He Fangmei, Wang Libin, Yang Qian, Wang Jue
College of Medical Rehabilitation, Shaanxi Energy Institute, Xianyang.
The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, Shaanxi.
Neuroreport. 2025 Sep 3;36(13):767-776. doi: 10.1097/WNR.0000000000002199. Epub 2025 Jul 17.
High-definition transcranial direct current stimulation (HD-tDCS) enhances cognitive function, but its mechanisms and neural basis in mild cognitive impairment (MCI) are unclear. This study investigated whether HD-tDCS modulates cognition in MCI patients and correlates with resting-state functional MRI (rs-fMRI) measured changes in spontaneous brain activity.
Forty-three patients with MCI were randomized to receive 10 sessions of active HD-tDCS targeting the left dorsolateral prefrontal cortex or sham stimulation. rs-fMRI assessed degree centrality (DC) changes before and after the intervention. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Paired t-tests, independent t-tests, and analysis of variance were used to analyze DC differences and group-by-time interactions, with age, gender, education, and head motion as covariates.
The HD-tDCS group exhibited significant DC increases in the cerebellum, right inferior temporal gyrus, left middle temporal gyrus, right precentral gyrus, and left dorsolateral superior frontal gyrus, with decreases in the left operculum inferior frontal gyrus, left angular gyrus, left superior parietal gyrus, and right superior occipital gyrus (P < 0.05, AlphaSim corrected). Sham stimulation induced minimal DC changes. No significant MMSE/MoCA improvements occurred in either group (P > 0.05).
HD-tDCS selectively modulates key nodes of cognitive and motor networks in MCI, as demonstrated by targeted DC alterations. Despite the absence of MMSE/MoCA improvements, this network-specific neuromodulation indicates HD-tDCS engages disease-relevant functional circuits. Longer interventions and sensitive cognitive metrics may clarify clinical relevance.
高清晰度经颅直流电刺激（HD-tDCS）可增强认知功能，但其在轻度认知障碍（MCI）中的机制和神经基础尚不清楚。本研究调查了HD-tDCS是否能调节MCI患者的认知，并与静息态功能磁共振成像（rs-fMRI）测量的自发脑活动变化相关。
43例MCI患者被随机分为两组，分别接受针对左侧背外侧前额叶皮层的10次主动HD-tDCS或假刺激。rs-fMRI评估干预前后的度中心性（DC）变化。使用简易精神状态检查表（MMSE）和蒙特利尔认知评估量表（MoCA）评估认知功能。采用配对t检验、独立t检验和方差分析来分析DC差异以及组间与时间的交互作用，将年龄、性别、教育程度和头部运动作为协变量。
HD-tDCS组在小脑、右侧颞下回、左侧颞中回、右侧中央前回和左侧背外侧额上回的DC显著增加，而在左侧额下回岛盖部、左侧角回、左侧顶上小叶和右侧枕上回的DC降低（P < 0.05，经AlphaSim校正）。假刺激引起的DC变化极小。两组的MMSE/MoCA均未出现显著改善（P > 0.05）。
如靶向性DC改变所示，HD-tDCS可选择性调节MCI患者认知和运动网络的关键节点。尽管MMSE/MoCA未出现改善，但这种网络特异性神经调节表明HD-tDCS参与了与疾病相关的功能回路。更长时间的干预和更敏感的认知指标可能会阐明其临床相关性。
