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一项关于经颅直流电刺激对阿尔茨海默病患者认知功能影响的系统评价和荟萃分析。

A systematic review and meta-analysis of transcranial direct-current stimulation effects on cognitive function in patients with Alzheimer's disease.

机构信息

Exp ORL, Department of Neuroscience, Leuven Brain Institute, KU Leuven, Leuven, Belgium.

Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

Mol Psychiatry. 2022 Apr;27(4):2000-2009. doi: 10.1038/s41380-022-01444-7. Epub 2022 Feb 3.


DOI:10.1038/s41380-022-01444-7
PMID:35115703
Abstract

Transcranial direct-current stimulation (tDCS) appears to enhance cognitive function in Alzheimer's disease (AD). Accordingly, over the last two decades, the number of studies using tDCS for AD has grown. This study aimed to provide a quantitative assessment of the efficacy of tDCS in improving cognitive function in patients with AD. We systematically searched the literature until May 2021 to identify relevant publications for inclusion in our systematic review and meta-analysis. Eligible studies were sham-controlled trials assessing the impacts of anodal or cathodal tDCS on cognitive function in patients with AD. The outcome measure of this study was the effects of tDCS on distinct cognitive domains including memory, attention, and global cognitive function. The initial search yielded a total of 323 records. Five other articles were found using manual search of the databases. Of these, 13 publications (14 different studies) with a total of 211 patients of various degrees of AD severity underwent meta-analysis. Meta-analysis revealed the non-significant effects of tDCS on attention (0.425 SMD, 95% CI, -0.254 to 1.104, p = 0.220), and significant positive impacts on the amelioration of general cognitive measures (1.640 SMD, 95% CI, 0.782 to 2.498, p < 0.000), and memory (1.031 SMD, 95% CI, 0.688 to 1.373, p < 0.000) dysfunction in patients with AD. However, the heterogeneity of the studies were high in all subdomains of cognition (ϰ = 22.810, T = 0.55, d.f. = 5, I = 78.80%, p < 0.000 for attention, ϰ = 96.29, T = 1.727, d.f. = 10, I = 89.61%, p < 0.000 for general cognition, and ϰ = 7.253, T = 0.085, d.f. = 5, I = 31.06%, p = 0.203 for memory). Improved memory and general cognitive function in patients with AD was shown in this meta-analysis. However, due to the small number of studies and the high heterogeneity of the data, more high-quality studies using standardized parameters and measures are needed before tDCS can be considered as a treatment for AD.

摘要

经颅直流电刺激(tDCS)似乎可以增强阿尔茨海默病(AD)患者的认知功能。因此,在过去的二十年中,使用 tDCS 治疗 AD 的研究数量有所增加。本研究旨在对 tDCS 改善 AD 患者认知功能的疗效进行定量评估。我们系统地检索了文献,直到 2021 年 5 月,以确定纳入我们系统评价和荟萃分析的相关出版物。合格的研究是评估阳极或阴极 tDCS 对 AD 患者认知功能影响的假对照试验。本研究的结果测量是 tDCS 对不同认知领域的影响,包括记忆、注意力和整体认知功能。最初的搜索共产生了 323 条记录。通过手动搜索数据库还发现了另外 5 篇文章。其中,13 篇出版物(14 项不同的研究)共纳入了 211 名不同严重程度 AD 患者进行荟萃分析。荟萃分析显示 tDCS 对注意力的影响无统计学意义(0.425 SMD,95%CI,-0.254 至 1.104,p=0.220),对改善一般认知测量的影响有统计学意义(1.640 SMD,95%CI,0.782 至 2.498,p<0.000),以及对 AD 患者记忆障碍的改善有统计学意义(1.031 SMD,95%CI,0.688 至 1.373,p<0.000)。然而,在所有认知亚领域的研究中都存在很高的异质性(ϰ=22.810,T=0.55,d.f.=5,I=78.80%,p<0.000 用于注意力,ϰ=96.29,T=1.727,d.f.=10,I=89.61%,p<0.000 用于一般认知,以及 ϰ=7.253,T=0.085,d.f.=5,I=31.06%,p=0.203 用于记忆)。荟萃分析显示 AD 患者的记忆和一般认知功能得到改善。然而,由于研究数量较少且数据异质性较高,在考虑将 tDCS 作为 AD 治疗方法之前,需要更多使用标准化参数和措施的高质量研究。

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本文引用的文献

[1]
tDCS peripheral nerve stimulation: a neglected mode of action?

Mol Psychiatry. 2021-2

[2]
Evidence against benefits from cognitive training and transcranial direct current stimulation in healthy older adults.

Nat Hum Behav. 2021-1

[3]
Pharmacotherapy in multiple sclerosis-induced cognitive impairment: A systematic review and meta-analysis.

Mult Scler Relat Disord. 2020-11

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Brain Stimul. 2020-2-23

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Effects of Transcranial Direct Current Stimulation on Episodic Memory in Older Adults: A Meta-analysis.

J Gerontol B Psychol Sci Soc Sci. 2021-3-14

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Front Hum Neurosci. 2019-9-6

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Behavioural and electrophysiological modulations induced by transcranial direct current stimulation in healthy elderly and Alzheimer's disease patients: A pilot study.

Clin Neurophysiol. 2019-8-26

[10]
Effects of 6-month at-home transcranial direct current stimulation on cognition and cerebral glucose metabolism in Alzheimer's disease.

Brain Stimul. 2019-6-4

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