Hits and misses: leveraging tDCS to advance cognitive research

An Investigation of Parameter-Dependent Cell-Type Specific Effects of Transcranial Focused Ultrasound Stimulation Using an Awake Head-Fixed Rodent Model

Transcranial focused ultrasound (tFUS) is a promising neuromodulation technique able to target shallow and deep brain structures with high precision. Previous studies have demonstrated that tFUS stimulation responses are both cell-type specific and controllable through altering stimulation parameters. Specifically, tFUS can elicit time-locked neural activity in regular spiking units (RSUs) that is sensitive to increases in pulse repetition frequency (PRF), while time-locked responses are not seen in fast spiking units (FSUs). These findings suggest a unique capability of tFUS to alter circuit network dynamics with cell-type specificity; however, these results could be biased by the use of anesthesia, which significantly modulates neural activities. In this study, we develop an awake head-fixed rat model specifically designed for tFUS study, and address a key question if tFUS still has cell-type specificity under awake conditions. Using this novel animal model, we examined a series of PRFs and burst duty cycles (DCs) to determine their effects on neuronal subpopulations without anesthesia. We conclude that cell-type specific time-locked and delayed responses to tFUS as well as PRF and DC sensitivity are present in the awake animal model and that despite some differences in response, isoflurane anesthesia is not a major confound in studying the cell-type specificity of ultrasound neuromodulation. We further determine that, in an awake, head-fixed setting, the preferred PRF and DC for inducing time-locked excitation with our pulsed tFUS paradigm are 1500 Hz and 60%, respectively.

Transcranial direct current stimulation over the left posterior temporal lobe modulates semantic control: Evidence from episodic memory distortions

Evidence accumulates to show that semantic cognition requires, in addition to semantic representations, control processes that regulate the accessibility and use of semantic knowledge in a task- and time-appropriate fashion. Semantic control has been recently proposed to rely on a distributed network that includes the posterior temporal cortex. Along these lines, recent meta-analyses of neuroimaging data and studies with patients suffering from semantic aphasia have suggested that the left posterior middle temporal gyrus (pMTG) is critically involved whenever situational context must constrain semantic retrieval. In the present experiment, we used transcranial direct current stimulation over the left posterior temporal lobe in an attempt to interfere with semantic control while participants performed a DRM task, a procedure for inducing conceptually-based false recognition that is contingent on both activation and control processes. Paralleling findings with patients suffering from brain damage restricted to the temporoparietal cortex, anodal stimulation (relative to sham stimulation) resulted in increased false recognition but intact true recognition. These findings fit well with the idea that the left pMTG is a key component of a semantic control network, the alteration of which results in memory performance that is affected by the intrusion of contextually-inappropriate semantic information.

Capturing postpandemic changes in research participants

The impact of the COVID-19 pandemic on physical and mental health hardly need be reiterated. Yet, there are likely other indirect aftereffects of COVID-19 infection in addition to the direct effects. This article aims to initiate a conversation regarding difficult-to-capture outcomes of the pandemic that are relevant to researchers who test human participants. These considerations encourage collection of additional measures when assessing pre- versus postpandemic patterns of behavior.

Stress and Right Prefrontal Transcranial Direct Current Stimulation (tDCS) Interactive Effects on Visual Working Memory and Learning

Stress impacts prefrontal cortex (PFC) activity and modulates working memory performance. In a recent study, stimulating the dorsolateral PFC (dlPFC) using transcranial direct current stimulation (tDCS) interacted with social stress in modulating participants' working memory. More specifically, stress disrupted the enhancing effects of dlPFC tDCS on working memory performance. The current study aimed to further explore these initial findings by randomizing healthy females to four experimental conditions (N = 130); stimulation (right dlPFC tDCS vs. sham) and stress manipulation (social stress vs. control). Participants performed cognitive tasks (i.e., visual working memory task and a visual declarative memory task) at baseline and post-stimulation. They also completed self-report measures of stress and anxiety. A significant stimulation × stress interaction was evident in the declarative memory (One-Card Learning, OCL) task, while working memory performance was unaffected. Though tDCS stimulation and stress did not interact to affect working memory, further research is warranted as these initial findings suggest that immediate visual-memory learning may be affected by these factors. The limited number of earlier studies, as well as the variability in their designs, provides additional impetus for studying the interactive effects of stress and tDCS on human visual learning.

Transcranial Direct Current Stimulation in Nicotine Use: Nursing Implications for Patient Outcomes

ABSTRACT

Tobacco use is a leading cause of cancer, cardiovascular and respiratory disease, and preventable death in the United States. The brains of individuals with nicotine dependence are characterized by damaged mesolimbic pathways in the medial portion of the limbic and frontal lobes, creating positive reinforcing mechanisms. Transcranial direct current stimulation (tDCS) targets this neuroadaptation to improve smokers' nicotine-related outcomes, such as craving and smoking behavior, by depolarizing or hyperpolarizing the neurons of the brain. Recent literature reported promising outcomes in smokers after tDCS treatment interventions. tDCS has great potential for clinical nursing research for tobacco control given its multiple methodological advantages and few disadvantages. Nurse researchers can consider individualized and home-based tDCS interventions for community-based tobacco control research and may need to consider objective outcome measures (e.g., cotinine in urine) and addiction-related cognitive variables (e.g., self-regulation). Users of electronic nicotine delivery systems also need to be considered as participants in tDCS interventions. Additional considerations for nursing research are discussed.

