Effects of transcranial direct current stimulation combined with cognitive-motor dual task training on memory and executive function in patients with post-stroke cognitive impairment

doi:10.11958/20250535

Abstract

Abstract:

Objective To explore the influences of transcranial direct current stimulation (tDCS) in combination with cognitive-motor dual task training (CMDT) on memory and executive function in patients suffering from post-stroke cognitive impairment. Methods A total of 75 stroke patients were randomly divided into the tDCS group, the CMDT group and the combined group, each consisting of 25 cases. All patients in the three groups received routine rehabilitation treatment. The tDCS group underwent tDCS stimulation of dorsolateral prefrontal lobe (DLPFC）of the region, the CMDT group received CMDT and the combined group received CMDT on the basis of tDCS treatment. The fourth edition of the Wechsler Memory Scale (WMS-IV), Wisconsin Card Test (WCST), Montreal Cognitive Assessment (MoCA) and Modified Barthel Index (MBI) were used to evaluate the overall cognitive function, memory, executive function, and daily living ability of the patients before and 4 weeks after treatment, respectively. Results Before treatment, there were no significant differences in the evaluation indices between the three groups (P>0.05). After 4 weeks of treatment, the scores of WCST, WMS-IV, MoCA and MBI in the three groups were improved compared with those before the treatment (P<0.05), and the combined group was significantly superior to the tDCS group and the CMDT group (P<0.05). Conclusion The combination of tDCS and CMDT can improve the cognitive function after stroke, and at the same time exert a synergistic effect on memory and executive function.

Key words: stroke, cognition disorders, memory, transcranial direct current stimulation, cognitive-motor dual task training, executive function

CLC Number:

R493，R743.9

Figures/Tables 3

References 22

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组别	性别（男/女）	年龄/ 岁	病程/d	脑梗死/ 脑出血	受教育年限/年
tDCS组	15/10	58.45±8.82	89.54±38.48	19/6	10.63±4.26
CMDT组	16/9	57.63±8.70	86.56±39.57	21/4	10.48±4.05
联合组	18/7	59.15±9.18	85.64±32.46	15/10	10.37±4.13
χ²或t	1.025	5.327	1.539	2.562	1.754

组别	性别（男/女）	年龄/ 岁	病程/d	脑梗死/ 脑出血	受教育年限/年
tDCS组	15/10	58.45±8.82	89.54±38.48	19/6	10.63±4.26
CMDT组	16/9	57.63±8.70	86.56±39.57	21/4	10.48±4.05
联合组	18/7	59.15±9.18	85.64±32.46	15/10	10.37±4.13
χ²或t	1.025	5.327	1.539	2.562	1.754

组别	PR				CC					CR
组别	治疗前	治疗后	t		治疗前	治疗后		t		治疗前		治疗后		t
tDCS组	30.53±6.72	26.05±6.81	7.521^＊＊		3.02±1.51	3.82±1.35		6.373^＊＊		45.62±8.75		56.31±9.87		12.357^＊＊
CMDT组	31.06±5.98	25.43±6.49	8.763^＊＊		3.14±1.26	3.91±1.41		7.542^＊＊		46.78±8.96		58.18±9.13		14.582^＊＊
联合组	30.98±7.21	19.56±6.86^ab	14.685^＊＊		3.08±1.73	4.53±1.62^ab		12.354^＊＊		46.25±8.67		65.74±9.53^ab		26.684^＊＊
F	0.568	10.751^＊＊			0.283	18.357^＊＊				0.249		21.387^＊＊
组别	ER			PE							NPE
组别	治疗前	治疗后	t	治疗前			治疗后		t		治疗前		治疗后		t
tDCS组	52.41±6.75	41.23±5.12	15.946^＊＊	27.84±5.02			23.71±4.32		7.538^＊＊		23.63±9.36		21.27±8.64		4.637^＊＊
CMDT组	50.46±6.48	40.57±5.26	17.573^＊＊	28.43±5.24			25.09±4.65		8.647^＊＊		23.87±9.52		21.54±9.02		5.269^＊＊
联合组	51.87±6.38	32.89±4.27^ab	30.380^＊＊	28.58±5.94			20.16±4.08^ab		15.259^＊＊		23.59±9.73		19.21±8.47^ab		9.851^＊＊
F	0.647	20.421^＊＊		0.376			18.671^＊＊				0.523		11.472^＊＊

组别	PR				CC					CR
组别	治疗前	治疗后	t		治疗前	治疗后		t		治疗前		治疗后		t
tDCS组	30.53±6.72	26.05±6.81	7.521^＊＊		3.02±1.51	3.82±1.35		6.373^＊＊		45.62±8.75		56.31±9.87		12.357^＊＊
CMDT组	31.06±5.98	25.43±6.49	8.763^＊＊		3.14±1.26	3.91±1.41		7.542^＊＊		46.78±8.96		58.18±9.13		14.582^＊＊
联合组	30.98±7.21	19.56±6.86^ab	14.685^＊＊		3.08±1.73	4.53±1.62^ab		12.354^＊＊		46.25±8.67		65.74±9.53^ab		26.684^＊＊
F	0.568	10.751^＊＊			0.283	18.357^＊＊				0.249		21.387^＊＊
组别	ER			PE							NPE
组别	治疗前	治疗后	t	治疗前			治疗后		t		治疗前		治疗后		t
tDCS组	52.41±6.75	41.23±5.12	15.946^＊＊	27.84±5.02			23.71±4.32		7.538^＊＊		23.63±9.36		21.27±8.64		4.637^＊＊
CMDT组	50.46±6.48	40.57±5.26	17.573^＊＊	28.43±5.24			25.09±4.65		8.647^＊＊		23.87±9.52		21.54±9.02		5.269^＊＊
联合组	51.87±6.38	32.89±4.27^ab	30.380^＊＊	28.58±5.94			20.16±4.08^ab		15.259^＊＊		23.59±9.73		19.21±8.47^ab		9.851^＊＊
F	0.647	20.421^＊＊		0.376			18.671^＊＊				0.523		11.472^＊＊

组别	WMS-Ⅳ
组别	干预前	干预后	t
tDCS组	74.85±3.52	82.26±3.87	15.352^＊＊
CMDT组	75.13±3.67	83.14±3.57	16.439^＊＊
联合组	75.08±3.84	89.38±3.86^ab	31.547^＊＊
F	0.576	23.158^＊＊
组别	MoCA
组别	干预前	干预后	t
tDCS组	16.55±2.34	19.87±2.15	7.554^＊＊
CMDT组	17.24±2.58	19.36±2.49	8.739^＊＊
联合组	17.18±2.51	24.39±2.87^ab	13.158^＊＊
F	0.394	10.394^＊＊
组别	MBI
组别	干预前	干预后	t
tDCS组	41.42±4.51	56.53±5.88	18.356^＊＊
CMDT组	42.39±4.32	57.28±5.67	19.152^＊＊
联合组	41.94±4.86	65.57±8.25^ab	32.619^＊＊
F	0.487	26.852^＊＊