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Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial
Ko MH, Yoon JY, Jo YJ, Son MN, Kim DS, Kim GW, Won YH, Park SH et al.. Stroke, 2022-08-17
Topic: Risk, prevention and care in population studies
Background Transcranial direct current stimulation (tDCS) is a promising tool for improving poststroke cognitive function. Home-based rehabilitation is increasingly required for patients with stroke, and additional benefits are expected if supplemented with remotely supervised tDCS (RS-tDCS). We evaluated the cognitive improvement effect and feasibility of RS-tDCS in patients with chronic stroke. Methods Twenty-six patients with chronic stroke and cognitive impairment (Korean version of the Montreal Cognitive Assessment [K-MoCA] score <26) were randomized into real and sham RS-tDCS groups and underwent concurrent computerized cognitive training and RS-tDCS. Patients and caregivers underwent training to ensure correct tDCS self-application, were monitored, and treated 5 d/wk for 4 weeks. We investigated several cognition tests including K-MoCA, Korean version of the Dementia Rating Scale-2, Korean-Boston Naming Test, Trail Making Test, Go/No Go, and Controlled Oral Word Association Test at the end of the training sessions and one month later. Repeated-measures ANOVA was used for comparison between the groups and within each group. The adherence rate of the appropriate RS-tDCS session was also investigated. Results In within-group comparison, unlike the sham group, the real group showed significant improvement in K-MoCA ( P real =0.004 versus P sham =0.132), particularly in patients with lower baseline K-MoCA (K-MoCA 10-17 ; P real =0.001 versus P sham =0.835, K-MoCA 18-25 ; P real =0.060 versus P sham =0.064) or with left hemispheric lesions (left; P real =0.010 versus P sham =0.454, right; P real =0.106 versus P sham =0.128). In between-group comparison, a significant difference was observed in K-MoCA in the lower baseline K-MoCA subgroup (K-MoCA 10-17 ; P time×group =0.048), but no significant difference was found in other cognitive tests. The adherence rate of successful application of the RS-tDCS was 98.4%, and no serious adverse effects were detected. Conclusions RS-tDCS is a safe and feasible rehabilitation modality for poststroke cognitive dysfunction. Specifically, RS-tDCS is effective in patients with moderate cognitive decline. Additionally, these data demonstrate the potential to enhance home-based cognitive training, although significant differences were not consistently found in between-group comparisons; therefore, further larger studies are needed. Registration URL: https://cris.nih.go.kr; Unique identifier: KCT0003427.
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APA 7th
Ko, M. H., Yoon, J. Y., Jo, Y. J., Son, M. N., Kim, D. S., Kim, G. W., et al. (2022). Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial. Stroke. https://doi.org/10.1161/strokeaha.121.037629
Vancouver
Ko MH, Yoon JY, Jo YJ, Son MN, Kim DS, Kim GW, et al. Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial. Stroke. 2022. doi:10.1161/strokeaha.121.037629. PMID: 35975663.
BibTeX
@article{ko2022-35975663,
author = {Ko, M. H. and Yoon, J. Y. and Jo, Y. J. and Son, M. N. and Kim, D. S. and Kim, G. W. and Won, Y. H. and Park, S. H. and others},
title = {{Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial}},
journal = {Stroke},
year = {2022},
doi = {10.1161/strokeaha.121.037629},
pmid = {35975663},
url = {https://doi.org/10.1161/strokeaha.121.037629}
}
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Key findings
- Results In within-group comparison, unlike the sham group, the real group showed significant improvement in K-MoCA ( P real =0.004 versus P sham =0.132), particularly in patients with lower baseline K-MoCA (K-MoCA 10-17 ; P real =0.001 versus P sham =0.835, K-MoCA 18-25 ; P real =0.060 versus P sham =0.064) or with left hemispheric lesions (left; P real =0.010 versus P sham =0.454, right; P real =0.106 versus P sham =0.128).
- In between-group comparison, a significant difference was observed in K-MoCA in the lower baseline K-MoCA subgroup (K-MoCA 10-17 ; P time×group =0.048), but no significant difference was found in other cognitive tests.
- Additionally, these data demonstrate the potential to enhance home-based cognitive training, although significant differences were not consistently found in between-group comparisons; therefore, further larger studies are needed.
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Study details
- Effect size98.4%
- Evidence strengthHigh
How this study scored 76/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 44 of the 58 points we could judge it on, which is 76 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 3 / 5 | 2022 — within 6 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 35975663) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 44 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 44 of the 58 points we could judge it on is 76 out of 100. |
| Total | 76 / 100 | — |
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