ObjectiveThis study aims to evaluate the effectiveness and long-term effects of response inhibition training as a therapeutic approach in healthy adults.MethodsThe PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP) were searched for studies. Data on the improvement of Cognitive function and its long-term effect were extracted by two authors independently. The pooled data were meta-analyzed using a random-effects model, and the quality of each eligible study was assessed by The Cochrane Collaboration’s tool.ResultsNine articles were included. 1 of the articles included 2 trials, so 10 eligible trials (response inhibition training group vs. control group) were identified. A total of 490 patients were included. Response inhibition training has beneficial effects on improving cognitive function in healthy adults compared to control treatment (SMD, −0.93; 95% CI, −1.56 to −0.30; Z = 2.88, P = 0.004), the subgroup analysis results showed that either GNG training alone (SMD, −2.27; 95% CI, −3.33 to −1.21; Z = 4.18, P < 0.0001) or the combination of both SST and GNG significantly improved cognitive function in healthy adults (SMD, −0.94; 95% CI, −1.33 to −0.56; Z = 4.80, P < 0.0001), whereas SST training alone did not have such an effect (SMD, −0.15; 95% CI, −0.76 to 0.47; Z = 0.47, P = 0.64). But its long-term effects are not significant (SMD, −0.29; 95% CI, −0.68 to 0.10; Z = 1.45, P = 0.15). The subgroup analysis results showed that neither GNG training alone (SMD, −0.25; 95% CI, −0.75 to 0.24; Z = 0.99, P = 0.32) nor SST training alone (SMD, 0.03; 95% CI, −0.42 to 0.48; Z = 0.14, P = 0.89) could improve the cognitive function of healthy adults in the long term. In contrast, the combination of both training (SMD, −0.95; 95% CI, −1.46 to −0.45; Z = 3.68, P = 0.0002) can have long-term effects on the improvement of cognitive function in healthy adults.ConclusionThe findings of our study indicate that response inhibition training can improve the cognitive function of healthy adults and that more RCTs need to be conducted to validate their usefulness in clinical cases.

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ObjectiveThis study aimed to elucidate the efficacy, safety, and long-term implications of vagus nerve stimulation (VNS) as a viable therapeutic option for patients with upper limb dysfunction following a stroke.MethodsData from the following libraries were searched from inception to December 2022: PubMed, Wanfang, Scopus, China Science and Technology Journal Database, Embase, Web of Science, China Biology Medicine Disc, Cochrane Library, and China National Knowledge Infrastructure. Outcomes included indicators of upper limb motor function, indicators of prognosis, and indicators of safety (incidence of adverse events [AEs] and serious AEs [SAEs]). Two of the authors extracted the data independently. A third researcher arbitrated when disputes occurred. The quality of each eligible study was evaluated using the Cochrane Risk of Bias tool. Meta-analysis and bias analysis were performed using Stata (version 16.0) and RevMan (version 5.3).ResultsTen trials (VNS combined with rehabilitation group vs. no or sham VNS combined with rehabilitation group) with 335 patients were included in the meta-analysis. Regarding upper extremity motor function, based on Fugl–Meyer assessment scores, VNS combined with other treatment options had immediate (mean difference [MD] = 2.82, 95% confidence interval [CI] = 1.78–3.91, I2 = 62%, p < 0.00001) and long-term (day-30 MD = 4.20, 95% CI = 2.90–5.50, p < 0.00001; day-90 MD = 3.27, 95% CI = 1.67–4.87, p < 0.00001) beneficial effects compared with that of the control treatment. Subgroup analyses showed that transcutaneous VNS (MD = 2.87, 95% CI = 1.78–3.91, I2 = 62%, p < 0.00001) may be superior to invasive VNS (MD = 3.56, 95% CI = 1.99–5.13, I2 = 77%, p < 0.0001) and that VNS combined with integrated treatment (MD = 2.87, 95% CI = 1.78–3.91, I2 = 62%, p < 0.00001) is superior to VNS combined with upper extremity training alone (MD = 2.24, 95% CI = 0.55–3.93, I2 = 48%, p = 0.009). Moreover, lower frequency VNS (20 Hz) (MD = 3.39, 95% CI = 2.06–4.73, I2 = 65%, p < 0.00001) may be superior to higher frequency VNS (25 Hz or 30 Hz) (MD = 2.29, 95% CI = 0.27–4.32, I2 = 58%, p = 0,03). Regarding prognosis, the VNS group outperformed the control group in the activities of daily living (standardized MD = 1.50, 95% CI = 1.10–1.90, I2 = 0%, p < 0.00001) and depression reduction. In contrast, quality of life did not improve (p = 0.51). Safety was not significantly different between the experimental and control groups (AE p = 0.25; SAE p = 0.26).ConclusionVNS is an effective and safe treatment for upper extremity motor dysfunction after a stroke. For the functional restoration of the upper extremities, noninvasive integrated therapy and lower-frequency VNS may be more effective. In the future, further high-quality studies with larger study populations, more comprehensive indicators, and thorough data are required to advance the clinical application of VNS.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42023399820.