Data Sheet 1_Multifocal transcranial electrical stimulation to enhance cognitive functions: a systematic review.docx

BackgroundMultifocal transcranial Electrical Stimulation (tES) has emerged as an innovative approach for modulating cognitive functions by concurrently targeting multiple brain regions. Despite its potential, the efficacy and underlying mechanisms of this technique remain unclear.
ObjectiveTo evaluate the efficacy of multifocal tES in enhancing cognitive function by examining targeted brain regions, stimulation protocols, and behavioral and neurophysiological outcomes.
MethodsA systematic search of PubMed, EMBASE, Cochrane Library, Scopus, and Web of Science databases was conducted up to February 10, 2025, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. The inclusion criteria encompassed human studies utilizing concurrent dual-site or multifocal tES with pre- and post-intervention behavioral assessments. Studies on deep brain stimulation, corticocortical paired associative stimulation, sequential stimulation, case reports, and reviews were excluded.
ResultsOf the 1,453 initial records, 14 met the inclusion criteria. The studies predominantly employed transcranial direct current stimulation/transcranial alternating current stimulation, targeting the frontoparietal network. Neurophysiological data from electroencephalography and functional magnetic resonance imaging revealed network-level modulations. Behavioral outcomes were inconsistent, with some studies reporting improvements in executive function, working memory, and response inhibition, whereas others showed no significant advantages over sham stimulation.
ConclusionAlthough multifocal tES is a promising modality, clearly determining its efficacy is currently limited by heterogeneous study designs, small sample sizes, and conflicting findings. Future research should prioritize multi-arm trials, incorporate neurophysiological biomarkers, and develop personalized stimulation protocols to optimize the effectiveness of this technique.
Trial registrationPROSPERO Registration # CRD420250646196.

研究背景：多灶经颅电刺激（multifocal transcranial Electrical Stimulation, tES）作为一种创新手段，可通过同时靶向多个脑区来调制认知功能。尽管该技术具有应用潜力，但其疗效与潜在机制仍不明确。
研究目的：通过考察靶向脑区、刺激方案以及行为与神经生理学结局，评估多灶经颅电刺激改善认知功能的疗效。
研究方法：本研究遵循《系统综述与元分析优先报告条目2020版》（Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020）指南，于2025年2月10日前对PubMed、EMBASE、Cochrane图书馆、Scopus及Web of Science数据库开展系统性检索。纳入标准涵盖同时采用双位点或多灶经颅电刺激且包含干预前后行为评估的人体研究；排除涉及深部脑刺激、皮层-皮层配对关联刺激、序贯刺激、病例报告及综述类的研究。
研究结果：初始检索获得1453条记录，其中14条符合纳入标准。现有研究多采用经颅直流电刺激/经颅交流电刺激，靶向额顶网络。脑电图与功能性磁共振成像的神经生理学数据显示，该技术可引发网络水平的神经调制。行为学结局存在不一致性：部分研究报道受试者的执行功能、工作记忆与反应抑制能力得到改善，而其余研究则显示其相较于假刺激无显著优势。
研究结论：尽管多灶经颅电刺激是一种颇具前景的干预手段，但目前由于研究设计异质性较强、样本量较小且研究结果存在冲突，其疗效仍难以明确界定。未来研究应优先开展多臂试验，纳入神经生理学生物标志物，并制定个性化刺激方案，以优化该技术的应用效果。
试验注册：PROSPERO注册编号：CRD420250646196。