文献类型：期刊文献

英文题名：Comparative efficacy of non-pharmacological interventions for post-stroke cognitive impairment: a systematic review and network meta-analysis of randomized controlled trials

作者：Niu, Hongmei[1,2];Li, Weili[3,4];Du, Lidong[5];Zheng, Xin[1];Liang, Jin[6];Yang, Xiujuan[5];Luo, Jun[7]

第一作者：Niu, Hongmei

通信作者：Yang, XJ[1];Luo, J[2]

机构：[1]Northwest Minzu Univ, Lanzhou, Gansu, Peoples R China;[2]State Ethn Affairs Commiss, Key Lab Environm Ecol & Populat Hlth Northwest Eth, Lanzhou, Gansu, Peoples R China;[3]Shandong First Med Univ, Affiliated Hosp 1, Dept Neurol, Jinan, Peoples R China;[4]Shandong Prov Qianfoshan Hosp, Jinan, Peoples R China;[5]Gansu Univ Chinese Med, Sch Pharm, Lanzhou, Gansu, Peoples R China;[6]Gansu Prov Hosp, Lanzhou, Gansu, Peoples R China;[7]Gansu Univ Chinese Med, Sch Integrated Chinese & Western Med, Lanzhou, Gansu, Peoples R China

第一机构：Northwest Minzu Univ, Lanzhou, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Sch Pharm, Lanzhou, Gansu, Peoples R China;[2]corresponding author), Gansu Univ Chinese Med, Sch Integrated Chinese & Western Med, Lanzhou, Gansu, Peoples R China.|[10735]甘肃中医药大学;

年份：2026

卷号：17

外文期刊名：FRONTIERS IN NEUROLOGY

收录：;Scopus(收录号：2-s2.0-105033061159);WOS:【SCI-EXPANDED(收录号:WOS:001715666500001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. This work was supported by the Fundamental Research Funds for the Central Universities (Project No. 31920250007), the Lanzhou City Youth Talent Innovation Project (Project No. 2024-QN-148), the Gansu Province Science and Technology Program (Project No. 25CXGA021), and the Young Doctor Fund Project of the Gansu Provincial Department of Education (Project No. 2025QB-009), the Gansu Province Science and Technology Program (Project No. 25CXGA097).

语种：英文

外文关键词：cognitive training; network meta-analysis; non-pharmacological interventions; post-stroke cognitive impairment; transcranial brain stimulation

摘要：Background Post-stroke cognitive impairment (PSCI) substantially diminishes quality of life and functional independence in stroke survivors. Various non-pharmacological interventions have been proposed to improve cognitive and functional outcomes; however, their relative effectiveness remains uncertain.Methods A network meta-analysis of 23 RCTs (1,723 participants) evaluated seven non-drug therapies, including computer-based cognitive training (CCT), transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), acupuncture, exercise, and their combinations. Primary and secondary outcomes were MoCA and MBI scores, respectively.Results Regarding MoCA scores, the most effective intervention was CCT combined with tDCS (mean difference vs. control: 6.67; 95% CrI: 1.20-12.13), followed by acupuncture combined with rTMS (6.59; 95% CrI: 4.34-8.84) and rTMS alone (4.26; 95% CrI: 2.65-5.88). SUCRA rankings indicated that CCT + tDCS and acupuncture + rTMS had the highest probabilities of being the most effective treatments. For MBI scores, tDCS (8.41; 95% CrI: 4.50-12.32), exercise rehabilitation (6.87; 95% CrI: 4.92-8.82), and CCT (6.62; 95% CrI: 3.84-9.39) demonstrated the greatest improvements compared to control. Funnel plots revealed no significant publication bias, and contribution plots supported the stability of the network geometry.Conclusion Among non-pharmacological approaches for PSCI, combined CCT and tDCS produced the most consistent cognitive improvements, while tDCS and exercise rehabilitation yielded the most pronounced gains in functional recovery. These findings support the clinical integration of multimodal brain stimulation and cognitive rehabilitation strategies in the management of PSCI.