Effectiveness of therapeutic massage for improving motor symptoms in Parkinson's disease: A systematic review and meta-analysis

Will the Artificial Intelligence Touch Substitute for the Human Touch?

Nowadays, artificial intelligence is used in many fields to diagnose and treat different diseases. Robots are also useful tools that substitute for human work. Despite robots being used also for touch therapy, can they substitute for the human touch? Human touch has a strong social component, and it is necessary for the correct development of newborns and the treatment of pathological situations. To substitute human touch, it is necessary to integrate robots with artificial intelligence as well as with sensors that mimic human skin. Today, the question remains without answer: Can human touch be substituted with AI in its social and affiliative components?

Perceptions and attitudes regarding complementary, alternative, and integrative medicine among published neurology authors: a large-scale, international cross-sectional survey

BACKGROUND

While many patients with neurological disorders and conditions use complementary, alternative, and integrative medicine (CAIM), little is known about the use, perceptions, and attitudes regarding CAIM among published neurology authors. With the increasing popularity of CAIM, our objective was to assess practices, perceptions, and attitudes towards CAIM among published neurology authors.

METHODS

We conducted an anonymous online survey of authors who had published articles in neurology journals indexed in MEDLINE. We emailed potential participants our cross-sectional electronic survey after extracting their email addresses from one of their publications in our sample of journals. Basic descriptive statistics were drawn from quantitative data, and thematic content analysis was used to analyse qualitative data from any open-ended questions.

RESULTS

The survey was completed by 783 published neurology authors (1.7% response rate, 83.9% completion rate). Overall, respondents perceived CAIM to be promising in preventing, treating, and/or managing neurological diseases. Mind-body therapies received the most positive responses, indicated by over half of respondents cumulatively agreeing that they are promising (n = 368, 59.0%) and safe (n = 280, 50.3%). Whole medical systems and biofield therapy were less favourable. Most neurology clinicians reported a lack of formal (n = 211, 70.3%) and supplementary training (n = 158, 52.5%) on CAIM. Nearly half of clinicians did not feel comfortable counselling patients about CAIM therapies (n = 121, 44.5%), and over half did not feel comfortable recommending them (n = 161, 59.3%). A lack of scientific evidence for CAIM's safety and efficacy was reported as the greatest challenge to CAIM (n = 515, 92.5%). The majority of respondents believed there is value to conducting research on this topic (n = 461, 82.0%) and supported increasing allocation of research funding towards CAIM (n = 241, 58.9%).

CONCLUSIONS

Although many participants found CAIM to be promising to the field of neurology, the vast majority did not feel open to integrating CAIM into mainstream medical practices on account of a perceived lack of scientific evidence for its safety and efficacy. Future studies can use our findings to gather more detailed insights, improve educational resources on CAIM within neurology, as well as examine what effects a tailored CAIM education has on the perceptions and attitudes of published neurology authors towards CAIM.

The acceptance of traditional Chinese medicine among patients with Parkinson's disease: A hospital survey

OBJECTIVE

The efficacy of medications for Parkinson's disease (PD) tend to decline over time, which has a serious impact on patients' health and quality of life. To some extent, traditional Chinese medicine (TCM) can resolve the distressing problem of ineffective dopaminergic medication in PD patients. The purpose of this study was to investigate the attitude, acceptance, and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital.

METHODS

A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023. A self-report questionnaire was developed to investigate PD patients' attitudes and acceptance of TCM based on the questionnaire. Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients' adoption of TCM therapy.