Transcranial Direct Current Stimulation Modulates Working Memory Maintenance Processes in Healthy Individuals

The effects of transcranial direct current stimulation (tDCS) at the pFC are often investigated using cognitive paradigms, particularly working memory tasks. However, the neural basis for the neuromodulatory cognitive effects of tDCS, including which subprocesses are affected by stimulation, is not completely understood. We investigated the effects of tDCS on working memory task-related spectral activity during and after tDCS to gain better insights into the neurophysiological changes associated with stimulation. We reanalyzed data from 100 healthy participants grouped by allocation to receive either sham (0 mA, 0.016 mA, and 0.034 mA) or active (1 mA or 2 mA) stimulation during a 3-back task. EEG data were used to analyze event-related spectral power in frequency bands associated with working memory performance. Frontal theta event-related synchronization (ERS) was significantly reduced post-tDCS in the active group. Participants receiving active tDCS had slower RTs following tDCS compared with sham, suggesting interference with practice effects associated with task repetition. Theta ERS was not significantly correlated with RTs or accuracy. tDCS reduced frontal theta ERS poststimulation, suggesting a selective disruption to working memory cognitive control and maintenance processes. These findings suggest that tDCS selectively affects specific subprocesses during working memory, which may explain heterogenous behavioral effects.

Inconsistencies in mapping current distribution in transcranial direct current stimulation

INTRODUCTION

tDCS is a non-invasive neuromodulation technique that has been widely studied both as a therapy for neuropsychiatric diseases and for cognitive enhancement. However, recent meta-analyses have reported significant inconsistencies amongst tDCS studies. Enhancing empirical understanding of current flow in the brain may help elucidate some of these inconsistencies.

METHODS

We investigated tDCS-induced current distribution by injecting a low frequency current waveform in a phantom and in vivo. MR phase images were collected during the stimulation and a time-series analysis was used to reconstruct the magnetic field. A current distribution map was derived from the field map using Ampere's law.

RESULTS

The current distribution map in the phantom showed a clear path of current flow between the two electrodes, with more than 75% of the injected current accounted for. However, in brain, the results did evidence a current path between the two target electrodes but only some portion ( 25%) of injected current reached the cortex demonstrating that a significant fraction of the current is bypassing the brain and traveling from one electrode to the other external to the brain, probably due to conductivity differences in brain tissue types. Substantial inter-subject and intra-subject (across consecutive scans) variability in current distribution maps were also observed in human but not in phantom scans.

DISCUSSIONS

An in-vivo current mapping technique proposed in this study demonstrated that much of the injected current in tDCS was not accounted for in human brain and deviated to the edge of the brain. These findings would have ramifications in the use of tDCS as a neuromodulator and may help explain some of the inconsistencies reported in other studies.

Transcranial Direct Current Stimulation Over the Right Anterior Temporal Lobe Does Not Modulate False Recognition

Non-invasive transcranial direct current stimulation (tDCS) over the left anterior temporal lobe (ATL) has been shown to cause a reduction in the rate of false memories with semantically related words. Such a reduction seems to be specific to false memories induced by the study of associative lists, but is not observed when the studied lists are categorical in nature. These findings are interpreted as evidence that the left ATL functions as an integration hub that is crucial for the binding of semantic information into coherent representations of concepts. In order to investigate whether the right ATL might also contribute to semantic integration in the processing of verbal associative material, a follow-up tDCS study was conducted with the stimulation at study lateralized on the right ATL. A sample of 75 undergraduate students participated in an experiment in which they studied 8 associative lists and 8 categorical lists. One third of the participants studied all their word lists under anodal stimulation, another third studied under cathodal stimulation and the other third under sham stimulation. Results showed that stimulation of the right ATL by tDCS does not modulate false recognition for either association-related critical words or category-related critical words. These results provide preliminary support to views positing asymmetric connectivity between the anterior temporal lobes and the semantic representational network, and provide evidence for understanding bilateral brain dynamics and the nature of semantically induced memory distortions.

Influence of tDCS over right inferior frontal gyrus and pre-supplementary motor area on perceptual decision-making and response inhibition: A healthy ageing perspective

A wide body of literature suggests that transcranial direct current stimulation (tDCS) administered over the prefrontal cortex can improve executive function - including decision-making and inhibitory control - in healthy young adults. However, the effects of tDCS in older adults are largely unknown. Here, using a double-blind, sham-controlled approach, changes in a combined perceptual decision-making and inhibitory control task were assessed before and after the application of tDCS (1 mA, 20 minute) targeting the right inferior frontal gyrus (rIFG) or pre-supplementary motor area (preSMA) in 42 young (18-34 years) and 41 older (60-80 years) healthy adults. Compared to sham stimulation, anodal tDCS over the preSMA improved decision-making speed for both age groups. Furthermore, the inhibitory control performance of older and younger adults was improved by preSMA and rIFG stimulation, respectively. This study provides evidence that tDCS can improve both perceptual decision-making and inhibitory control in healthy older adults, with the causal role of the preSMA and rIFG regions in cognitive control appearing to vary as a function of healthy ageing.

