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Aksu S, Indahlastari A, O'Shea A, Marsiske M, Cohen R, Alexander GE, DeKosky ST, Hishaw GA, Dai Y, Wu SS, Woods AJ. Facilitation of working memory capacity by transcranial direct current stimulation: a secondary analysis from the augmenting cognitive training in older adults (ACT) study. GeroScience 2024; 46:4075-4110. [PMID: 38789832 PMCID: PMC11336148 DOI: 10.1007/s11357-024-01205-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Aging is a public health concern with an ever-increasing magnitude worldwide. An array of neuroscience-based approaches like transcranial direct current stimulation (tDCS) and cognitive training have garnered attention in the last decades to ameliorate the effects of cognitive aging in older adults. This study evaluated the effects of 3 months of bilateral tDCS over the frontal cortices with multimodal cognitive training on working memory capacity. Two hundred ninety-two older adults without dementia were allocated to active or sham tDCS paired with cognitive training. These participants received repeated sessions of bilateral tDCS over the bilateral frontal cortices, combined with multimodal cognitive training. Working memory capacity was assessed with the digit span forward, backward, and sequencing tests. No baseline differences between active and sham groups were observed. Multiple linear regressions indicated more improvement of the longest digit span backward from baseline to post-intervention (p = 0.021) and a trend towards greater improvement (p = 0.056) of the longest digit span backward from baseline to 1 year in the active tDCS group. No significant between-group changes were observed for digit span forward or digit span sequencing. The present results provide evidence for the potential for tDCS paired with cognitive training to remediate age-related declines in working memory capacity. These findings are sourced from secondary outcomes in a large randomized clinical trial and thus deserve future targeted investigation in older adult populations.
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Affiliation(s)
- Serkan Aksu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
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Lv Y, Wu S, Nitsche MA, Yue T, Zschorlich VR, Qi F. A meta-analysis of the effects of transcranial direct current stimulation combined with cognitive training on working memory in healthy older adults. Front Aging Neurosci 2024; 16:1454755. [PMID: 39376507 PMCID: PMC11456488 DOI: 10.3389/fnagi.2024.1454755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 09/12/2024] [Indexed: 10/09/2024] Open
Abstract
Background Working memory (WM) loss, which can lead to a loss of independence, and declines in the quality of life of older adults, is becoming an increasingly prominent issue affecting the ageing population. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, is emerging as a potential alternative to pharmacological treatments that shows promise for enhancing WM capacity and May enhance the effects of cognitive training (CT) interventions. Objective The purpose of this meta-analysis was to explore how different tDCS protocols in combination with CT enhanced WM in healthy older adults. Methods Randomized controlled trials (RCTs) exploring the effects of tDCS combined with CT on WM in healthy older adults were retrieved from the Web of Science, PubMed, Embase, Scopus and the Cochrane Library databases. The search time period ranged from database inception to January 15, 2024. Methodological quality of the trials was assessed using the risk-of-bias criteria for RCTs from the Cochrane Collaboration Network, and RevMan 5.3 (Cochrane, London, United Kingdom) was used for the meta-analysis of the final literature outcomes. Results Six RCTs with a total of 323 participants were ultimately included. The results of the meta-analysis show that tDCS combined with CT statistically significantly improves WM performance compared to the control sham stimulation group in healthy older adults [standard mean difference (SMD) = 0.35, 95% CI: 0.11-0.59, I 2 = 0%, Z = 2.86, p = 0.004]. The first subgroup analysis indicated that, when the stimulus intensity was 2 mA, a statistically significant improvement in WM performance in healthy older adults was achieved (SMD = 0.39, 95% CI: 0.08-0.70, I 2 = 6%, Z = 2.46, p = 0.01). The second subgroup analysis showed that long-term intervention (≥ 10 sessions) with tDCS combined with CT statistically significantly improved WM compared to the control group in healthy older adults (SMD = 0.72, 95% CI: 0.22-1.21, I 2 = 0%, Z = 2.85, p = 0.004). Conclusion tDCS combined with CT statistically significantly improves WM in healthy older adults. For the stimulus parameters, long-term interventions (≥ 10 sessions) with a stimulation intensity of 2 mA are the most effective.
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Affiliation(s)
- Yanxin Lv
- Sports, Exercise, and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
| | - Shuo Wu
- Faculty of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
| | - Tian Yue
- Sports, Exercise, and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
| | - Volker R. Zschorlich
- Faculty of Philosophy, Institute of Sports Science, University of Rostock, Rostock, Germany
- Faculty of Interdisciplinary Research, Department of Ageing of Individuals and Society, University of Rostock, Rostock, Germany
- Department of Sport Science, University of Oldenburg, Oldenburg, Germany
| | - Fengxue Qi
- Sports, Exercise, and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
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Chuderski A, Chinta SR. Transcranial alternating current stimulation barely enhances working memory in healthy adults: A meta-analysis. Brain Res 2024; 1839:149022. [PMID: 38801916 DOI: 10.1016/j.brainres.2024.149022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 05/29/2024]
Abstract
Working memory (WM) is a pivotal neural mechanism for cognitive function and ability. Transcranial alternating current stimulation (tACS) was used to improve WM by entraining key brain rhythms. We submitted to meta-analysis 143 effects of tACS on WM performance, found in 42 reports published between 2014 and 2023, encompassing a total of 1386 healthy adults stimulated. The overall effect size of 134 interventions intended to improve WM equaled Hedges' g = 0.076 [0.039, 0.113]. However, after correcting for a significant publication bias this effect size dropped to zero. By contrast, 9 interventions distorting the brain synchronization using antiphase tACS reliably decreased WM performance, with Hedges' g = -0.266, [-0.458, -0.074]. Individuating the targeted frequency band was the only reliable moderator. The disparity between our null outcome and moderately positive tACS effects estimated by previous meta-analyses resulted from our inclusion of the most recent studies mostly reporting negligible effects. Our results suggest that current tACS protocols barely enhance WM in healthy adults. More research is needed to develop effective methods for WM stimulation.
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Li S, Tang Y, Zhou Y, Ni Y. Effects of Transcranial Direct Current Stimulation on Cognitive Function in Older Adults with and without Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Gerontology 2024; 70:544-560. [PMID: 38452749 DOI: 10.1159/000537848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Noninvasive brain stimulation (NIBS) has shown benefits for cognitive function in older adults. However, the effects of transcranial direct current stimulation (tDCS) on cognitive function in older adults are inconsistent across studies, and the evidence for tDCS has limitations. We aim to explore whether tDCS can improve cognitive function and different cognitive domains (i.e., learning and memory and executive function) in adults aged 65 years and older with and without mild cognitive impairment and to further analyze the influencing factors of tDCS. METHODS Five English databases (PubMed, Cochrane Library, EMBASE, Web of Science, the cumulative Index to Nursing and Allied Health Literature [CINAHL]) and four Chinese databases were searched from inception to October 14, 2023. Literature screening, data extraction, and quality assessment were completed independently by two reviewers. All statistical analyses were conducted using RevMan software (version 5.3). Standardized mean difference (SMD) along with a 95% confidence interval (CI) was used to express the effect size of the outcomes, and a random-effect model was also used. RESULTS A total of 10 RCTs and 1,761 participants were included in the meta-analysis, and the risk of bias in those studies was relatively low. A significant effect favoring tDCS on immediate postintervention cognitive function (SMD = 0.16, Z = 2.36, p = 0.02) was found. However, the effects on immediate postintervention learning and memory (SMD = 0.20, Z = 2.00, p = 0.05) and executive function (SMD = 0.10, Z = 1.22, p = 0.22), and 1-month postintervention cognitive function (SMD = 0.12, Z = 1.50, p = 0.13), learning and memory (SMD = 0.17, Z = 1.39, p = 0.16), and executive function (SMD = 0.08, Z = 0.67, p = 0.51) were not statistically significant. CONCLUSION tDCS can significantly improve the immediate postintervention cognitive function of healthy older adults and MCI elderly individuals. Additional longitudinal extensive sample studies are required to clarify the specific effects of tDCS on different cognitive domains, and the optimal tDCS parameters need to be explored to guide clinical practice.
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Affiliation(s)
- Sijia Li
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China,
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
| | - Ying Tang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - You Zhou
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunxia Ni
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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McDonald MA, Meckes SJ, Shires J, Berryhill ME, Lancaster CL. Augmenting Virtual Reality Exposure Therapy for Social and Intergroup Anxiety With Transcranial Direct Current Stimulation. J ECT 2024; 40:51-60. [PMID: 38009966 PMCID: PMC10920400 DOI: 10.1097/yct.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Exposure therapy is a cornerstone of social anxiety treatment, yet not all patients respond. Symptoms in certain social situations, including intergroup (ie, out-group) contexts, may be particularly resistant to treatment. Exposure therapy outcomes may be improved by stimulating neural areas associated with safety learning, such as the medial prefrontal cortex (mPFC). The mPFC also plays an important role in identifying others as similar to oneself. We hypothesized that targeting the mPFC during exposure therapy would reduce intergroup anxiety and social anxiety. METHODS Participants (N = 31) with the public speaking subtype of social anxiety received active (anodal) or sham transcranial direct current stimulation (tDCS) targeting the mPFC during exposure therapy. Exposure therapy consisted of giving speeches to audiences in virtual reality. To target intergroup anxiety, half of the public speaking exposure trials were conducted with out-group audiences, defined in this study as audiences of a different ethnicity. RESULTS Contrary to hypotheses, tDCS did not facilitate symptom reduction. Some evidence even suggested that tDCS temporarily increased in-group favoritism, although these effects dissipated at 1-month follow-up. In addition, collapsing across all participants, we found reductions across time for public speaking anxiety and intergroup anxiety. CONCLUSIONS The data provide evidence that standard exposure therapy techniques for social anxiety can be adapted to target intergroup anxiety. Transcranial direct current stimulation targeting the mPFC may boost safety signaling, but only in contexts previously conditioned to signal safety, such as an in-group context.
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Faralli A, Fucà E, Lazzaro G, Menghini D, Vicari S, Costanzo F. Transcranial Direct Current Stimulation in neurogenetic syndromes: new treatment perspectives for Down syndrome? Front Cell Neurosci 2024; 18:1328963. [PMID: 38456063 PMCID: PMC10917937 DOI: 10.3389/fncel.2024.1328963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/25/2024] [Indexed: 03/09/2024] Open
Abstract
This perspective review aims to explore the potential neurobiological mechanisms involved in the application of transcranial Direct Current Stimulation (tDCS) for Down syndrome (DS), the leading cause of genetically-based intellectual disability. The neural mechanisms underlying tDCS interventions in genetic disorders, typically characterized by cognitive deficits, are grounded in the concept of brain plasticity. We initially present the neurobiological and functional effects elicited by tDCS applications in enhancing neuroplasticity and in regulating the excitatory/inhibitory balance, both associated with cognitive improvement in the general population. The review begins with evidence on tDCS applications in five neurogenetic disorders, including Rett, Prader-Willi, Phelan-McDermid, and Neurofibromatosis 1 syndromes, as well as DS. Available evidence supports tDCS as a potential intervention tool and underscores the importance of advancing neurobiological research into the mechanisms of tDCS action in these conditions. We then discuss the potential of tDCS as a promising non-invasive strategy to mitigate deficits in plasticity and promote fine-tuning of the excitatory/inhibitory balance in DS, exploring implications for cognitive treatment perspectives in this population.
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Affiliation(s)
- Alessio Faralli
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Elisa Fucà
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
- Life Sciences and Public Health Department, Catholic University of Sacred Heart, Rome, Italy
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Bambino Gesù Children's Hospital (IRCCS), Rome, Italy
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Šimko P, Pupíková M, Gajdoš M, Klobušiaková P, Vávra V, Šimo A, Rektorová I. Exploring the impact of intensified multiple session tDCS over the left DLPFC on brain function in MCI: a randomized control trial. Sci Rep 2024; 14:1512. [PMID: 38233437 PMCID: PMC10794210 DOI: 10.1038/s41598-024-51690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
Transcranial direct current stimulation combined with cognitive training (tDCS-cog) represents a promising approach to combat cognitive decline among healthy older adults and patients with mild cognitive impairment (MCI). In this 5-day-long double-blinded randomized trial, we investigated the impact of intensified tDCS-cog protocol involving two trains of stimulation per day on working memory (WM) enhancement in 35 amnestic and multidomain amnestic MCI patients. Specifically, we focused to improve WM tasks relying on top-down attentional control and hypothesized that intensified tDCS would enhance performance of visual object matching task (VOMT) immediately after the stimulation regimen and at a 1-month follow-up. Secondarily, we explored whether the stimulation would augment online visual working memory training. Using fMRI, we aimed to elucidate the neural mechanisms underlying the intervention effects by analyzing BOLD activations during VOMT. Our main finding revealed no superior after-effects of tDCS-cog over the sham on VOMT among individuals with MCI as indicated by insignificant immediate and long-lasting after-effects. Additionally, the tDCS-cog did not enhance online training as predicted. The fMRI analysis revealed brain activity alterations in right insula that may be linked to tDCS-cog intervention. In the study we discuss the insignificant behavioral results in the context of the current evidence in tDCS parameter space and opening the discussion of possible interference between trained cognitive tasks.
