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经颅直流电刺激对轻度认知障碍认知功能的影响:随机对照试验的系统评价和荟萃分析。

The effects of transcranial direct current stimulation on cognitive function for mild cognitive impairment: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Faculty of Medicine, The Hashemite University, Zarqa, Jordan.

Faculty of Medicine, Tanta University, Tanta, Egypt.

出版信息

Aging Clin Exp Res. 2023 Nov;35(11):2293-2306. doi: 10.1007/s40520-023-02528-2. Epub 2023 Sep 5.

Abstract

BACKGROUND

Transcranial direct current stimulation (tDCS) emerged as a potential modality for enhancing cognitive functions in patients with cognitive decline, including mild cognitive impairment (MCI). Our systematic review and meta-analysis aim to synthesize the available randomized controlled trials (RCTs) on the effects of tDCS on cognitive functions in patients with MCI.

METHODS

Our review protocol was registered on PROSPERO with ID: CRD42022360587. We conducted a systematic database search until September 2022. Standardized mean difference (SMD) and pooled effect size (ES) for robust variance estimation (RVE) method were used as effect estimates for our meta-analysis.

RESULTS

We included 11 RCTs with a total of 429 participants. The meta-analysis showed that, compared to sham groups, tDCS did not improve global functioning (measured by MOCA) (SMD = 0.02, CI =  - 0.30 to 0.35; p = 0.88), memory domain (ES = 0.681, CI =  - 2.15 to 3.51, p = 0.576), sustained attention (measured by TMT-A) (SMD =  - 0.21, CI =  - 0.52 to 0.10, p = 0.19), and executive function (measured by TMT-B) (SMD =  - 0.53, CI =  - 1.56 to 0.50, p = 0.20).

CONCLUSION

Our meta-analysis found no significant effect of tDCS on cognitive functions in MCI patients, including effects on global functioning, memory, sustained attention, and executive function. Therefore, an important change to be tested in future studies is to look for a better combination with tDCS for patients with MCI.

摘要

背景

经颅直流电刺激(tDCS)作为一种增强认知功能的潜在方法,已在认知能力下降的患者中得到应用,包括轻度认知障碍(MCI)患者。我们的系统评价和荟萃分析旨在综合评估 tDCS 对 MCI 患者认知功能影响的现有随机对照试验(RCT)。

方法

我们的综述方案在 PROSPERO 上注册,编号为 CRD42022360587。我们系统地检索了截至 2022 年 9 月的数据库。我们使用标准化均数差(SMD)和汇总效应量(ES)进行稳健方差估计(RVE)方法,作为荟萃分析的效应估计。

结果

我们纳入了 11 项 RCT,共 429 名参与者。荟萃分析结果显示,与假刺激组相比,tDCS 并未改善整体功能(以 MOCA 评估)(SMD=0.02,CI=-0.30 至 0.35;p=0.88)、记忆域(ES=0.681,CI=-2.15 至 3.51,p=0.576)、持续注意力(以 TMT-A 评估)(SMD=-0.21,CI=-0.52 至 0.10,p=0.19)和执行功能(以 TMT-B 评估)(SMD=-0.53,CI=-1.56 至 0.50,p=0.20)。

结论

我们的荟萃分析发现 tDCS 对 MCI 患者的认知功能没有显著影响,包括对整体功能、记忆、持续注意力和执行功能的影响。因此,未来研究的一个重要变化是寻找更好的与 tDCS 联合治疗 MCI 患者的方法。

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