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SYSTEMATIC REVIEW article

Front. Neurol.
Sec. Neurorehabilitation
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1327065

Network meta-analysis of non-pharmacological interventions for cognitive impairment after an ischemic stroke

Provisionally accepted
Guangming Yang Guangming Yang Liyun Guo Liyun Guo *Yuan Zhang Yuan Zhang Shan Li Shan Li
  • Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province, China

The final, formatted version of the article will be published soon.

    Objective: This study aims to evaluate the effectiveness of non-pharmacological interventions in improving cognitive function in patients with ischemic stroke through network meta-analysis.: We searched databases including the Cochrane Library, PubMed, EmBase, Web of Science for randomized controlled trials (RCTs) on non-pharmacological treatments for improving cognitive impairment following ischemic stroke. The publication date was up to March 15, 2023. Due to the insufficiency of included studies, supplementary searches for high-quality Chinese literature were performed in databases such as CNKI, WanFang Data, and VIP Chinese Science Journals Database. Two reviewers independently went through the literature, extracted data, and assessed the risk of bias in the included studies using the risk of bias assessment tool recommended by the Cochrane Handbook for Systematic Reviews of Interventions 5.1.0. By utilizing R 4.2.3, RStudio software, and the GeMTC package, a Bayesian network meta-analysis was conducted to assess the improvement in Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores under a variety of non-pharmacological interventions. Results: A total of 22 RCTs involving 2111 patients and 14 different non-pharmacological treatments were included. These interventions were transcranial direct current stimulation (tDCS), reminiscence therapy (RT), remote ischemic conditioning (RIC), physical fitness training (PFT), intensive patient care program (IPCP), moderate-intensity continuous training + high-intensity interval training (MICT+HIIT), medium intensity continuous training (MICT), grip training (GT), acupuncture, cognitive behavioral therapy (CBT), cognitive rehabilitation training (CRT), high pressure oxygen (HPO), moxibustion, and repetitive transcranial magnetic stimulation (rTMS). The results of the network meta-analysis indicated that rTMS had the highest likelihood of being the most effective intervention for improving MMSE and MoCA scores.The evidence from this study suggests that rTMS holds promise for improving MMSE and MoCA scores in patients with cognitive impairment following ischemic stroke. However, further high-quality research is needed to confirm and validate this finding.

    Keywords: ischemic stroke, cognitive impairment, Network meta-analysis, randomized controlled trials, non-pharmacological interventions

    Received: 08 Nov 2023; Accepted: 29 Apr 2024.

    Copyright: © 2024 Yang, Guo, Zhang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Liyun Guo, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.