在轻度认知障碍老年人中联合应用3.2 mA的6 Hz经颅交流电刺激（tACS）与数字化认知训练的可行性和耐受性。
完整摘要 · 中文译文
目的：经颅交流电刺激（tACS）可能增强轻度认知障碍（MCI）患者的认知功能并增强数字化认知训练（DCT）的效果。最佳刺激强度仍不确定，因为较高电流可能增加皮层电场但引起耐受性方面的顾虑。我们评估了3.2 mA tACS联合DCT的可行性和耐受性，并探索性评估了活性刺激与假刺激对抑制控制和认知迁移的效果。 方法：十名MCI老年人在DCT期间接受每日五次6 Hz tACS刺激左侧背外侧前额叶皮层；来自一项随机试验的十名假刺激组参与者完成了相同的DCT。通过依从性、脱落率和副作用监测评估可行性和耐受性。探索性疗效分析采用重复测量方差分析及Bonferroni校正的配对比较。结局指标包括反扫视总错误数、言语记忆和视觉记忆以及视空间建构能力。 结果：所有参与者均完成治疗（100%依从性）。活性刺激会话副作用为轻度的占67%，中度的占23%；未发生严重不良事件。副作用负担与DCT表现无关（p = 0.22）。反扫视总错误数显示组×时间交互作用（p = 0.028），有利于活性刺激。反应时未显示刺激特异性效应。言语记忆和视觉记忆显示时间效应（p = 0.016和p = 0.002），而视空间建构能力显示趋势水平的组×时间交互作用，有利于活性刺激（p = 0.054）。 结论：高强度tACS联合DCT是可行的，并且我们 在患有轻度认知障碍（MCI）的老年人中耐受性良好。探索性研究结果表明，主动刺激可能改善抑制控制并促进向特定认知领域的迁移。有待正在进行的随机对照试验予以证实。
完整摘要 · 英文原文
PURPOSE: Transcranial alternating current stimulation (tACS) may enhance cognition and potentiate digital cognitive training (DCT) in mild cognitive impairment (MCI). Optimal intensity remains uncertain because higher currents may increase cortical electric fields but raise tolerability concerns. We evaluated feasibility and tolerability of 3.2 mA tACS plus DCT, and exploratorily assessed active versus sham effects on inhibitory control and cognitive transfer. METHODS: Ten older adults with MCI received five daily 6-Hz tACS sessions over the left dorsolateral prefrontal cortex during DCT; ten sham-arm participants from a randomized trial completed identical DCT. Feasibility and tolerability were assessed by adherence, attrition, and side-effect monitoring. Exploratory efficacy used repeated-measures ANOVA with Bonferroni-corrected paired comparisons. Outcomes included antisaccade total errors, verbal and visual memory, and visuoconstructive abilities. RESULTS: All participants completed treatment (100% adherence). Active-session side effects were mild in 67% and moderate in 23%; no severe events occurred. Side-effect burden was unrelated to DCT performance (p = 0.22). Antisaccade total errors showed a group × time interaction (p = 0.028), favoring active stimulation. Reaction time showed no stimulation-specific effects. Verbal and visual memory showed time effects (p = 0.016 and p = 0.002), whereas visuoconstructive abilities showed a trend-level group × time interaction favoring active stimulation (p = 0.054). CONCLUSIONS: Higher-intensity tACS plus DCT was feasible and well tolerated in older adults with MCI. Exploratory findings suggest that active stimulation may improve inhibitory control and facilitate transfer to selected cognitive domains. Confirmation in the ongoing randomized controlled trial is warranted.