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Affiliation(s)
- P Šimko
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - M Pupíková
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - M Gajdoš
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Brno, Czech Republic
| | - P Klobušiaková
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
- Surgeon General Office of the, Slovak Armed Forces, Ružomberok, Slovak Republic
| | - V Vávra
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - A Šimo
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - I Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Brno, Czech Republic.
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Antonenko D, Fromm AE, Thams F, Kuzmina A, Backhaus M, Knochenhauer E, Li SC, Grittner U, Flöel A. Cognitive training and brain stimulation in patients with cognitive impairment: a randomized controlled trial. Alzheimers Res Ther 2024; 16:6. [PMID: 38212815 PMCID: PMC10782634 DOI: 10.1186/s13195-024-01381-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/01/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Repeated sessions of training and non-invasive brain stimulation have the potential to enhance cognition in patients with cognitive impairment. We hypothesized that combining cognitive training with anodal transcranial direct current stimulation (tDCS) will lead to performance improvement in the trained task and yield transfer to non-trained tasks. METHODS In our randomized, sham-controlled, double-blind study, 46 patients with cognitive impairment (60-80 years) were randomly assigned to one of two interventional groups. We administered a 9-session cognitive training (consisting of a letter updating and a Markov decision-making task) over 3 weeks with concurrent 1-mA anodal tDCS over the left dorsolateral prefrontal cortex (20 min in tDCS, 30 s in sham group). Primary outcome was trained task performance (letter updating task) immediately after training. Secondary outcomes included performance in tasks testing working memory (N-back task), decision-making (Wiener Matrices test) and verbal memory (verbal learning and memory test), and resting-state functional connectivity (FC). Tasks were administered at baseline, at post-assessment, and at 1- and 7-month follow-ups (FU). MRI was conducted at baseline and 7-month FU. Thirty-nine participants (85%) successfully completed the intervention. Data analyses are reported on the intention-to-treat (ITT) and the per-protocol (PP) sample. RESULTS For the primary outcome, no difference was observed in the ITT (β = 0.1, 95%-CI [- 1.2, 1.3, p = 0.93] or PP sample (β = - 0.2, 95%-CI [- 1.6, 1.2], p = 0.77). However, secondary analyses in the N-back working memory task showed that, only in the PP sample, the tDCS outperformed the sham group (PP: % correct, β = 5.0, 95%-CI [- 0.1, 10.2], p = 0.06, d-prime β = 0.2, 95%-CI [0.0, 0.4], p = 0.02; ITT: % correct, β = 3.0, 95%-CI [- 3.9, 9.9], p = 0.39, d-prime β = 0.1, 95%-CI [- 0.1, 0.3], p = 0.5). Frontoparietal network FC was increased from baseline to 7-month FU in the tDCS compared to the sham group (pFDR < 0.05). Exploratory analyses showed a correlation between individual memory improvements and higher electric field magnitudes induced by tDCS (ρtDCS = 0.59, p = 0.02). Adverse events did not differ between groups, questionnaires indicated successful blinding (incidence rate ratio, 1.1, 95%-CI [0.5, 2.2]). CONCLUSIONS In sum, cognitive training with concurrent brain stimulation, compared to cognitive training with sham stimulation, did not lead to superior performance enhancements in patients with cognitive impairment. However, we observed transferred working memory benefits in patients who underwent the full 3-week intervention. MRI data pointed toward a potential intervention-induced modulation of neural network dynamics. A link between individual performance gains and electric fields suggested dosage-dependent effects of brain stimulation. Together, our findings do not support the immediate benefit of the combined intervention on the trained function, but provide exploratory evidence for transfer effects on working memory in patients with cognitive impairment. Future research needs to explore whether individualized protocols for both training and stimulation parameters might further enhance treatment gains. TRIAL REGISTRATION The study is registered on ClinicalTrials.gov (NCT04265378). Registered on 7 February 2020. Retrospectively registered.
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Affiliation(s)
- Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany.
| | - Anna Elisabeth Fromm
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Anna Kuzmina
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Malte Backhaus
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Elena Knochenhauer
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Technische Universität Dresden, 01062, Dresden, Germany
- Centre for Tactile Internet With Human-in-the-Loop, Technische Universität Dresden, 01062, Dresden, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), 10187, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Humboldt-Universität Zu Berlin, Berlin Institute of Health, 10117, Berlin, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475, Greifswald, Germany
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Ke Y, Liu S, Chen L, Wang X, Ming D. Lasting enhancements in neural efficiency by multi-session transcranial direct current stimulation during working memory training. NPJ SCIENCE OF LEARNING 2023; 8:48. [PMID: 37919371 PMCID: PMC10622507 DOI: 10.1038/s41539-023-00200-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/20/2023] [Indexed: 11/04/2023]
Abstract
The neural basis for long-term behavioral improvements resulting from multi-session transcranial direct current stimulation (tDCS) combined with working memory training (WMT) remains unclear. In this study, we used task-related electroencephalography (EEG) measures to investigate the lasting neurophysiological effects of anodal high-definition (HD)-tDCS applied over the left dorsolateral prefrontal cortex (dlPFC) during a challenging WMT. Thirty-four healthy young adults were randomized to sham or active tDCS groups and underwent ten 30-minute training sessions over ten consecutive days, preceded by a pre-test and followed by post-tests performed one day and three weeks after the last session, respectively, by performing high-load WM tasks along with EEG recording. Multi-session HD-tDCS significantly enhanced the behavioral benefits of WMT. Compared to the sham group, the active group showed facilitated increases in theta, alpha, beta, and gamma task-related oscillations at the end of training and significantly increased P300 response 3 weeks post-training. Our findings suggest that applying anodal tDCS over the left dlPFC during multi-session WMT can enhance the behavioral benefits of WMT and facilitate sustained improvements in WM-related neural efficiency.
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Affiliation(s)
- Yufeng Ke
- Academy of Medical Engineering and Translational Medicine, Tianjin International Joint Research Centre for Neural Engineering, and Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, PR China.
- Haihe Laboratory of Brain-computer Interaction and Human-machine Integration, Tianjin, PR China.
| | - Shuang Liu
- Academy of Medical Engineering and Translational Medicine, Tianjin International Joint Research Centre for Neural Engineering, and Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, PR China.
- Haihe Laboratory of Brain-computer Interaction and Human-machine Integration, Tianjin, PR China.
| | - Long Chen
- Academy of Medical Engineering and Translational Medicine, Tianjin International Joint Research Centre for Neural Engineering, and Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, PR China
- Haihe Laboratory of Brain-computer Interaction and Human-machine Integration, Tianjin, PR China
| | - Xiashuang Wang
- The Second Academy of China Aerospace Science and Industry Corporation, Beijing, PR China
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin International Joint Research Centre for Neural Engineering, and Tianjin Key Laboratory of Brain Science and Neural Engineering, Tianjin University, Tianjin, PR China.
- Haihe Laboratory of Brain-computer Interaction and Human-machine Integration, Tianjin, PR China.
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Vandendoorent B, Nackaerts E, Zoetewei D, Hulzinga F, Gilat M, Orban de Xivry JJ, Nieuwboer A. Effect of transcranial direct current stimulation on learning in older adults with and without Parkinson's disease: A systematic review with meta-analysis. Brain Cogn 2023; 171:106073. [PMID: 37611344 DOI: 10.1016/j.bandc.2023.106073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/26/2023] [Accepted: 07/31/2023] [Indexed: 08/25/2023]
Abstract
Older adults with and without Parkinson's disease show impaired retention after training of motor or cognitive skills. This systematic review with meta-analysis aims to investigate whether adding transcranial direct current stimulation (tDCS) to motor or cognitive training versus placebo boosts motor sequence and working memory training. The effects of interest were estimated between three time points, i.e. pre-training, post-training and follow-up. This review was conducted according to the PRISMA guidelines (PROSPERO: CRD42022348885). Electronic databases were searched from conception to March 2023. Following initial screening, 24 studies were eligible for inclusion in the qualitative synthesis and 20 could be included in the meta-analysis, of which 5 studies concerned motor sequence learning (total n = 186) and 15 working memory training (total n = 650). Results were pooled using an inverse variance random effects meta-analysis. The findings showed no statistically significant additional effects of tDCS over placebo on motor sequence learning outcomes. However, there was a strong trend showing that tDCS boosted working memory training, although methodological limitations and some heterogeneity were also apparent. In conclusion, the present findings do not support wide implementation of tDCS as an add-on to motor sequence training at the moment, but the promising results on cognitive training warrant further investigations.
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Affiliation(s)
- Britt Vandendoorent
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
| | - Evelien Nackaerts
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Demi Zoetewei
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Femke Hulzinga
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Moran Gilat
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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11
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Tetsuka M, Sakurada T, Matsumoto M, Nakajima T, Morita M, Fujimoto S, Kawai K. Higher prefrontal activity based on short-term neurofeedback training can prevent working memory decline in acute stroke. Front Syst Neurosci 2023; 17:1130272. [PMID: 37388942 PMCID: PMC10300420 DOI: 10.3389/fnsys.2023.1130272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
This study aimed to clarify whether short-term neurofeedback training during the acute stroke phase led to prefrontal activity self-regulation, providing positive efficacy to working memory. A total of 30 patients with acute stroke performed functional near-infrared spectroscopy-based neurofeedback training for a day to increase their prefrontal activity. A randomized, Sham-controlled, double-blind study protocol was used comparing working memory ability before and after neurofeedback training. Working memory was evaluated using a target-searching task requiring spatial information retention. A decline in spatial working memory performance post-intervention was prevented in patients who displayed a higher task-related right prefrontal activity during neurofeedback training compared with the baseline. Neurofeedback training efficacy was not associated with the patient's clinical background such as Fugl-Meyer Assessment score and time since stroke. These findings demonstrated that even short-term neurofeedback training can strengthen prefrontal activity and help maintain cognitive ability in acute stroke patients, at least immediately after training. However, further studies investigating the influence of individual patient clinical background, especially cognitive impairment, on neurofeedback training is needed. Current findings provide an encouraging option for clinicians to design neurorehabilitation programs, including neurofeedback protocols, for acute stroke patients.
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Affiliation(s)
- Masayuki Tetsuka
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
| | - Takeshi Sakurada
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
- Faculty of Science and Technology, Seikei University, Tokyo, Japan
- Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan
| | - Mayuko Matsumoto
- Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan
- College of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Takeshi Nakajima
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
- Rehabilitation Center, Jichi Medical University Hospital, Tochigi, Japan
| | - Mitsuya Morita
- Rehabilitation Center, Jichi Medical University Hospital, Tochigi, Japan
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Shigeru Fujimoto
- Division of Neurology, Department of Medicine, Jichi Medical University, Tochigi, Japan
| | - Kensuke Kawai
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
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12
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Antonenko D, Fromm AE, Thams F, Grittner U, Meinzer M, Flöel A. Microstructural and functional plasticity following repeated brain stimulation during cognitive training in older adults. Nat Commun 2023; 14:3184. [PMID: 37268628 DOI: 10.1038/s41467-023-38910-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
The combination of repeated behavioral training with transcranial direct current stimulation (tDCS) holds promise to exert beneficial effects on brain function beyond the trained task. However, little is known about the underlying mechanisms. We performed a monocenter, single-blind randomized, placebo-controlled trial comparing cognitive training to concurrent anodal tDCS (target intervention) with cognitive training to concurrent sham tDCS (control intervention), registered at ClinicalTrial.gov (Identifier NCT03838211). The primary outcome (performance in trained task) and secondary behavioral outcomes (performance on transfer tasks) were reported elsewhere. Here, underlying mechanisms were addressed by pre-specified analyses of multimodal magnetic resonance imaging before and after a three-week executive function training with prefrontal anodal tDCS in 48 older adults. Results demonstrate that training combined with active tDCS modulated prefrontal white matter microstructure which predicted individual transfer task performance gain. Training-plus-tDCS also resulted in microstructural grey matter alterations at the stimulation site, and increased prefrontal functional connectivity. We provide insight into the mechanisms underlying neuromodulatory interventions, suggesting tDCS-induced changes in fiber organization and myelin formation, glia-related and synaptic processes in the target region, and synchronization within targeted functional networks. These findings advance the mechanistic understanding of neural tDCS effects, thereby contributing to more targeted neural network modulation in future experimental and translation tDCS applications.
