Table_1_The influential factors and non-pharmacological interventions of cognitive impairment in children with ischemic stroke.XLSX

BackgroundThe prevalence of pediatric ischemic stroke rose by 35% between 1990 and 2013. Affected patients can experience the gradual onset of cognitive impairment in the form of impaired language, memory, intelligence, attention, and processing speed, which affect 20–50% of these patients. Only few evidence-based treatments are available due to significant heterogeneity in age, pathological characteristics, and the combined epilepsy status of the affected children. MethodsWe searched the literature published by Web of Science, Scopus, and PubMed, which researched non-pharmacological rehabilitation interventions for cognitive impairment following pediatric ischemic stroke. The search period is from the establishment of the database to January 2022. ResultsThe incidence of such impairment is influenced by patient age, pathological characteristics, combined epilepsy status, and environmental factors. Non-pharmacological treatments for cognitive impairment that have been explored to date mainly include exercise training, psychological intervention, neuromodulation strategies, computer-assisted cognitive training, brain-computer interfaces (BCI), virtual reality, music therapy, and acupuncture. In childhood stroke, the only interventions that can be retrieved are psychological intervention and neuromodulation strategies. ConclusionHowever, evidence regarding the efficacy of these interventions is relatively weak. In future studies, the active application of a variety of interventions to improve pediatric cognitive function will be necessary, and neuroimaging and electrophysiological measurement techniques will be of great value in this context. Larger multi-center prospective longitudinal studies are also required to offer more accurate evidence-based guidance for the treatment of patients with pediatric stroke.背景 1990年至2013年间，儿童缺血性脑卒中（pediatric ischemic stroke）的患病率上升了35%。患病儿童可逐渐出现以语言、记忆、智力、注意力及加工速度受损为表现的认知障碍，此类症状在患者中的占比为20%~50%。由于受累儿童在年龄、病理特征及合并癫痫（epilepsy）状态方面存在显著异质性，目前可供选择的循证治疗方案寥寥无几。 方法 本研究检索了Web of Science、Scopus及PubMed数据库中关于儿童缺血性脑卒中后认知障碍的非药物康复干预相关文献，检索时限为各数据库建库至2022年1月。 结果 此类认知障碍的发生率受患者年龄、病理特征、合并癫痫状态及环境因素影响。截至目前，已被探索用于认知障碍的非药物治疗手段主要包括运动训练、心理干预、神经调控策略、计算机辅助认知训练、脑机接口（brain-computer interfaces, BCI）、虚拟现实、音乐疗法及针灸。但在儿童脑卒中相关研究中，仅能检索到心理干预与神经调控策略两类干预手段。 结论 然而，现有关于上述干预手段疗效的研究证据相对薄弱。未来研究中，需积极应用多元干预手段以改善儿童认知功能，而神经影像学与电生理测量技术在此领域将具备重要应用价值。此外，还需开展大规模多中心前瞻性纵向研究，为儿童脑卒中患者的临床治疗提供更为精准的循证指导。