The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search Strategy
2.2. Study Selection
2.3. Data Extraction and Synthesis
2.4. Methodological Quality
2.5. Statistical Analysis
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.2.1. Effect of rTMS
3.2.2. Effect of tDCS
3.2.3. Safety
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Study | Disease | Design—LoE | PEDro | Sample | Sex (M:F) | Age (SD) | Time between Stroke Onset and Treatment |
TMS | |||||||
Liu et al. 2020 [32] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 10 | I: 29 C (Sham): 29 | 26:32 | I: 58.5(6.24) C:57.7(7.25) | I: 8.79(1.84) C: 8.62(1.84) months |
Li et al. 2020 [33] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 8 | I: 15 C (Sham): 15 | 16:14 | I: 65.5(3.68) C:64.5(4.72) | I: 22.73(8.05) C: 19.13(7.95) days |
Tsai et al. 2020 [40] | Stroke | RCT-1 5 Hz rTMS vs iTBS vs C(Sham) | 10 | 5 Hz rTMS: 11 iTBS: 15 C (Sham): 15 | 33:8 | 5 Hz rTMS:57.5(12.3) iTBS: 60.1(14.1) C:56.2(12) | 5 Hz rTMS:33.3(26.4) iTBS: 18.5(20.2) C:38(7.9) months |
Yin et al. 2020 [34] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 8 | I: 16 C (Sham): 18 | 30:4 | I: 56.7(12.9) C:58.2(11.3) | I: 52(38.25–98.75) C: 55(39.75–94.75) days |
Lu et al. 2015 [35] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 8 | I: 19 C (Sham): 21 | 25:15 | I: 42.5(12.3) C:47.3(11.8) | 61 (30–365) days |
Kim et al. 2010 [36] | Stroke | RCT-1 1 Hz + Re vs 10 Hz + Re vs C(Sham) + Re | 7 | I: 12 (1 Hz 6, 10 Hz 6) C (Sham): 6 | 10:8 | I: LFS 68.3(7.4) HFS: 53.5(16.9) C: 66.8(17.2) | I: LFS 404.4(71.7) HFS: 241.2(42.5) C: 69.7(39.0) days |
tDCS | |||||||
Shaker et al. 2018 [37] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 7 | I: 20 C (Sham): 20 | 40:0 | I: 54.45(4.68) C: 53.05(6.32) | I: 14.05(1.53) C: 16.55(2.78) months |
Hosseinzadeh et al. 2018 [41] | Stroke | RCT-1 Anodal vs Cathodal vs Sham vs Control(routine treatment) | 6 | Anodal: 25 Cathodal: 25 Sham: 25 Control: 25 | 49:51 | Anodal: 58(8) Cathodal: 60(7) Sham: 59(7) Control: 59(8) | 25–180 days |
Yun et al. 2015 [38] | Stroke | RCT-2 Left;Re vs Right + Re vs Sham + Re | 5 | I:30(Left 15, Right15) C (Sham): 15 | 20:25 | I: Left 60.9(12.9) I: Right58.9(15.0) C: 68.5(14.6) | I: Left 42.2(31.9) I: Right 38.1(27.0) C: 39.5(29.6) days |
Park et al. 2013 [39] | Stroke | RCT-1 I + Re vs C(Sham) + Re | 6 | I: 6 C (Sham): 5 | 5:6 | I: 65.3(14.3) C: 66.0(10.8) | I: 29.0(18.7) C:25.2(17.5) days |
Study | Disease | Targets | Stimulation Site | Parameter | Session | Rehabilitation | Assessments & Follow-Up | Results |
TMS | ||||||||
Liu et al. 2020 [32] | Stroke | Cognition Attention WM | Left DLPFC | 10 Hz 90%MT 700 pulses/session | 20 | Both groups of patients were given comprehensive cognitive function training. The cognitive function training was carried out on a touch screen computer. | TMT-A, DST, DS, MMSE, FIM | Intervention group was significantly improved in all assessment categories compared with the control. |
Li et al. 2020 [33] | Stroke | Cognition | Left DLPFC | 5 Hz 100%MT 2000 pulses/session | 15 | Routine cognitive training (included memory, attention, orientation, visual and spatial, judging and reasoning, executive capability) for 30 min/time, 1time/day and 5 days/week for total of 15 times in 3 weeks | MMSE, MoCA | Cognitive improvements were observed both in the intervention group and the control group, while the rTMS group got more significant improvement than the control group. |
Tsai et al. 2020 [40] | Stroke | Attention, WM, Memory | Left DLPFC | rTMS:5 Hz 80%MT 600 pulses/session iTBS:3 pulses of 50 Hz repeated at 5 Hz for total 190 sec(600pulses) | 10 | None | RBANS, BDI | The 5 Hz rTMS group showed significantly greater improvement than the sham group in RBANS total score, attention, and delayed memory. The iTBS group showed significantly greater improvement than the sham group in RBANS total score and delayed memory. The 5 Hz rTMS group exhibited a superior modulating effect in attention compared to the iTBS group. |