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Affiliation(s)
- Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany.
| | | | - Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Marcus Meinzer
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
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13
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Yang Z, Qi Y, Song Q, Zhang Y. Association between exposure to air pollution and memory: the mediating effect of health. J Public Health (Oxf) 2023. [DOI: 10.1007/s10389-023-01875-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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14
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Aksu S, Hasırcı Bayır BR, Sayman C, Soyata AZ, Boz G, Karamürsel S. Working memory ımprovement after transcranial direct current stimulation paired with working memory training ın diabetic peripheral neuropathy. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-14. [PMID: 36630270 DOI: 10.1080/23279095.2022.2164717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Association of cognitive deficits and diabetic peripheral neuropathy (DPN) is frequent. Working memory (WM) deficits result in impairment of daily activities, diminished functionality, and treatment compliance. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) with concurrent working memory training (WMT) ameliorates cognitive deficits. Emboldening results of tDCS were shown in DPN. The study aimed to evaluate the efficacy of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) coupled with cathodal right DLPFC with concurrent WMT in DPN for the first time. The present randomized triple-blind parallel-group sham-controlled study evaluated the efficacy of 5 sessions of tDCS over the DLPFC concurrent with WMT in 28 individuals with painful DPN on cognitive (primary) and pain-related, psychiatric outcome measures before, immediately after, and 1-month after treatment protocol. tDCS enhanced the efficacy of WMT on working memory and yielded lower anxiety levels than sham tDCS but efficacy was not superior to sham on other cognitive domains, pain severity, quality of life, and depression. tDCS with concurrent WMT enhanced WM and ameliorated anxiety in DPN without affecting other cognitive and pain-related outcomes. Further research scrutinizing the short/long-term efficacy with larger samples is accredited.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Türkiye
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Buse Rahime Hasırcı Bayır
- Department of Neurology, Health Sciences University, Haydarpaşa Numune Education and Research Hospital, Istanbul, Türkiye
| | - Ceyhun Sayman
- Translational Neurodevelopmental Neuroscience Phd Programme, Institute of Health Science, Istanbul University, Istanbul, Türkiye
| | - Ahmet Zihni Soyata
- Psychiatry Outpatient Clinic, Başakşehir State Hospital, İstanbul, Turkey
| | - Gökalp Boz
- Department of Psychology, Istanbul University, Istanbul, Türkiye
| | - Sacit Karamürsel
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
- Department of Physiology, School of Medicine, Koc University, Istanbul, Türkiye
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15
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Meléndez JC, Satorres E, Pitarque A, Escudero J, Delhom I, Navarro-Prados AB. Transcranial Direct Current Stimulation Intervention in Alzheimer's Disease and Its Follow-Up. J Alzheimers Dis 2023; 96:1685-1693. [PMID: 38007663 DOI: 10.3233/jad-230826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) stands as the prevailing type of dementia, marked by gradual memory loss and cognitive decline. Transcranial direct current stimulation (tDCS) is a non-invasive method used to regulate cortical brain function and has been explored as a potential treatment for cognitive impairment. OBJECTIVE This study aimed to compare the effects of daily home-based active or sham tDCS on cognitive function in patients with early-stage AD and its follow-up after one month. METHODS The study involved a randomized, blinded, and controlled-placebo design, with 18 participants enrolled. The primary outcome measures were general cognitive function, immediate, and delayed recall, and executive function. Participants included in the study were randomly assigned to the anodal and sham tDCS groups. Participants were assessed before and after the intervention and one month after the end of treatment. The home-based intervention was applied for 5 consecutive days, daily. RESULTS The results showed a significant interaction between the active and sham groups; in particular, improvements in MMSE scores, immediate memory and delayed recall were observed at one-month follow-up in the active group. CONCLUSIONS The positive effects of tDCS on cognitive function in AD patients observed suggest that tDCS may induce long-term neuroplastic changes, leading to sustained improvements in cognitive abilities.
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Affiliation(s)
- Juan C Meléndez
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Encarnación Satorres
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Alfonso Pitarque
- Department of Methodology, Faculty of Psychology, University of Valencia, Valencia, Spain
| | | | | | - Ana-Belén Navarro-Prados
- Department of Developmental Psychology, Faculty of Psychology, University of Salamanca, Salamanca, Spain
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16
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Westwood SJ, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Agbedjro D, Wexler BE, Cohen Kadosh R, Asherson P, Rubia K. Transcranial direct current stimulation (tDCS) combined with cognitive training in adolescent boys with ADHD: a double-blind, randomised, sham-controlled trial. Psychol Med 2023; 53:497-512. [PMID: 34225830 PMCID: PMC9899574 DOI: 10.1017/s0033291721001859] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 03/19/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) could be a side-effect-free alternative to psychostimulants in attention-deficit/hyperactivity disorder (ADHD). Although there is limited evidence for clinical and cognitive effects, most studies were small, single-session and stimulated left dorsolateral prefrontal cortex (dlPFC). No sham-controlled study has stimulated the right inferior frontal cortex (rIFC), which is the most consistently under-functioning region in ADHD, with multiple anodal-tDCS sessions combined with cognitive training (CT) to enhance effects. Thus, we investigated the clinical and cognitive effects of multi-session anodal-tDCS over rIFC combined with CT in double-blind, randomised, sham-controlled trial (RCT, ISRCTN48265228). METHODS Fifty boys with ADHD (10-18 years) received 15 weekday sessions of anodal- or sham-tDCS over rIFC combined with CT (20 min, 1 mA). ANCOVA, adjusting for baseline measures, age and medication status, tested group differences in clinical and ADHD-relevant executive functions at posttreatment and after 6 months. RESULTS ADHD-Rating Scale, Conners ADHD Index and adverse effects were significantly lower at post-treatment after sham relative to anodal tDCS. No other effects were significant. CONCLUSIONS This rigorous and largest RCT of tDCS in adolescent boys with ADHD found no evidence of improved ADHD symptoms or cognitive performance following multi-session anodal tDCS over rIFC combined with CT. These findings extend limited meta-analytic evidence of cognitive and clinical effects in ADHD after 1-5 tDCS sessions over mainly left dlPFC. Given that tDCS is commercially and clinically available, the findings are important as they suggest that rIFC stimulation may not be indicated as a neurotherapy for cognitive or clinical remediation for ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
- Department of Neuroimaging, King's College London, London, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
| | | | - Bruce E. Wexler
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Roi Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry, King's College London, London, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, King's College London, London, UK
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17
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Pupíková M, Šimko P, Lamoš M, Gajdoš M, Rektorová I. Inter-individual differences in baseline dynamic functional connectivity are linked to cognitive aftereffects of tDCS. Sci Rep 2022; 12:20754. [PMID: 36456622 PMCID: PMC9715685 DOI: 10.1038/s41598-022-25016-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has the potential to modulate cognitive training in healthy aging; however, results from various studies have been inconsistent. We hypothesized that inter-individual differences in baseline brain state may contribute to the varied results. We aimed to explore whether baseline resting-state dynamic functional connectivity (rs-dFC) and/or conventional resting-state static functional connectivity (rs-sFC) may be related to the magnitude of cognitive aftereffects of tDCS. To achieve this aim, we used data from our double-blind randomized sham-controlled cross-over tDCS trial in 25 healthy seniors in which bifrontal tDCS combined with cognitive training had induced significant behavioral aftereffects. We performed a backward regression analysis including rs-sFC/rs-dFC measures to explain the variability in the magnitude of tDCS-induced improvements in visual object-matching task (VOMT) accuracy. Rs-dFC analysis revealed four rs-dFC states. The occurrence rate of a rs-dFC state 4, characterized by a high correlation between the left fronto-parietal control network and the language network, was significantly associated with tDCS-induced VOMT accuracy changes. The rs-sFC measure was not significantly associated with the cognitive outcome. We show that flexibility of the brain state representing readiness for top-down control of object identification implicated in the studied task is linked to the tDCS-enhanced task accuracy.
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Affiliation(s)
- Monika Pupíková
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Patrik Šimko
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Lamoš
- Brain and Mind Research Program, Central European Institute of Technology - CEITEC, Masaryk university, Brno, Czech Republic
| | - Martin Gajdoš
- Multimodal and Functional Neuroimaging Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
| | - Irena Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic.
- First Department of Neurology, St. Anne's University Hospital and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
- International Clinical Research Center, ICRC, St Anne's University Hospital and Faculty of Medicine, Brno, Czech Republic.
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18
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Voegtle A, Reichert C, Hinrichs H, Sweeney-Reed CM. Repetitive Anodal TDCS to the Frontal Cortex Increases the P300 during Working Memory Processing. Brain Sci 2022; 12:1545. [PMID: 36421869 PMCID: PMC9688092 DOI: 10.3390/brainsci12111545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 10/17/2023] Open
Abstract
Transcranial direct current stimulation (TDCS) is a technique with which neuronal activity, and therefore potentially behavior, is modulated by applying weak electrical currents to the scalp. Application of TDCS to enhance working memory (WM) has shown promising but also contradictory results, and little emphasis has been placed on repeated stimulation protocols, in which effects are expected to be increased. We aimed to characterize potential behavioral and electrophysiological changes induced by TDCS during WM training and evaluate whether repetitive anodal TDCS has a greater modulatory impact on the processes underpinning WM than single-session stimulation. We examined the effects of single-session and repetitive anodal TDCS to the dorsolateral prefrontal cortex (DLPFC), targeting the frontal-parietal network, during a WM task in 20 healthy participants. TDCS had no significant impact on behavioral measures, including reaction time and accuracy. Analyzing the electrophysiological response, the P300 amplitude significantly increased following repetitive anodal TDCS, however, positively correlating with task performance. P300 changes were identified over the parietal cortex, which is known to engage with the frontal cortex during WM processing. These findings support the hypothesis that repetitive anodal TDCS modulates electrophysiological processes underlying WM.
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Affiliation(s)
- Angela Voegtle
- Neurocybernetics and Rehabilitation, Department of Neurology, Otto von Guericke University, 39120 Magdeburg, Germany
| | - Christoph Reichert
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, 39118 Magdeburg, Germany
- Center for Behavioral Brain Sciences—CBBS, Otto von Guericke University, 39106 Magdeburg, Germany
| | - Hermann Hinrichs
- Department of Behavioral Neurology, Leibniz Institute for Neurobiology, 39118 Magdeburg, Germany
- Center for Behavioral Brain Sciences—CBBS, Otto von Guericke University, 39106 Magdeburg, Germany
- Department of Neurology, Otto von Guericke University, 39120 Magdeburg, Germany
| | - Catherine M. Sweeney-Reed
- Neurocybernetics and Rehabilitation, Department of Neurology, Otto von Guericke University, 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences—CBBS, Otto von Guericke University, 39106 Magdeburg, Germany
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19
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Assecondi S, Hu R, Kroeker J, Eskes G, Shapiro K. Older adults with lower working memory capacity benefit from transcranial direct current stimulation when combined with working memory training: A preliminary study. Front Aging Neurosci 2022; 14:1009262. [PMID: 36299611 PMCID: PMC9589058 DOI: 10.3389/fnagi.2022.1009262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 09/20/2022] [Indexed: 11/27/2022] Open
Abstract
Aging is a very diverse process: successful agers retain most cognitive functioning, while others experience mild to severe cognitive decline. This decline may eventually negatively impact one’s everyday activities. Therefore, scientists must develop approaches to counteract or, at least, slow down the negative change in cognitive performance of aging individuals. Combining cognitive training and transcranial direct current stimulation (tDCS) is a promising approach that capitalizes on the plasticity of brain networks. However, the efficacy of combined methods depends on individual characteristics, such as the cognitive and emotional state of the individual entering the training program. In this report, we explored the effectiveness of working memory training, combined with tDCS to the right dorsolateral prefrontal cortex (DLPFC), to manipulate working memory performance in older individuals. We hypothesized that individuals with lower working memory capacity would benefit the most from the combined regimen. Thirty older adults took part in a 5-day combined regimen. Before and after the training, we evaluated participants’ working memory performance with five working memory tasks. We found that individual characteristics influenced the outcome of combined cognitive training and tDCS regimens, with the intervention selectively benefiting old-old adults with lower working memory capacity. Future work should consider developing individualized treatments by considering individual differences in cognitive profiles.
