Research Progress of Transcranial Direct Current Stimulation Therapy for Cognitive Impairment after Stroke
Post-stroke cognitive impairment(PSCI)refers to the symptoms of cognitive decline after stroke,which seriously impairs patients'quality of life and survival time.Compared with cognitive impairment caused by other neurological diseases,pre-ventability and treatability are important characteristics of PSCI,making early intervention particularly important.Transcranial direct current stimulation(tDCS)is a non-invasive brain stimulation technique with the advantages of high safety and low pain,and it is an effective neurological rehabilitation treatment for PSCI.The tDCS treatment regimen for PSCI usually consists of a stimulation intensity of 1 to 2 mA applied to the dorsolateral prefrontal cortex for 20 to 30 minutes.The stimulation site is usually the dorsolateral prefrontal lobe,but researchers have also confirmed the effectiveness of other stimulation sites,such as the bilateral M1 area and right parietal cortex.tDCS improves cognitive function by affecting neurotransmitters(such as calcium ions and γ-aminobu-tyric acid in astrocytes),the state of neurons,cerebral blood flow,and the connectivity of functional areas of the brain.tDCS not only produces an immediate boosting effect and an after-effect that is effective about 1 hour after stimulation,but also has long-term enhancement(LTP)and long-term depression(LTD)effects.Therefore,the timing of treatment should be grasped when tDCS is applied clinically.At present,various traditional treatments for cognitive function(such as drug therapy,cognitive training,virtual reality technology,acupuncture,etc.)have their own strengths,but there are still problems such as adverse drug reactions,long treat-ment time and slow recovery.In order to overcome the limitations and shortcomings of tDCS alone and to achieve a better therapeu-tic effect,the combined application of other cognitive rehabilitation measures at the same time or within 1 hour of tDCS stimulation is an alternative approach.This article aims to review the research progress of tDCS and other cognitive rehabilitation methods in PSCI,so as to provide therapeutic experience and reference for the comprehensive rehabilitation of PSCI.
post-stroke cognitive impairmentstroketranscranial direct current stimulationcombination therapytiming
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