Effects of Dual-Target Transcranial Direct Current Stimulation on Post-Stroke Cognitive Impairment

<bold>Objective</bold>To investigate the effects of dual-target transcranial direct current stimulation (tDCS) on cognitive function in patients with post-stroke cognitive impairment (PSCI).<bold>Methods</bold>A total of 34 patients with PSCI admitted to the Department of Rehabilitation Medicine and the Department of Acupuncture at Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from June 2024 to January 2025 were randomly divided into control group and experimental group, with 17 patients in each group. One patient in the control group withdrew voluntarily, and one patient in the experimental group was lost to follow-up due to hospital transfer, a total of 16 patients were included in each group finally. Both groups received conventional rehabilitation therapy. The experimental group received dual-target tDCS in conjunction with conventional rehabilitation therapy, targeting the ipsilesional dorsolateral prefrontal cortex (DLPFC) and angular gyrus (AG) with anodal stimulation. The protocol involved a current intensity of 1.5 mA for 20 minutes per session, administered once daily, five times per week, for two consecutive weeks. The control group received sham tDCS targeting the DLPFC, maintaining the same stimulation parameters (intensity, duration, electrode size, and placement) as the experimental group, in addition to conventional rehabilitation therapy. Before and after treatment, the Montreal Cognitive Assessment (MoCA) was used to assess the overall cognitive function, the Digit Span Test (DST) was used to assess the working memory, and the Trail Making Test (TMT-A and TMT-B) were used to assess the attention and executive function.<bold>Results</bold>(1) MoCA scores: compared with that before treatment, MoCA scores in both groups significantly increased after treatment (P&lt;0.05). There were no significant differences of MoCA scores between two groups after treatment (P&gt;0.05). The difference of MoCA score before and after treatment in the observation group was significantly higher than that of the control group (P&lt;0.05). (2) DST scores: compared with that before treatment, DST-F scores in both groups after treatment (P&lt;0.05), and DST-B scores significantly increased in the experimental group after treatment (P&lt;0.05). Compared with the control group, the changes of DST-F score and DST-B score before and after treatment in the observation group was significantly higher (P&lt;0.05). (3) TMT completion time: compared with that before treatment, the completion time for TMT-a and TMT-B in the observation group were significantly shortened after treatment (P&lt;0.05). Compared with the control group, the reduction in completion time for TMT-a and TMT-B before and after treatment in the observation group were significantly shorter (P&lt;0.05).<bold>Conclusion</bold>Dual-target tDCS significantly enhances the overall cognitive function, working memory function, attention and executive function in patients with PSCI.