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Affiliation(s)
- Sara Assecondi
- Center for Mind/Brain Sciences—CIMeC, University of Trento, Rovereto, Italy
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Center for Human Brain Health (CHBH), University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Sara Assecondi, ,
| | - Rong Hu
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Department of Neurology, School of Medicine, Guangzhou First People’s Hospital, South China University of Technology, Guangzhou, China
| | - Jacob Kroeker
- Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Gail Eskes
- Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Kim Shapiro
- Visual Experience Laboratory, School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Center for Human Brain Health (CHBH), University of Birmingham, Birmingham, United Kingdom
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20
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Satorres E, Meléndez JC, Pitarque A, Real E, Abella M, Escudero J. Enhancing Immediate Memory, Potential Learning, and Working Memory with Transcranial Direct Current Stimulation in Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12716. [PMID: 36232016 PMCID: PMC9564946 DOI: 10.3390/ijerph191912716] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has emerged as a prevention method or minimizer of the normal cognitive deterioration that occurs during the aging process. tDCS can be used to enhance cognitive functions such as immediate memory, learning, or working memory in healthy subjects. The objective of this study was to analyze the effect of two 20-min sessions of anodal transcranial direct stimulation on immediate memory, learning potential, and working memory in healthy older adults. METHODS A randomized, single-blind, repeated-measures, sham-controlled design was used. The sample is made up of 31 healthy older adults, of whom 16 were in the stimulation group and 15 were in the sham group. The anode was placed on position F7, coinciding with the left dorsolateral prefrontal cortex region, and the cathode was placed on Fp2, the right supraorbital area (rSO). RESULTS When comparing the results of the treatment group and the sham group, differences were observed in working memory and learning potential; however, no differences in immediate memory were found. CONCLUSION The results showed that tDCS is a non-invasive and safe tool to enhance cognitive processes in healthy older adults interested in maintaining some cognitive function.
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Affiliation(s)
- Encarnación Satorres
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Juan C. Meléndez
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Alfonso Pitarque
- Department of Methodology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Elena Real
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Mireia Abella
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Joaquin Escudero
- Hospital General of Valencia, Av. Tres Cruces, 2, 46014 Valencia, Spain
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21
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Association between WeChat Use and Memory Performance among Older Adults in China: The Mediating Role of Depression. Behav Sci (Basel) 2022; 12:bs12090323. [PMID: 36135127 PMCID: PMC9495430 DOI: 10.3390/bs12090323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/17/2022] Open
Abstract
Changes to memory performance in the course of aging may be influenced by behavioral factors. The use of social media among elderly people is increasing, but studying its effect on cognitive functions such as memory remains at an early stage of development. Meanwhile, the linking mechanisms underlying the association between social media use and memory performance, if any exist, have not been revealed. This study attempted to examine the association between the use of WeChat, the most popular social media platform in China, and memory performance among older people, and to test the possible mediating role of depression underlying this association. Data were drawn from the five-wave survey of the China Family Panel Study (CFPS), and 4929 respondents aged 60 or older (mean age = 68.19, SD = 5.84, 48.2% females) were included. Based on the descriptive statistics, the chi-squared test, Student’s t-test, correlation analysis, and mediation analysis were conducted. The results indicated that the usage rate of WeChat among the sample was 20.1%. After controlling for demographic variables, the use of WeChat was related to higher levels of memory performance and lower levels of depression. Moreover, depression partially mediated the relationship between WeChat use and memory performance. To maintain memory performance and promote cognitive health in the course of aging, using social media and alleviating depression merit special attention.
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22
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Thams F, Rocke M, Malinowski R, Nowak R, Grittner U, Antonenko D, Flöel A. Feasibility of Cognitive Training in Combination With Transcranial Direct Current Stimulation in a Home-Based Context (TrainStim-Home): study protocol for a randomised controlled trial. BMJ Open 2022; 12:e059943. [PMID: 35688585 PMCID: PMC9189820 DOI: 10.1136/bmjopen-2021-059943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION With the worldwide increase of life expectancy leading to a higher proportion of older adults experiencing age-associated deterioration of cognitive abilities, the development of effective and widely accessible prevention and therapeutic measures has become a priority and challenge for modern medicine. Combined interventions of cognitive training and transcranial direct current stimulation (tDCS) have shown promising results for counteracting age-associated cognitive decline. However, access to clinical centres for repeated sessions is challenging, particularly in rural areas and for older adults with reduced mobility, and lack of clinical personnel and hospital space prevents extended interventions in larger cohorts. A home-based and remotely supervised application of tDCS would make the treatment more accessible for participants and relieve clinical resources. So far, studies assessing feasibility of combined interventions with a focus on cognition in a home-based setting are rare. With this study, we aim to provide evidence for the feasibility and the effects of a multisession home-based cognitive training in combination with tDCS on cognitive functions of healthy older adults. METHODS AND ANALYSIS The TrainStim-Home trial is a monocentric, randomised, double-blind, placebo-controlled study. Thirty healthy participants, aged 60-80 years, will receive 2 weeks of combined cognitive training and anodal tDCS over left dorsolateral prefrontal cortex (target intervention), compared with cognitive training plus sham stimulation. The cognitive training will comprise a letter updating task, and the participants will be stimulated for 20 min with 1.5 mA. The intervention sessions will take place at the participants' home, and primary outcome will be the feasibility, operationalised by two-thirds successfully completed sessions per participant. Additionally, performance in the training task and an untrained task will be analysed. ETHICS AND DISSEMINATION Ethical approval was granted by the ethics committee of the University Medicine Greifswald. Results will be available through publications in peer-reviewed journals and presentations at national and international conferences. TRIAL REGISTRATION NUMBER NCT04817124.
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Affiliation(s)
- Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Merle Rocke
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Robert Malinowski
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Rafal Nowak
- Department of Neurology, University of California San Francisco, San Francisco, California, USA
- Neuroelectrics Barcelona SL, Barcelona, Spain
| | - Ulrike Grittner
- Berlin Institute of Health, Charité - University Medicine Berlin, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - University Medicine Berlin, Corporate Member of Freie Universität Berlin, Humboldt-University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases, Greifswald, Germany
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23
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Caulfield KA, Indahlastari A, Nissim NR, Lopez JW, Fleischmann HH, Woods AJ, George MS. Electric Field Strength From Prefrontal Transcranial Direct Current Stimulation Determines Degree of Working Memory Response: A Potential Application of Reverse-Calculation Modeling? Neuromodulation 2022; 25:578-587. [PMID: 35670064 DOI: 10.1111/ner.13342] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) for working memory is an enticing treatment, but there is mixed evidence to date. OBJECTIVES We tested the effects of electric field strength from uniform 2 mA dosing on working memory change from prestimulation to poststimulation. Second, we statistically evaluated a reverse-calculation method of individualizing tDCS dose and its effect on normalizing electric field at the cortex. MATERIALS AND METHODS We performed electric field modeling on a data set of 28 healthy older adults (15 women, mean age = 73.7, SD = 7.3) who received ten sessions of active 2 mA tDCS (N = 14) or sham tDCS (N = 14) applied over bilateral dorsolateral prefrontal cortices (DLPFC) in a triple-blind design. We evaluated the relationship between electric field strength and working memory change on an N-back task in conditions of above-median, high electric field from active 2 mA (N = 7), below-median, low electric field from active 2 mA (N = 7), and sham (N = 14) at regions of interest (ROI) at the left and right DLPFC. We then determined the individualized reverse-calculation dose to produce the group average electric field and measured the electric field variance between uniform 2 mA doses vs individualized reverse-calculation doses at the same ROIs. RESULTS Working memory improvements from pre- to post-tDCS were significant for the above-median electric field from active 2 mA condition at the left DLPFC (mixed ANOVA, p = 0.013). Furthermore, reverse-calculation modeling significantly reduced electric field variance at both ROIs (Levene's test; p < 0.001). CONCLUSIONS Higher electric fields at the left DLPFC from uniform 2 mA doses appear to drive working memory improvements from tDCS. Individualized doses from reverse-calculation modeling significantly reduce electric field variance at the cortex. Taken together, using reverse-calculation modeling to produce the same, high electric fields at the cortex across participants may produce more effective future tDCS treatments for working memory.
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Affiliation(s)
- Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - James W Lopez
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Holly H Fleischmann
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Mark S George
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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24
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Westwood SJ, Bozhilova N, Criaud M, Lam SL, Lukito S, Wallace-Hanlon S, Kowalczyk OS, Kostara A, Mathew J, Wexler BE, Kadosh RC, Asherson P, Rubia K. The effect of transcranial direct current stimulation (tDCS) combined with cognitive training on EEG spectral power in adolescent boys with ADHD: A double-blind, randomized, sham-controlled trial. IBRO Neurosci Rep 2022; 12:55-64. [PMID: 35746969 PMCID: PMC9210460 DOI: 10.1016/j.ibneur.2021.12.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/19/2021] [Indexed: 12/19/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a possible alternative to psychostimulants in Attention-Deficit/Hyperactivity Disorder (ADHD), but its mechanisms of action in children and adolescents with ADHD are poorly understood. We conducted the first 15-session, sham-controlled study of anodal tDCS over right inferior frontal cortex (rIFC) combined with cognitive training (CT) in 50 children/adolescents with ADHD. We investigated the mechanisms of action on resting and Go/No-Go Task-based QEEG measures in a subgroup of 23 participants with ADHD (n, sham = 10; anodal tDCS = 13). We failed to find a significant sham versus anodal tDCS group differences in QEEG spectral power during rest and Go/No-Go Task performance, a correlation between QEEG and Go/No-Go Task performance, and changes in clinical and cognitive measures. These findings extend the non-significant clinical and cognitive effects in our sample of 50 children/adolescents with ADHD. Given that the subgroup of 23 participants would have been underpowered, the interpretation of our findings is limited and should be used as a foundation for future investigations. Larger, adequately powered randomized controlled trials should explore different protocols titrated to the individual and using comprehensive measures to assess cognitive, clinical, and neural effects of tDCS and its underlying mechanisms of action in ADHD.
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Affiliation(s)
- Samuel J. Westwood
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Wolverhampton, Wolverhampton WV1 1LY UK
- Department of Psychology, School of Social Science, University of Westminster, London W1W 6UW, UK
| | - Natali Bozhilova
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Marion Criaud
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sheut-Ling Lam
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Steve Lukito
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Sophie Wallace-Hanlon
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Olivia S. Kowalczyk
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Afroditi Kostara
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Joseph Mathew
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Bruce E. Wexler
- Department of Psychiatry, Yale University School of Medicine, 06520–8096, USA
| | - Roi Cohen Kadosh
- School of Psychology, University of Surrey, Guildford GU2 7XH, UK
| | - Philip Asherson
- Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
| | - Katya Rubia
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK
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25
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Antal A, Luber B, Brem AK, Bikson M, Brunoni AR, Cohen Kadosh R, Dubljević V, Fecteau S, Ferreri F, Flöel A, Hallett M, Hamilton RH, Herrmann CS, Lavidor M, Loo C, Lustenberger C, Machado S, Miniussi C, Moliadze V, Nitsche MA, Rossi S, Rossini PM, Santarnecchi E, Seeck M, Thut G, Turi Z, Ugawa Y, Venkatasubramanian G, Wenderoth N, Wexler A, Ziemann U, Paulus W. Non-invasive brain stimulation and neuroenhancement. Clin Neurophysiol Pract 2022; 7:146-165. [PMID: 35734582 PMCID: PMC9207555 DOI: 10.1016/j.cnp.2022.05.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/19/2022] [Accepted: 05/18/2022] [Indexed: 12/15/2022] Open
Abstract
Attempts to enhance human memory and learning ability have a long tradition in science. This topic has recently gained substantial attention because of the increasing percentage of older individuals worldwide and the predicted rise of age-associated cognitive decline in brain functions. Transcranial brain stimulation methods, such as transcranial magnetic (TMS) and transcranial electric (tES) stimulation, have been extensively used in an effort to improve cognitive functions in humans. Here we summarize the available data on low-intensity tES for this purpose, in comparison to repetitive TMS and some pharmacological agents, such as caffeine and nicotine. There is no single area in the brain stimulation field in which only positive outcomes have been reported. For self-directed tES devices, how to restrict variability with regard to efficacy is an essential aspect of device design and function. As with any technique, reproducible outcomes depend on the equipment and how well this is matched to the experience and skill of the operator. For self-administered non-invasive brain stimulation, this requires device designs that rigorously incorporate human operator factors. The wide parameter space of non-invasive brain stimulation, including dose (e.g., duration, intensity (current density), number of repetitions), inclusion/exclusion (e.g., subject's age), and homeostatic effects, administration of tasks before and during stimulation, and, most importantly, placebo or nocebo effects, have to be taken into account. The outcomes of stimulation are expected to depend on these parameters and should be strictly controlled. The consensus among experts is that low-intensity tES is safe as long as tested and accepted protocols (including, for example, dose, inclusion/exclusion) are followed and devices are used which follow established engineering risk-management procedures. Devices and protocols that allow stimulation outside these parameters cannot claim to be "safe" where they are applying stimulation beyond that examined in published studies that also investigated potential side effects. Brain stimulation devices marketed for consumer use are distinct from medical devices because they do not make medical claims and are therefore not necessarily subject to the same level of regulation as medical devices (i.e., by government agencies tasked with regulating medical devices). Manufacturers must follow ethical and best practices in marketing tES stimulators, including not misleading users by referencing effects from human trials using devices and protocols not similar to theirs.
