双靶点经颅直流电刺激对脑卒中后认知功能障碍的影响OA

Objective To investigate the effects of dual-target transcranial direct current stimulation(tDCS)on cognitive func-tion in patients with post-stroke cognitive impairment(PSCI).Methods A total of 34 patients with PSCI who were admitted to the Department of Rehabilitation Medicine and the Department of Acupuncture at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine from June 2024 to January 2025 were randomly divided into control group and observation group,with 17 patients in each group.One patient in the control group withdrew voluntarily,and one patient in the observation group was lost to follow-up due to transfer to another hospital.A total of 16 patients were included in each group finally.Both groups received conventional rehabilitation therapy.The observation group received dual-target tDCS in conjunction with conventional rehabilitation therapy,targeting the ipsilesional dorsolateral prefrontal cortex(DLPFC)and angular gyrus(AG)with anodal stimulation.The protocol involved a current intensity of 1.5 mA for 20 minutes per session,administered once daily,five times per week,for two consecutive weeks.The control group received single-target tDCS targeting the DLPFC,with the same stimulation parameters(intensity,duration,electrode size,and placement)as the observation group,in addition to the conventional rehabilitation therapy,Before and after treatment,the Montreal Cognitive Assessment(MoCA)was used to assess the global cognitive function,the Digit Span Test-Forward(DST-F)and Digit Span Test-Backward(DST-B)was used to assess the working memory,and the Trail Making Test(TMT-A and TMT-B)were used to assess the attention and executive function.Results(1)MoCA scores:compared with those before treatment,MoCA scores in both groups increased significantly after treatment(P<0.05).There was no significant difference in MoCA scores between the two groups after treatment(P>0.05).The difference of MoCA score before and after treatment in the observation group was significantly higher than that of the control group(P<0.05).(2)DST scores:compared with those before treatment,DST-F scores in both groups(P<0.05)and DST-B score in the observation group increased significantly after treatment(P<0.05).Compared with the control group,the differences in DST-F scores and DST-B scores before and after treatment in the observation group were significantly higher(P<0.05).(3)TMT completion time:compared with that before treatment,the completion time for TMT-A and TMT-B in the observation group was significantly reduced after treat-ment(P<0.05).Compared with the control group,the differences in the completion time for TMT-A and TMT-B before and after treatment in the observation group were significantly greater(P<0.05).Conclusion Dual-target tDCS significantly enhances the global cognitive function,working memory function,attention and executive function in patients with PSCI.