认知训练同步经颅直流电刺激治疗对卒中后认知障碍患者工作记忆的改善效果

目的 分析认知训练同步经颅直流电刺激（tDCS）治疗卒中后认知碍（PSCI）患者工作记忆的疗效。方法 选取2022年12月至2023年7月徐州市中心医院康复科和徐州市康复医院收治的60例PSCI患者为研究对象，采用随机数字表法分为伪刺激组、试验组A和试验组B，每组20例。3组患者均接受常规药物治疗和康复训练，伪刺激组在此基础上同时接受认知训练和tDCS伪刺激；试验组A同时接受认知训练和tDCS治疗；试验组B于认知训练结束2 h后接受tDCS治疗。认知训练与tDCS治疗均为5次/周，持续4周。在治疗前后分别采用蒙特利尔认知评估量表（MoCA）、数字广度测试（DST）、n-back任务（包括0-back、1-back）、改良Barthel指数（MBI）及定量脑电图[包括功率比指数（DTABR）、α波相对功率（αRP）及θ波相对功率（θRP）]比较3组患者的认知功能、工作记忆储存和信息编码能力、数字工作记忆、日常生活自理能力及脑神经功能。结果 3组患者治疗前的MoCA、DST、0-back、1-back、MBI得分以及DTABR、αRP、θRP比较，差异均无统计学意义（均P>0.05）...

Improvement effects of cognitive training synchronized with transcranial direct current stimulation for the treatment of working memory in patients with post-stroke cognitive impairment

Objective To explore the effect of cognitive training synchronized with transcranial direct current stimulation （tDCS） for the treatment of working memory in patients with post-stroke cognitive impairment （PSCI）. Methods From December 2022 to July 2023， 60 patients with PSCI admitted to the Rehabilitation Department of Xuzhou Central Hospital and Xuzhou Rehabilitation Hospital were selected as the research subject. Using the random number table method， patients were randomly divided into the pseudo stimulation group， experimental group A， and experimental group B， with 20 cases in each group. All three groups received conventional medication and rehabilitation training， on which the pseudo stimulation group received both cognitive training and tDCS pseudo stimulation therapy； experimental group A received both cognitive training and tDCS therapy； experimental group B received tDCS therapy 2 h after the end of cognitive training. Both cognitive training and tDCS treatment were 5 times per week for 4 weeks. Before and after treatment， the Montreal Cognitive Assessment （MoCA）， Digital Span Test （DST）， n-back task （including 0-back， 1-back）， Modified Barthel Index （MBI）， and quantitative electroencephalogram ［including delta theta/alpha beta ratio （DTABR）， alpha relative power （αRP）， and θ relative power （θRP）］ were used to compare the cognitive function， working memory storage and information encoding ability， digital working memory， activity of daily living， and cranial nerve function of the three groups of patients. Results There was no statistically significant difference in MoCA scores， DST scores， 0-back scores， 1-back scores， MBI scores， DTABR， αRP and θRP among the three groups of patients before treatment （all P ＞ 0.05）. The difference in MoCA， DST， 0-back， 1-back， and MBI scores and the difference in DTABR， αRP， and θRP before and after treatment of the 3 groups were statistically significant （all P＜ 0.05）. The difference in MoCA， DST， 0-back， 1-back， and MBI scores and the difference in DTABR， αRP， and θRP before and after treatment in the experimental groups A and B were higher than those in the pseudo stimulation group， and the differences were statistically significant （all P ＜ 0.05）. The difference in MoCA， DST， 1-back score and the difference in DTABR， θRP before and after treatment in the experimental group A were higher than that in experimental group B， and the difference were statistically significant （all P＜ 0.05）. Conclusions Cognitive training and synchronized tDCS have more advantages in improving the working memory of patients with PSCI compared to separate treatment.