Effects of Transcutaneous Electrical Acupoint Stimulation on Motor Functions and Self-Care Ability in Children with Cerebral Palsy.
J Altern Complement Med. 2018 Jan;24(1):55-61
Authors: Zhang B, Zhu Y, Jiang C, Li C, Li Y, Bai Y, Wu Y
OBJECTIVES: To observe the effects of transcutaneous electrical acupoint stimulation (TEAS) in improving motor functions and self-care abilities in children with cerebral palsy in their early childhood.
DESIGN: A preliminary, prospective, cohort study.
SUBJECTS: Children aged 2-6 years old.
INTERVENTIONS: Twenty-three children were included in the study and randomly assigned to a control group ([CG] N = 11) or a therapeutic group ([TG] N = 12). In the TG, children were treated with TEAS (Shousanli [LI10] and Waiguan [SJ5]) plus the exercise therapy, while in the control group, they were treated with sham TEAS plus exercise therapy. Therapies were performed five days per week for eight weeks.
OUTCOME MEASURES: The Gross Motor Function Measure (GMFM) and the Functional Independent Measurement for children (WeeFIM) were used to evaluate motor functions and self-care abilities before and after the therapies.
RESULTS: Greater improvements were observed in the TG concerning all the measurements, although without statistical differences. The increments of the GMFM score and the WeeFIM motor, self-care and total scores were 36.08 ± 18.34 (26%), 16.17 ± 8.21 (33%), 7.67 ± 3.42 (40%) and 20.33 ± 10.08 (28%) in the TG, while 22.73 ± 16.54 (17%), 9.09 ± 9.43 (19%), 5.64 ± 6.73 (29%) and 12.82 ± 11.77 (18%) in the CG, respectively. No statistically significant correlations were shown between functional improvements and the demographics in the TG or the CG. The GMFM improvement was not statistically correlated with the improvements of the WeeFIM motor, self-care or total scores. However, the WeeFIM motor, self-care and total score were significantly positively correlated with one another in both groups (P < 0.01). No adverse effect was recorded during the study.
CONCLUSION: TEAS may be effective in improving motor functions and self-care abilities in children with cerebral palsy, in addition to conventional exercise therapy. Larger samples are required to confirm the efficacies.
PMID: 28767271 [PubMed - indexed for MEDLINE]
Impaired cholinergic transmission in patients with Parkinson's disease and olfactory dysfunction.
J Neurol Sci. 2017 Jun 15;377:55-61
Authors: Versace V, Langthaler PB, Sebastianelli L, Höller Y, Brigo F, Orioli A, Saltuari L, Nardone R
Olfactory dysfunction represents a frequent and disturbing non-motor manifestation of Parkinson's disease (PD). The pathophysiology of olfactory dysfunction in PD is still poorly understood. Experimental evidence suggests that olfactory impairment could be related to central cholinergic dysfunction. Short latency afferent inhibition (SAI) technique gives the opportunity to test an inhibitory cholinergic circuit in the human cerebral motor cortex. The objective of the study was to assess the cholinergic function, as measured by SAI, in PD patients with different degrees of olfactory dysfunction. We applied SAI technique in 31 patients with PD. These patients also underwent Olfactory Event-Related Potentials (OERPs) studies to objectively evaluate the olfactory system and a battery of neuropsychological tests to assess the cognitive functions. Absent OERPs indicated a severe olfactory dysfunction in 13 subjects. The presence of OERPs with an alteration in latency and/or amplitude can be considered as a borderline condition of slight alteration of smell and was found in other 15 patients. Only 3 patients showed normal OERPs. SAI was significantly reduced in the PD patients with absent OERPs compared with those with present but abnormal OERPs. Neuropsychological examination showed a mild cognitive impairment in 12 out of 13 PD patients with severe olfactory dysfunction, and in 3 out of the 15 patients with borderline olfactory dysfunction. SAI abnormalities and presence of severe olfactory impairment strongly support the hypothesis of cholinergic dysfunction in some patients with PD, who will probably develop a dementia. Longitudinal studies are required to verify whether SAI abnormalities in PD patients with olfactory dysfunction can predict a future severe cognitive decline.
PMID: 28477708 [PubMed - indexed for MEDLINE]
Radiofrequency energy delivery to the lower esophageal sphincter improves gastroesophageal reflux patient-reported outcomes in failed laparoscopic Nissen fundoplication cohort.
Surg Endosc. 2017 Jul;31(7):2854-2862
Authors: Noar M, Squires P, Khan S
BACKGROUND: Patients with uncontrollable gastroesophageal reflux disease (GERD) often undergo laparoscopic Nissen fundoplication (LNF); however, long-term there are often recurring symptoms and need for continuous medication use. Refractory LNF patients may receive radiofrequency energy delivery to the lower esophageal sphincter (Stretta) to ameliorate symptoms and medication requirements. The aim was to assess and compare long-term patient-reported outcomes of Stretta in refractory patients with and without previous LNF.
