A systematic review and meta-analysis of the impact of transcranial direct current stimulation on cognitive function in older adults with cognitive impairments: the influence of dosage parameters.

IF 7.9 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's Research & Therapy Pub Date : 2025-02-04 DOI:10.1186/s13195-025-01677-y

Thatchaya Prathum, Thanwarat Chantanachai, Oranich Vimolratana, Chotica Laksanaphuk, Irin Apiworajirawit, Benchaporn Aneksan, Kanthika Latthirun, Cheng-Ta Yang, Wanalee Klomjai

{"title":"A systematic review and meta-analysis of the impact of transcranial direct current stimulation on cognitive function in older adults with cognitive impairments: the influence of dosage parameters.","authors":"Thatchaya Prathum, Thanwarat Chantanachai, Oranich Vimolratana, Chotica Laksanaphuk, Irin Apiworajirawit, Benchaporn Aneksan, Kanthika Latthirun, Cheng-Ta Yang, Wanalee Klomjai","doi":"10.1186/s13195-025-01677-y","DOIUrl":null,"url":null,"abstract":"Introduction: Numerous studies have demonstrated the effects of transcranial direct current stimulation (tDCS) on cognitive function in the older people. This study further explores the impact of tDCS and its dosage parameters on cognitive enhancement in older people with cognitive impairments.Methods: Randomized controlled trials (RCTs) published through November 2023 were retrieved from databases including PubMed, Scopus, EMBASE, EBSCO, and the Cochrane Library. Participants were older adults with cognitive impairments, including Alzheimer's disease (AD), mild cognitive impairment (MCI), and dementia. AD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or the National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer' Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Dementia was diagnosed using the DSM-V or NINCDS-ADRDA criteria, while MCI was diagnosed using the DSM-V, the Petersen criteria, or assessments such as Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating (CDR). Standardized mean difference (SMD) values were analyzed to assess the effects.Results: A total of 19 RCTs were included. tDCS significantly improved the Mini-Mental State Examination score both immediately post-intervention (SMD = 0.51, p = 0.005) and at follow-up (SMD = 2.29, p = 0.0003). Significant effects were observed when tDCS was used alone (SMD = 0.39, p = 0.04), at current densities <math><mo>≤</mo></math> 0.06 mA/cm2 (SMD = 0.25, p = 0.04), session durations exceeding 20 min (SMD = 0.89, p = 0.01), up to 15 sessions (SMD = 0.28, p = 0.009), and when an active electrode was placed over the temporal area (SMD = 0.33, p = 0.02). People with AD showed greater improvements compared to those with MCI or dementia (SMD = 0.91, p = 0.02). However, tDCS did not significantly improve memory or executive function.Conclusion: tDCS demonstrated efficacy in enhancing global cognition in older people with cognitive impairments, providing insight into optimal parameters for clinical application. However, no improvement were observed in memory or executive function.","PeriodicalId":7516,"journal":{"name":"Alzheimer's Research & Therapy","volume":"17 1","pages":"37"},"PeriodicalIF":7.9000,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796231/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alzheimer's Research & Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13195-025-01677-y","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Numerous studies have demonstrated the effects of transcranial direct current stimulation (tDCS) on cognitive function in the older people. This study further explores the impact of tDCS and its dosage parameters on cognitive enhancement in older people with cognitive impairments.

Methods: Randomized controlled trials (RCTs) published through November 2023 were retrieved from databases including PubMed, Scopus, EMBASE, EBSCO, and the Cochrane Library. Participants were older adults with cognitive impairments, including Alzheimer's disease (AD), mild cognitive impairment (MCI), and dementia. AD was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or the National Institute of Neurological and Communicative Disorders and Stroke - Alzheimer' Disease and Related Disorders Association (NINCDS-ADRDA) criteria. Dementia was diagnosed using the DSM-V or NINCDS-ADRDA criteria, while MCI was diagnosed using the DSM-V, the Petersen criteria, or assessments such as Montreal Cognitive Assessment (MoCA) and Clinical Dementia Rating (CDR). Standardized mean difference (SMD) values were analyzed to assess the effects.