Cognitive outcomes after tDCS in schizophrenia patients with prominent negative symptoms: Results from the placebo-controlled STARTS trial

Cognitive deficits and negative symptoms in schizophrenia are associated with poor functional outcomes and limited in terms of treatment. The Schizophrenia Treatment With Electric Transcranial Stimulation (STARTS) trial has shown efficacy of transcranial direct current stimulation (tDCS) for improving negative symptoms. In this secondary analysis, we investigate its effects on cognitive performance. In STARTS, a double-blinded, sham-controlled, randomized clinical trial, patients were treated with twice-daily, 20-min, 2-mA fronto-temporal tDCS over 5 days or sham-tDCS. In 90 patients, we evaluated the cognitive performance up to 12 weeks post-treatment. We found that active-tDCS showed no beneficial effects over sham-tDCS in any of the tests. Based on a 5-factor cognitive model, improvements of executive functions and delayed memory were observed in favor of sham-tDCS. Overall, the applied active-tDCS protocol, primarily designed to improve negative symptoms, did not promote cognitive improvement. We discuss possible protocol modification potentially required to increase tDCS effects on cognition. ClinicalTrials.gov identifier: NCT02535676.

The effects of stress and transcranial direct current stimulation (tDCS) on working memory: A randomized controlled trial

Recent reviews of transcranial direct current stimulation (tDCS) show limited support for its initially cited enhancing effects on working memory (WM). They highlight the need for additional research, assessing the specific circumstances that optimize stimulation outcome. Social stress is an attractive candidate in this regard, as it affects WM and is mediated by prefrontal cortex activity; tDCS that targets these neuronal networks may, therefore, interact with social stress to affect WM. Our objective was to explore the interaction between social stress and tDCS on WM performance in a healthy cohort, 69 female participants were randomized to four experimental conditions (i.e., 2 × 2 design): stimulation (dlPFC tDCS vs. sham stimulation) and stress manipulation (Trier Social Stress Test [TSST] procedure vs. a friendly control TSST). Participants' attention, WM (assessed using an n-back task), and subjective/objective indicators of stress were assessed. A significant Stimulation × Stress Manipulation interaction was found, F(1, 65) = 6.208, p = .015, suggesting that active tDCS may increase WM performance in the no-stress conditions, while decreasing it under stress. Follow-up analyses of variance, however, were not significant (i.e., ps=.083 / .093), and Bayesian analyses were inconclusive. In conclusion, stress seems to be a crucial factor in determining the effects of tDCS, and tDCS may have an enhancing effect on WM at lower levels of stress, while being detrimental at higher stress levels (i.e., reversing the direction of effect). Possible theoretical underpinnings of the findings are discussed, while acknowledging the need for further research.

Effects of anodal multichannel transcranial direct current stimulation (tDCS) on social-cognitive performance in healthy subjects: A randomized sham-controlled crossover pilot study

Recent studies suggest that temporoparietal junction (TPJ) modulation can influence attention and social cognition performance. Nevertheless, no studies have used multichannel transcranial direct current stimulation (tDCS) over bilateral TPJ to estimate the effects on these neuropsychological functions. The project STIPED is using optimized multichannel stimulation as an innovative treatment approach for chronic pediatric neurodevelopmental disorders, namely in children/adolescents with Autism Spectrum Disorder (ASD). In this pilot study, we aim to explore whether anodal multichannel tDCS coupled with a Joint Attention Task (JAT) influences social-cognitive task performance relative to sham stimulation, both in an Emotion Recognition Task (ERT) and in a Mooney Faces Detection Task (MFDT), as well as to evaluate this technique's safety and tolerability. Twenty healthy adults were enrolled in a randomized, single-blinded, sham-controlled, crossover study. During two sessions, participants completed the ERT and the MFDT before and after 20min of sham or anodal tDCS over bilateral TPJ. No significant differences on performance accuracy and reaction time were found between stimulation conditions for all tasks, including the JAT. A significant main time effect for overall accuracy and reaction time was found for the MFDT. Itching was the most common side effect and stimulation conditions detection was at chance level. Results suggest that multichannel tDCS over bilateral TPJ does not affect performance of low-level emotional recognition tasks in healthy adults. Although preliminary safety and tolerability are demonstrated, further studies over longer periods will be pursued to investigate the clinical efficacy in children/adolescents with ASD, where social cognition impairments are preponderant.

The limited effect of neural stimulation on visual attention and social cognition in individuals with schizophrenia

BACKGROUND

Research demonstrates a relationship between faulty visual attention and poorer social cognition in schizophrenia. One potential explanatory model suggests abnormal neuromodulation in specific neural networks may result in reduced attention to socially important cues, leading to poorer understanding of another's emotional state or intentions.

