Explore combined use of transcranial direct current stimulation and cognitive training on executive function after stroke.
Yuan-Wen Liu, Zhong-Hua Chen, Jing Luo and 6 others
PMID 33634831WHAT IT FOUND
Adding real brain stimulation to cognitive training improved executive function and complex daily tasks in stroke patients more than sham stimulation.
However, gains in some key cognitive tests did not reach the threshold for clinically meaningful change.
Key findings
01Participants receiving real transcranial direct current stimulation (tDCS) alongside cognitive training showed significantly greater improvements in executive function tests than those receiving sham stimulation.
02While statistically significant, the overall improvement in the Digit Symbol Test did not exceed its minimal clinically important difference value.
03Improvements in Instrumental Activities of Daily Living were significantly better in the real tDCS group, but no significant difference was found in Basic Activities of Daily Living.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The sample size was small (50 participants). The intervention period was short (4 weeks) with no long-term follow-up to assess sustainability. Key cognitive improvements did not exceed the minimal clinically important difference, meaning the statistical significance may not translate to noticeable functional changes for patients. The study was single-blind, meaning therapists knew which treatment was being administered, which could influence how they delivered the concurrent cognitive training.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume the statistical significance implies a noticeable functional improvement for patients. The study explicitly notes that gains in the Digit Symbol Test and MoCA did not exceed the minimal clinically important difference, so the practical benefit of adding tDCS to cognitive training may be less than the p-values suggest.