Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510000, Guangdong Province, PR China.
Xiamen Humanity Rehabilitation Hospital, Xiamen 361009, Fujian Province, PR China.
Clin Neurophysiol. 2024 Feb;158:43-55. doi: 10.1016/j.clinph.2023.12.011. Epub 2023 Dec 27.
This study aimed to explore the effect of catechol-O-methyltransferase (COMT) Val158Met and brain-derived neurotrophic factor (BDNF) Val66Met to post-stroke cognitive impairment (PSCI) and the interaction with transcranial direct current stimulation (tDCS).
Seventy-six patients with PSCI were randomly assigned to Group (1) (n = 38) to receive anodal tDCS of left dorsolateral prefrontal cortex or Group (2) (n = 38) to receive sham stimulation. The intensity of the tDCS was 2 mA, and the stimulations were applied over the left DLPFC for 10 sessions. The Montreal Cognitive Assessment (MoCA) and backward digit span test (BDST) were assessed before, immediately after, and one month after stimulation.
After stimulation, patients in the tDCS group showed better improvement in both MoCA and BDST than those in the sham group. The results of GLMs also supported the main effects of tDCS on general cognitive function and working memory. Then we found that COMT genotype may have a main effect on the improvement of MoCA and BDST, and there may be an interaction between COMT genotype and tDCS in enhancing BDST. In contrast, BDNF genotype showed no significant main or interaction effects on any scales.
These findings demonstrate that tDCS can improve cognition after stroke. Gene polymorphisms of COMT can affect the efficacy of tDCS on PSCI, but BDNF may not.
This study found that COMT Val158Met has an interaction on the efficacy of prefrontal tDCS in cognitive function, which provides reference for future tDCS research and clinical application.
本研究旨在探讨儿茶酚氧位甲基转移酶(COMT)Val158Met 和脑源性神经营养因子(BDNF)Val66Met 对卒中后认知障碍(PSCI)的影响,以及与经颅直流电刺激(tDCS)的相互作用。
76 例 PSCI 患者被随机分为 1 组(n=38)接受左侧背外侧前额叶的阳极 tDCS 或 2 组(n=38)接受假刺激。tDCS 的强度为 2 mA,在左侧 DLPFC 上进行 10 次刺激。在刺激前、刺激后即刻和刺激后 1 个月评估蒙特利尔认知评估(MoCA)和倒背数字广度测试(BDST)。
刺激后,tDCS 组患者的 MoCA 和 BDST 改善均优于假刺激组。GLMs 的结果也支持 tDCS 对总体认知功能和工作记忆的主要影响。然后我们发现 COMT 基因型可能对 MoCA 和 BDST 的改善有主要影响,并且 COMT 基因型和 tDCS 之间可能存在增强 BDST 的相互作用。相比之下,BDNF 基因型对任何量表均无显著的主要或相互作用影响。
这些发现表明 tDCS 可以改善卒中后的认知功能。COMT 基因多态性可能影响 tDCS 对 PSCI 的疗效,但 BDNF 可能没有影响。
本研究发现 COMT Val158Met 对前额叶 tDCS 治疗认知功能的疗效有交互作用,为未来 tDCS 研究和临床应用提供了参考。