Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Mar 10, 2025
Open Peer Review Period: Mar 11, 2025 - May 6, 2025
Date Accepted: May 15, 2025
(closed for review but you can still tweet)
Digital interventions for cognitive dysfunction in stroke patients: Systematic Review and Meta-analysis
ABSTRACT
Background:
In recent years, digital technologies have shown possibilities for improving cognitive function after stroke, but their effectiveness and treatment options vary, the optimal treatment remains unclear, and the current evidence is somewhat contradictory.
Objective:
To evaluate the efficacy of various digital interventions in improving post-stroke cognitive function and provide evidence-based support for clinical decision-making.
Methods:
This study adhered to the PRISMA guidelines for systematic review. We conducted searches in PubMed, Web of Science, Cochrane Library, Scopus, EMBASE, and CNKI databases from inception to January 2025. Outcomes included the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Randomized controlled trials (RCTs) were included.
Results:
A total of 2,128 articles were retrieved, with 27 meeting the inclusion criteria. Compared to conventional rehabilitation or care, computer-assisted cognitive therapy (CACT) demonstrated significant superiority in MoCA scores (MD=2.36, 95% CI=1.45 to 3.27; SUCRA=83.2%); while cognitive training (CCT) demonstrated no statistical difference (MD=0.28, 95% CI=−0.81 to 1.37). For MMSE scores, robot-assisted therapy (RAT) ranked highest in efficacy (MD=5.77, 95% CI=3.47–8.08; SUCRA=99%); whereas both virtual reality (VR) (MD=0.69, 95% CI=−0.93 to 2.31) and CCT (MD=0.78, 95% CI=−1.19 to 2.75) showed no significant improvement.
Conclusions:
Digital therapies effectively improve cognitive function in post-stroke patients. CACT exhibited superior efficacy in MoCA (which emphasizes executive function), while RAT ranked highest in MMSE (which focuses on basic cognition), suggesting distinct domain-specific effects. However, caution is warranted due to heterogeneity, risk of bias, and limited sample sizes in the included studies. Future research should focus on optimizing intervention protocols, integrating neuroregulatory or traditional Chinese rehabilitation techniques, and exploring cost-effective strategies for clinical implementation. Clinical Trial: CRD420251006601
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