Efficacy of Mindfulness Based Intervention and TDCs on Cognitive Disorders in patients with stroke: a randomized clinical trial

Abstract

Stroke is one of the main causes of disability that often leads to cognitive impairment or even dementia. This disease leads to motor, cognitive and emotional disorders and these problems affect the brain and physical function of patients. Mindfulness and tDCS are some of the methods that have been suggested to improve the symptoms of cognitive disorders as well as the depressive state in stroke patients. The main purpose of this study was to evaluate the effectiveness of mindfulness-based intervention and TDCs on cognitive function in patients with stroke. Methods: In a pilot study with pretest-posttest design with control group, stroke patients were randomly selected into 3 groups (mindfulness, TDCs and control). At first, patients were evaluated for inclusion and exclusion criteria and participated in the study if they met the conditions and taking into account ethical considerations. The Addenbrooke's Cognitive Examination (Attention/Orientation, Memory, Verbal Fluency, Language, and Spatial Visual) was used to assess cognitive disorders, and the Beck Depression Inventory was used to assess the severity of patients' psychological symptoms. 2 mA electric was passed through the skulls of TDCs for 20 minutes during 10 sessions. The mindfulness intervention group was trained in eight sessions of two and a half hours based on the stress reduction treatment plan based on Jon Kabat-Zinn. Results: A total of 30 patients participated in this study, of which 11 patients were in the control group, 5 patients were in the mindfulness group and 14 patients were in the tDCS group. The age range of participants in this study was 33 to 75 years and 23 participants (76.7%) were male and the remaining 7 (23.3%) were female. Study groups were not significantly different in terms of gender (p = 0.42) and depression status at the beginning of the study (p = 0.58) and depression status at the end of the study (after interventions) (p = 0.58). Although the BDI score of patients before the study (p = 0.04) and after the intervention (p = 0.04) was significantly different between the control group and mindfulness, but the changes in the BDI score as an indicator of depression were not significantly different (p = 0.78). Regarding the cognitive status of patients, no significant difference was observed in ACE before the start of the study (p = 0.22), after the intervention (p = 0.18) and also in changes in the ACE score (p = 0.69) between the control group and mindfulness. The control and tDCS groups did not differ significantly in BDI score before the start of the study (p = 0.38), at the end of the study (p = 0.25) and its changes (p = 0.63). The results of this study also showed that the control groups and tDCS were not significantly different in cognitive status based on ACE before intervention (p = 0.99) and after intervention (p = 0.17); However, in the group of patients who underwent tDCS, a greater improvement in cognitive status was observed than the control group (p = 0.01), which had an effect on mental and smooth areas (p = 0.04) and memory status of patients (p = 0.03).