OBJECTIVE

The current study experimentally manipulated neural networks using tDCS to examine this potential causal mechanism. The primary aim was to determine whether stimulation to the right temporoparietal junction (rTPJ) improves visual attention, and secondary aims were to determine whether 1) stimulation improves social cognitive performance and 2) visual attention moderates this improved performance.

METHOD

Using a double-blind crossover design, 69 individuals with schizophrenia underwent both active and sham stimulation to either the rTPJ of the ventral attention network (n = 36) or the dorsomedial prefrontal cortex of the social brain network (dmPFC; n = 33). Following stimulation, participants completed tasks assessing emotion recognition and mentalizing. Concurrent eye tracking assessed visual attention, measuring proportion of time spent attending to areas of interest.

RESULTS

For emotion recognition, stimulation failed to impact either visual attention or social cognitive task accuracy. Similarly, neurostimulation failed to affect visual attention on the mentalizing task. However, exploratory analyses demonstrated that mentalizing accuracy significantly improved after stimulation to the active comparator, dmPFC, with no improvement after stimulation to rTPJ.

CONCLUSION

Results demonstrate limited effect of a single stimulation session on visual attention and emotion recognition accuracy but provide initial support for an alternate neural mechanism for mentalizing, highlighting the importance of executive functions over visual attention.

Cognitive Aftereffects of Acute tDCS Coupled with Cognitive Training: An fMRI Study in Healthy Seniors

Enhancing cognitive functions through noninvasive brain stimulation is of enormous public interest, particularly for the aging population in whom processes such as working memory are known to decline. In a randomized double-blind crossover study, we investigated the acute behavioral and neural aftereffects of bifrontal and frontoparietal transcranial direct current stimulation (tDCS) combined with visual working memory (VWM) training on 25 highly educated older adults. Resting-state functional connectivity (rs-FC) analysis was performed prior to and after each stimulation session with a focus on the frontoparietal control network (FPCN). The bifrontal montage with anode over the left dorsolateral prefrontal cortex enhanced VWM accuracy as compared to the sham stimulation. With the rs-FC within the FPCN, we observed significant stimulation × time interaction using bifrontal tDCS. We found no cognitive aftereffects of the frontoparietal tDCS compared to sham stimulation. Our study shows that a single bifrontal tDCS combined with cognitive training may enhance VWM performance and rs-FC within the relevant brain network even in highly educated older adults.

Anodal tDCS over the dorsolateral prefrontal cortex reduces Stroop errors. A comparison of different tasks and designs

In the present work, we evaluated the possibility to induce changes in the inhibitory control through non-invasive excitatory stimulation of the prefrontal cortex (PFC). To this aim, different montages of the transcranial direct current stimulation (tDCS) were adopted in three separate experiments, wherein different cognitive tasks were performed before and after the stimulation. In the first experiment, participants performed a visual Go/no-go task, and a bilateral anodic or sham stimulation was provided over the scalp area corresponding to the inferior frontal gyrus (IFG). In the second experiment, the IFG was stimulated unilaterally over the right hemisphere, and participants performed a Stroop task combined with a concurrent n-back task, which was aimed at overloading PFC activity. Since no behavioral effects of tDCS were observed in both experiments, we conducted a third experiment with different montage and paradigm. Stimulation was provided bilaterally over the dorsolateral PFC (DLPFC) in the context of a classic Stroop task: results indicated that anodal stimulation favored a reduction of errors. Present findings suggest that the bihemispheric stimulation of the DLPFC might be effective to increase inhibition in healthy subjects, and that this effect might be mediated by the implementation of sustained attention, as predicted by the attentional account of the inhibitory control.

Noninvasive brain stimulation to lateral prefrontal cortex alters the novelty of creative idea generation

Theories of the processes involved in creative cognition posit that cognitive control has a negative effect on creative idea generation but a positive effect on creative idea evaluation. Brain stimulation research has started to examine empirically the effects of cognitive control, with several reports of decreased cognitive control facilitating creative ideation. Such studies have shown how decreased cognitive control mechanisms facilitate creative idea generation, potentially by allowing participants access to less inhibited weaker-related associations, thereby increasing novelty. In the current study, we advance this line of work by investigating how cognitive control affects creative thinking, potentially inhibiting or facilitating novel idea generation based on task demands. Participants read sentences with the final word missing and were instructed to complete the sentence with an uncommon (but appropriate) ending. Participants performed this task while undergoing either anodal (excitatory), cathodal (inhibitory), or sham (control) transcranial direct current stimulation over their left prefrontal cortex. These responses were then rated for their novelty and appropriateness by an independent sample of raters. We found that anodal stimulation increased the appropriateness and decreased the novelty of participants' responses. Contrary to previous studies, we did not find that cathodal stimulation increased the novelty of participants' responses, which may be due to the nature of our task. Overall, we demonstrate how cognitive control mechanisms may inhibit novel idea generation.

tDCS peripheral nerve stimulation: a neglected mode of action?

