Purpose: Brain areas frequently implicated in language recovery after stroke comprise perilesional sites in the left hemisphere and homotopic regions in the right hemisphere. However, the neuronal mechanisms underlying language restoration are still largely unclear. Methods and materials: In the present study, we investigated the brain function in 15 patients with poststroke aphasia and 30 matched control subjects by combining the regional homogeneity (ReHo) and amplitudes of low-frequency fluctuation (ALFF) analysis methods based on resting-state fMRI. Results: Compared to the control subjects, the patients with aphasia exhibited increased ReHo and ALFF values in the ipsilateral perilesional areas and increased ReHo in the contralesional right middle frontal gyrus. Conclusions: The increased spontaneous brain activity in patients with poststroke aphasia during the recovery period, specifically in the ipsilateral perilesional regions and the homologous language regions of the right hemisphere, has potential implications for the treatment of patients with aphasia.

Background: Exploring the brain reorganization patterns associated with language recovery would promote the treatment of global aphasia. While functional near-infrared spectroscopy (fNIRS) has been widely used in the study of speech and language impairment, its application in the field of global aphasia is still limited.Aims: We aimed to identify cortical activation patterns of patients with global aphasia during naming and repetition tasks.Methods and procedures: We recruited patients with post-stroke aphasia from the Department of Rehabilitation Medicine at Huashan Hospital. These individuals were diagnosed with global aphasia without cognitive impairments, as assessed by speech-language pathology evaluations. Age- and sex-matched healthy controls were recruited from the greater Shanghai area. During fNIRS measurement, patients and healthy controls completed the picture-naming and phrase repetition task. Cortical activation patterns on each of these language tasks were then compared between groups.Outcomes and results: A total of nine patients with global aphasia and 14 healthy controls were included in this study. Compared with the healthy subjects, patients with global aphasia showed increased activation in the left Broca's area, middle temporal gyrus (MTG), superior temporal gyrus (STG), and pre-motor and supplementary motor cortex (SMA) (p < 0.05) in the picture-naming task. Furthermore, the latency of the oxyhemoglobin (HbO) concentration in the left supramarginal gyrus (SMG) region had a strong negative correlation with their score of the naming task (p < 0.01). In the phrase repetition task, decreased activation was detected in the left SMA and SMG (p < 0.05) of patients relative to controls.Conclusion: The left SMG plays a critical role in the language function of patients with global aphasia, especially in their abilities to name and repeat. fNIRS is a promising approach to revealing the changes in brain activities in patients with aphasia, and we believe it will contribute to a deeper understanding of the neurological mechanisms and the establishment of a novel treatment approach for global aphasia.

Stroke remains a leading cause of death and disability worldwide, and electroacupuncture has a long history of use in stroke treatment. This meta-analysis and systematic review aimed to evaluate the efficacy of electroacupuncture and explore its potential mechanisms in animal models of ischemic stroke. The PubMed, EMBASE, Web of Science, CENTRAL, and CINAHL databases were comprehensively searched up to May 1, 2024. This review included articles on preclinical investigations of the efficacy and mechanisms of electroacupuncture in treating ischemic stroke. Data from 70 eligible studies were analyzed in Stata 18.0, using a random-effects model to calculate the standardized mean difference (Hedge’s g). The risk of bias was assessed using RevMan 5.4 software, and the quality of evidence was rated according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system. Subgroup analyses were conducted to test the consistency of the results and sensitivity analyses were used to assess their robustness. The quality assessment revealed that most studies adequately handled incomplete data and selective reporting. However, several methodological limitations were identified: only 4 studies demonstrated a low risk of allocation concealment, 26 achieved a low risk of outcome assessment bias, and 9 had a high risk of randomization bias. Additionally, there was an unclear risk regarding participant blinding and other methodological aspects. The GRADE assessment rated 12 outcomes as moderate quality and 6 as low quality. The mechanisms of electroacupuncture treatment for ischemic stroke can be categorized as five primary pathways: (1) Electroacupuncture significantly reduced infarct volume and apoptotic cell death ( P < 0.01) in ischemic stroke models; (2) electroacupuncture significantly decreased the levels of pro-inflammatory factors ( P < 0.01) while increasing the levels of anti-inflammatory factors ( P = 0.02); (3) electroacupuncture reduced the levels of oxidative stress indicators ( P < 0.01) and enhanced the expression of antioxidant enzymes ( P < 0.01); (4) electroacupuncture significantly promoted nerve regeneration ( P < 0.01); and (5) electroacupuncture influenced blood flow remodeling ( P < 0.01) and angiogenesis ( P < 0.01). Subgroup analyses indicated that electroacupuncture was most effective in the transient middle cerebral artery occlusion model ( P < 0.01) and in post-middle cerebral artery occlusion intervention ( P < 0.01). Dispersive waves were found to outperform continuous waves with respect to neuroprotection and anti-inflammatory effects ( P < 0.01), while scalp acupoints demonstrated greater efficacy than body acupoints ( P < 0.01). The heterogeneity among the included studies was minimal, and sensitivity analyses indicated stable results. Their methodological quality was generally satisfactory. In conclusion, electroacupuncture is effective in treating cerebral ischemia by modulating cell apoptosis, oxidative stress, inflammation, stroke-induced nerve regeneration, blood flow remodeling, and angiogenesis. The efficacy of electroacupuncture may be influenced by factors such as the middle cerebral artery occlusion model, the timing of intervention onset, waveform, and acupoint selection. Despite the moderate to low quality of evidence, these findings suggest that electroacupuncture has clinical potential for improving outcomes in ischemic stroke.