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Key Words
- AD, Alzheimer’s Disease
- BDNF, brain derived neurotrophic factor
- Cognitive enhancement
- DARPA, Defense Advanced Research Projects Agency
- DIY stimulation
- DIY, Do-It-Yourself
- DLPFC, dorsolateral prefrontal cortex
- EEG, electroencephalography
- EMG, electromyography
- FCC, Federal Communications Commission
- FDA, (U.S.) Food and Drug Administration
- Home-stimulation
- IFCN, International Federation of Clinical Neurophysiology
- LTD, long-term depression
- LTP, long-term potentiation
- MCI, mild cognitive impairment
- MDD, Medical Device Directive
- MDR, Medical Device Regulation
- MEP, motor evoked potential
- MRI, magnetic resonance imaging
- NIBS, noninvasive brain stimulation
- Neuroenhancement
- OTC, Over-The-Counter
- PAS, paired associative stimulation
- PET, positron emission tomography
- PPC, posterior parietal cortex
- QPS, quadripulse stimulation
- RMT, resting motor threshold
- SAE, serious adverse event
- SMA, supplementary motor cortex
- TBS, theta-burst stimulation
- TMS, transcranial magnetic stimulation
- Transcranial brain stimulation
- rTMS, repetitive transcranial magnetic stimulation
- tACS
- tACS, transcranial alternating current stimulation
- tDCS
- tDCS, transcranial direct current stimulation
- tES, transcranial electric stimulation
- tRNS, transcranial random noise stimulation
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Affiliation(s)
- Andrea Antal
- Department of Neurology, University Medical Center, Göttingen, Germany
| | - Bruce Luber
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Marom Bikson
- Biomedical Engineering at the City College of New York (CCNY) of the City University of New York (CUNY), NY, USA
| | - Andre R. Brunoni
- Departamento de Clínica Médica e de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Veljko Dubljević
- Science, Technology and Society Program, College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, CERVO Brain Research Centre, Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Florinda Ferreri
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475 Greifswald, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roy H. Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Michal Lavidor
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Israel
| | - Collen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales; The George Institute; Sydney, Australia
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Carlo Miniussi
- Center for Mind/Brain Sciences – CIMeC and Centre for Medical Sciences - CISMed, University of Trento, Rovereto, Italy
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU, Dortmund, Germany
- Dept. Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Paolo M. Rossini
- Department of Neuroscience and Neurorehabilitation, Brain Connectivity Lab, IRCCS-San Raffaele-Pisana, Rome, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Margitta Seeck
- Department of Clinical Neurosciences, Hôpitaux Universitaires de Genève, Switzerland
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, School of Psychology and Neuroscience, EEG & Epolepsy Unit, University of Glasgow, United Kingdom
| | - Zsolt Turi
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Walter Paulus
- Department of of Neurology, Ludwig Maximilians University Munich, Germany
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26
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Senkowski D, Sobirey R, Haslacher D, Soekadar SR. Boosting working memory: Uncovering the differential effects of tDCS and tACS. Cereb Cortex Commun 2022; 3:tgac018. [PMID: 35592391 PMCID: PMC9113288 DOI: 10.1093/texcom/tgac018] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 04/07/2022] [Accepted: 04/14/2022] [Indexed: 11/12/2022] Open
Abstract
Abstract
Working memory (WM) is essential for reasoning, decision making and problem solving. Recently, there has been an increasing effort in improving WM through non-invasive brain stimulation, especially transcranial direct and alternating current stimulation (tDCS/tACS). Studies suggest that tDCS and tACS can modulate WM performance, but large variability in research approaches hinders identification of optimal stimulation protocols and interpretation of study results. Moreover, it is unclear whether tDCS and tACS differentially affect WM. Here, we summarize and compare studies examining the effects of tDCS and tACS on WM performance in healthy adults. Following PRISMA-selection criteria, our systematic review resulted in 43 studies (29 tDCS, 11 tACS, 3 both) with a total of 1826 adult participants. For tDCS, only 4 out of 23 single-session studies reported effects on WM, while 7 out of 9 multi-session experiments showed positive effects on WM training. For tACS, 10 out of 14 studies demonstrated effects on WM, which were frequency dependent and robust for frontoparietal stimulation. Our review revealed no reliable effect of single-session tDCS on WM, but moderate effects of multi-session tDCS and single-session tACS. We discuss implications of these findings and future directions in the emerging research field of non-invasive brain stimulation and WM.
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Affiliation(s)
- Daniel Senkowski
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charitéplatz 1, 10117 Berlin
| | - Rabea Sobirey
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charitéplatz 1, 10117 Berlin
| | - David Haslacher
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charitéplatz 1, 10117 Berlin
| | - Surjo R Soekadar
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences, Charité Campus Mitte (CCM), Charitéplatz 1, 10117 Berlin
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27
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Au J, Smith-Peirce RN, Carbone E, Moon A, Evans M, Jonides J, Jaeggi SM. Effects of Multisession Prefrontal Transcranial Direct Current Stimulation on Long-term Memory and Working Memory in Older Adults. J Cogn Neurosci 2022; 34:1015-1037. [PMID: 35195728 PMCID: PMC9836784 DOI: 10.1162/jocn_a_01839] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive form of electrical brain stimulation popularly used to augment the effects of working memory (WM) training. Although success has been mixed, some studies report enhancements in WM performance persisting days, weeks, or even months that are actually more reminiscent of consolidation effects typically observed in the long-term memory (LTM) domain, rather than WM improvements per se. Although tDCS has been often reported to enhance both WM and LTM, these effects have never been directly compared within the same study. However, given their considerable neural and behavioral overlap, this is a timely comparison to make. This study reports results from a multisession intervention in older adults comparing active and sham tDCS over the left dorsolateral pFC during training on both an n-back WM task and a word learning LTM task. We found strong and robust effects on LTM, but mixed effects on WM that only emerged for those with lower baseline ability. Importantly, mediation analyses showed an indirect effect of tDCS on WM that was mediated by improvements in consolidation. We conclude that tDCS over the left dorsolateral pFC can be used as an effective intervention to foster long-term learning and memory consolidation in aging, which can manifest in performance improvements across multiple memory domains.
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Affiliation(s)
- Jacky Au
- School of Education, University of California, Irvine, Irvine CA, 92697, USA
| | | | - Elena Carbone
- Department of General Psychology, University of Padova, Padova, 35131, Italy
| | - Austin Moon
- Department of Psychology, University of California, Riverside, Riverside CA, 92521, USA
| | - Michelle Evans
- Department of Psychology, University of Michigan, Ann Arbor MI, 48109, USA
| | - John Jonides
- Department of Psychology, University of Michigan, Ann Arbor MI, 48109, USA
| | - Susanne M. Jaeggi
- School of Education, University of California, Irvine, Irvine CA, 92697, USA
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28
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Teixeira-Santos AC, Moreira CS, Pereira DR, Pinal D, Fregni F, Leite J, Carvalho S, Sampaio A. Working Memory Training Coupled With Transcranial Direct Current Stimulation in Older Adults: A Randomized Controlled Experiment. Front Aging Neurosci 2022; 14:827188. [PMID: 35493937 PMCID: PMC9039392 DOI: 10.3389/fnagi.2022.827188] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects. Methods In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven’s Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis. Results Working memory training improved dual n-back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim. Conclusion This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up.
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Affiliation(s)
- Ana C. Teixeira-Santos
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Department of Social Sciences, Institute for Research on Socio-Economic Inequality, University of Luxembourg, Esch-Belval, Luxembourg
- *Correspondence: Ana C. Teixeira-Santos,
| | - Célia S. Moreira
- Department of Mathematics, Centre for Mathematics of the University of Porto, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Diana R. Pereira
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Diego Pinal
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Jorge Leite
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Portucalense Institute for Human Development, Universidade Portucalense, Porto, Portugal
| | - Sandra Carvalho
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Adriana Sampaio,
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Thams F, Antonenko D, Fleischmann R, Meinzer M, Grittner U, Schmidt S, Brakemeier EL, Steinmetz A, Flöel A. Neuromodulation through brain stimulation-assisted cognitive training in patients with post-COVID-19 cognitive impairment (Neuromod-COV): study protocol for a PROBE phase IIb trial. BMJ Open 2022; 12:e055038. [PMID: 35410927 PMCID: PMC9002255 DOI: 10.1136/bmjopen-2021-055038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION A substantial number of patients diagnosed with COVID-19 experience long-term persistent symptoms. First evidence suggests that long-term symptoms develop largely independently of disease severity and include, among others, cognitive impairment. For these symptoms, there are currently no validated therapeutic approaches available. Cognitive training interventions are a promising approach to counteract cognitive impairment. Combining training with concurrent transcranial direct current stimulation (tDCS) may further increase and sustain behavioural training effects. Here, we aim to examine the effects of cognitive training alone or in combination with tDCS on cognitive performance, quality of life and mental health in patients with post-COVID-19 subjective or objective cognitive impairments. METHODS AND ANALYSIS This study protocol describes a prospective randomised open endpoint-blinded trial. Patients with post-COVID-19 cognitive impairment will either participate in a 3-week cognitive training or in a defined muscle relaxation training (open-label interventions). Irrespective of their primary intervention, half of the cognitive training group will additionally receive anodal tDCS, all other patients will receive sham tDCS (double-blinded, secondary intervention). The primary outcome will be improvement of working memory performance, operationalised by an n-back task, at the postintervention assessment. Secondary outcomes will include performance on trained and untrained tasks and measures of health-related quality of life at postassessment and follow-up assessments (1 month after the end of the trainings). ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee of the University Medicine Greifswald (number: BB 066/21). Results will be available through publications in peer-reviewed journals and presentations at national and international conferences. TRIAL REGISTRATION NUMBER NCT04944147.
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Affiliation(s)
- Friederike Thams
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Daria Antonenko
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Robert Fleischmann
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sein Schmidt
- Clinical Research Unit, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Anke Steinmetz
- Department of Physical and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Rostock, Germany
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Jones KT, Smith CC, Gazzaley A, Zanto TP. Research outside the laboratory: Longitudinal at-home neurostimulation. Behav Brain Res 2022; 428:113894. [DOI: 10.1016/j.bbr.2022.113894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 03/14/2022] [Accepted: 04/11/2022] [Indexed: 11/02/2022]
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Balduin-Philipps LS, Weiss S, Mueller H. Supporting auditory word recognition with transcranial direct current stimulation: effects in elderly individuals with and without objective memory complaints. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2022; 29:237-259. [PMID: 33432880 DOI: 10.1080/13825585.2020.1861203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 12/03/2020] [Indexed: 06/12/2023]
Abstract
Healthy elderly people often experience a subjective loss of daily memory performance whereas an objective decrease in memory performance is often observed in patients with memory complaints. In this paper, we investigate the influence of a single session of "anodal" transcranial direct current stimulation (a-tDCS) on auditory word recognition performance in a decision time experiment. Three groups of participants (>64 years of age) with and without memory complaints underwent a word recognition task, in which they had to recognize words previously encoded among several distractors (semantically or phonologically related words) via a button press. In this double-blinded study, the participants completed two sessions (sham/a-tDCS), counterbalanced between subjects with a washout period of at least 10 days. Twenty minutes of 1.5 mA a-tDCS was applied over the left temporal cortex during the memorizing and decision phases. Overall, our results demonstrated that the participants, independent of their memory performance, were faster in word recognition during a-tDCS. As expected, older participants with memory complaints recognized significantly less words correctly compared to other participants. However, tDCS did not have a beneficial effect on the extent of successful word recognition. These results suggest a general effect of a single session of a-tDCS over the left temporal cortex, with participants becoming faster in their word recognition, thus having easier access to encoded words.
