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Objective: The aim of the study is to determine the efficacy of transcranial direct current stimulation on global cognition and ability in daily life activities of patients with poststroke cognitive impairment. Design: Nine electronic databases were searched from their respective inceptions through January 2022. We included the randomized controlled trials that used transcranial direct current stimulation for poststroke cognitive impairment and included at least one global cognitive function or ability in daily life activities outcome indicators. Two reviewers appraised the risks of bias through the Cochrane Collaboration’s tool and performed the meta-analysis. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. Results: Twenty-two studies (1198 participants) were included. Most studies had no significant bias in the quality of the methodology. Meta-analyses found that compared with the control group, transcranial direct current stimulation increased Montreal cognitive assessment, Mini-mental state examination, Loewenstein occupational therapy cognitive assessment, total effective rate of cognition, modified Barthel Index, and decreased P300 latency (all P < 0.05). These results showed transcranial direct current stimulation can improve cognitive function and ability in daily life activities in poststroke cognitive impairment. Conclusions: The transcranial direct current stimulation may have a significant rehabilitation effect on global cognitive functioning and ability in daily life activities of patients with poststroke cognitive impairment. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to investigate the effectiveness and safety of low-frequency repetitive transcranial magnetic stimulation (LF-rTMS) in patients with poststroke aphasia. Method: We comprehensively searched for eligible studies from 11 electronic medical databases from their inception to February 20, 2019. Randomized controlled trials reporting the effectiveness of LF-rTMS for patients with poststroke aphasia were included. The primary outcome was language ability. The secondary outcomes were functional communication and adverse events. The methodological quality of the randomized controlled trials was evaluated by the Cochrane Back Review Group Risk of Bias Assessment Criteria. Results: Of the 567 records retrieved, 18 studies with a total of 536 participants were included. All the included studies were of relatively acceptable methodological quality. All studies but one used LF-rTMS + speech and language therapy (SLT), not LF-rTMS alone. The meta-analysis showed that LF-rTMS had beneficial effects for patients with aphasia after a stroke in terms of naming, repetition, comprehension, written language, and functional communication. The subgroup analyses of language performance showed positive effects of LF-rTMS among stroke patients with chronic aphasia and acute aphasia. LF-rTMS + SLT had effects on language performance that were superior to the sham rTMS + SLT and SLT alone. A shorter LF-rTMS duration benefited language performance more than a longer duration. Additionally, 20 min of LF-rTMS per session produced a positive effect on language ability for patients with aphasia after a stroke. No adverse events were reported. Conclusions: LF-rTMS + SLT is an effective and safe method for patients with poststroke aphasia to improve their language performance. Additionally, the most commonly used LF-rTMS protocol for patients with aphasia after a stroke was 90% of the resting motor threshold 20 min per day, 5 days per week, for 2 weeks. [ABSTRACT FROM AUTHOR]

BACKGROUND: Coronary artery aneurysms (CAAs) are a well-known complication of Kawasaki disease (KD), but there are no data on incidence or outcomes of systemic artery aneurysms (SAAs) in the current era. METHODS: From April 1, 2016, to March 31, 2019, we screened for SAAs in 162 patients with KD at risk for SAAs with magnetic resonance angiography or peripheral angiography and analyzed incidence and early outcomes of SAAs. RESULTS: Twenty-three patients had SAAs, demonstrating an incidence of 14.2% (23 of 162) in patients who were screened at 1 month after onset. The proportion of patients with SAAs was estimated to be 2% (23 of 1148) of all patients with KD. The median age at onset of KD with SAAs was 5 months. All patients with SAAs had CAAs, with z scores >8. Of patients with giant CAAs, 38.6% (17 of 44) had SAAs. A total of 129 SAAs occurred in 17 different named arteries. The most common sites for SAAs were the axillary (18.6%), common iliac (12.4%), and brachial (11.6%) arteries. During a median follow-up time of 6 months, 92.9% (79 of 85) of SAAs had some degree of regression, with 80% (68 of 85) of SAAs returning to normal. The overall regression rate was higher for medium to large SAAs than for medium to giant CAAs. CONCLUSIONS: Although the incidence of SAAs may not be as dramatically reduced as we expected compared with previous data, SAAs have a high regression rate during short-term follow-up. [ABSTRACT FROM AUTHOR]