PTOTSLPSystematic ReviewFrontiers in rehabilitation sciences2022

Can Transcranial Electrical Stimulation Facilitate Post-stroke Cognitive Rehabilitation? A Systematic Review and Meta-Analysis.

Ahsan Khan, Kai Yuan, Shi-Chun Bao and 4 others

PMID 36188889

WHAT IT FOUND

tDCS may briefly improve attention and language recovery in stroke survivors, but does not help global thinking, memory, or visual neglect.

The evidence is weak, based on small studies with no long-term follow-up, so it should not replace standard therapy.

Key findings

01tDCS showed a significant improvement in aphasia symptoms, with the effect remaining significant even after removing outlier studies.

02tDCS showed a significant impact on attention tasks, though the confidence interval crossed zero and heterogeneity was high.

03tDCS did not improve global cognition, working memory, or visual neglect.

STILL TO COME

How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs

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What it does not show

High heterogeneity across studies in all domains. Most studies had very small sample sizes. Almost all studies measured immediate post-stimulation effects, with no long-term follow-up to see if benefits persisted. The included studies used varying stimulation parameters (intensity, duration, electrode placement), making it hard to compare results. No studies used high-definition tDCS or other advanced forms of stimulation. The authors note that improvement in lab tasks may not reflect real-world functional ability.

Declared interests

The authors declared no commercial or financial conflicts of interest.

The easy way to misread this

Do not interpret the positive findings for aphasia and attention as evidence that tDCS is an established treatment. The effects were small, short-term, and based on low-quality studies with high variability. The lack of long-term follow-up means we do not know if these brief improvements lead to lasting functional gains.

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