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Affiliation(s)
- Larissa S Balduin-Philipps
- Experimental Neurolinguistics Group, Bielefeld University, Bielefeld, Germany
- Cluster of Excellence "Cognitive Interaction Technology" (CITEC), Bielefeld University, Bielefeld, Germany
| | - Sabine Weiss
- Experimental Neurolinguistics Group, Bielefeld University, Bielefeld, Germany
- Cluster of Excellence "Cognitive Interaction Technology" (CITEC), Bielefeld University, Bielefeld, Germany
- Clinical Linguistics, Bielefeld University, Bielefeld, Germany
| | - Horst Mueller
- Experimental Neurolinguistics Group, Bielefeld University, Bielefeld, Germany
- Cluster of Excellence "Cognitive Interaction Technology" (CITEC), Bielefeld University, Bielefeld, Germany
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Antonenko D, Thams F, Grittner U, Uhrich J, Glöckner F, Li S, Flöel A. Randomized trial of cognitive training and brain stimulation in non-demented older adults. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2022; 8:e12262. [PMID: 35229023 PMCID: PMC8864498 DOI: 10.1002/trc2.12262] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 12/09/2021] [Accepted: 01/11/2022] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Given rapid global population aging, developing interventions against age-associated cognitive decline is an important medical and societal goal. We evaluated a cognitive training protocol combined with transcranial direct current stimulation (tDCS) on trained and non-trained functions in non-demented older adults. METHODS Fifty-six older adults (65-80 years) were randomly assigned to one of two interventional groups, using age and baseline performance as strata. Both groups performed a nine-session cognitive training over 3 weeks with either concurrent anodal tDCS (atDCS, 1 mA, 20 minutes) over the left dorsolateral prefrontal cortex (target intervention) or sham stimulation (control intervention). Primary outcome was performance on the trained letter updating task immediately after training. Secondary outcomes included performance on other executive and memory (near and far transfer) tasks. All tasks were administered at baseline, post-intervention, and at 1- and 7-month follow-up assessments. Prespecified analyses to investigate treatment effects were conducted using mixed-model analyses. RESULTS No between-group differences emerged in the trained letter updating and Markov decision-making tasks at post-intervention and at follow-up timepoints. Secondary analyses revealed group differences in one near-transfer task: Superior n-back task performance was observed in the tDCS group at post-intervention and at follow-up. No such effects were observed for the other transfer tasks. Improvements in working memory were associated with individually induced electric field strengths. DISCUSSION Cognitive training with atDCS did not lead to superior improvement in trained task performance compared to cognitive training with sham stimulation. Thus, our results do not support the immediate benefit of tDCS-assisted multi-session cognitive training on the trained function. As the intervention enhanced performance in a near-transfer working memory task, we provide exploratory evidence for effects on non-trained working memory functions in non-demented older adults that persist over a period of 1 month.
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Affiliation(s)
- Daria Antonenko
- Department of NeurologyUniversitätsmedizin GreifswaldGreifswaldGermany
| | - Friederike Thams
- Department of NeurologyUniversitätsmedizin GreifswaldGreifswaldGermany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH)BerlinGermany
- Charité – Universitätsmedizin Berlin, Humboldt‐Universität zu BerlinBerlin Institute of HealthInstitute of Biometry and Clinical EpidemiologyBerlinGermany
| | - Jessica Uhrich
- Department of NeurologyUniversitätsmedizin GreifswaldGreifswaldGermany
| | - Franka Glöckner
- Lifespan Developmental NeuroscienceFaculty of PsychologyTU DresdenDresdenGermany
| | - Shu‐Chen Li
- Lifespan Developmental NeuroscienceFaculty of PsychologyTU DresdenDresdenGermany
| | - Agnes Flöel
- Department of NeurologyUniversitätsmedizin GreifswaldGreifswaldGermany
- German Centre for Neurodegenerative Diseases (DZNE) Standort GreifswaldGreifswaldGermany
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Sakurada T, Matsumoto M, Yamamoto SI. Individual Sensory Modality Dominance as an Influential Factor in the Prefrontal Neurofeedback Training for Spatial Processing: A Functional Near-Infrared Spectroscopy Study. Front Syst Neurosci 2022; 16:774475. [PMID: 35221936 PMCID: PMC8866872 DOI: 10.3389/fnsys.2022.774475] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 01/07/2022] [Indexed: 11/23/2022] Open
Abstract
Neurofeedback is a neuromodulation technique used to improve brain function by self-regulating brain activity. However, the efficacy of neurofeedback training varies widely between individuals, and some participants fail to self-regulate brain activity. To overcome intersubject variation in neurofeedback training efficacy, it is critical to identify the factors that influence this type of neuromodulation. In this study, we considered that individual differences in cognitive ability may influence neurofeedback training efficacy and aimed to clarify the effect of individual working memory (WM) abilities, as characterized by sensory modality dominance, on neurofeedback training efficacy in healthy young adults. In particular, we focused on the abilities of individuals to retain internal (tactile or somatosensory) or external (visual) body information in their WM. Forty participants performed functional near-infrared spectroscopy-based neurofeedback training aimed at producing efficient and lower-level activity in the bilateral dorsolateral prefrontal cortex and frontopolar cortex. We carried out a randomized, sham-controlled, double-blind study that compared WM ability before and after neurofeedback training. Individual WM ability was quantified using a target searching task that required the participants to retain spatial information presented as vibrotactile or visual stimuli. Participants who received feedback information based on their own prefrontal activity showed gradually decreasing activity in the right prefrontal area during the neurofeedback training and demonstrated superior WM ability during the target searching task with vibrotactile stimuli compared with the participants who performed dummy neurofeedback training. In comparison, left prefrontal activity was not influenced by the neurofeedback training. Furthermore, the efficacy of neurofeedback training (i.e., lower right prefrontal activity and better searching task performance) was higher in participants who exhibited tactile dominance rather than visual dominance in their WM. These findings indicate that sensory modality dominance in WM may be an influential neurophysiological factor in determining the efficacy of neurofeedback training. These results may be useful in the development of neurofeedback training protocols tailored to individual needs.
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Affiliation(s)
- Takeshi Sakurada
- Department of Robotics, College of Science and Engineering, Ritsumeikan University, Shiga, Japan
- Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
- *Correspondence: Takeshi Sakurada,
| | - Mayuko Matsumoto
- Functional Brain Science Laboratory, Center for Development of Advanced Medical Technology, Jichi Medical University, Tochigi, Japan
- Graduate School of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Shin-ichiroh Yamamoto
- Graduate School of Systems Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
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Rezayat E, Clark K, Dehaqani MRA, Noudoost B. Dependence of Working Memory on Coordinated Activity Across Brain Areas. Front Syst Neurosci 2022; 15:787316. [PMID: 35095433 PMCID: PMC8792503 DOI: 10.3389/fnsys.2021.787316] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/06/2021] [Indexed: 11/15/2022] Open
Abstract
Neural signatures of working memory (WM) have been reported in numerous brain areas, suggesting a distributed neural substrate for memory maintenance. In the current manuscript we provide an updated review of the literature focusing on intracranial neurophysiological recordings during WM in primates. Such signatures of WM include changes in firing rate or local oscillatory power within an area, along with measures of coordinated activity between areas based on synchronization between oscillations. In comparing the ability of various neural signatures in any brain area to predict behavioral performance, we observe that synchrony between areas is more frequently and robustly correlated with WM performance than any of the within-area neural signatures. We further review the evidence for alteration of inter-areal synchrony in brain disorders, consistent with an important role for such synchrony during behavior. Additionally, results of causal studies indicate that manipulating synchrony across areas is especially effective at influencing WM task performance. Each of these lines of research supports the critical role of inter-areal synchrony in WM. Finally, we propose a framework for interactions between prefrontal and sensory areas during WM, incorporating a range of experimental findings and offering an explanation for the observed link between intra-areal measures and WM performance.
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Affiliation(s)
- Ehsan Rezayat
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
| | - Kelsey Clark
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, United States
| | - Mohammad-Reza A. Dehaqani
- School of Cognitive Sciences, Institute for Research in Fundamental Sciences (IPM), Tehran, Iran
- Cognitive Systems Laboratory, Control and Intelligent Processing Center of Excellence (CIPCE), School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Behrad Noudoost
- Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, United States
- *Correspondence: Behrad Noudoost,
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Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O’Shea A, Indahlastari A, Albizu A, Nissim NR, Evangelista ND, Cohen R, Porges EC, Woods AJ. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci 2021; 13:761348. [PMID: 34744698 PMCID: PMC8568306 DOI: 10.3389/fnagi.2021.761348] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study examines the impact of transcranial direct current stimulation (tDCS) combined with cognitive training on neurotransmitter concentrations in the prefrontal cortex. Materials and Methods: Twenty-three older adults were randomized to either active-tDCS or sham-tDCS in combination with cognitive training for 2 weeks. Active-tDCS was delivered over F3 (cathode) and F4 (anode) electrode placements for 20 min at 2 mA intensity. For each training session, 40-min of computerized cognitive training were applied with active or sham stimulation delivered during the first 20-min. Glutamine/glutamate (Glx) and gamma-aminobutyric acid (GABA) concentrations via proton magnetic resonance spectroscopy were evaluated at baseline and at the end of 2-week intervention. Results: Glx concentrations increased from pre- to post-intervention (p = 0.010) in the active versus sham group after controlling for age, number of intervention days, MoCA scores, and baseline Glx concentration. No difference in GABA concentration was detected between active and sham groups (p = 0.650) after 2-week intervention. Conclusion: Results provide preliminary evidence suggesting that combining cognitive training and tDCS over the prefrontal cortex elicits sustained increase in excitatory neurotransmitter concentrations. Findings support the combination of tDCS and cognitive training as a potential method for altering neurotransmitter concentrations in the frontal cortices, which may have implications for neuroplasticity in the aging brain.
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Affiliation(s)
- Stacey Alvarez-Alvarado
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Emanuel M. Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole R. Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
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Brioschi Guevara A, Bieler M, Altomare D, Berthier M, Csajka C, Dautricourt S, Démonet JF, Dodich A, Frisoni GB, Miniussi C, Molinuevo JL, Ribaldi F, Scheltens P, Chételat G. Protocols for cognitive enhancement. A user manual for Brain Health Services-part 5 of 6. Alzheimers Res Ther 2021; 13:172. [PMID: 34635149 PMCID: PMC8507160 DOI: 10.1186/s13195-021-00844-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Abstract
Cognitive complaints in the absence of objective cognitive impairment, observed in patients with subjective cognitive decline (SCD), are common in old age. The first step to postpone cognitive decline is to use techniques known to improve cognition, i.e., cognitive enhancement techniques.We aimed to provide clinical recommendations to improve cognitive performance in cognitively unimpaired individuals, by using cognitive, mental, or physical training (CMPT), non-invasive brain stimulations (NIBS), drugs, or nutrients. We made a systematic review of CMPT studies based on the GRADE method rating the strength of evidence.CMPT have clinically relevant effects on cognitive and non-cognitive outcomes. The quality of evidence supporting the improvement of outcomes following a CMPT was high for metamemory; moderate for executive functions, attention, global cognition, and generalization in daily life; and low for objective memory, subjective memory, motivation, mood, and quality of life, as well as a transfer to other cognitive functions. Regarding specific interventions, CMPT based on repeated practice (e.g., video games or mindfulness, but not physical training) improved attention and executive functions significantly, while CMPT based on strategic learning significantly improved objective memory.We found encouraging evidence supporting the potential effect of NIBS in improving memory performance, and reducing the perception of self-perceived memory decline in SCD. Yet, the high heterogeneity of stimulation protocols in the different studies prevent the issuing of clear-cut recommendations for implementation in a clinical setting. No conclusive argument was found to recommend any of the main pharmacological cognitive enhancement drugs ("smart drugs", acetylcholinesterase inhibitors, memantine, antidepressant) or herbal extracts (Panax ginseng, Gingko biloba, and Bacopa monnieri) in people without cognitive impairment.Altogether, this systematic review provides evidence for CMPT to improve cognition, encouraging results for NIBS although more studies are needed, while it does not support the use of drugs or nutrients.
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Affiliation(s)
- Andrea Brioschi Guevara
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
| | - Melanie Bieler
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Daniele Altomare
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Marcelo Berthier
- Unit of Cognitive Neurology and Aphasia, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga - IBIMA, Malaga, Spain
| | - Chantal Csajka
- Center for Research and Innovation in clinical Pharmaceutical Sciences, University Hospital and University of Lausanne, Lausanne, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Geneva, Switzerland
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
| | - Jean-François Démonet
- Centre Leenaards de la Mémoire, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Alessandra Dodich
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Giovanni B Frisoni
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center, Pasqual Maragall Foundation, Barcelona, Spain
| | - Federica Ribaldi
- Laboratory of Neuroimaging of Aging (LANVIE), University of Geneva, Geneva, Switzerland
- Memory Clinic, Geneva University Hospitals, Geneva, Switzerland
- Laboratory of Alzheimer's Neuroimaging and Epidemiology (LANE), Saint John of God Clinical Research Centre, Brescia, Italy
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Gael Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, 14000, Caen, France
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Brooks H, Oughli HA, Kamel L, Subramanian S, Morgan G, Blumberger DM, Kloeckner J, Kumar S, Mulsant BH, Lenze EJ, Rajji TK. Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial. Mindfulness (N Y) 2021; 12:3047-3059. [PMID: 34630733 PMCID: PMC8491443 DOI: 10.1007/s12671-021-01764-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2021] [Indexed: 11/30/2022]
Abstract
Objectives Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline. Methods We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home. Results Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active (n = 12) or sham tDCS (n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness (d = 0.6) and social functioning (d = 0.9) (F(1,21) = 3.68, p = 0.07 and F(1,21) = 3.9, p = 0.06, respectively). Conclusions Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS. Trial Registration ClinicalTrials.gov (NCT03653351 and NCT03680664). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01764-9.
