Efficacy and hematological markers of tDCS combined with aerobic exercise in improving executive function in patients with PSCI.

OBJECTIVE

This study investigated the effects of combined transcranial direct current stimulation (tDCS) and aerobic exercise (AE) on executive function and hematological markers in poststroke cognitive impairment (PSCI) patients.

METHODS

A total of 74 PSCI patients were randomly assigned to three groups: the tDCS + AE, tDCS, and AE groups. The tDCS group received 2.0 mA anodal stimulation over the left dorsolateral prefrontal cortex (DLPFC) for 30 min, five days per week for four weeks. The AE group performed moderate-intensity exercise (60-70% HRmax) for 30 min with sham tDCS. The combined group received both interventions concurrently. Executive function was assessed using C-EXIT25, the Stroop test, the 1-back task, and word recall tests. Emotional state was evaluated with the Hamilton Depression Rating Scale (HAMD) and the Hamilton Anxiety Rating Scale (HAMA). Serum biomarkers were analyzed pre- and postintervention. Statistical analyses included repeated measures ANOVA and Spearman correlation with Bonferroni correction.

RESULTS

Executive function significantly improved in the combined group, with lower C-EXIT25 scores, faster Stroop congruent reaction times, and fewer word recall errors compared to the tDCS and AE groups. HAMD scores significantly decreased in the combined group. BDNF, NGF, DA, GABA, 5-HT, and ACh levels increased postintervention, whereas the level of Glu decreased in the combined group. An increase in BDNF correlated with faster Stroop response times, and an increase in NGF correlated with improvements in MMSE scores.

CONCLUSION

tDCS combined with AE significantly enhanced executive function in PSCI patients. These benefits were associated with increased neurotrophic factor levels, supporting a central-peripheral integrative rehabilitation approach for PSCI treatment.