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经颅直流电刺激联合认知训练对健康老年人执行功能的影响:ACT试验的二次分析

Effect of transcranial direct current stimulation with cognitive training on executive functions in healthy older adults: a secondary analysis from the ACT trial.

作者信息

Aksu Serkan, Indahlastari Aprinda, O'Shea Andrew, Marsiske Michael, Cohen Ronald, Alexander Gene E, DeKosky Steven T, Hishaw Georg A, Dai Yunfeng, Wu Samuel S, Woods Adam J

机构信息

Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1225 Center Dr, PO Box 100165, Gainesville, FL, 32610, USA.

Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, 1225 Center Dr, PO Box 100165, Gainesville, FL, 32610, USA.

出版信息

Geroscience. 2025 Feb;47(1):1361-1380. doi: 10.1007/s11357-024-01455-y. Epub 2024 Nov 30.

Abstract

Cognitive aging has become a public health concern as the mean age of the population is ever-increasing. It is a naturalistic and common process of degenerative and compensatory changes that may result in neurocognitive disorders. While heterogeneous, cognitive aging mostly affects executive functions that may be associated with functional losses during activities of daily living. Cognition-oriented treatments like cognitive training and transcranial direct current stimulation (tDCS) have garnered considerable attention in the past few decades while the exact picture regarding their efficacy in healthy older adults has not been determined yet. The present paper aimed to evaluate the effects of a 3-month intervention of tDCS over the dorsolateral prefrontal cortex (DLPFC) with multimodal cognitive training on the Stroop test and Trail Making Tests A and B performance. One hundred and ninety-three healthy older adults from 2 sites were administered repeated sessions of active/sham tDCS with cognitive training. Baseline, post-intervention, and 1-year performance results between groups were compared using multiple linear regressions. Active tDCS resulted in better Stroop test performance at post-intervention (p = 0.033) but not at 1-year follow-up while no differences between groups were observed in Trail Making Tests A & B performance. The present results may correspond to a modest improvement in conflict monitoring, potentially due to modulation of prefrontal regions, without changing shifting performance. Further investigation is warranted to draw an interference regarding the subdomain-specific impact of repeated tDCS with multimodal cognitive training on executive functions.

摘要

随着人口平均年龄不断增长,认知衰老已成为一个公共卫生问题。它是一个自然且常见的退行性和代偿性变化过程,可能导致神经认知障碍。虽然认知衰老具有异质性,但主要影响执行功能,而执行功能可能与日常生活活动中的功能丧失有关。在过去几十年中,诸如认知训练和经颅直流电刺激(tDCS)等以认知为导向的治疗方法受到了广泛关注,但其对健康老年人的疗效的确切情况尚未确定。本文旨在评估对背外侧前额叶皮质(DLPFC)进行为期3个月的tDCS干预联合多模式认知训练对Stroop测试以及连线测验A和B成绩的影响。来自2个地点的193名健康老年人接受了多次主动/假tDCS联合认知训练。使用多元线性回归比较了组间的基线、干预后和1年的成绩结果。主动tDCS在干预后使Stroop测试成绩更好(p = 0.033),但在1年随访时未出现这种情况,而在连线测验A和B成绩方面未观察到组间差异。目前的结果可能对应于冲突监测方面的适度改善,这可能是由于前额叶区域的调节作用,而未改变转换能力。有必要进行进一步研究,以得出关于重复tDCS联合多模式认知训练对执行功能的特定子领域影响的结论。

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