Transcranial direct current stimulation (tDCS) is a noninvasive neuromodulation method widely used by neuroscientists and clinicians for research and therapeutic purposes. tDCS is currently under investigation as a treatment for a range of psychiatric disorders. Despite its popularity, a full understanding of tDCS's underlying neurophysiological mechanisms is still lacking. tDCS creates a weak electric field in the cerebral cortex which is generally assumed to cause the observed effects. Interestingly, as tDCS is applied directly on the skin, localized peripheral nerve endings are exposed to much higher electric field strengths than the underlying cortices. Yet, the potential contribution of peripheral mechanisms in causing tDCS's effects has never been systemically investigated. We hypothesize that tDCS induces arousal and vigilance through peripheral mechanisms. We suggest that this may involve peripherally-evoked activation of the ascending reticular activating system, in which norepinephrine is distributed throughout the brain by the locus coeruleus. Finally, we provide suggestions to improve tDCS experimental design beyond the standard sham control, such as topical anesthetics to block peripheral nerves and active controls to stimulate non-target areas. Broad adoption of these measures in all tDCS experiments could help disambiguate peripheral from true transcranial tDCS mechanisms.

A Systematic Review and Meta-Analysis of Transcranial Direct Current Stimulation to Remediate Age-Related Cognitive Decline in Healthy Older Adults

BACKGROUND

Transcranial direct current stimulation (tDCS) has been proposed as a possible method for remediating age-associated cognitive decline in the older adult population. While tDCS has shown potential for improving cognitive functions in healthy older adults, stimulation outcomes on various cognitive domains have been mixed.

METHODS

A systematic search was performed in four databases: PubMed, EMBASE, Web of Science, and PsychInfo. Search results were then screened for eligibility based on inclusion/exclusion criteria to only include studies where tDCS was applied to improve cognition in healthy older adults 65 years and above. Eligible studies were reviewed and demographic characteristics, tDCS dose parameters, study procedures, and cognitive outcomes were extracted. Reported effect sizes for active compared to sham group in representative cognitive domain were converted to Hedges' g.

MAIN RESULTS

A total of thirteen studies involving healthy older adults (n=532, mean age=71.2+5.3 years) were included in the meta-analysis. The majority of included studies (94%) targeted the prefrontal cortex with stimulation intensity 1-2 mA using various electrode placements with anodes near the frontal region. Across all studies, we found Hedges' g values ranged from -0.31 to 1.85 as reported group effect sizes of active stimulation compared to sham.

CONCLUSION

While observed outcomes varied, overall findings indicated promising effects of tDCS to remediate cognitive aging and thus deserves further exploration. Future characterization of inter-individual variability in tDCS dose response and applications in larger cohorts are warranted to further validate benefits of tDCS for cognition in healthy older adults.

Anodal Transcranial Direct Current Stimulation of Anterior Cingulate Cortex Modulates Subcortical Brain Regions Resulting in Cognitive Enhancement

Transcranial direct current stimulation (tDCS) has been widely utilized in research settings and modulates brain activity. The application of anodal tDCS on the prefrontal cortex has indicated improvement in cognitive functioning. The cingulate cortex, situated in the medial aspect of the prefrontal cortex, has been identified as a core region performing cognitive functions. Most of the previous studies investigating the impact of stimulation on the prefrontal cortex stimulated the dorsolateral prefrontal cortex (DLPFC), however, the impact of stimulation on cingulate has not been explored. The current study investigates the effect of stimulation on the resting-state functional connectivity of the anterior cingulate cortex with other regions of the brain and changes in behavioral results in a color-word Stroop task, which has repeatedly elicited activation in different regions of the cingulate. Twenty subjects were randomly assigned to the experimental and sham group, and their medial prefrontal area was stimulated using MRI compatible tDCS. Resting-state functional magnetic resonance imaging (rs-fMRI) and cognitive Stroop task were monitored before, during, and after the stimulation. Neuroimaging results indicated a significant decrease in resting-state functional connectivity in the experimental group during and after stimulation as compared to before stimulation in two clusters including right insular cortex, right central operculum cortex, right frontal operculum cortex and right planum polare with the left anterior cingulate cortex (L-ACC) selected as the seed. The behavioral results indicated a significant decrease in reaction time (RT) following stimulation in the experimental group compared to the sham group. Moreover, the change in functional connectivity in subcortical regions with L-ACC as the seed and change in RT was positively correlated. The results demonstrated that ACC has a close functional relationship with the subcortical regions, and stimulation of ACC can modulate these connections, which subsequently improves behavioral performance, thus, providing another potential target of stimulation for cognitive enhancement.

Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT04318522.

