Comparing <scp>C</scp>erebralcare <scp>G</scp>ranule and aspirin for neurological dysfunction in acute stroke in real‐life practice

Zhao, Luqing; Liao, Lianming; Hu, Fengyun

doi:10.1111/psyg.12180

Cited by 5 publications

(5 citation statements)

References 56 publications

(103 reference statements)

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“…Preliminary and exploratory studies suggest potential cognitive benefits from various herbal treatments and vitamins, including huperzine A, 167 depsides salts from Salvia miltiorrhiza, 168 ginkgo biloba, 169 pomegranate polyphenols, 170 and Cerebralcare Granule, 171 but no benefits from mailuoning, 172 folic acid, and B vitamins. 173 None of these are approved by the US Food and Drug Administration for use in PSCI.…”

Section: Management Of Pscimentioning

confidence: 99%

“…164 The combination of acupuncture with other therapies (eg, cognitive or physical rehabilitation) may enhance the benefits of either alone. 165,166 Preliminary and exploratory studies suggest potential cognitive benefits from various herbal treatments and vitamins, including huperzine A, 167 depsides salts from Salvia miltiorrhiza, 168 ginkgo biloba, 169 pomegranate polyphenols, 170 and Cerebralcare Granule, 171 but no benefits from mailuoning, 172 folic acid, and B vitamins. 173…”

Section: Emerging Complementary and Integrative Treatmentsmentioning

confidence: 99%

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Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

Husseini¹,

Katzan²,

Rost³

et al. 2023

Stroke

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Purpose: Cognitive impairment is a common consequence of stroke and has direct implications for poststroke functioning and quality of life, including the ability to maintain a job, live independently, sustain interpersonal relationships, and drive a vehicle. In this scientific statement, we critically appraise the literature on the prevalence, diagnosis, and management of poststroke cognitive impairment (PSCI) and provide a framework for clinical care while highlighting gaps that merit further study. Methods: We performed a scoping literature review of randomized controlled clinical trials, prospective and retrospective cohort studies, case-control studies, clinical guidelines, review articles, and editorials on the incidence and prevalence, natural history, diagnosis, and management of PSCI. Scoping reviews determine the scope of a body of literature on a given topic to indicate the volume of literature and the studies currently available and provide an overview of its focus. Results: PSCI is common after stroke, especially in the first year, and ranges from mild to severe. Although cognitive impairment is reversible in some cases early after stroke, up to one-third of individuals with stroke develop dementia within 5 years. The pathophysiology is not yet fully elucidated but is likely attributable to an acute stroke precipitating a series of pathological events, often in the setting of preexisting microvascular and neurodegenerative changes. Screening for associated comorbidities and interdisciplinary management are integral components of the care of individuals with PSCI. There is a need for prospective studies evaluating the individual trajectory of PSCI and the role of the acute vascular event in the predisposition for Alzheimer disease and related dementias, as well as high-quality, randomized clinical trials focused on PSCI management.

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Section: Management Of Pscimentioning

confidence: 99%

Section: Emerging Complementary and Integrative Treatmentsmentioning

confidence: 99%

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

Husseini¹,

Katzan²,

Rost³

et al. 2023

Stroke

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“…Pharmacological trials were small for the most part and varied from poor (eg, Simis and Nitrini 55 and Delbari et al 24 ) to fair (eg, Zhang et al 56 ) methodological rigor. The largest trial (n = 3644) in this recovery phase 57 tested a certified Chinese herb-based antioxidant medicine (Cerebralcare Granule) and compared it with aspirin, achieving fair methodological quality and mediumsized treatment effects in favor of the former (g = 0.67 Cerebralcare Granule; g = 0.41 aspirin). Similarly, nonroutine interventions at this stage that provided evidence of strong effects on cognition were again virtual reality, 54 robot-assisted therapy, and ergometry, 20 all coupled with usual care, as in the acute stage.…”

Section: Intervention Type Stage Of Recovery and Quality Of Evidencementioning

confidence: 99%

Cognitive Recovery After Stroke: A Meta-analysis and Metaregression of Intervention and Cohort Studies