RESULTS

A total of 397 patients completed the questionnaire, of which 78.09% were willing to be treated with TCM and 21.91% indicated that they were not willing to use TCM. Multifactorial logistic regression analysis showed that several parameters were correlated with a patient's willingness to include TCM in their therapeutic regime. These included education level of a bachelor's degree (odds ratio [OR) = 8.554; 95% confidence interval [CI]: 4.112-17.794; P < 0.001, vs junior high school education), living in an urban setting (OR = 8.022; 95% CI: 4.577-14.060; P < 0.001, vs rural), having other underlying diseases (OR = 5.126; 95% CI: 3.078-8.537; P < 0.001, vs none), having previously used TCM (OR = 3.083; 95% CI: 1.852-5.134; P < 0.001, vs not used), believing that TCM therapy is safe (OR = 3.530; 95% CI: 1.446-8.616; P = 0.006, vs not thought), believing that TCM therapy is effective (OR = 3.859; 95% CI: 1.482-10.047; P = 0.006, vs not understood), and being willing to discuss ongoing TCM therapy with an attending physician (OR = 62.468; 95% CI: 30.350-128.574; P < 0.001, vs not informed).

CONCLUSION

This study initially investigated the acceptance, attitude, and independent predictors of TCM use among PD patients. To expand the prevalence of TCM use among patients with PD, we recommend to broadening the public outreach for TCM via contemporary means of Internet and broadcast communication, enhancing access to TCM services in rural communities, and strengthening the communication between doctors and patients. Please cite this article as: Wang P, Hong J, Tang ZQ, Gong BZ, Qi XR, Jiang H, Pan B, Chen Q. The acceptance of traditional Chinese medicine among patients with Parkinson's disease: A hospital survey. J Integr Med. 2024; 22(2): 180-187.

Tuina therapy promotes behavioral improvement and brain plasticity in rats with peripheral nerve injury and repair

INTRODUCTION

Tuina is currently one of the popular complementary and alternative methods of rehabilitation therapy. Tuina can improve patients' pain and mobility function. However, the underlying physiological mechanism remains largely unknown, which might limit its further popularization in clinical practice. The aim of this study is to explore the short-term and long-term changes in brain functional activity following Tuina intervention for peripheral nerve injury repair.

METHODS

A total of 16 rats were equally divided into the intervention group and the control group. Rats in the intervention group received Tuina therapy applying on the gastrocnemius muscle of the right side for 4 months following sciatic nerve transection and immediate repair, while the control group received nerve transection and repair only. The block-design functional magnetic resonance imaging scan was applied in both groups at 1 and 4 months after the surgery. During the scan, both the injured and intact hindpaw was electrically stimulated according to a "boxcar" paradigm.

RESULTS

When stimulating the intact hindpaw, the intervention group exhibited significantly lower activation in the somatosensory area, limbic/paralimbic areas, pain-regulation areas, and basal ganglia compared to the control group, with only the prefrontal area showing higher activation. After 4 months of sciatic nerve injury, the control group exhibited decreased motor cortex activity compared to the activity observed at 1 month, and the intervention group demonstrated stronger bilateral motor cortex activity compared to the control group.

CONCLUSION

Tuina therapy on the gastrocnemius muscle of rats with sciatic nerve injury can effectively alleviate pain and maintain the motor function of the affected limb. In addition, Tuina therapy reduced the activation level of pain-related brain regions and inhibited the decreased activity of the motor cortex caused by nerve injury, reflecting the impact of peripheral stimulation on brain plasticity.

Social Touch: Its Mirror-like Responses and Implications in Neurological and Psychiatric Diseases

What is the significance of a touch encoded by slow-conducted unmyelinated C-tactile (CT) fibers? It is the so-called affiliative touch, which has a fundamental social impact. In humans, it has been demonstrated that the affiliative valence of this kind of touch is encoded by a dedicated central network, not involved in the encoding of discriminative touch, namely, the "social brain". Moreover, CT-related touch has significant consequences on the human autonomic system, not present in the case of discriminative touch, which does not involve CT fibers as the modulation of vagal tone. In addition, CT-related touch provokes central effects as well. An interesting finding is that CT-related touch can elicit "mirror-like responses" since there is evidence that we would have the same perception of a caress regardless of whether it would be felt or seen and that the same brain areas would be activated. Information from CT afferents in the posterior insular cortex likely provides a basis for encoding observed caresses. We also explored the application of this kind of touch in unphysiological conditions and in premature newborns. In the present literature review, we aim to (1) examine the effects of CT-related touch at autonomic and central levels and (2) highlight CT-related touch and mirror networks, seeking to draw a line of connection between them. Finally, the review aims to give an overview of the involvement of the CT system in some neurologic and psychiatric diseases.