Effects of Multiple Sessions of Cathodal Priming and Anodal HD-tDCS on Visuo Motor Task Plateau Learning and Retention

A single session of priming cathodal transcranial direct current stimulation (tDCS) prior to anodal tDCS (c-a-tDCS) allows cumulative effects on motor learning and retention. However, the impact of multiple sessions of c-a-tDCS priming on learning and retention remains unclear. Here, we tested whether multiple sessions of c-a-tDCS (over 3 consecutive days) applied over the left sensorimotor cortex can further enhance motor learning and retention of an already learned visuo-motor task as compared to anodal tDCS (a-tDCS) or sham. In a between group and randomized double-blind sham-controlled study design, 25 participants separated in 3 independent groups underwent 2 days of baseline training without tDCS followed by 3-days of training with both online and offline tDCS, and two retention tests (1 and 14 days later). Each training block consisted of five trials of a 60 s circular-tracing task intersected by 60 s rest, and performance was assessed in terms of speed-accuracy trade-off represented notably by an index of performance (IP). The main findings of this exploratory study were that multiple sessions of c-a-tDCS significantly further enhanced IP above baseline training levels over the 3 training days that were maintained over the 2 retention days, but these learning and retention performance changes were not significantly different from the sham group. Subtle differences in the changes in speed-accuracy trade-off (components of IP) between c-a-tDCS (maintenance of accuracy over increasing speed) and a-tDCS (increasing speed over maintenance of accuracy) provide preliminary insights to a mechanistic modulation of motor performance with priming and polarity of tDCS.

Transcranial magnetic stimulation, deep brain stimulation, and other forms of neuromodulation for substance use disorders: Review of modalities and implications for treatment

Given the high prevalence of individuals diagnosed with substance use disorder, along with the elevated rate of relapse following treatment initiation, investigating novel approaches and new modalities for substance use disorder treatment is of vital importance. One such approach involves neuromodulation which has been used therapeutically for neurological and psychiatric disorders and has demonstrated positive preliminary findings for the treatment of substance use disorder. The following article provides a review of several forms of neuromodulation which warrant consideration as potential treatments for substance use disorder. PubMed, PsycINFO, Ovid MEDLINE, and Web of Science were used to identify published articles and clinicaltrials.gov was used to identify currently ongoing or planned studies. Search criteria for Brain Stimulation included the following terminology: transcranial direct current stimulation, transcranial magnetic stimulation, theta burst stimulation, deep brain stimulation, vagus nerve stimulation, trigeminal nerve stimulation, percutaneous nerve field stimulation, auricular nerve stimulation, and low intensity focused ultrasound. Search criteria for Addiction included the following terminology: addiction, substance use disorder, substance-related disorder, cocaine, methamphetamine, amphetamine, alcohol, nicotine, tobacco, smoking, marijuana, cannabis, heroin, opiates, opioids, and hallucinogens. Results revealed that there are currently several forms of neuromodulation, both invasive and non-invasive, which are being investigated for the treatment of substance use disorder. Preliminary findings have demonstrated the potential of these various neuromodulation techniques in improving substance treatment outcomes by reducing those risk factors (e.g. substance craving) associated with relapse. Specifically, transcranial magnetic stimulation has shown the most promise with several well-designed studies supporting the potential for reducing substance craving. Deep brain stimulation has also shown promise, though lacks well-controlled clinical trials to support its efficacy. Transcranial direct current stimulation has also demonstrated promising results though consistently designed, randomized trials are also needed. There are several other forms of neuromodulation which have not yet been investigated clinically but warrant further investigation given their mechanisms and potential efficacy based on findings from other studied indications. In summary, given promising findings in reducing substance use and craving, neuromodulation may provide a non-pharmacological option as a potential treatment and/or treatment augmentation for substance use disorder. Further research investigating neuromodulation, both alone and in combination with already established substance use disorder treatment (e.g. medication treatment), warrants consideration.

tDCS as a treatment for anxiety and related cognitive deficits

INTRODUCTION

Anxiety is characterized by psychological, physiological, and cognitive complaints. Current treatments have significant limitations, and often overlook any potential benefits to common cognitive symptoms, notably attention and executive function issues. The current study aimed to investigate the use of transcranial direct current stimulation (tDCS) on both common anxiety symptoms and executive function abilities in a college aged sample.

METHOD

As this is one of the first large scale anxiety studies utilizing tDCS, participants were given a single session of tDCS (anodal, cathodal, or sham) for 20 min at 2 mA over the left dorsolateral prefrontal cortex (lDLPFC). Participants also completed a series of self-reported anxiety measures and measures of executive functioning (Rey-O Copy and Wisconsin Card Sorting Task).

RESULTS

While there were no differences in anxiety between tDCS groups, a trend was noted demonstrating better performance on Rey-O Copy for the cathodal group. Anxiety increased pre to post for all groups.

CONCLUSION

Overall, results suggest that while anodal stimulation of the lDLPFC may benefit cognitive abilities for this population, targeting psychological symptoms of anxiety likely requires stimulation over other cortex, possibly right DLPFC. Further, the use of tDCS, whether active or sham, may be distressing to patients.

Can genetic polymorphisms predict response variability to anodal transcranial direct current stimulation of the primary motor cortex?

