Sandhya G, Malo Palash Kumar, Issac Thomas Gregor
Centre for Brain Research, Indian Institute of Science, Bengaluru, Karnataka, India.
J Neurosci Rural Pract. 2024 Apr-Jun;15(2):194-202. doi: 10.25259/JNRP_629_2023. Epub 2024 Apr 16.
Mild cognitive impairment (MCI) is a transition state in which individuals have cognitive abilities that are in between those of normal aging and dementia. Although not everyone with MCI develops dementia, the risk of progression to dementia is higher in people with MCI. Interventions at this stage can prevent or delay the onset of dementia. In recent years, studies on non-invasive brain stimulation techniques, namely transcranial direct current stimulation (tDCS), have gained momentum for cognitive enhancement in MCI. Since there are very few studies that also report varied results, it becomes important to analyze the effect of tDCS in MCI. The aim of this study was to systematically review the available evidence about using tDCS for MCI and to assess its efficacy using meta-analysis.
Eight single- or double-blinded randomized controlled trials were included in the study. Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) for global cognition; and digit span test forward and backward, trail-making test (TMT) A and B; and logical memory test (LMT) assessing specific cognitive domains were considered. A random-effects model was used wherein the standardized mean difference (SMD) and its 95% confidence intervals were reported.
The effect of the active tDCS (MoCA [SMD 0.37, 95% CI -0.22-0.95], MMSE [SMD 0.26, 95% CI 0.25-0.77], TMT-A [SMD -0.01, 95% CI -0.42-0.40], and LMT [SMD 0.80, 95% CI -0.24-1.83]) when compared with the sham tDCS was statistically insignificant.
The current meta-analysis identified insignificant improvement in cognitive performance with active tDCS treatment as compared to sham tDCS among people with MCI.
轻度认知障碍(MCI)是一种过渡状态,处于该状态的个体其认知能力介于正常衰老和痴呆之间。虽然并非每个MCI患者都会发展为痴呆,但MCI患者发展为痴呆的风险更高。在此阶段进行干预可预防或延缓痴呆的发作。近年来,关于非侵入性脑刺激技术,即经颅直流电刺激(tDCS),在MCI认知增强方面的研究势头渐起。由于很少有研究报告了不同的结果,分析tDCS对MCI的影响就变得很重要。本研究的目的是系统回顾关于使用tDCS治疗MCI的现有证据,并通过荟萃分析评估其疗效。
本研究纳入了八项单盲或双盲随机对照试验。采用蒙特利尔认知评估量表(MoCA)和简易精神状态检查表(MMSE)评估整体认知;采用数字广度顺背和倒背测验、连线测验(TMT)A和B;以及逻辑记忆测验(LMT)评估特定认知领域。使用随机效应模型,报告标准化平均差(SMD)及其95%置信区间。
与假刺激tDCS相比,主动tDCS(MoCA [SMD 0.37,95% CI -0.22 - 0.95],MMSE [SMD 0.26,95% CI 0.25 - 0.77],TMT - A [SMD -0.01,95% CI -0.42 - 0.40],以及LMT [SMD 0.80,95% CI -0.24 - 1.83])的效果在统计学上无显著差异。
当前的荟萃分析表明,与假刺激tDCS相比,主动tDCS治疗对MCI患者认知表现的改善不显著。