Over the past decade, an increasing number of studies investigated the innovative approach of supplementing cognitive training (CT) with noninvasive brain stimulation (NIBS) to increase the effects on outcomes. In this review, we aim to summarize the evidence for this treatment combination. We identified 72 published and unpublished studies (reporting 773 effect sizes), including 2,518 participants from healthy and clinical populations indexed in PubMed, MEDLINE, APA PsycInfo, ProQuest, Web of Science, and https://ClinicalTrials.gov (last search: August 9, 2022) that compared the effects of NIBS combined with CT on cognitive, symptoms, and everyday functioning to CT alone at postintervention and/or follow-up. We performed random-effects meta-analyses with robust variance estimation and assessed risk of bias with the Cochrane ROB tool. Only four studies had low risk of bias in all domains, and many studies lacked standard controls such as keeping the outcome assessor and trainer unaware of the treatment condition. Following sensitivity analyses, only learning/memory robustly improved significantly more when CT was combined with NIBS compared to CT only (g = 0.18, 95% CI [0.07, 0.29]) at postintervention, but not in the long term. The effect was small and limited by substantial heterogeneity. The other seven cognitive outcome domains, symptoms, and everyday functioning did not benefit from adding NIBS to CT. Given the methodological limitation of prior studies, more high-quality trials that focus on the potential of combining NIBS and CT to enhance benefits in everyday functioning in the short and long term are needed to evaluate whether combining NIBS and CT is relevant for clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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认知训练和无创脑刺激相结合的功效：跨诊断系统评价和荟萃分析。


在过去的十年中，越来越多的研究调查了用无创脑刺激 (NIBS) 补充认知训练 (CT) 的创新方法，以增加对结果的影响。在这篇综述中，我们的目的是总结这种治疗组合的证据。我们确定了 72 项已发表和未发表的研究（报告了 773 个效应量），包括来自 PubMed、MEDLINE、APA PsycInfo、ProQuest、Web of Science 和 https://ClinicalTrials.gov 索引的健康和临床人群的 2,518 名参与者（上次搜索：8 月） 2022 年 9 月 9 日），在干预后和/或随访中比较了 NIBS 联合 CT 对认知、症状和日常功能与单独 CT 的影响。我们使用稳健的方差估计进行随机效应荟萃分析，并使用 Cochrane ROB 工具评估偏倚风险。只有四项研究在所有领域的偏倚风险较低，并且许多研究缺乏标准控制，例如让结果评估者和培训师不了解治疗条件。经过敏感性分析，只有当 CT 与 NIBS 相结合时，与仅使用 CT 相比，干预后的学习/记忆能力才显着改善（g = 0.18，95% CI [0.07，0.29]），但长期来看则不然。效果很小并且受到显着异质性的限制。其他七个认知结果领域、症状和日常功能并未因在 CT 中添加 NIBS 而受益。鉴于先前研究的方法学限制，需要更多高质量的试验，重点关注将 NIBS 和 CT 结合起来以增强短期和长期日常功能的益处的潜力，以评估 NIBS 和 CT 结合是否与临床实践相关。 （PsycInfo 数据库记录 (c) 2024 APA，保留所有权利）。