Results: A total of 19 RCTs were included. tDCS significantly improved the Mini-Mental State Examination score both immediately post-intervention (SMD = 0.51, p = 0.005) and at follow-up (SMD = 2.29, p = 0.0003). Significant effects were observed when tDCS was used alone (SMD = 0.39, p = 0.04), at current densities $\leq$ 0.06 mA/cm² (SMD = 0.25, p = 0.04), session durations exceeding 20 min (SMD = 0.89, p = 0.01), up to 15 sessions (SMD = 0.28, p = 0.009), and when an active electrode was placed over the temporal area (SMD = 0.33, p = 0.02). People with AD showed greater improvements compared to those with MCI or dementia (SMD = 0.91, p = 0.02). However, tDCS did not significantly improve memory or executive function.

Conclusion: tDCS demonstrated efficacy in enhancing global cognition in older people with cognitive impairments, providing insight into optimal parameters for clinical application. However, no improvement were observed in memory or executive function.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

导言许多研究已经证明了经颅直流电刺激（tDCS）对老年人认知功能的影响。本研究进一步探讨了经颅直流电刺激（tDCS）及其剂量参数对认知障碍老年人认知能力增强的影响：从 PubMed、Scopus、EMBASE、EBSCO 和 Cochrane Library 等数据库中检索了截至 2023 年 11 月发表的随机对照试验（RCT）。参与者为有认知障碍的老年人，包括阿尔茨海默病（AD）、轻度认知障碍（MCI）和痴呆症。阿尔茨海默病的诊断依据是《精神疾病诊断与统计手册》第四版（DSM-IV）或美国国家神经与交流障碍和中风研究所-阿尔茨海默病及相关疾病协会（NINCDS-ADRDA）的标准。痴呆的诊断采用 DSM-V 或 NINCDS-ADRDA 标准，而 MCI 的诊断则采用 DSM-V、彼得森标准或蒙特利尔认知评估 (MoCA) 和临床痴呆评级 (CDR) 等评估方法。对标准化均差（SMD）值进行分析，以评估效果：tDCS 可显著改善干预后即刻（SMD = 0.51，p = 0.005）和随访时（SMD = 2.29，p = 0.0003）的迷你精神状态检查评分。当单独使用 tDCS 时（SMD = 0.39，p = 0.04）、电流密度≤ 0.06 mA/cm2 时（SMD = 0.25，p = 0.04）、疗程超过 20 分钟时（SMD = 0.89，p = 0.01）、最多 15 个疗程时（SMD = 0.28，p = 0.009）以及将有源电极置于颞部时（SMD = 0.33，p = 0.02），均观察到显著效果。与 MCI 或痴呆症患者相比，注意力缺失症患者的改善幅度更大（SMD = 0.91，p = 0.02）。结论：tDCS在提高认知障碍老年人的整体认知能力方面表现出疗效，为临床应用提供了最佳参数。但是，在记忆力和执行功能方面没有观察到任何改善。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Alzheimer's Research & Therapy 医学-神经病学

CiteScore

13.10

自引率

3.30%

发文量

172

审稿时长

>12 weeks

期刊介绍： Alzheimer's Research & Therapy is an international peer-reviewed journal that focuses on translational research into Alzheimer's disease and other neurodegenerative diseases. It publishes open-access basic research, clinical trials, drug discovery and development studies, and epidemiologic studies. The journal also includes reviews, viewpoints, commentaries, debates, and reports. All articles published in Alzheimer's Research & Therapy are included in several reputable databases such as CAS, Current contents, DOAJ, Embase, Journal Citation Reports/Science Edition, MEDLINE, PubMed, PubMed Central, Science Citation Index Expanded (Web of Science) and Scopus.