The effects of transcranial direct current stimulation on ischemic stroke patients with cognitive impairment as assessed by using tract-based spatial statistics
10.3760/cma.j.cn421666-20240816-00664
- VernacularTitle:经颅直流电刺激对缺血性脑卒中后认知障碍的影响：基于纤维束示踪空间统计学分析
- Author:
Jiali ZHONG
1
;
Xiaoshan JING
;
Ying LIANG
;
Ruchen PENG
;
Ruiqiang XIN
Author Information
1. 首都医科大学附属北京潞河医院医学影像科，北京 101149
- Publication Type:Journal Article
- Keywords:
Ischemic stroke;
Cognitive impairment;
Diffusion tensor imaging;
Tract-based spatial statistics;
Magnetic resonance imaging
- From:
Chinese Journal of Physical Medicine and Rehabilitation
2025;47(9):815-821
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate any effect of transcranial direct current stimulation (tDCS) on cognitive impairment after an ischemic stroke (IS) using tract-based spatial statistics (TBSS).Methods:Fifty-one patients with mild or more serious cognitive impairment after an IS were divided into an electrical stimulation group (26 cases) and a control group (25 cases) using a random number table. In addition to conventional rehabilitation treatment, the electrical stimulation group was given tDCS, while the control group was given sham tDCS for 15 days. Before and after the treatment, both groups were evaluated using the Mini-mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Diffusion tensor imaging (DTI) was also performed. TBSS were computed for the differences in fractional anisotropy (FA) between the two groups before and after the treatment, and Pearson correlation analysis was applied to the pre-treatment and post-treatment FA differences within each group and the improvements in MMSE and MoCA scores.Results:After the treatment, the average MMSE and MoCA scores of both groups had improved significantly, but the improvement was significantly greater in the electrical stimulation group. After the treatment, the FA values among the electrical stimulation group had increased significantly in the bilateral genu of the corpus callosum, the bilateral inferior fronto-occipital fasciculus, the bilateral anterior thalamic radiation and the left superior longitudinal fasciculus. In the control group significant increases were recorded only in the left superior longitudinal fasciculus and the left anterior thalamic radiation. The FA change in the left superior longitudinal fasciculus of the electrical stimulation group was then positively correlated with the improvement in MMSE scores ( r=0.42), and that in the left anterior thalamic radiation was positively correlated with the improvement in MoCA scores ( r=0.45). Conclusions:tDCS can significantly improve the cognition of stroke survivors with cognitive impairment and promote the recovery of white matter fiber tracts. The FA values of the anterior thalamic radiation and the superior longitudinal fasciculus may be useful predictors and indicators of the recovery of cognitive function among such patients.