Objectives: The aims of the study were to investigate the effect of tongue-pressure resistance training in poststroke dysphagia patients with oral motor dysfunction and to examine the therapeutic value of tongue-pressure resistance training in the oral and pharyngeal phases. Design: Patients were divided into an experimental and a control group. Both groups received 30 mins of traditional swallowing rehabilitation treatment every day for 4 wks. In addition, the experimental group received tongue-pressure resistance training for an extra 20 mins/d. Maximum tongue pressure and fiberoptic endoscopic examination of swallowing were assessed before and after treatments. Results: Compared with the control group, the experimental group showed significant improvement in Functional Communication Measure for swallowing, Oral Motor Function Scale, maximum tongue pressure, Murray Secretion Scale, Rosenbek Penetration–Aspiration Scale, and food residue in pyriform sinuses (P < 0.05). There was no significant difference in food residue in epiglottic vallecula between both groups (P > 0.05). Conclusions: This study demonstrated that tongue-pressure resistance training is an effective approach to improve the overall swallowing function in patients with oral motor dysfunction. The improvement of oral motor function could facilitate the recovery of pharyngeal motor function. Tongue-pressure resistance training seems to have more clearance of residue in piriform sinus than epiglottic vallecula.

Purpose: This study investigated the disparities in brain activation patterns during the Stroop task among individuals with mild cognitive impairment (MCI) and those without any cognitive impairments (healthy controls, HCs) using functional near-infrared spectroscopy (fNIRS).Methods: We analyzed the cortical activation patterns of 73 patients with MCI and 63 HC individuals as they completed the Stroop task, employing fNIRS. The regions of interest (ROIs) included the dorsal prefrontal cortex (dPFC), ventrolateral prefrontal cortex (VLPFC), and parietal lobe (PL). The Stroop task is divided into early stage (0–15 s) and late stage (15–30 s). We also measured participants’ behavior during the Stroop task, analyzed variations in cortical activation intensity at different experiment stages, and performed correlation analysis between Montreal Cognitive Assessment (MoCA) scores, Stroop performance, and oxygenation levels.Results: Our analysis revealed that individuals with MCI and HC demonstrated elevated cortical activation in the dPFC, VLPFC, and PL areas while performing the Stroop task (q < 0.05, FDR-corrected). The MCI group displayed longer response latencies compared to the HC group while demonstrating comparable accuracy performance across both congruent and incongruent Stroop trials. The MCI group showed compensatory activation in the VLPFC, and PL regions compared to the HC group during the late stage of the Stroop task (q < 0.05, FDR-corrected). Correlational analysis revealed a negative association between MoCA scores and oxygenation levels in the dPFC, VLPFC, and PL regions during the late stage of the Stroop task (p < 0.05). However, no correlation was found with behavioral performance.Conclusion: Mild cognitive impairment patients demonstrated effective compensation for their cognitive impairments at a partial behavioral level by engaging compensatory activation in the prefrontal, and parietal regions while performing the Stroop task.

Pulmonary fibrosis (PF) remains a major sequela of COVID-19, yet its pharmacotherapy remains unsatisfactory. Recently, Traditional Chinese medicine (TCM) has garnered increasing recognition among patients and researchers because of its few side effects and efficacy. The objective of this study is to use bibliometric analysis to explore the current research landscape and emerging trajectories of TCM treating PF(TCM/PF) researches, and comprehensively evaluate publications with substantial citations within the domain of TCM/PF. TCM/PF publications from 1996 to June 15, 2023 were identified by a comprehensive search of the Web of Science Core Collection (WoSCC). The Bibliometrix of Origin, CiteSpace, Gephi, dycharts and VOSviewer were used for bibliometric analysis. A total of 358 papers were included. A rapid increase in the number of papers after 2013 was observed. China had the highest publication output and research contributions in this field. Beijing University of Traditional Chinese Medicine and Nanjing University of Traditional Chinese Medicineare leaders in productive research of this field. Nanjing University of Traditional Chinese Medicine had the highest citations (227). LI JIANSHENG from Henan University of Chinese Medicine was the most prolific author (8), with the highest number of citations (61), and TONG XIAO LIN from China Academy of Chinese Medical Sciences had the highest H-index (30). The leading journal publishing the most research (37) is Frontiers in Pharmacology and the Journal of Ethnopharmacology had the highest total citations (486). Burst analysis of keywords revealed three distinct phases of research. 1996 to 2013 marked the nascent stage of TCM/PF research; from 2014 to 2018, studies gradually focused on the underlying mechanisms governing TCM/PF. The most significant phase occurred from 2019 onward, where TCM/PF exhibited an explosive growth trend. This progression signifies a transition from foundational explorations to a comprehensive understanding of the mechanisms involved, ultimately leading to the current surge in research activities focused on TCM/PF. Notable research teams of this stage, led by LI JIAN SHENG and TONG XIAO LIN, have been at the forefront of advancing TCM/PF research. Their studies on Jinshui Huanxian formula and Qimai Feiluoping decoction have been pivotal in advancing the frontier of research in this domain. Furthermore, the monomeric compounds, including emodin, curcumin, salvianolic acid, baicalin, and oxymatrine, have sustained longstanding prominence. This study gained insight into the research status, focal areas and evolving trends of global TCM/PF research. It also identified the most cited articles in TCM/PF and analyzed their characteristics, which may hold significant relevance for both clinical researchers and practitioners on future directions in this field.