治疗后两组患者血清GFAP和Aβ1-42的表达水平均显著降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者治疗期间均未见明显不良反应。结论丹红注射液联合吡拉西坦治疗VD具有良好的临床疗效,可有效改善患者的认知功能、日常生活能力和神经功能缺损状况,降低血清GFAP和Aβ1-42的表达,且未见明显不良反应。
文摘目的探究重复经颅磁刺激联合认知训练对非痴呆型血管性认知障碍(vascular cognitive impairment no dementia,VCI-ND)患者认知功能、事件相关电位P300及生活能力的影响。方法选取我科2017年10月至2019年10月间107例VCI-ND患者,按随机数字表法分为对照组(53例)组和观察组(54例),对照组患者实行认知训练,观察组在对照组的基础上给予重复经颅磁刺激,治疗均进行2个疗程,为期1个月。观察两组患者在干预前后认知功能、事件相关电位P300检测、生活能力及并发症的发生情况。结果干预1个月后,观察组蒙特利尔认知评估量表、洛文斯顿认知评价箱的评分较对照组高(P<0.05);观察组事件相关电位P300的潜伏期N2、P3平均值低于对照组,但波幅P3和生活能力评分均高于对照组(P<0.05)。结论认知训练联合重复经颅磁刺激相较于单纯行认知训练的治疗方式,能够调节VCI-ND患者突触及神经传导功能,改善其认知障碍,提升患者大脑高级思维活动,纠正事件相关电位P300,并可有效增强患者日常生活能力。
