Chan Nga Huen, Ng Shamay S M
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
Research Centre for Chinese Medicine Innovation, The Hong Kong Polytechnic University, Hung Hom, Hong Kong SAR, China.
Front Neurol. 2025 Apr 23;16:1556506. doi: 10.3389/fneur.2025.1556506. eCollection 2025.
BACKGROUND: Transcutaneous electrical nerve stimulation (TENS), which involves the application of electrical stimulation to peripheral nerves, is used to improve or maintain cognitive function. Although many studies have examined the effect of TENS on cognition over the past 20 years, a comprehensive review and meta-analysis on this topic is lacking. This study aimed to evaluate the efficacy of TENS in improving cognitive function in older adults with cognitive impairment. METHODS: A systematic search was performed in six electronic databases (CINAHL, Cochrane Library, Embase, Medline, PubMed, and Web of Science) to identify relevant studies published until May 2024. Moreover, the registered clinical trials, forward citation searches, and reference lists of identified publications were reviewed to identify additional relevant studies. Randomised controlled trials investigating the effect of TENS on cognitive function in older adults with cognitive impairment were included. RESULTS: Seven studies including 247 older adults with cognitive impairment were included. The findings revealed a trend towards positive effects of TENS on face recognition memory [mean difference (MD) = 1.19, 95% confidence interval (CI) = -0.13 to 2.52] and verbal fluency [standardised MD (SMD) = 0.29, 95% CI = -0.01 to 0.59] when compared with placebo stimulation (control condition). TENS demonstrated a significant positive delayed effect on visual memory (SMD = 0.55, 95% CI = 0.11 to 0.98). Subgroup analysis indicated that TENS applied on the concha was more effective than that applied on the spinal column and earlobe in improving verbal memory in the delayed condition. CONCLUSION: A positive trend of immediate effect and a significant long-term effect on some cognitive domains were found after applying TENS in in older adults with cognitive impairment. Future studies with robust experimental designs and adequate sample sizes are warranted to investigate the efficacy of TENS in improving cognitive function. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD42023408611, PROSPERO: CRD42023408611.
背景：经皮电刺激神经疗法（TENS）是将电刺激应用于外周神经，用于改善或维持认知功能。尽管在过去20年里有许多研究探讨了TENS对认知的影响，但缺乏关于该主题的全面综述和荟萃分析。本研究旨在评估TENS对认知功能受损的老年人改善认知功能的疗效。 方法：在六个电子数据库（CINAHL、Cochrane图书馆、Embase、Medline、PubMed和Web of Science）中进行系统检索，以识别截至2024年5月发表的相关研究。此外，还对注册的临床试验、向前引文检索以及已识别出版物的参考文献列表进行了审查，以识别其他相关研究。纳入了调查TENS对认知功能受损的老年人认知功能影响的随机对照试验。 结果：纳入了七项研究，共247名认知功能受损的老年人。研究结果显示，与安慰剂刺激（对照条件）相比，TENS在面部识别记忆[平均差（MD）=1.19，95%置信区间（CI）=-0.13至2.52]和语言流畅性[标准化MD（SMD）=0.29，95%CI=-0.01至0.59]方面有积极影响的趋势。TENS对视觉记忆有显著的积极延迟效应（SMD=0.55，95%CI=0.11至0.98）。亚组分析表明，在延迟条件下，应用于耳甲的TENS在改善语言记忆方面比应用于脊柱和耳垂的TENS更有效。 结论：在认知功能受损的老年人中应用TENS后，发现对某些认知领域有即时效应的积极趋势和显著的长期效应。有必要开展具有稳健实验设计和足够样本量的未来研究，以调查TENS改善认知功能的疗效。 系统评价注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD42023408611，PROSPERO：CRD42023408611。
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