Zhao Jing, Meng Qian, Qi Shuo, Zhao Hongfei, Xia Ling
Department of Rehabilitation Medicine, Zibo Central Hospital, Zibo, Shandong, China.
Front Neurol. 2024 Oct 16;15:1424792. doi: 10.3389/fneur.2024.1424792. eCollection 2024.
Previous studies have suggested that repetitive transcranial magnetic stimulation (rTMS) may be an effective and safe alternative treatment for post-stroke cognitive impairment (PSCI). Similarly, the application of transcranial direct current stimulation (tDCS) during stroke rehabilitation has been shown to improve cognitive function in PSCI patients. However, there have been conflicting results from some studies. Therefore, this study aims to conduct a meta-analysis to evaluate the effects of tDCS and rTMS on PSCI.
The meta-analysis search for articles published from the initial availability date to 5 February 2024 in databases. The extracted study data were entered into STATA 12.0 software for statistical analysis.
This meta-analysis provides evidence that both rTMS and tDCS have a positive impact on general cognitive function in PSCI patients [immediate effect of rTMS: standard mean difference (SMD) = 2.58, 95% confidence interval (CI) = 1.44 to 3.71; long-term effect of rTMS: SMD = 2.33, 95% CI = 0.87-3.78; immediate effect of tDCS: SMD = 2.22, 95% CI = 1.31-3.12]. Specifically, rTMS was found to significantly improve attention, language, memory, and visuospatial functions, while it did not show a significant therapeutic effect on executive function (attention: SMD = 3.77, 95% CI = 2.30-5.24; executive function: SMD = -0.52, 95% CI = -3.17-2.12; language: SMD = 3.43, 95% CI = 1.50-5.36; memory: SMD = 3.52, 95% CI = 1.74-5.30; visuospatial function: SMD = 4.71, 95% CI = 2.61-6.80). On the other hand, tDCS was found to significantly improve executive and visuospatial functions but did not show a significant improvement in attention function and memory (attention: SMD = 0.63, 95% CI = -0.30-1.55; executive function: SMD = 2.15, 95% CI = 0.87-3.43; memory: SMD = 0.99, 95% CI = -0.81-2.80; visuospatial function: SMD = 2.64, 95% CI = 1.04-4.23).
In conclusion, this meta-analysis demonstrates that both rTMS and tDCS are effective therapeutic techniques for improving cognitive function in PSCI. However, more large-scale studies are needed to further investigate the effects of these techniques on different cognitive domains in PSCI.
先前的研究表明，重复经颅磁刺激（rTMS）可能是一种治疗脑卒中后认知障碍（PSCI）的有效且安全的替代疗法。同样，在脑卒中康复期间应用经颅直流电刺激（tDCS）已被证明可改善PSCI患者的认知功能。然而，一些研究得出了相互矛盾的结果。因此，本研究旨在进行一项荟萃分析，以评估tDCS和rTMS对PSCI的影响。
该荟萃分析在数据库中检索从初始可用日期至2024年2月5日发表的文章。将提取的研究数据输入STATA 12.0软件进行统计分析。
该荟萃分析提供的证据表明，rTMS和tDCS对PSCI患者的一般认知功能均有积极影响[rTMS的即时效应：标准均数差（SMD）=2.58，95%置信区间（CI）=1.44至3.71；rTMS的长期效应：SMD=2.33，95%CI=0.87 - 3.78；tDCS的即时效应：SMD=2.22，95%CI=1.31 - 3.12]。具体而言，发现rTMS能显著改善注意力、语言、记忆和视觉空间功能，但对执行功能未显示出显著治疗效果（注意力：SMD=3.77，95%CI=2.30 - 5.24；执行功能：SMD=-0.52，95%CI=-3.17 - 2.12；语言：SMD=3.43，95%CI=1.50 - 5.36；记忆：SMD=3.52，95%CI=1.74 - 5.30；视觉空间功能：SMD=4.71，95%CI=2.61 - 6.80）。另一方面，发现tDCS能显著改善执行和视觉空间功能，但在注意力功能和记忆方面未显示出显著改善（注意力：SMD=0.63，95%CI=-0.30 - 1.55；执行功能：SMD=2.15，95%CI=0.87 - 3.43；记忆：SMD=0.99，95%CI=-0.81 - 2.80；视觉空间功能：SMD=2.64，95%CI=1.04 - 4.23）。
总之，该荟萃分析表明，rTMS和tDCS都是改善PSCI患者认知功能的有效治疗技术。然而，需要更多大规模研究来进一步探究这些技术对PSCI不同认知领域的影响。