METHODS: We prospectively assessed and compared patient-reported outcomes in 18 refractory LNF patients and 81 standard refractory GERD patients that all underwent Stretta during 10-year follow-up. Patient-reported outcomes measured were GERD-HRQL (health-related quality of life), patient satisfaction scores, and daily medication requirements.
RESULTS: The refractory LNF subset demonstrated median improvements in GERD-HRQL, satisfaction, and medication use at all follow-up time points ≥6 months to 10 years, which was significant from a baseline of both on- and off-medications (p < 0.05). Specifically at 10 years, median GERD-HRQL decreased from 36 to 7 (p < 0.001), satisfaction increased from 1 to 4 (p < 0.001), and medication score decreased from 7 to 6 (p = 0.040). Nine patients decreased medication use by half at 10 years. No significant differences existed between refractory LNF and standard refractory GERD subsets at any follow-up time point ≥6 months to 10 years (p > 0.05) after Stretta. At 10 years, no significant differences were noted between refractory LNF and standard Stretta subsets regarding medication use (p = 0.088), patient satisfaction (p = 0.573), and GERD-HRQL (p = 0.075). Stretta procedures were completed without difficulty or significant intraoperative or long-term adverse events.
CONCLUSION: Within a small cohort of refractory LNF patients, Stretta resulted in sustained improvement over 10 years with equivalent outcomes to non-LNF standard Stretta patients. Refractory LNF patients are a subpopulation that may be safely, effectively, and robustly aided by Stretta with fewer complications compared to redo of Nissen or chronic medication use.
PMID: 28039654 [PubMed - indexed for MEDLINE]
The influence of transcutaneous electrical nerve stimulation parameters on the level of pain perceived by participants with painful diabetic neuropathy: A crossover study.
Diabetes Metab Syndr. 2017 Apr - Jun;11(2):113-118
Authors: Upton GA, Tinley P, Al-Aubaidy H, Crawford R
AIMS: This pilot study aimed to investigate and compare the perceived pain relief effectiveness of two different modes of TENS in people with painful diabetic neuropathy (PDN).
METHODS: A cross-over study was conducted at Charles Sturt University, Orange. Five participants with PDN were assessed with a McGill Pain Questionnaire before and after each of the two TENS treatments. Participants were randomly allocated to Traditional TENS (80Hz, 200ms) or Acupuncture-like TENS (2Hz, 200ms) and the treatments were applied daily for 30min over ten days. Following a seven day washout period, the alternate mode of TENS was carried out using the same method. Wilcoxon Signed Rank tests were used to statistically analyse the results.
RESULTS: All five participants reported personally meaningful pain relief during one or both of the TENS treatments. The Wilcoxon signed rank testing showed no statistical significance, p=1, likely due to the small sample size. Acupuncture-like TENS had a large effect size (z=-1.625, r=0.514), whilst Traditional TENS produced a medium effect size (z=-1.214, r=0.384). No adverse effects were reported.
CONCLUSION: Acupuncture-like TENS may be more effective for PDN than traditional TENS. A larger scale replication of this pilot study is warranted.
PMID: 27595389 [PubMed - indexed for MEDLINE]
Tumor treating fields inhibit glioblastoma cell migration, invasion and angiogenesis.
Oncotarget. 2016 Oct 04;7(40):65125-65136
Authors: Kim EH, Song HS, Yoo SH, Yoon M
Treatment with alternating electric fields at an intermediate frequency (100-300 kHz), referred to as tumor treating fields (TTF) therapy, inhibits cancer cell proliferation. In the present study, we demonstrated that TTF application suppressed the metastatic potential of U87 and U373 glioblastoma cell lines via the NF-kB, MAPK and PI3K/AKT signaling pathways. Wound-healing and transwell assays showed that TTF suppressed cell migration and invasion compared with controls. Soft agar and three-dimensional culture assays showed that TTF inhibited both anchorage-dependent (cell proliferation) and anchorage-independent (colony formation) GBM cell growth. TTF dysregulated epithelial-to-mesenchymal transition-related genes, such as vimentin and E-cadherin, which partially accounted for TTF inhibition of cell migration and invasion. We further demonstrated that TTF application suppressed angiogenesis by downregulating VEGF, HIF1α and matrix metalloproteinases 2 and 9. TTF also inhibited NF-kB transcriptional activity. Collectively, our findings show that TTF represents a promising novel anti-invasion and anti-angiogenesis therapeutic strategy for use in GBM patients.
PMID: 27556184 [PubMed - indexed for MEDLINE]