Department of Neurology, University of Szeged, 6, Semmelweis Street, Szeged, 6725, Hungary.
Department of Clinical Psychology, Semmelweis University, 25, Üllői Street, Budapest, 1091, Hungary.
BMC Neurol. 2024 Sep 4;24(1):314. doi: 10.1186/s12883-024-03813-x.
Working memory (WM) impairment is a common phenomenon after stroke; however, its management in rehabilitation is less researched. This systematic review and meta-analysis aimed to provide a quantitative synthesis of the impact of computerised cognitive training (CCT) and transcranial direct current stimulation (tDCS) on WM span in post-stroke individuals.
The literature search in PubMed, Embase, Scopus, and Cochrane Library focused on randomized controlled trials testing the effect of CCT and tDCS on treated stroke patients as compared to untreated controls. Neuropsychological instruments such as Digit Span Forward/Backward and Visual Span Forward Tests defined the outcome of WM span. After extracting study characteristics and quality assessment using the Cochrane Risk of Bias Tool, we conducted a meta-analysis and meta-regression using standardised mean differences.
The search yielded 4142 articles, nine of which (N = 461) fulfilled the inclusion criteria. In the case of CCT, we found significant improvement in Digit Span Backward Test (Z = 2.65, P = 0.008; 95% CI [0.10, 0.67]) and Visual Span Forward Test performance (Z = 3.05, P = 0.002; 95% CI [0.15, 0.69]), while for tDCS, we could not find a sufficient number of studies for the analysis. Furthermore, no significant moderating factor was found in the meta-regression.
In conclusion, CCT appears to be a suitable choice to enhance WM span performance after stroke. However, further research is needed to investigate the effect of tDCS due to the limited number of studies.
The meta-analysis was conducted according to PRISMA (Preferred Reporting of Systematic Reviews and Meta-Analyses) standards with a PROSPERO registration protocol (ID: CRD42023387182).
工作记忆（WM）损伤是中风后常见的现象，但康复治疗中对其的管理研究较少。本系统评价和荟萃分析旨在定量综合计算机认知训练（CCT）和经颅直流电刺激（tDCS）对中风后个体 WM 跨度的影响。
在 PubMed、Embase、Scopus 和 Cochrane Library 中进行文献检索，重点是测试 CCT 和 tDCS 对治疗后的中风患者与未治疗对照组影响的随机对照试验。数字跨度前向/后向和视觉跨度前向测试等神经心理学工具定义了 WM 跨度的结果。在使用 Cochrane 偏倚风险工具提取研究特征和质量评估后，我们使用标准化均数差进行了荟萃分析和荟萃回归。
搜索结果产生了 4142 篇文章，其中 9 篇（N=461）符合纳入标准。在 CCT 的情况下，我们发现数字跨度后向测试（Z=2.65，P=0.008；95%CI[0.10，0.67]）和视觉跨度前向测试表现（Z=3.05，P=0.002；95%CI[0.15，0.69]）有显著改善，而对于 tDCS，我们无法找到足够数量的研究进行分析。此外，元回归中没有发现显著的调节因素。
总之，CCT 似乎是增强中风后 WM 跨度表现的合适选择。然而，由于研究数量有限，需要进一步研究 tDCS 的效果。
荟萃分析根据 PRISMA（系统评价和荟萃分析的首选报告）标准进行，并根据 PROSPERO 注册方案（ID：CRD42023387182）进行。
