Ma Shenhong, Zhuang Weisheng, Wang Xu, Zhang Di, Wang Heling, Han Qiaohua, Ding Qixin, Li Yuefang, Li Wanyue, Li Tianshu
School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China.
Department of Rehabilitation, Henan Provincial People's Hospital, School of Rehabilitation Medicine, Henan University of Chinese Medicine, Zhengzhou, China.
Front Aging Neurosci. 2025 Feb 19;17:1495492. doi: 10.3389/fnagi.2025.1495492. eCollection 2025.
To assess the therapeutic effect of tDCS on cognitive function in patients with Parkinson's disease.
From the start of the library's construction until June 24, 2024, we searched the following databases for literature: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, China Science and Technology Journal Database (VIP), and China Biomedical Literature Database (CBM). We also looked through the references in the articles. The improvement of overall cognition in patients with Parkinson's disease with tDCS was the primary outcome indicator. The improvement of executive function, memory, attention, language, quality of life, and depression with tDCS were the secondary outcome indicators. Two researchers extracted data independently, with a third researcher mediating in the event of a dispute. The Cochrane risk of bias tool was used to evaluate the quality of the included literature.
A total of 23 articles encompassing 874 subjects were included. tDCS has shown significant efficacy on overall cognition (SMD = 0.73, 95% CI = 0.57 to 0.89, I = 0%, < 0.00001), particularly in the areas of executive function (SMD = -0.32, 95% CI = -0.56 to -0.07, I = 0%, = 0.01) and language function (SMD = 0.5, 95% CI = 0.2 to 0.8, I = 0%, P = 0.001). Furthermore, the clinical efficacy of tDCS was enhanced with a stimulation intensity of 2 mA (SMD = 0.76, 95% CI = 0.58 to 0.93, I = 7%, < 0.00001), a stimulation duration of ≥25 min (SMD = 0.70, 95% CI = 0.49 to 0.91, I = 6%, < 0.00001), and a minimum of 10 stimulation sessions (SMD = 0.74, 95% CI = 0.56 to 0.92, I = 0%, < 0.00001). Furthermore, tDCS has shown efficacy in alleviating depressive mood (SMD = -0.46, 95% CI = -0.79 to -0.13, I = 0%, = 0.006).
tDCS demonstrated substantial efficacy in enhancing overall cognition in patients with PD. The efficacy of tDCS was obvious in executive function, language, and depressive mood. Nonetheless, a substantial quantity of rigorous clinical trials on tDCS for cognitive function in patients with PD remains necessary in the future.
评估经颅直流电刺激（tDCS）对帕金森病患者认知功能的治疗效果。
从图书馆建设开始至2024年6月24日，我们在以下数据库检索文献：PubMed、Embase、Web of Science、Cochrane图书馆、中国知网（CNKI）、万方、维普中文科技期刊数据库（VIP）和中国生物医学文献数据库（CBM）。我们还查阅了文章中的参考文献。tDCS对帕金森病患者整体认知的改善是主要结局指标。tDCS对执行功能、记忆、注意力、语言、生活质量和抑郁的改善是次要结局指标。两名研究人员独立提取数据，如有争议由第三名研究人员进行协调。采用Cochrane偏倚风险工具评估纳入文献的质量。
共纳入23篇文章，涉及874名受试者。tDCS对整体认知显示出显著疗效（标准化均数差[SMD]=0.73，95%可信区间[CI]=0.57至0.89，I²=0%，P<0.00001），尤其在执行功能（SMD=-0.32，95%CI=-0.56至-0.07，I²=0%，P=0.01）和语言功能（SMD=0.5，95%CI=0.2至0.8，I²=0%，P=0.001）方面。此外，刺激强度为2 mA（SMD=0.76，95%CI=0.58至0.93，I²=7%，P<0.00001）、刺激持续时间≥25分钟（SMD=0.70，95%CI=0.49至0.91，I²=6%，P<0.00001）以及最少10次刺激疗程（SMD=0.74，95%CI=0.56至0.92，I²=0%，P<0.00001）时，tDCS的临床疗效增强。此外，tDCS在缓解抑郁情绪方面显示出疗效（SMD=-0.46，95%CI=-0.79至-0.13，I²=0%，P=0.006）。
tDCS在增强帕金森病患者的整体认知方面显示出显著疗效。tDCS在执行功能、语言和抑郁情绪方面的疗效明显。尽管如此，未来仍需要大量关于tDCS对帕金森病患者认知功能的严格临床试验。
