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Comparative Study
. 2024 Dec;38(11-12):863-876.
doi: 10.1177/15459683241274755. Epub 2024 Sep 10.

Comparative Efficacy of Cognitive Training for Post-Stroke Aphasia: A Systematic Review and Network Meta-Analysis

Qiao Kong  1 , Jiaqi Wang  1 , Xing Huang  2 , Junyi He  1 , Jingling Chang  1
Affiliations
Comparative Study

Comparative Efficacy of Cognitive Training for Post-Stroke Aphasia: A Systematic Review and Network Meta-Analysis

Qiao Kong et al. Neurorehabil Neural Repair. 2024 Dec.

Abstract

Background: Although cognitive training has shown potential for treating post-stroke aphasia (PSA), its efficacy varies across studies, and the optimal training approaches remain unclear.

Objective: To evaluate and compare the effects of distinct cognitive training interventions, either combined with or independent of speech and language therapy (SLT), on language function in individuals with PSA.

Methods: A systematic search encompassing PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, VIP, and Chinese Biomedical Databases was conducted for randomized controlled trials (RCTs). A network meta-analysis evaluated interventions, including computer-assisted cognitive training (CCT), conventional cognitive training (CT), virtual reality (VR)-based cognitive training (vrCT), telerehabilitation computer-assisted cognitive training (tCCT), working memory (WM) training, and attention training (AT).

Results: Eleven RCTs comprising 501 participants were included. Individuals with PSA who underwent combined WM training with SLT led to significantly enhanced Western Aphasia Battery (WAB) Aphasia Quotient (AQ), as well as in spontaneous speech, auditory comprehension, repetition, and naming, compared to those receiving SLT alone. This combination was more effective than both CCT with SLT and tCCT with SLT in improving WAB AQ. Similarly, it outperformed both CCT with SLT and vrCT with SLT in enhancing WAB spontaneous speech. Additionally, both AT and CT combined with SLT were more effective than SLT alone in enhancing WAB spontaneous speech. Specifically, AT combined with SLT proved more effective than vrCT with SLT in this area. Moreover, vrCT combined with SLT significantly improved auditory comprehension compared with SLT alone.

Conclusions: Combining WM training and SLT and integrating vrCT with SLT both significantly enhance language function in individuals with PSA, compared with SLT alone. Our findings advocate for the use of these cognitive training approaches as promising strategies for language rehabilitation in this population. PROSPERO registration number: CRD42023462361.

Keywords: cognitive training; network meta-analysis; post-stroke aphasia; speech and language therapy.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of literature search and selection.
Figure 2.
Figure 2.
(A) NMA figure for Western Aphasia Battery AQ. (B) SUCRA plot for Western Aphasia Battery AQ.
Figure 3.
Figure 3.
(A) NMA figure for Western Aphasia Battery spontaneous speech score. (B) SUCRA plot for Western Aphasia Battery spontaneous speech score.
Figure 4.
Figure 4.
(A) NMA figure for Western Aphasia Battery auditory comprehension score. (B) SUCRA plot for Western Aphasia Battery auditory comprehension score.
Figure 5.
Figure 5.
(A) NMA figure for Western Aphasia Battery repetition score. (B) SUCRA plot for Western Aphasia Battery repetition score.
Figure 6.
Figure 6.
(A) NMA figure for Western Aphasia Battery naming score. (B) SUCRA plot for Western Aphasia Battery naming score.
See this image and copyright information in PMC

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