Yin et al. 2020 [34] | Stroke | Cognition, Memory, Executive | Left DLPFC | 10 Hz 80%MT 2000 pulses/session | 20 | 30-min computer-assisted cognitive rehabilitation referring to attention, executive function, memory, calculation, language and visuospatial skills after treatment. | MoCA, VST(a colored dots trail (A), a neutral words trail (B), and an incongruent- colored words trail (C)), RBMT, BI | The MoCA score in both groups increased significantly after four weeks and the score for the intervention group was significantly higher than that in the control group after treatments. The improvement of the RBMT score for the intervention group was significantly higher than that in the control group after treatments. The improvement of VST-B and -C for the intervention group was significantly higher than that in the control group after treatments. |
Lu et al. 2015 [35] | Stroke | Cognition, Memory | Right DLPFC | 1 Hz 100%MT 600 pulses/session | 20 | All patients received regular computer-assisted cognitive training for 30 min every day. | MoCA, LOTCA, RBMT Follow-up at 3 days and 2 months | No difference was observed between the intervention group and the control group for MoCA, LOTCA, and RBMT. However, RBMT was better in the intervention group. Two months after treatment, RMBT in the intervention group was higher than in the control group, but not MoCA and LOTCA scores. |
Kim et al. 2010 [36] | Stroke | Attention, WM, Memory, Executive | Left DLPFC | 1 Hz 900 pulses/ 10 Hz 450 pulses 80% MT | 10 | All patients received conventional cognitive rehabilitation two or three times a week for 2 wks. | DS, VS, VerL, VisL, VCPT, auditory CPT, a word-color test, ToL, BI, Beck Depression Inventory | There was no significant improvement about cognition in each intervention groups. However, mood state significantly improved with 10 Hz stimulation. |
tDCS | ||||||||
Shaker et al. 2018 [37] | Stroke | Attention, Memory | Bilateral DLPFC | 2 mA × 30 min, The anode electrode was placed over the right and left DLPFC. The cathode was placed over the contralateral supraorbital area. | 12 | All patients received cognitive training program. | Computer-based cognitive therapy tool (attention and concentration, figural memory, reaction behavior, and logical reasoning.), FIM | There was a significant improvement in the scores of attention and concentration, figural memory, logical reasoning, reaction behaviour in both groups. However, the improvement was significantly higher in the intervention group compared to the control group. |
Hosseinzadeh et al. 2018 [41] | Stroke | Attention | anodal: left STG, cathodal: Right PPC | 2 mA/35 cm2 × 30 min | 12 | None | NIHSS, TMT, Beck test Follow-up at 1 and 3 months | In TMT, the control group, the Anodal group, and the Cathodal group showed improvement after 1 month and 3 months compared with baseline, but there was no significant difference between all groups. NIHSS, Beck test was improved in Anodal. |
Yun et al. 2015 [38] | Stroke | Cognition, Attention, WM, Memory | fronto-temporal(T3 or T4) | 2 mA/25 cm2 × 30 min The anodal stimulation was placed over T3 or T4. | 15 | All patients received cognitive rehabilitation. | MMSE, DS, VS, VerL, VisL, VCPT, ACPT, BI | Left anodal tDCS improved digit and visual span task and verbal memory. Right anodal tDCS improved only verbal memory between pre and post treatment. Left anodal tDCS significantly improved verbal memory compared to the other groups. |
Park et al. 2013 [39] | Stroke | Cognition Attention, WM | Bilateral PFC | 2 mA/25 cm2 × 30 min, The anodal stimulation was placed over bilateral PFC and the cathodal stimulation were placed over the non-dominant arm. | mean 18.5 | All patients received computer assisted cognitive rehabilitation | DS, VS, CPT, MMSE | Intervention group was significantly improved in auditory and visual continuous performance compared with control. |
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Hara, T.; Shanmugalingam, A.; McIntyre, A.; Burhan, A.M. The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis. Diagnostics 2021, 11, 227. https://doi.org/10.3390/diagnostics11020227
Hara T, Shanmugalingam A, McIntyre A, Burhan AM. The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis. Diagnostics. 2021; 11(2):227. https://doi.org/10.3390/diagnostics11020227
Chicago/Turabian StyleHara, Takatoshi, Aturan Shanmugalingam, Amanda McIntyre, and Amer M. Burhan. 2021. "The Effect of Non-Invasive Brain Stimulation (NIBS) on Attention and Memory Function in Stroke Rehabilitation Patients: A Systematic Review and Meta-Analysis" Diagnostics 11, no. 2: 227. https://doi.org/10.3390/diagnostics11020227