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经颅直流电刺激联合认知训练对轻度认知障碍患者的影响:一项对照的 3 臂平行研究。

Transcranial direct current stimulation in combination with cognitive training in individuals with mild cognitive impairment: a controlled 3-parallel-arm study.

机构信息

Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY, USA.

Institute of Neuroscience, Florence, Italy.

出版信息

CNS Spectr. 2023 Aug;28(4):489-494. doi: 10.1017/S1092852922000979. Epub 2022 Sep 12.

DOI:10.1017/S1092852922000979
PMID:36093863
Abstract

OBJECTIVE

Several studies showed that transcranial direct current stimulation (tDCS) enhances cognition in patients with mild cognitive impairment (MCI), however, whether tDCS leads to additional gains when combined with cognitive training remains unclear. This study aims to compare the effects of a concurrent tDCS-cognitive training intervention with either tDCS or cognitive training alone on a group of patients with MCI.

METHODS

The study was a 3-parallel-arm study. The intervention consisted of 20 daily sessions of 20 minutes each. Patients (n = 62) received anodal tDCS to the left dorsolateral prefrontal cortex, cognitive training on 5 cognitive domains (orientation, attention, memory, language, and executive functions), or both. To examine intervention gains, we examined global cognitive functioning, verbal short-term memory, visuospatial memory, and verbal fluency pre- and post-intervention.

RESULTS

All outcome measures improved after the intervention in the 3 groups. The improvement in global cognitive functioning and verbal fluency was significantly larger in patients who received the combined intervention. Instead, the intervention gain in verbal short-term memory and visuospatial memory was similar across the 3 groups.

DISCUSSION

tDCS, regardless of the practicalities, could be an efficacious treatment in combination with cognitive training given the increased effectiveness of the combined treatment.

CONCLUSIONS

Future studies will need to consider individual differences at baseline, including genetic factors and anatomical differences that impact the electric field generated by tDCS and should also consider the feasibility of at-home treatments consisting of the application of tDCS with cognitive training.

摘要

目的

几项研究表明,经颅直流电刺激(tDCS)可增强轻度认知障碍(MCI)患者的认知能力,但 tDCS 与认知训练联合使用是否会带来额外的益处尚不清楚。本研究旨在比较同时进行 tDCS-认知训练干预与单独进行 tDCS 或认知训练对一组 MCI 患者的影响。

方法

该研究为 3 组平行臂研究。干预包括 20 次每日 20 分钟的疗程。患者(n=62)接受左背外侧前额叶皮层的阳极 tDCS、5 个认知领域(定向、注意力、记忆、语言和执行功能)的认知训练或两者结合的治疗。为了检查干预效果,我们在干预前后检查了整体认知功能、言语短期记忆、视空间记忆和言语流畅性。

结果

三组患者在干预后所有的评估指标都有所改善。接受联合干预的患者的整体认知功能和言语流畅性的改善明显更大。相反,言语短期记忆和视空间记忆的干预效果在三组间相似。

讨论

tDCS 无论在实际操作上如何,都可能与认知训练联合使用是一种有效的治疗方法,因为联合治疗的效果增加了。

结论

未来的研究需要考虑基线时的个体差异,包括影响 tDCS 产生的电场的遗传因素和解剖差异,还应考虑由 tDCS 与认知训练联合应用组成的家庭治疗的可行性。

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