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Affiliation(s)
- Heather Brooks
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | | | - Lojine Kamel
- Washington University School of Medicine, St. Louis, MO USA
| | | | - Gwen Morgan
- Centre for Mindfulness Studies, Toronto, Canada
| | - Daniel M Blumberger
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | | | - Sanjeev Kumar
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Eric J Lenze
- Washington University School of Medicine, St. Louis, MO USA
| | - Tarek K Rajji
- Centre for Addiction and Mental Health and Department of Psychiatry, University of Toronto, Toronto, ON Canada.,Toronto Dementia Research Alliance, University of Toronto, Toronto, Canada
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Au J, Katz B, Moon A, Talati S, Abagis TR, Jonides J, Jaeggi SM. Post-training stimulation of the right dorsolateral prefrontal cortex impairs working memory training performance. J Neurosci Res 2021; 99:2351-2363. [PMID: 33438297 PMCID: PMC8273206 DOI: 10.1002/jnr.24784] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 12/23/2020] [Indexed: 11/08/2022]
Abstract
Research investigating transcranial direct current stimulation (tDCS) to enhance cognitive training augments both our understanding of its long-term effects on cognitive plasticity as well as potential applications to strengthen cognitive interventions. Previous work has demonstrated enhancement of working memory training while applying concurrent tDCS to the dorsolateral prefrontal cortex (DLPFC). However, the optimal stimulation parameters are still unknown. For example, the timing of tDCS delivery has been shown to be an influential variable that can interact with task learning. In the present study, we used tDCS to target the right DLPFC while participants trained on a visuospatial working memory task. We sought to compare the relative efficacy of online stimulation delivered during training to offline stimulation delivered either immediately before or afterwards. We were unable to replicate previously demonstrated benefits of online stimulation; however, we did find evidence that offline stimulation delivered after training can actually be detrimental to training performance relative to sham. We interpret our results in light of evidence suggesting a role of the right DLPFC in promoting memory interference, and conclude that while tDCS may be a promising tool to influence the results of cognitive training, more research and an abundance of caution are needed before fully endorsing its use for cognitive enhancement. This work suggests that effects can vary substantially in magnitude and direction between studies, and may be heavily dependent on a variety of intervention protocol parameters such as the timing and location of stimulation delivery, about which our understanding is still nascent.
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Affiliation(s)
- Jacky Au
- School of Education, University of California, Irvine, Irvine, CA, 92697, USA
| | - Benjamin Katz
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, 24061, USA
| | - Austin Moon
- School of Education, University of California, Irvine, Irvine, CA, 92697, USA
| | - Sheebani Talati
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Tessa R. Abagis
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - John Jonides
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Susanne M. Jaeggi
- School of Education, University of California, Irvine, Irvine, CA, 92697, USA
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Huo L, Zhu X, Zheng Z, Ma J, Ma Z, Gui W, Li J. Effects of Transcranial Direct Current Stimulation on Episodic Memory in Older Adults: A Meta-analysis. J Gerontol B Psychol Sci Soc Sci 2021; 76:692-702. [PMID: 31782505 DOI: 10.1093/geronb/gbz130] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES In the last two decades, the number of intervention studies using transcranial direct current stimulation (tDCS) has grown enormously. Though some studies have shown positive influences on episodic memory among older adults, disagreement exists in the literature. Therefore, the current meta-analysis aimed to provide a quantitative assessment of the efficacy of tDCS in modulating episodic memory functions in older adults. METHOD Eligible studies were sham-controlled trials examining the effects of anodal tDCS on episodic memory in older adults. Twenty-four articles comprising 566 participants aged over 60 qualified for inclusion. RESULTS Compared to the sham tDCS group, the active tDCS group showed significant memory improvements at both immediate poststimulation (Hedges' g = 0.625, p = .001) and long-term follow-up (Hedges' g = 0.404, p = .002). There were no differences in effect sizes between cognitively healthy and impaired older adults. Moderator analyses suggested that tDCS having a duration of 20 min or less, bilateral stimulation, or a larger stimulation area would produce greater benefits for episodic memory performance in older adults. DISCUSSION These findings suggest that tDCS holds great promise to ameliorate memory decline in older individuals. In the future, well-designed randomized controlled trials are expected to verify the optimal stimulation protocols and determine the factors impacting the long-term effects of tDCS in enhancing episodic memory.
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Affiliation(s)
- Lijuan Huo
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xinyi Zhu
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhiwei Zheng
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jialing Ma
- School of Psychology, University of Aberdeen, UK
| | - Zhuoya Ma
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Wenjun Gui
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Juan Li
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Lee JH, Lee TL, Kang N. Transcranial direct current stimulation decreased cognition-related reaction time in older adults: A systematic review and meta-analysis. Ageing Res Rev 2021; 70:101377. [PMID: 34089900 DOI: 10.1016/j.arr.2021.101377] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/18/2021] [Accepted: 05/31/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND This systematic review and meta-analysis investigated the effects of transcranial direct current stimulation (tDCS) on the cognitive functions of healthy older adults by focusing on the changes in reaction time during cognitive tasks. METHOD A total of 31 studies qualified for this meta-analysis, and we acquired 36 comparisons from the included studies for data synthesis. The individual effect sizes were calculated by comparing the altered reaction time during the performance of a specific cognitive task between the active tDCS and sham groups. In two moderator variable analyses, we examined the potentially different effects of the tDCS protocols on the cognition-related reaction time based on the tDCS protocol used (i.e., online vs. offline tDCS) and the five cognitive domains: (a) perceptual-motor function, (b) learning and memory, (c) executive function / complex attention, (d) language, and (e) social cognition. Meta-regression analyses were conducted to estimate the relationship between demographic and tDCS parameter characteristics and the changes in reaction time. RESULTS The random-effects model meta-analysis revealed significant small effects of tDCS on cognition-related reaction time. Specifically, providing online tDCS significantly reduced the reaction time, and these patterns were observed during learning and memory and executive function / complex attention tasks. However, applying offline tDCS failed to find any significant reduction of reaction time across various cognitive tasks. The meta-regression analysis revealed that the effects of tDCS on the reaction time during the performance of cognitive tasks increased for the older people. CONCLUSIONS These findings suggest that providing online tDCS may effectively improve the ageing-induced reaction time related to specific cognitive functions of elderly people.
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Stimulation of the Social Brain Improves Perspective Selection in Older Adults: A HD-tDCS Study. COGNITIVE AFFECTIVE & BEHAVIORAL NEUROSCIENCE 2021; 21:1233-1245. [PMID: 34287817 PMCID: PMC8563543 DOI: 10.3758/s13415-021-00929-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/17/2022]
Abstract
There is evidence for dissociable, causal roles for two key social brain regions in young adults. Specifically, the right temporoparietal junction (rTPJ) is associated with embodied perspective taking, whereas the dorsomedial prefrontal cortex (dmPFC) is associated with the integration of social information. However, it is unknown whether these causal brain-behaviour associations are evident in older adults. Fifty-two healthy older adults were stratified to receive either rTPJ or dmPFC anodal high-definition transcranial direct current stimulation in a sham-controlled, double-blinded, repeated-measures design. Self-other processing was assessed across implicit and explicit level one (line-of-sight) and level two (embodied rotation) visual perspective taking (VPT) tasks, and self-other encoding effects on episodic memory. Both rTPJ and dmPFC stimulation reduced the influence of the alternate perspective during level one VPT, indexed by a reduced congruency effect (difference between congruent and incongruent perspectives). There were no stimulation effects on level two perspective taking nor self-other encoding effects on episodic memory. Stimulation to the rTPJ and dmPFC improved perspective selection during level one perspective taking. However, dissociable effects on self-other processing, previously observed in young adults, were not identified in older adults. The results provide causal evidence for age-related changes in social brain function that requires further scrutinization.
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Vaqué-Alcázar L, Abellaneda-Pérez K, Solé-Padullés C, Bargalló N, Valls-Pedret C, Ros E, Sala-Llonch R, Bartrés-Faz D. Functional brain changes associated with cognitive trajectories determine specific tDCS-induced effects among older adults. J Neurosci Res 2021; 99:2188-2200. [PMID: 34047384 DOI: 10.1002/jnr.24849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 04/01/2021] [Accepted: 04/07/2021] [Indexed: 12/21/2022]
Abstract
The combination of transcranial direct current stimulation (tDCS) with functional magnetic resonance imaging (fMRI) can provide original data to investigate age-related brain changes. We examined neural activity modulations induced by two multifocal tDCS procedures based on two distinct montages fitting two N-back task-based fMRI patterns ("compensatory" and "maintenance") related to high working memory (WM) in a previous publication (Fernández-Cabello et al. Neurobiol Aging (2016);48:23-33). We included 24 participants classified as stable or decliners according to their 4-year WM trajectories following a retrospective longitudinal approach. Then, we studied longitudinal fMRI differences between groups (stable and decliners) and across multifocal tDCS montages ("compensatory" and "maintenance") applied using a single-blind sham-controlled cross-over design. Decliners evidenced over-activation of non-related WM areas after 4 years of follow-up. Focusing on tDCS effects, among the decliner group, the "compensatory"-tDCS montage reduced the activity over the posterior regions where these subjects showed longitudinal hyperactivation. These results reinforce the notion that tDCS effects are characterized by an activity reduction and might be more noticeable in compromised systems. Importantly, the data provide novel evidence that cognitive trajectories predict tDCS effects in older adults.
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Affiliation(s)
- Lídia Vaqué-Alcázar
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Kilian Abellaneda-Pérez
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Cristina Solé-Padullés
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Núria Bargalló
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Neuroradiology Section, Radiology Service, Centre de Diagnòstic per la Imatge, Hospital Clínic, Barcelona, Spain
| | - Cinta Valls-Pedret
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Emilio Ros
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Lipid Clinic, Endocrinology and Nutrition Service, Hospital Clínic, Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Roser Sala-Llonch
- Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Department of Biomedicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Consorcio Centro de Investigación Biomédica en Red (CIBER) de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona, Spain
| | - David Bartrés-Faz
- Department of Medicine, Faculty of Medicine and Health Sciences, Institute of Neurosciences, University of Barcelona, Barcelona, Spain.,Institute of Biomedical Research August Pi i Sunyer (IDIBAPS), Barcelona, Spain.,Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Barcelona, Spain
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Farnad L, Ghasemian-Shirvan E, Mosayebi-Samani M, Kuo MF, Nitsche MA. Exploring and optimizing the neuroplastic effects of anodal transcranial direct current stimulation over the primary motor cortex of older humans. Brain Stimul 2021; 14:622-634. [PMID: 33798763 DOI: 10.1016/j.brs.2021.03.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND tDCS modulates cortical plasticity and has shown potential to improve cognitive/motor functions in healthy young humans. However, age-related alterations of brain structure and functions might require an adaptation of tDCS-parameters to achieve a targeted plasticity effect in older humans and conclusions obtained from young adults might not be directly transferable to older adults. Thus, our study aimed to systematically explore the association between tDCS-parameters and induced aftereffects on motor cortical excitability to determine optimal stimulation protocols for older individuals, as well as to investigate age-related differences of motor cortex plasticity in two different age groups of older adults. METHODS 32 healthy, volunteers from two different age groups of Young-Old (50-65 years, n = 16) and Old-Old (66-80 years, n = 16) participated in this study. Anodal tDCS was applied over the primary motor cortex, with respective combinations of three intensities (1, 2, and 3 mA) and durations (15, 20, and 30 min), in a sham-controlled cross-over design. Cortical excitability alterations were monitored by single-pulse TMS-induced MEPs until the next day morning after stimulation. RESULTS All active stimulation conditions resulted in a significant enhancement of motor cortical excitability in both age groups. The facilitatory aftereffects of anodal tDCS did not significantly differ between age groups. We observed prolonged plasticity in the late-phase range for two protocols with the highest stimulation intensity (i.e., 3 mA-20 min, 3 mA-30 min). CONCLUSIONS Our study highlights the role of stimulation dosage in tDCS-induced neuroplastic aftereffects in the motor cortex of healthy older adults and delivers crucial information about optimized tDCS protocols in the domain of the primary motor cortex. Our findings might set the grounds for the development of optimal stimulation protocols to reinstate neuroplasticity in different cortical areas and induce long-lasting, functionally relevant plasticity in normal aging and in pathological conditions, which would require however systematic tDCS titration studies over respective target areas.
