Rédacteurs : Johan Nguyen, Claude Pernice
Différences
Ci-dessous, les différences entre deux révisions de la page.
| Les deux révisions précédentes Révision précédente | |||
|
acupuncture:evaluation:neuro-psychiatrie:14. troubles cognitifs [21 Apr 2025 05:56] Nguyen Johan [3.1. Istituto Superiore di Sanità (ISS, Italy) 2024 Ø] |
acupuncture:evaluation:neuro-psychiatrie:14. troubles cognitifs [21 Apr 2025 06:01] (Version actuelle) Nguyen Johan [1.3.2.1. O'Caoimh 2019] |
||
|---|---|---|---|
| Ligne 280: | Ligne 280: | ||
| ^Results| In all, 53 papers representing 48 studies were included. Participant age ranged from 67.3 to 89.4 years. Most studies (79%) had small samples (<50 participants, range 1-173) and were conducted in long-term/residential care (62%). The majority (85%) recruited participants with moderate-severe dementia; mean MMSE scores ranged from 0 to 28.3/30. Four studies examined MCI. Light therapy delivered over 1-10 weeks was the most studied stand-alone intervention (n = 27), and the majority (81.5%) of these studies found improvements on objective or subjective sleep measures, though the evidence was inconclusive with significant clinical and methodological heterogeneity. Seven multi-modal intervention studies were identified, all incorporating light exposure, and six of these reported improved sleep. Other interventions included electrotherapy stimulation (n = 4), physical exercises/activities (n = 4),** acupressure/acupuncture (n = 3)** and mindfulness/cognitive behavioural therapy (n = 3). Those examining MCI utilised different mono-modal approaches. A meta-analysis of data from randomised controlled trials showed a statistically significant (mean difference = 3.44, 95% CI: 0.89-5.99, I2=0%; p = 0.008) improvement in sleep efficiency between interventions and controls, favouring the pooled interventions (bright light, multi-domain and other therapies). No other significant differences in sleep or non-sleep outcomes were found. | | ^Results| In all, 53 papers representing 48 studies were included. Participant age ranged from 67.3 to 89.4 years. Most studies (79%) had small samples (<50 participants, range 1-173) and were conducted in long-term/residential care (62%). The majority (85%) recruited participants with moderate-severe dementia; mean MMSE scores ranged from 0 to 28.3/30. Four studies examined MCI. Light therapy delivered over 1-10 weeks was the most studied stand-alone intervention (n = 27), and the majority (81.5%) of these studies found improvements on objective or subjective sleep measures, though the evidence was inconclusive with significant clinical and methodological heterogeneity. Seven multi-modal intervention studies were identified, all incorporating light exposure, and six of these reported improved sleep. Other interventions included electrotherapy stimulation (n = 4), physical exercises/activities (n = 4),** acupressure/acupuncture (n = 3)** and mindfulness/cognitive behavioural therapy (n = 3). Those examining MCI utilised different mono-modal approaches. A meta-analysis of data from randomised controlled trials showed a statistically significant (mean difference = 3.44, 95% CI: 0.89-5.99, I2=0%; p = 0.008) improvement in sleep efficiency between interventions and controls, favouring the pooled interventions (bright light, multi-domain and other therapies). No other significant differences in sleep or non-sleep outcomes were found. | | ||
| ^Conclusions|While evidence is available for non-pharmacological sleep interventions, particularly multi-domain approaches, studies were diverse and had small samples. More research examining multi-modal interventions, community-dwellers and those with MCI is required. | | ^Conclusions|While evidence is available for non-pharmacological sleep interventions, particularly multi-domain approaches, studies were diverse and had small samples. More research examining multi-modal interventions, community-dwellers and those with MCI is required. | | ||
| + | |||
| + | === Animal model === | ||
| + | |||
| + | == Liu 2025 == | ||
| + | |||
| + | |||
| + | Liu C, Su Y, Yau YM, Lin H, Chen Y, Fang W, Xu N, Wu Z. Effect of acupuncture on cognitive impairment induced by sleep deprivation in animal models: a preclinical systematic review and meta-analysis. Front Aging Neurosci. 2025 Mar 19;17:1560032. https://doi.org/10.3389/fnagi.2025.1560032 | ||
| + | ^Backgound| Sleep deprivation (SD) has been associated with cognitive deficits, mediated by mechanisms such as neuroinflammation and oxidative stress. Acupuncture, a core component of traditional Chinese medicine, has shown promise in mitigating SD-induced cognitive impairment. However, the effectiveness and underlying mechanisms of acupuncture need further validation through high-quality evidence. This study aims to evaluate the therapeutic effects and molecular mechanisms of acupuncture on cognitive impairment resulting from SD by conducting a systematic review and meta-analysis.| | ||
| + | ^Methods| This study comprehensively searched eight databases for randomized controlled trials (RCTs) that examine the effects of acupuncture on SD-induced cognitive impairment. Primary outcomes were assessed using the Morris Water Maze (MWM), including measures of escape latency and time spent in the target quadrant. Secondary outcomes focused on molecular markers such as brain-derived neurotrophic factor (BDNF), tropomyosin receptor kinase B (TrkB), and indicators of oxidative stress. The risk of bias was evaluated using the SYRCLE tool, and data were analyzed using R software. Standardized mean differences (MD) and 95% confidence intervals (CIs) were calculated.| | ||
| + | ^Results| **Eight RCTs involving 222 rodents were analyzed**. The findings indicate that acupuncture significantly improves cognitive performance in SD models, evidenced by increased platform crossings [MD = 1.67, 95% CI (1.42, 1.91)] and extended time in the target quadrant [MD = 8.54, 95% CI (6.35, 10.73)], along with reduced escape latency [MD = -8.33, 95% CI (-11.68, -4.99)]. Electroacupuncture (EA) was found to regulate the expression of BDNF and its receptor, TrkB, and to decrease oxidative stress markers such as malondialdehyde (MDA) while enhancing antioxidant activities, including those of superoxide dismutase (SOD). Manual acupuncture (MA) influenced apoptosis markers by decreasing Bax and increasing Bcl-2 expression. Despite these positive findings, the studies exhibited heterogeneity in intervention methods and variability in acupuncture techniques.| | ||
| + | ^Conclusion| This study preliminarily confirms that acupuncture, specifically electroacupuncture, and manual acupuncture, can effectively alleviate cognitive impairment caused by sleep deprivation. The benefits are observed through modulation of BDNF-TrkB signaling, reduction in oxidative stress, and regulation of apoptosis. Although the current evidence is derived from animal studies, it suggests potential applications in human clinical trials to explore the viability of acupuncture for treating cognitive impairment related to SD.| | ||
| + | |||
| ===== Overviews of Systematic Reviews ===== | ===== Overviews of Systematic Reviews ===== | ||