Current Treatments and New, Tentative Therapies for Parkinson’s Disease

Parkinson’s disease (PD) is a neurodegenerative pathology, the origin of which is associated with the death of neuronal cells involved in the production of dopamine. The prevalence of PD has increased exponentially. The aim of this review was to describe the novel treatments for PD that are currently under investigation and study and the possible therapeutic targets. The pathophysiology of this disease is based on the formation of alpha-synuclein folds that generate Lewy bodies, which are cytotoxic and reduce dopamine levels. Most pharmacological treatments for PD target alpha-synuclein to reduce the symptoms. These include treatments aimed at reducing the accumulation of alpha-synuclein (epigallocatechin), reducing its clearance via immunotherapy, inhibiting LRRK2, and upregulating cerebrosidase (ambroxol). Parkinson’s disease continues to be a pathology of unknown origin that generates a significant social cost for the patients who suffer from it. Although there is still no definitive cure for this disease at present, there are numerous treatments available aimed at reducing the symptomatology of PD in addition to other therapeutic alternatives that are still under investigation. However, the therapeutic approach to this pathology should include a combination of pharmacological and non-pharmacological strategies to maximise outcomes and improve symptomatological control in these patients. It is therefore necessary to delve deeper into the pathophysiology of the disease in order to improve these treatments and therefore the quality of life of the patients.

The mediating role of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease

With the application of positive psychology in health management, many studies have confirmed the close relationship between post-traumatic growth, psychological capital and uncertainty in illness. However, there is still a lack of attention to the positive psychology of patients with Parkinson's disease, and previous studies have not clarify the specific relationship. Therefore, the present study sought to explore the multiple mediating roles of psychological capital between post-traumatic growth and uncertainty in illness among patients with Parkinson's disease. We conducted a cross-sectional survey, a total of 268 patients with Parkinson's disease were investigated by the Post-Traumatic Growth Inventory, the Positive Psychological Capital Questionnaire and the Mishel Uncertainty in Illness Scale - Adults from November 2021 to June 2022 in the Parkinson's specialist outpatient department of three 3a-grade hospitals in Tianjin, China. The results showed that the score of post-traumatic growth was (51.78±17.872), the score of uncertainty in illness was (68.08±17.555), and the score of self-efficacy, resilience, hope, and optimism dimensions of psychological capital were (28.93±10.511), (28.79±11.553), (27.57±8.558) and (25.35±9.768). Post-traumatic growth was negatively correlated with uncertainty in illness and positively correlated with all four dimensions of psychological capital (p < 0.01), and uncertainty in illness was negatively correlated with all four dimensions of psychological capital (p < 0.01). Bootstrap test showed that the direct effect of post-traumatic growth on uncertainty in illness of patients with Parkinson's disease was not significant; the total indirect effect of psychological capital between post-traumatic growth and uncertainty in illness was significant. The mediating effects of resilience and hope were significant, accounting for 53.07% and 19.41% of the total indirect effects, respectively. Based on the research results, psychological capital played a completely mediating role between post-traumatic growth and uncertainty in illness of patients with Parkinson's disease. Post-traumatic growth affected uncertainty in illness through two dimensions: resilience and hope. Healthcare professionals should pay attention to the level of psychological capital of patients with Parkinson's disease and implement targeted positive psychological interventions focusing on the two dimensions of resilience and hope, to enhance post-traumatic growth and reduce the level of uncertainty in illness.