Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Dec 19, 2023; 13(12): 1027-1036
Published online Dec 19, 2023. doi: 10.5498/wjp.v13.i12.1027
Efficacy of enhanced extracorporeal counterpulsation combined with atorvastatin in the treatment of cognitive impairment after stroke
Yan Duan, Hui-Xia Tang
Yan Duan, Hui-Xia Tang, Department of Rehabilitation, Shengjing Hospital of China Medical University, Shenyang 110000, Liaoning Province, China
Author contributions: Duan Y initiated the project, designed the experiment and conducted clinical data collection; Tang HX performed postoperative follow-up and recorded data, conducted a number of collation and statistical analysis, and wrote the original manuscript; both authors reviewed and approved the paper; and all authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Shengjing Hospital of China Medical University.
Informed consent statement: The ethics committee waived the requirement for informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: All data generated or analyzed during this study are included in this published article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui-Xia Tang, MM, Nurse, Department of Rehabilitation, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110000, Liaoning Province, China. 18940258255@163.com
Received: September 12, 2023
Peer-review started: September 12, 2023
First decision: September 25, 2023
Revised: October 20, 2023
Accepted: November 8, 2023
Article in press: November 8, 2023
Published online: December 19, 2023
Abstract
BACKGROUND

Cerebral apoplexy patients are prone to cognitive impairment, and it is very important to choose appropriate treatment methods to improve their cognitive impairment after stroke.

AIM

To evaluate the effects of enhanced external counterpulsation (EECP) in conjunction with atorvastatin on cognitive function, neurotransmitter levels, and the repair of brain tissue damage in patients with cognitive impairment due to stroke.

METHODS

In this retrospective study, data from 60 patients with poststroke cognitive impairment due to stroke who were treated in our hospital from February 2021 to July 2022 were analyzed and divided into a treatment group (n = 30) and a control group (n = 30) according to the different nursing methods applied. Patients in the treatment group received EECP in addition to atorvastatin, while those in the control group received atorvastatin alone. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) scale scores were compared between the two groups. Additionally, the two groups were compared in terms of serum acetylcholine (ACh), acetylcholinesterase (AChE), nitric oxide (NO), endothelin-1 (ET-1), β2-microglobulin (β2-MG), glial fibrillary acidic protein (GFAP), and visinin-like protein 1 (VILIP-1) in the serum. Blood flow measurements from the anterior cerebral artery (ACA), middle cerebral artery (MCA) and posterior cerebral artery (PCA) were compared between the two groups before and after treatment, and the pulsatility index (PI) and resistance index (RI) of each artery were determined.

RESULTS

MMSE, MoCA, and ADL scores all improved in both groups following treatment, with the study group showing more improvement than the control group (P < 0.05). After treatment, there were statistically significant increases in both ACh and NO levels, whereas decreases occurred in AChE, ET-1, β2-MG, VILIP-1, and GFAP, levels and the PI and RI of the left-ACA, right-ACA, left-MCA, right-MCA, left-PCA, and right-PCA. The study group showed greater gains in all metrics than the control group (P < 0.05).

CONCLUSION

EECP combined with atorvastatin is effective in the treatment of cognitive impairment after stroke and can effectively improve the cognitive function, neurotransmitter levels, and brain tissue damage status of patients.

Keywords: Enhanced extracorporeal counterpulsation, Atorvastatin, Cognitive impairment after stroke, Neurotransmitters, Brain tissue damage status

Core Tip: Enhanced extracorporeal counterpulsation and atorvastatin are widely used in the treatment of stroke patients with cognitive impairment, but the effect of enhanced counterpulsation combined with atorvastatin on cognitive function of stroke patients with cognitive impairment has not been discussed. The objective of this study was to compare the efficacy of enhanced external counterpulsation combined with atorvastatin vs atorvastatin alone in the treatment of post-stroke cognitive impairment. Combined therapy is better than atorvastatin therapy alone.