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Affiliation(s)
- Leila Farnad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Ensiyeh Ghasemian-Shirvan
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; International Graduate School of Neuroscience, Ruhr University Bochum, Bochum, Germany
| | - Mohsen Mosayebi-Samani
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Min-Fang Kuo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany.
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Brambilla M, Dinkelbach L, Bigler A, Williams J, Zokaei N, Cohen Kadosh R, Brem AK. The Effect of Transcranial Random Noise Stimulation on Cognitive Training Outcome in Healthy Aging. Front Neurol 2021; 12:625359. [PMID: 33767658 PMCID: PMC7985554 DOI: 10.3389/fneur.2021.625359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 02/09/2021] [Indexed: 12/20/2022] Open
Abstract
Background and Objective: Aging is associated with a decline in attentional and executive abilities, which are linked to physiological, structural, and functional brain changes. A variety of novel non-invasive brain stimulation methods have been probed in terms of their neuroenhancement efficacy in the last decade; one that holds significant promise is transcranial random noise stimulation (tRNS) that delivers an alternate current at random amplitude and frequency. The aim of this study was to investigate whether repeated sessions of tRNS applied as an add-on to cognitive training (CT) may induce long-term near and far transfer cognitive improvements. Methods: In this sham-controlled, randomized, double-blinded study forty-two older adults (age range 60-86 years) were randomly assigned to one of three intervention groups that received 20 min of 0.705 mA tRNS (N = 14), 1 mA tRNS (N = 14), or sham tRNS (N = 19) combined with 30 min of CT of executive functions (cognitive flexibility, inhibitory control, working memory). tRNS was applied bilaterally over the dorsolateral prefrontal cortices for five sessions. The primary outcome (non-verbal logical reasoning) and other cognitive functions (attention, memory, executive functions) were assessed before and after the intervention and at a 1-month follow-up. Results: Non-verbal logical reasoning, inhibitory control and reaction time improved significantly over time, but stimulation did not differentially affect this improvement. These changes occurred during CT, while no further improvement was observed during follow-up. Performance change in logical reasoning was significantly correlated with age in the group receiving 1 mA tRNS, indicating that older participants profited more from tRNS than younger participants. Performance change in non-verbal working memory was significantly correlated with age in the group receiving sham tRNS, indicating that in contrast to active tRNS, older participants in the sham group declined more than younger participants. Interpretation: CT induced cognitive improvements in all treatment groups, but tRNS did not modulate most of these cognitive improvements. However, the effect of tRNS depended on age in some cognitive functions. We discuss possible explanations leading to this result that can help to improve the design of future neuroenhancement studies in older populations.
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Affiliation(s)
- Michela Brambilla
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Biomedical and Clinical Sciences Department, Center for Research and Treatment on Cognitive Dysfunctions, “Luigi Sacco” Hospital, University of Milan, Milan, Italy
| | - Lars Dinkelbach
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Neurology, Institute of Clinical Neuroscience and Medical Psychology, Heinrich Heine University, Duesseldorf, Germany
| | - Annelien Bigler
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Experimental Psychology, Ghent University, Ghent, Belgium
| | - Joseph Williams
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Medical Sciences Division, University of Oxford, Oxford, United Kingdom
| | - Nahid Zokaei
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Roi Cohen Kadosh
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Anna-Katharine Brem
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation and Division for Cognitive Neurology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
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Balconi M, Angioletti L, Cassioli F, Crivelli D. Neurocognitive Empowerment in Healthy Aging: a Pilot Study on the Effect of Non-invasive Brain Stimulation on Executive Functions. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-020-00203-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Dedoncker J, Baeken C, De Raedt R, Vanderhasselt MA. Combined transcranial direct current stimulation and psychological interventions: State of the art and promising perspectives for clinical psychology. Biol Psychol 2020; 158:107991. [PMID: 33232800 DOI: 10.1016/j.biopsycho.2020.107991] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 10/14/2020] [Accepted: 11/15/2020] [Indexed: 12/14/2022]
Abstract
Recent literature shows great heterogeneity in the reported efficacy of transcranial direct current stimulation (tDCS) as a stand-alone psychiatric treatment. Aiming to increase its efficacy, tDCS has been combined with psychological interventions. Our state-of-the-art overview of such combined treatment trials indicates, however, that these usually do not elicit synergistic clinical effects. We therefore explored more basic mechanisms related to the brain state-dependency of tDCS. Importantly, based on our overview, the efficacy of combined interventions may depend on whether individual patients present with endophenotypes that are implicated in the development and maintenance of psychopathology, such as prefrontal-mediated cognitive dysfunction. We discuss how future studies may contribute to the development of personally-tailored dual active treatments by adhering to the Research Domain Criteria (RDoC) framework. RDoC-based mechanistic research may reveal alternative neural circuits that should be functionally targeted by both tDCS and psychological interventions, with promising avenues for clinical psychological science and practice.
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Affiliation(s)
- Josefien Dedoncker
- Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium.
| | - Chris Baeken
- Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Psychiatry, University Hospital UZBrussel, Brussels, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, the Netherlands
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin - Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium
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Thams F, Kuzmina A, Backhaus M, Li SC, Grittner U, Antonenko D, Flöel A. Cognitive training and brain stimulation in prodromal Alzheimer's disease (AD-Stim)-study protocol for a double-blind randomized controlled phase IIb (monocenter) trial. Alzheimers Res Ther 2020; 12:142. [PMID: 33160420 PMCID: PMC7648990 DOI: 10.1186/s13195-020-00692-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/16/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Given the growing older population worldwide, and the associated increase in age-related diseases, such as Alzheimer's disease (AD), investigating non-invasive methods to ameliorate or even prevent cognitive decline in prodromal AD is highly relevant. Previous studies suggest transcranial direct current stimulation (tDCS) to be an effective method to boost cognitive performance, especially when applied in combination with cognitive training in healthy older adults. So far, no studies combining tDCS concurrent with an intense multi-session cognitive training in prodromal AD populations have been conducted. METHODS The AD-Stim trial is a monocentric, randomized, double-blind, placebo-controlled study, including a 3-week tDCS-assisted cognitive training with anodal tDCS over left DLPFC (target intervention), compared to cognitive training plus sham (control intervention). The cognitive training encompasses a letter updating task and a three-stage Markov decision-making task. Forty-six participants with subjective cognitive decline (SCD) or mild cognitive impairment (MCI) will be randomized block-wise to either target or control intervention group and participate in nine interventional visits with additional pre- and post-intervention assessments. Performance in the letter updating task after training and anodal tDCS compared to sham stimulation will be analyzed as primary outcome. Further, performance on the second training task and transfer tasks will be investigated. Two follow-up visits (at 1 and 7 months post-training) will be performed to assess possible maintenance effects. Structural and functional magnetic resonance imaging (MRI) will be applied before the intervention and at the 7-month follow-up to identify possible neural predictors for successful intervention. SIGNIFICANCE With this trial, we aim to provide evidence for tDCS-induced improvements of multi-session cognitive training in participants with SCD and MCI. An improved understanding of tDCS effects on cognitive training performance and neural predictors may help to develop novel approaches to counteract cognitive decline in participants with prodromal AD. TRIAL REGISTRATION ClinicalTrials.gov , NCT04265378 . Registered on 07 February 2020. Retrospectively registered. Protocol version: Based on BB 004/18 version 1.2 (May 17, 2019). SPONSOR University Medicine Greifswald.
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Affiliation(s)
- Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Anna Kuzmina
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Malte Backhaus
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Faculty of Psychology, TU Dresden, Zellescher Weg 17, 01062 Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop, TU Dresden, 01062 Dresden, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Anna-Louisa-Karsch-Straße 2, 10178 Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, And Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Charitéplatz 1, 10117 Berlin, Germany
| | - Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
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48
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Horne KS, Filmer HL, Nott ZE, Hawi Z, Pugsley K, Mattingley JB, Dux PE. Evidence against benefits from cognitive training and transcranial direct current stimulation in healthy older adults. Nat Hum Behav 2020; 5:146-158. [PMID: 33106629 DOI: 10.1038/s41562-020-00979-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 09/21/2020] [Indexed: 12/20/2022]
Abstract
Cognitive training and brain stimulation show promise for ameliorating age-related neurocognitive decline. However, evidence for this is controversial. In a Registered Report, we investigated the effects of these interventions, where 133 older adults were allocated to four groups (left prefrontal cortex anodal transcranial direct current stimulation (tDCS) with decision-making training, and three control groups) and trained over 5 days. They completed a task/questionnaire battery pre- and post-training, and at 1- and 3-month follow-ups. COMT and BDNF Val/Met polymorphisms were also assessed. Contrary to work in younger adults, there was evidence against tDCS-induced training enhancement on the decision-making task. Moreover, there was evidence against transfer of training gains to untrained tasks or everyday function measures at any post-intervention time points. As indicated by exploratory work, individual differences may have influenced outcomes. But, overall, the current decision-making training and tDCS protocol appears unlikely to lead to benefits for older adults.
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Affiliation(s)
- Kristina S Horne
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia.
| | - Hannah L Filmer
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Zoie E Nott
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Ziarih Hawi
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Kealan Pugsley
- School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Jason B Mattingley
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia.,Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Paul E Dux
- School of Psychology, University of Queensland, Brisbane, Queensland, Australia
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49
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Cerreta AGB, Mruczek REB, Berryhill ME. Predicting Working Memory Training Benefits From Transcranial Direct Current Stimulation Using Resting-State fMRI. Front Psychol 2020; 11:570030. [PMID: 33154728 PMCID: PMC7591503 DOI: 10.3389/fpsyg.2020.570030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022] Open
Abstract
The effects of transcranial direct current stimulation (tDCS) on working memory (WM) performance are promising but variable and contested. In particular, designs involving one session of tDCS are prone to variable outcomes with notable effects of individual differences. Some participants benefit, whereas others are impaired by the same tDCS protocol. In contrast, protocols including multiple sessions of tDCS more consistently report WM improvement across participants. The objective of the current project was to test whether differences in resting-state connectivity between stimulation site and two WM-relevant networks [default mode network (DMN) and central executive network (CEN)] could account for initial and longitudinal responses to tDCS. Healthy young adults completed 5 days of visual WM training during sham or anodal right frontal tDCS. The behavioral data showed that only the active tDCS group significantly improved over the visual WM training period. There were no significant correlations between initial response to tDCS and resting-state activity. DMN activity in the anterior cingulate cortex significantly correlated with WM training slope. These data underscore the importance of sampling in studies applying tDCS; homogeneity (e.g., of gender, special population, and WM capacity) may produce more consistent data in a single experiment with limited power, whereas heterogeneity is important in determining the mechanism(s) and potential for tDCS-linked protocols. This issue is a limitation in tDCS findings that continues to hamper its optimization and translational value.
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Affiliation(s)
- Adelle G B Cerreta
- Program in Cognitive and Brain Sciences, Program in Integrative Neuroscience, Department of Psychology, University of Nevada, Reno, NV, United States
| | - Ryan E B Mruczek
- Department of Psychology, College of the Holy Cross, Worcester, MA, United States
| | - Marian E Berryhill
- Program in Cognitive and Brain Sciences, Program in Integrative Neuroscience, Department of Psychology, University of Nevada, Reno, NV, United States
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50
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Perceval G, Martin AK, Copland DA, Laine M, Meinzer M. Multisession transcranial direct current stimulation facilitates verbal learning and memory consolidation in young and older adults. BRAIN AND LANGUAGE 2020; 205:104788. [PMID: 32199339 DOI: 10.1016/j.bandl.2020.104788] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/27/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
This study investigated effects of multisession transcranial direct-current stimulation on learning and maintenance of novel memory content and scrutinised effects of baseline cognitive status and the role of multi-session tDCS on overnight memory consolidation. In a prospective, randomized, double-blind, parallel-group, sham-tDCS controlled design, 101 healthy young and older adults completed a five-day verbal associative learning paradigm while receiving multisession tDCS to the task-relevant left prefrontal cortex. In older adults, active multisession tDCS enhanced recall performance after each daily training session. Effects were maintained the next morning and during follow-up assessments (one week; three months). In young adults, multisession tDCS significantly increased long-term recall. Unlike previous findings in the motor domain, beneficial effects of multisession tDCS on cognitive learning and memory were notexclusively due to enhanced memory consolidation. Positive stimulation effects were primarily found in participants with lower baseline learning ability, suggesting that multisession tDCS may counteract memory impairment in health and disease.
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Affiliation(s)
- Garon Perceval
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; Department of Psychology, School of Education, Soochow University, Suzhou, China
| | - Andrew K Martin
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; University of Kent, Department of Psychology, Canterbury, UK
| | - David A Copland
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - Matti Laine
- Åbo Akademi University, Department of Psychology, Turku, Finland
| | - Marcus Meinzer
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; University Medicine Greifswald, Department of Neurology, Greifswald, Germany.
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