Qin Yu, Xu Jianguo, Ng Shamay Sheung Mei
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, 11 Yuk Choi Rd, Hung Hom, Kowloon, Hong Kong SAR, China.
Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, Gansu, China.
Syst Rev. 2025 Mar 11;14(1):60. doi: 10.1186/s13643-025-02795-2.
To present, organize, and assess the methodological quality of the current research related to tDCS on motor function after a stroke and to identify gaps and clinical implications using an evidence mapping approach.
Six electronic databases (PubMed, Embase, Cochrane Library, Web of Science, CINAHL, PEDro), gray literature, and reference lists of articles were searched from inception until October 2023. The Assessment of Multiple Systematic Reviews 2 (AMSTAR-2) checklist and PEDro scale were used to assess the methodology quality of systematic reviews (SRs) and randomized controlled trials (RCTs).
A total of 172 articles met the inclusion criteria from 5759 records, including 46 SRs and 126 RCTs. Related studies came from 29 countries around the world, and China has performed the most, with 12 SRs and 21 RCTs. More than half of SRs (65.22%) were evaluated with low or critically low quality, while 78.58% of RCTs have shown excellent or good quality. A total of 26 SRs and 93 RCTs have reported outcomes on upper limb motor function with kinds of tDCS, and 15 SRs and 44 RCTs have focused on lower extremity function. Studies with safety concerns have reported no or mild adverse events.
This study systematically identified gaps and indicated that tDCS is a kind of potential and safe intervention. Given potential concerns on the clinical application, more high-quality research with large sample size and kinds of objectives is needed in the future.
运用证据图谱方法展示、整理并评估目前与中风后运动功能经颅直流电刺激（tDCS）相关研究的方法学质量，识别差距及临床意义。
检索了6个电子数据库（PubMed、Embase、Cochrane图书馆、科学网、护理学与健康领域数据库、循证医学数据库）、灰色文献以及文章的参考文献列表，检索时间从数据库建库至2023年10月。使用多重系统评价评估2（AMSTAR-2）清单和循证医学数据库评分量表评估系统评价（SRs）和随机对照试验（RCTs）的方法学质量。
从5759条记录中，共有172篇文章符合纳入标准，包括46篇系统评价和126项随机对照试验。相关研究来自世界29个国家，中国开展的研究最多，有12篇系统评价和21项随机对照试验。超过一半的系统评价（65.22%）被评估为低质量或极低质量，而78.58%的随机对照试验显示为高质量或良好质量。共有26篇系统评价和93项随机对照试验报告了各种经颅直流电刺激对上肢运动功能的影响结果，15篇系统评价和44项随机对照试验关注下肢功能。有关安全性的研究报告未出现或仅有轻微不良事件。
本研究系统地识别了差距，并表明经颅直流电刺激是一种有潜力且安全的干预措施。鉴于对临床应用的潜在担忧，未来需要更多大样本量、多目标的高质量研究。