Genetic mediation of cortical plasticity and the role genetic variants play in previously observed response variability to transcranial direct current stimulation (tDCS) have become important issues in the tDCS literature in recent years. This study investigated whether inter-individual variability to tDCS was in-part genetically mediated. In 61 healthy males, anodal-tDCS (a-tDCS) and sham-tDCS were administered to the primary motor cortex at 1 mA for 10-min via 6 × 4 cm active and 7 × 5 cm return electrodes. Twenty-five single-pulse transcranial magnetic stimulation (TMS) motor evoked potentials (MEP) were recorded to represent corticospinal excitability (CSE). Twenty-five paired-pulse MEPs were recorded with 3 ms inter-stimulus interval (ISI) to assess intracortical inhibition (ICI) via short-interval intracranial inhibition (SICI) and 10 ms ISI for intracortical facilitation (ICF). Saliva samples were tested for specific genetic polymorphisms in genes encoding for excitatory and inhibitory neuroreceptors. Individuals were sub-grouped based on a pre-determined threshold and via statistical cluster analysis. Two distinct subgroups were identified, increases in CSE following a-tDCS (i.e. Responders) and no increase or even reductions in CSE (i.e. Non-responders). No changes in ICI or ICF were reported. No relationships were reported between genetic polymorphisms in excitatory receptor genes and a-tDCS responders. An association was reported between a-tDCS responders and GABRA3 gene polymorphisms encoding for GABA-A receptors suggesting potential relationships between GABA-A receptor variations and capacity to undergo tDCS-induced cortical plasticity. In the largest tDCS study of its kind, this study presents an important step forward in determining the contribution genetic factors play in previously observed inter-individual variability to tDCS.

Is It Possible to Improve Working Memory With Prefrontal tDCS? Bridging Currents to Working Memory Models

A great deal of research has been performed with the promise of improving such critical cognitive functions as working memory (WM), with transcranial direct current stimulation (tDCS), a well-tolerated, inexpensive, easy-to-use intervention. Under the assumption that by delivering currents through electrodes placed in suitable locations on the scalp, it is possible to increase prefrontal cortex excitability and therefore improve WM. A growing number of studies have led to mixed results, leading to the realization that such oversimplified assumptions need revision. Models spanning currents to behavior have been advocated in order to reconcile and inform neurostimulation investigations. We articulate such multilevel exploration to tDCS/WM by briefly reviewing critical aspects at each level of analysis but focusing on the circuit level and how available biophysical WM models could inform tDCS. Indeed, such models should replace vague reference to cortical excitability changes with relevant tDCS net effects affecting neural computation and behavior in a more predictable manner. We will refer to emerging WM models and explore to what extent the general concept of excitation-inhibition (E/I) balance is a meaningful intermediate level of analysis, its relationship with gamma oscillatory activity, and the extent to which it can index tDCS effects. We will highlight some predictions that appear consistent with empirical evidence – such as non-linearities and trait dependency of effects and possibly a preferential effect on WM control functions – as well as limitations that appear related to the dynamical aspects of coding by persistent activity.

Impact of transcranial direct current stimulation on sustained attention in breast cancer survivors: Evidence for feasibility, tolerability, and initial efficacy

BACKGROUND

A significant subset of breast cancer survivors experience cognitive difficulties in attention and memory, which persist for years following treatment. Transcranial direct current stimulation (tDCS) has been shown to be effective in improving working memory, attention, processing speed, and other cognitive functions in both healthy and clinical populations. To date, no studies have examined tDCS for rehabilitation of cancer-related cognitive dysfunction.

OBJECTIVE/HYPOTHESIS

We aimed to provide preliminary evidence for feasibility, tolerability, acceptability, and efficacy of tDCS in improving performance on a measure of sustained attention.

METHODS

In a within-subjects design, 16 breast cancer survivors underwent 2 consecutive days of active tDCS over the prefrontal cortex, and 2 days of sham tDCS, counterbalanced for order of stimulation condition, while performing a continuous performance test.

RESULTS

Stimulation was feasible and tolerable, with 89% of participants completing all sessions, and none reporting more than mild to moderate discomfort. Analyses of efficacy showed that during active stimulation, participants had significantly lower standard errors of reaction times overall, indicating better sustained attention ability, as compared to sham stimulation (p < 0.05). Furthermore, the effect of stimulation on standard errors of reaction times differed by inter-stimulus interval (ISI): for 1 and 2 s ISIs, there was no significant difference in performance between sham and active tDCS conditions, but for 4 s ISIs, stimulation improved variability in response times relative to sham (p < 0.05).

CONCLUSIONS

Results suggest that tDCS is feasible, tolerable, and may be an effective intervention to improve sustained attention difficulties in survivors with cancer-related cognitive dysfunction.