Saa

Tse

Baum

et al. 2021

Neurorehabil Neural Repair

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Background Cognition affects poststroke recovery, but meta-analyses of cognition have not yet provided a comparison of observational and intervention evidence. Objective To describe the trajectory of poststroke cognition and the factors that moderate it across intervention and observational cohorts. Methods Six databases were searched up to January 2020. Studies describing quantitative changes in cognition in adults poststroke were included. Interventions were classified into pharmacological, therapist-led, nonroutine/alternative, and usual care. Summary estimates were compared via hierarchical mixed-effects models. Age, recovery stage, stroke etiology, cognitive domain targeted in studies, and intervention types were investigated as moderators of cognition. Recovery stage and intervention were further analyzed in a multiplicative metaregression model. Results A total of 43 intervention trials and 79 observation cohorts involving 28 222 stroke participants were included. Heterogeneity was significant (τ2 = 0.09; CI = 0.01-0.21, P < .001) with no evidence of publication bias. Cognitive recovery was greater in intervention trials ( g = 0.47; CI = 0.37-0.58) than observational cohorts ( g = 0.28; CI = 0.20-0.36) across all moderators analyzed. Nonroutine/alternative and pharmacological trials achieved the best overall results ( g = 0.57, CI = 0.42-0.73, and g = 0.52, CI = 0.30-0.74, respectively), followed by therapist-led ( g = 0.46; CI = 0.17-0.74), and usual care ( g = 0.28; CI = 0.11-0.45) interventions. Medium recovery effects (ie, g ≥ 0.5) were observed in examining first-ever stroke, executive function, visuo-perceptual, consciousness, and psychomotor skills, 61 to 180 days poststroke, in participants aged 65 to 70 years. Conclusion Cognitive recovery is possible using different controlled interventions in all recovery stages, with smaller benefits ≥2 years poststroke. Longer-term studies are needed to determine the role of nonroutine/alternative therapies and the association between cognitive recovery and performance in everyday activities.

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“…It was approved by the China State Food and Drug Administration in 1996 for treating headaches, insomnia, and vertigo (Sun et al, 2010; Wu C. H. et al, 2013). Some researchers, including our group (Xu et al, 2015; Guo et al, 2016), have begun to focus on how CG improves sub-healthy status (Tong, 2006) and cognitive function (Qu et al, 2016; Zhao et al, 2017). …”

Section: Introductionmentioning

confidence: 99%

“…Our group has used molecular biotechnology to investigate the mechanism of CG, and the results suggested that CG can attenuate cognitive impairment in rats continuously overexpressing microRNA-30e (Xu et al, 2015). On the other hand, a clinical study of post-stroke patients showed that CG use led to greater cognitive improvement than aspirin (Zhao et al, 2017). Other groups demonstrated that ischemia-induced cognitive impairment could be ameliorated by CG (Xu et al, 2009; Sun et al, 2010; Zhang X. X. et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Mechanism of Cerebralcare Granule® for Improving Cognitive Function in Resting-State Brain Functional Networks of Sub-healthy Subjects

Guo²,

Liu

et al. 2017

Front. Neurosci.

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Cerebralcare Granule® (CG), a Chinese herbal medicine, has been used to ameliorate cognitive impairment induced by ischemia or mental disorders. The ability of CG to improve health status and cognitive function has drawn researchers' attention, but the relevant brain circuits that underlie the ameliorative effects of CG remain unclear. The present study aimed to explore the underlying neurobiological mechanisms of CG in ameliorating cognitive function in sub-healthy subjects using resting-state functional magnetic resonance imaging (fMRI). Thirty sub-healthy participants were instructed to take one 2.5-g package of CG three times a day for 3 months. Clinical cognitive functions were assessed with the Chinese Revised Wechsler Adult Intelligence Scale (WAIS-RC) and Wechsler Memory Scale (WMS), and fMRI scans were performed at baseline and the end of intervention. Functional brain network data were analyzed by conventional network metrics (CNM) and frequent subgraph mining (FSM). Then 21 other sub-healthy participants were enrolled as a blank control group of cognitive functional. We found that administrating CG can improve the full scale of intelligence quotient (FIQ) and Memory Quotient (MQ) scores. At the same time, following CG treatment, in CG group, the topological properties of functional brain networks were altered in various frontal, temporal, occipital cortex regions, and several subcortical brain regions, including essential components of the executive attention network, the salience network, and the sensory-motor network. The nodes involved in the FSM results were largely consistent with the CNM findings, and the changes in nodal metrics correlated with improved cognitive function. These findings indicate that CG can improve sub-healthy subjects' cognitive function through altering brain functional networks. These results provide a foundation for future studies of the potential physiological mechanism of CG.

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Comparing Cerebralcare Granule and aspirin for neurological dysfunction in acute stroke in real‐life practice

Abstract: This large-scale, controlled trial indicated that CG may be a useful treatment in the management of post-stroke patients.

Cited by 5 publications

References 56 publications

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

Cognitive Impairment After Ischemic and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association/American Stroke Association

Cognitive Recovery After Stroke: A Meta-analysis and Metaregression of Intervention and Cohort Studies

Mechanism of Cerebralcare Granule® for Improving Cognitive Function in Resting-State Brain Functional Networks of Sub-healthy Subjects

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