Effects of Transcranial Direct Current Stimulation on Cognitive Function in Older Adults with and without Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IF 3.1 3区医学 Q3 GERIATRICS & GERONTOLOGY Gerontology Pub Date : 2024-01-01 Epub Date: 2024-03-08 DOI:10.1159/000537848

Sijia Li, Ying Tang, You Zhou, Yunxia Ni

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引用次数: 0

Abstract

Introduction: Noninvasive brain stimulation (NIBS) has shown benefits for cognitive function in older adults. However, the effects of transcranial direct current stimulation (tDCS) on cognitive function in older adults are inconsistent across studies, and the evidence for tDCS has limitations. We aim to explore whether tDCS can improve cognitive function and different cognitive domains (i.e., learning and memory and executive function) in adults aged 65 years and older with and without mild cognitive impairment and to further analyze the influencing factors of tDCS.

Methods: Five English databases (PubMed, Cochrane Library, EMBASE, Web of Science, the cumulative Index to Nursing and Allied Health Literature [CINAHL]) and four Chinese databases were searched from inception to October 14, 2023. Literature screening, data extraction, and quality assessment were completed independently by two reviewers. All statistical analyses were conducted using RevMan software (version 5.3). Standardized mean difference (SMD) along with a 95% confidence interval (CI) was used to express the effect size of the outcomes, and a random-effect model was also used.

Results: A total of 10 RCTs and 1,761 participants were included in the meta-analysis, and the risk of bias in those studies was relatively low. A significant effect favoring tDCS on immediate postintervention cognitive function (SMD = 0.16, Z = 2.36, p = 0.02) was found. However, the effects on immediate postintervention learning and memory (SMD = 0.20, Z = 2.00, p = 0.05) and executive function (SMD = 0.10, Z = 1.22, p = 0.22), and 1-month postintervention cognitive function (SMD = 0.12, Z = 1.50, p = 0.13), learning and memory (SMD = 0.17, Z = 1.39, p = 0.16), and executive function (SMD = 0.08, Z = 0.67, p = 0.51) were not statistically significant.

Conclusion: tDCS can significantly improve the immediate postintervention cognitive function of healthy older adults and MCI elderly individuals. Additional longitudinal extensive sample studies are required to clarify the specific effects of tDCS on different cognitive domains, and the optimal tDCS parameters need to be explored to guide clinical practice.

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经颅直流电刺激对患有或未患有轻度认知障碍的老年人认知功能的影响：随机对照试验的系统回顾和荟萃分析。

介绍：无创脑部刺激（NIBS）对老年人的认知功能有好处。然而，经颅直流电刺激（tDCS）对老年人认知功能的影响在不同研究中并不一致，而且有关 tDCS 的证据也有局限性。我们旨在探讨经颅直流电刺激是否能改善 65 岁及以上患有或未患有轻度认知障碍的成年人的认知功能和不同认知领域（即学习记忆和执行功能），并进一步分析经颅直流电刺激的影响因素：方法：检索了五个英文数据库（PubMed、Cochrane Library、EMBASE、Web of Science、护理与联合健康文献累积索引 [CINAHL]）和四个中文数据库，检索时间从开始到 2023 年 10 月 14 日。文献筛选、数据提取和质量评估由两名审稿人独立完成。所有统计分析均使用 RevMan 软件（5.3 版）进行。使用标准化平均差（SMD）和95%置信区间（CI）来表示结果的效应大小，同时还使用了随机效应模型：荟萃分析共纳入了 10 项 RCT 和 1761 名参与者，这些研究的偏倚风险相对较低。研究发现，tDCS 对干预后即刻认知功能有明显影响（SMD=0.16，Z=2.36，P=0.02）。然而，对干预后即刻学习和记忆（SMD=0.20，Z=2.00，P=0.05）和执行功能（SMD=0.10，Z=1.22，P=0.22）以及干预后1个月认知功能（SMD=0.12，Z=1.50，P=0.13）、学习和记忆（SMD=0.17，Z=1.39，P=0.16）和执行功能（SMD=0.08，Z=0.67，P=0.51）的影响均无统计学意义：TDCS能明显改善健康老年人和MCI老年人干预后的认知功能。需要进行更多的纵向大样本研究，以明确tDCS对不同认知领域的具体影响，并探索最佳的tDCS参数，以指导临床实践。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Gerontology 医学-老年医学

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： In view of the ever-increasing fraction of elderly people, understanding the mechanisms of aging and age-related diseases has become a matter of urgent necessity. ''Gerontology'', the oldest journal in the field, responds to this need by drawing topical contributions from multiple disciplines to support the fundamental goals of extending active life and enhancing its quality. The range of papers is classified into four sections. In the Clinical Section, the aetiology, pathogenesis, prevention and treatment of agerelated diseases are discussed from a gerontological rather than a geriatric viewpoint. The Experimental Section contains up-to-date contributions from basic gerontological research. Papers dealing with behavioural development and related topics are placed in the Behavioural Science Section. Basic aspects of regeneration in different experimental biological systems as well as in the context of medical applications are dealt with in a special section that also contains information on technological advances for the elderly. Providing a primary source of high-quality papers covering all aspects of aging in humans and animals, ''Gerontology'' serves as an ideal information tool for all readers interested in the topic of aging from a broad perspective.