BMC Complementary Medicine and Therapies最新文献

Background: Freezing of gait (FOG) is a common symptom of Parkinson's disease (PD) that impairs gait and quality of life. Current pharmacological and surgical treatment strategies cannot eliminate FOG. The supplementary motor area (SMA) is an important part of the motor network that contributing to generate anticipatory postural adjustments (APA) and becomes impaired in FOG. Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation technique, can regulate the SMA and its connections with other brain regions. It may serve as a valuable adjunctive therapeutic approach in alleviating FOG in PD. The aim of this trial is to investigate efficacy and safety of high-frequency SMA-rTMS on FOG in PD patients and reveal possible neural mechanism of this intervention via task-based functional magnetic resonance imaging (tb-fMRI).

Methods: We will conduct a double-blind, randomized sham-controlled clinical trial. Up to 52 PD patients with FOG will be recruited from the department of neurology or outpatient departments, and randomized to sham or active rTMS group in 1:1 ratio. 12 sessions with 10 Hz stimulation over the SMA are delivered 3 times a week for 4 weeks. The primary outcome is the change of New Freezing of Gait Questionnaire (NFOGQ) scores from baseline to post-stimulation. Secondary outcomes include the clinical scales of PD motor and non-motor symptoms, quality of PD's life scale and Clinical Global Impression Scale (CGI). Besides, objective gait parameters obtained with wearable device and fMRI are also collected as secondary outcomes. All outcomes will be assessed at baseline, 4 weeks, and 8 weeks in the "off" state.

Discussion: This study will aid us to explore the short and long-term effects of 10 Hz rTMS over SMA on FOG in patients with PD and its safety. Combining task imagery paradigm and fMRI, the study will reveal underlying therapeutic mechanism of rTMS, which may provide evidence for future developments of therapeutic approaches.

Trial registration: This trial has been registered in China Clinical Trials Registry (registration number: ChiCTR2100049370). (Registered on August 1, 2021).

Background: Various traditional medical procedures are widely practiced in Somalia. The most important reasons for this are difficulties in accessing modern health facilities, the low cost of traditional medicine and local beliefs in the beneficial effects of healers and local pharmacies. Guboow is a painful traditional treatment involving the application to the body of fire-heated wooden or similar objects. Although Guboow is known to be practiced in Somali society, community attitudes towards the practice and levels of dependence are unclear. In this study, we aimed to assess Guboow use and its determinants among parents of children being treated in a tertiary hospital in Somalia.

Methods: This study involved a cross-sectional survey of 290 parents of children receiving health care in a hospital in Somalia. Factors associated with use of Guboow were identified using multivariate logistic regression analysis.

Results: Guboow had been performed on 34.5% of the children in the study, and 39.8% of the parents had previously undergone the procedure. The use of Guboow increased as the educational levels of the mother and father decreased ([OR: 14.477(3.247-64.541)], [OR: 7.040(3.358-14.759)], respectively). Guboow was also more common among individuals with lower incomes ([OR: 6.480 (2.101-19.984)]).

Conclusion: The rate of Guboow use among children was considerable and strongly associated with lower socioeconomic status. These findings underscore the need for public health strategies that address the structural barriers to modern healthcare while also implementing community education programs to raise awareness of the risks associated with this traditional practice.

Background: Hypertension (HTN), a chronic inflammatory condition, is a major cardiovascular risk factor. Dysregulation of inflammatory cytokines and brain-gut peptides contributes to its progression. This study aimed to evaluate the effects of a Tai Chi rehabilitation program on blood pressure, inflammatory cytokines [interleukin-6 (IL-6), interleukin-10 (IL-10)], and brain-gut peptides [neurotensin (NT), gastrin (GAS)] in patients with HTN, hypothesizing that Tai Chi would improve these parameters compared with Fitness exercise or no intervention.

Methods: A randomized controlled trial enrolled 105 patients with HTN and coronary heart disease. Participants were randomized into the Tai Chi group (n = 35), Fitness group (n = 35), or Blank group (n = 35). The intervention lasted 24 weeks (3 sessions per week, 60 min per session, 40-60% heart rate reserve). Blood pressure and serum levels of IL-6, IL-10, NT, and GAS were measured before and after the intervention using enzyme-linked immunosorbent assay (ELISA). Statistical analysis was performed with SPSS version 27, applying paired t-tests, analysis of variance (ANOVA), and Pearson correlation.

Results: Ninety participants completed the study (Tai Chi group: 31, Fitness group: 28, Blank group: 31). The Tai Chi group showed significant reductions in systolic blood pressure (SBP) and IL-6 (p < 0.001), along with increases in IL-10, NT, and GAS (p < 0.001) compared to baseline. Compared with the Fitness group, the Tai Chi group achieved greater increases in NT and GAS (p < 0.05). Compared with the Blank group, the Tai Chi group demonstrated superior reductions in SBP and IL-6 (p < 0.05). Reductions in IL-6 were negatively correlated with increases in NT and GAS (p < 0.001).

Conclusion: Tai Chi rehabilitation lowered systolic blood pressure, reduced inflammation, and improved brain-gut peptides, supporting its role as a complementary therapy for hypertension. The modest sample size, 14.3% dropout rate, and recruitment from two hospitals may limit generalizability, and larger multi-center studies with longer follow-up are needed.

Trial registration: The trial was registered with the International Traditional Medicine Clinical Trial Registry (Registration No. ITMCTR2024000813; registration date: 2024/12/13).