Digital Interventions for Cognitive Dysfunction in Patients With Stroke: Systematic Review and Meta-Analysis.

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Digital Health

Background:

• Digital technologies offer potential for cognitive improvement post-stroke.
• Effectiveness and optimal treatment strategies for digital interventions remain unclear.
• Existing evidence on digital therapies for post-stroke cognitive impairment is contradictory.

Purpose of the Study:

• To evaluate the efficacy of various digital interventions for improving cognitive function after stroke.
• To provide evidence-based recommendations for clinical decision-making regarding digital therapies.
• To synthesize current research on virtual reality, computer-assisted cognitive therapy, and robot-assisted therapy for post-stroke cognitive impairment.

Main Methods:

• Systematic search of multiple databases (PubMed, Web of Science, etc.) up to January 2025.
• Inclusion of randomized controlled trials (RCTs) on digital interventions (VR, CACT, RAT) for adults with post-stroke cognitive impairment.
• Network meta-analysis using R software to compare intervention efficacy based on MoCA and MMSE scores, assessing heterogeneity and evidence quality.

Main Results:

• 27 RCTs involving 2128 articles were analyzed.
• Computer-assisted cognitive therapy (CACT) showed significant superiority in Montreal Cognitive Assessment (MoCA) scores (MD=3.03).
• Robot-assisted therapy (RAT) demonstrated the highest efficacy for Mini-Mental State Examination (MMSE) scores (MD=5.99), while VR and CCT showed no significant improvement on MMSE.

Conclusions:

• Digital therapies are effective for post-stroke cognitive enhancement.
• CACT and RAT show domain-specific efficacy (executive function vs. basic cognition).
• Caution is advised due to study heterogeneity, risk of bias, and limited sample sizes; further research is recommended.