{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:57:48Z","timestamp":1790618268853,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the clinical efficacy of dual transcranial direct current stimulation (tDCS) in patients with post\u2010stroke cognitive impairment (PSCI) and to explore the effects on the hierarchical organization of functional brain networks, ranging from regional synchronization to inter\u2010regional connectivity and global network topology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this randomized, double\u2010blind, sham\u2010controlled trial, 74 PSCI patients received conventional therapy alongside either active dual\u2010tDCS (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200938) or sham stimulation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200936). Active tDCS targeted the dorsolateral prefrontal cortex (DLPFC) via anodal\u2010left\/cathodal\u2010right nodes (2.0\u2009mA, 20\u2009min\/day, 20 sessions). The primary outcome was the Montreal Cognitive Assessment (MoCA). Secondary outcomes included the Mini\u2010Mental Status Examination (MMSE), Stroop Test (ST), Trail Making Test (TMT), Wechsler Memory Scale (WMS), and Barthel Index (BI). A subgroup of 36 participants (18 per group) underwent resting\u2010state functional magnetic resonance imaging (rs\u2010fMRI) to analyze regional homogeneity (ReHo), functional connectivity (FC), and network topology. Partial correlations assessed the association between neuroimaging alterations and clinical improvements.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The tDCS group showed significantly greater improvements in MoCA scores (tDCS: 5.74\u2009\u00b1\u20092.76 vs. sham: 2.69\u2009\u00b1\u20092.69;\n                      <jats:italic>t<\/jats:italic>\n                      \u2009=\u20094.799,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as well as in attention and memory domains compared to the sham group. The rs\u2010fMRI changes included increased ReHo in the right middle temporal gyrus (MTG) and the left inferior frontal gyrus (IFG), and reduced FC between the right MTG\u2010left superior frontal gyrus and left IFG\u2010cerebellum (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05, FWE\u2010corrected). Additionally, small\u2010worldness and global efficiency increased (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) with these alterations correlating with clinical recovery. Adverse events were rare and self\u2010limiting.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dual\u2010tDCS over bilateral DLPFC safely improves cognitive recovery in PSCI. These clinical gains are associated with rs\u2010fMRI alterations, specifically in regional synchronization, inter\u2010regional connectivity, and global topology, which suggest a potential biomarker for monitoring tDCS efficacy, offering a rationale for precision neuromodulation in stroke rehabilitation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cns.71111","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T04:20:33Z","timestamp":1788409233000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual Transcranial Direct Current Stimulation Modulates Hierarchical Functional Network Organization in Post\u2010Stroke Cognitive Impairment: A Randomized Controlled Trial"],"prefix":"10.1002","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5940-4988","authenticated-orcid":false,"given":"Yao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenjie","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Radiology The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"},{"name":"Institution of Brain Functional Imaging Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinxin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yin","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Radiology The First Affiliated Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9710-676X","authenticated-orcid":false,"given":"Jiang","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine The Affiliated Brain Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8448-6073","authenticated-orcid":false,"given":"Guangxu","family":"Xu","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine Center The First Affiliated Hospital of Nanjing Medical University  Nanjing Jiangsu Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/23969873211042192"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000430"},{"issue":"2","key":"e_1_2_12_4_1","article-title":"Cholinesterase Inhibitors for Vascular Dementia and Other Vascular Cognitive Impairments: A Network Meta\u2010Analysis","volume":"2","author":"Battle C. 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