Zhong Jiali, Jing Xiaoshan, Liang Ying, Hao Pan, Peng Ruchen, Xin Ruiqiang
Department of Radiology, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
Department of Rehabilitation, Beijing Luhe Hospital, Capital Medical University, Beijing, 101149, China.
Neurol Sci. 2025 Jul 12. doi: 10.1007/s10072-025-08348-8.
Post-stroke cognitive impairment (PSCI) is a common and severe consequence of ischemic stroke (IS) that significantly affects patient outcomes. Transcranial direct current stimulation (tDCS) has shown promise in enhancing cognitive function in IS patients, but its underlying mechanisms are not fully understood. This study investigates the effects of tDCS on brain functional connectivity and network topology using resting-state functional magnetic resonance imaging (rs-fMRI).
In this double-blind study, sixty-five IS patients with PSCI were randomly assigned to either the tDCS or control group. Rs-fMRI data were acquired before and after the intervention. We analyzed functional connectivity (FC) and graph theory-based topological properties. Cognitive performance was assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). RESULTS AFTER: treatment, both groups showed improvements in MMSE and MoCA scores, with the tDCS group demonstrating significantly greater improvements (p < 0.05). In the tDCS group, FC significantly increased between four pairs of brain regions (p < 0.05, FDR-corrected). Additionally, Global Efficiency (E) significantly improved (p < 0.05, FDR-corrected), and this improvement positively correlated with enhancements in MMSE scores (r = 0.403, p = 0.037).
These findings suggest that tDCS improves cognitive function in PSCI by altering brain network connectivity and topological organization, providing neuroimaging evidence to support its therapeutic mechanisms.
卒中后认知障碍（PSCI）是缺血性卒中（IS）常见且严重的后果，显著影响患者预后。经颅直流电刺激（tDCS）已显示出改善IS患者认知功能的潜力，但其潜在机制尚未完全明确。本研究采用静息态功能磁共振成像（rs-fMRI）探讨tDCS对脑功能连接和网络拓扑结构的影响。
在这项双盲研究中，65例患有PSCI的IS患者被随机分为tDCS组或对照组。在干预前后采集rs-fMRI数据。我们分析了功能连接（FC）和基于图论的拓扑属性。使用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评估认知表现。结果：治疗后，两组的MMSE和MoCA评分均有所改善，tDCS组的改善更为显著（p < 0.05）。在tDCS组中，四对脑区之间的FC显著增加（p < 0.05，经FDR校正）。此外，全局效率（E）显著提高（p < 0.05，经FDR校正），且这种改善与MMSE评分的提高呈正相关（r = 0.403，p = 0.037）。
这些发现表明，tDCS通过改变脑网络连接性和拓扑组织来改善PSCI患者的认知功能，为支持其治疗机制提供了神经影像学证据。
