IRCCS Centro Neurolesi Bonino Pulejo, 98124, Messina, Italy.
Unit of Neuro-Rehabilitation, IRCCS "Casa Sollievo della Sofferenza", 71013 San Giovanni Rotondo, Italy.
Brain Res. 2024 Oct 15;1841:149093. doi: 10.1016/j.brainres.2024.149093. Epub 2024 Jun 22.
Non-invasive brain stimulation induces changes in spontaneous neural activity in the cerebral cortex through facilitatory or inhibitory mechanisms, relying on neuromodulation of neural excitability to impact brain plasticity. This systematic review assesses the state-of-the art and existing evidence regarding the effectiveness of NIBS in cognitive recovery among patients with chronic stroke.
We conducted a systematic search, following PRISMA guidelines, for articles published from January 2010 through September 2023. We searched the following databases: PubMed, Embase, Cochrane Database of Systematic Reviews, PEDro, Rehab Data, and Web of Science.
Our electronic searches identified 109 papers. We assessed and included 61 studies based on their pertinence and relevance to the topic. After reading the full text of the selected publications and applying predefined inclusion criteria, we excluded 32 articles, leaving 28 articles for our qualitative analysis. We categorized our results into two sections as follows: (1) Cognitive and emotional domains (11 studies), (2) language and speech functions (16 studies).
Our findings highlight the potential of NIBS, such as tDCS and rTMS, in the cognitive, linguistic, and emotional recovery of post-stroke patients. Although it seems that NIBS may work as a complementary tool to enhance cognitive and communication abilities in patients with stroke -also in the chronic phase- evidence on behavioural outcomes is still poor. Future studies should focus on this important issue to confirm the effectiveness of neuromodulation in chronic neurological diseases. PROSPERO Registration: CRD42023458370.
非侵入性脑刺激通过促进或抑制机制诱导大脑皮层自发神经活动的变化，依赖于神经兴奋性的神经调制来影响大脑可塑性。本系统评价评估了非侵入性脑刺激在慢性中风患者认知康复中的最新技术和现有证据。
我们按照 PRISMA 指南进行了系统搜索，检索了 2010 年 1 月至 2023 年 9 月发表的文章。我们搜索了以下数据库：PubMed、Embase、Cochrane 系统评价数据库、PEDro、Rehab Data 和 Web of Science。
我们的电子搜索确定了 109 篇论文。我们根据相关性和与主题的相关性评估并纳入了 61 项研究。在阅读了所选出版物的全文并应用了预设的纳入标准后，我们排除了 32 篇文章，留下 28 篇文章进行定性分析。我们将结果分为以下两个部分：（1）认知和情绪领域（11 项研究），（2）语言和言语功能（16 项研究）。
我们的发现强调了非侵入性脑刺激（如 tDCS 和 rTMS）在中风后患者认知、语言和情感康复中的潜力。尽管非侵入性脑刺激似乎可以作为一种补充工具来提高中风患者的认知和沟通能力 - 即使在慢性阶段 - 但行为结果的证据仍然不足。未来的研究应关注这一重要问题，以确认神经调节在慢性神经疾病中的有效性。PROSPERO 注册：CRD42023458370。
