Role And Mechanism Of Enriched Environment On Rehabilitation Nursing Of Post-Stroke Cognitive Impairment

Objective:1.To observe the effect of enriched environment rehabilitation nursing model on the improvement of cognitive function of patients with PSCI;2.To explore the role of GluNR2B in the mechanisms of enriched environment on the improvement of cognitive function of PSCI.Methods:1.60PSCI patientswere randomly divided into traditional rehabilitation nursing group(conventional group)and enriched environment rehabilitation nursing group.Another 30 healthy counterparts were recruited to inform a healthy control group(enriched group),while age-matched healthy subjects from both groups were recruited into the healthy group as controls.The first two groups were given the same routine medication and the traditional group was given traditional rehabilitation while the enriched group was given enriched rehabilitation.Changes in cognitive function levels were compared before and three months after the intervention using the Montreal Cognitive Assessment Scale(MoCA scale),the Symbolic Digit Modality Test(SDMT)and the Connectedness Test(TMT).2.PSCI models were prepared by using SPF-grade C57BL/6 male mice,and randomly divided into Sham+SE group,PSCI+SE group,PSCI+EE group and PSCI+IH group.Different environmental interventions(SE,EE and IH)were performed.At the end of the intervention,the effects of different environmentson PSCI mice were observed by the new object recognition test and the Y-maze experiment.GluNR2B protein expression levels were measured by Western blot.Results:1.Before the intervention,there were no statistical differences in MoCA scores,SDMT scores and TMT test results between the traditional and enriched groups(p>0.05),but results between the first two groups and the healthy group were statistically different(p<0.05).After three months of intervention,the comparison of the results between the first two groups and the healthy group was still statistically different(p<0.05),and the results of the traditional and enriched groups were significantly better than before the intervention(p<0.05),with the enriched group improving better than the traditional group(p<0.05).2.After a series of environmental interventions,the PSCI+SE group showed significantly lower rates of new object exploration and spontaneous alternation in the Y-maze compared to the Sham+SE group(p<0.001),as well as significantly lower levels of GluNR2B expression(p<0.001).The PSCI+EE group showed a statistically significant difference between the PSCI+SE and Sham+SE groups(p<0.001).The rates of new object exploration and spontaneous alternation in the Y-maze were significantly lower in the PSCI+IH group compared to the Sham+SE group(p<0.001).Conclusion:1.The model of enriched environment rehabilitation nursing can improve the cognitive performance of PSCI patients.2.Different environmental interventions can have corresponding effects on the cognitive function level of PSCI mice.EE can improve the cognitive function,whileIH can further aggravate the cognitive dysfunction.The possible mechanism is that the hippocampal prefrontal glutamate neuron circuit improves or exacerbates cognitive function level of the brain by regulating the expression level of GluNR2B.