Encoding strategy mediates the effect of electrical stimulation over posterior parietal cortex on visual short-term memory

Over past decades, converging neuroimaging and electrophysiological findings have suggested a crucial role of posterior parietal cortex (PPC) in supporting the storage capacity of visual short-term memory (VSTM). Moreover, a few recent studies have shown that electrical stimulation over PPC can enhance VSTM capacity, making it a promising method for improving VSTM function. However, the reliability of these results is still in question because null findings have also been observed. Among studies that reported significant effects, some found increased VSTM capacity only in people with low capacity. Here, we hypothesized that subjects' encoding strategy might be a key source of these variable results. To directly test this hypothesis, we stimulated PPC using transcranial direct-current stimulation (tDCS) in male and female human subjects instructed to employ different encoding strategies during a VSTM recall task. We found that VSTM capacity was higher in subjects who were instructed to remember all items in the supra-capacity array of visual stimuli (i.e., the remember-all group), compared to subjects who were told to focus on a subset of these stimuli (i.e., the remember-subset group). As predicted, anodal tDCS over PPC significantly enhanced VSTM capacity only in the remember-subset group, but not in the remember-all group. Additionally, no effect of encoding strategy or its interaction with electrical stimulation was found on VSTM precision. Together, these results suggest that encoding strategy has a selective influence on VSTM capacity and this influence of encoding strategy mediates the effect of electrical stimulation over PPC on VSTM function.

Brain stimulation to left prefrontal cortex modulates attentional orienting to gaze cues

In social interactions, we rely on non-verbal cues like gaze direction to understand the behaviour of others. How we react to these cues is determined by the degree to which we believe that they originate from an entity with a mind capable of having internal states and showing intentional behaviour, a process called mind perception. While prior work has established a set of neural regions linked to mind perception, research has just begun to examine how mind perception affects social-cognitive mechanisms like gaze processing on a neuronal level. In the current experiment, participants performed a social attention task (i.e. attentional orienting to gaze cues) with either a human or a robot agent (i.e. manipulation of mind perception) while transcranial direct current stimulation (tDCS) was applied to prefrontal and temporo-parietal brain areas. The results show that temporo-parietal stimulation did not modulate mechanisms of social attention, neither in response to the human nor in response to the robot agent, whereas prefrontal stimulation enhanced attentional orienting in response to human gaze cues and attenuated attentional orienting in response to robot gaze cues. The findings suggest that mind perception modulates low-level mechanisms of social cognition via prefrontal structures, and that a certain degree of mind perception is essential in order for prefrontal stimulation to affect mechanisms of social attention. This article is part of the theme issue 'From social brains to social robots: applying neurocognitive insights to human-robot interaction'.

Impact of 3-Day Combined Anodal Transcranial Direct Current Stimulation-Visuospatial Training on Object-Location Memory in Healthy Older Adults and Patients with Mild Cognitive Impairment

BACKGROUND

Associative object-location memory (OLM) is known to decline even in normal aging, and this process is accelerated in patients with mild cognitive impairment (MCI). Given the lack of curative treatment for Alzheimer's disease, activating cognitive resources during its preclinical phase might prevent progression to dementia.

OBJECTIVE

To evaluate the effects of anodal transcranial direct current stimulation (atDCS) combined with an associative episodic memory training on OLM in MCI patients and in healthy elderly (HE).

METHODS

In a single-blind cross-over design, 16 MCI patients and 32 HE underwent a 3-day visuospatial OLM training paired with either 20 min or 30 s (sham) atDCS (1 mA, right temporoparietal cortex). Effects on immediate (training success) and long-term memory (1-month) were investigated by conducting Mixed Model analyses. In addition, the impact of combined intervention on within-session (online) and on between-session (offline) performance were explored.

RESULTS

OLM training+atDCS enhanced training success only in MCI patients, but not HE (difference n.s.). Relative performance gain was similar in MCI patients compared to HE under atDCS. No beneficial effect was found after 1-month. Exploratory analyses suggested a positive impact on online, but a negative effect on offline performance in MCI patients. In both groups, exploratory post-hoc analyses indicated an association between initially low-performers and greater benefit from atDCS.

CONCLUSION

Cognitive training in MCI may be enhanced by atDCS, but further delineation of the impact of current brain state, as well as temporal characteristics of multi-session atDCS-training application, may be needed to induce longer-lasting effects.

Transcranial Direct Current Stimulation over the Prefrontal Cortex Alters Encoding and Judgments of Learning Based on Fluency

Past research has shown that judgments of learning (JOLs), subjective confidence judgments made at study about later memorability, are inferential in nature and based on cues available during encoding. Participants tend to use fluency as a cue and give higher JOLs to more fluently encoded items, despite having better recognition memory for disfluently encoded items, which leads to poor JOL accuracy. Research has implicated the dorsolateral prefrontal cortex (DLPFC) and anterior prefrontal cortex (aPFC) in JOL and encoding processes, but no studies to date have tested how the roles of these regions vary with the information on which JOLs are based. We used high-definition transcranial direct current stimulation to test the causal roles of DLPFC and aPFC in encoding success, JOL ratings, and JOL accuracy. Participants studied and made JOLs about words that varied in fluency (i.e., frequency and orientation). High-definition transcranial direct current stimulation over the DLPFC impaired encoding, as evidenced by an increase in subsequent false alarms. For words that were less fluently encoded, aPFC stimulation improved JOL accuracy, perhaps making participants more aware of encoding failures under conditions of disfluency. Conversely, DLPFC and aPFC stimulation decreased JOL accuracy for high-frequency words, suggesting the roles of these regions in JOLs vary with the cognitive bases of the judgments. These results contribute to our understanding of the causal roles of prefrontal regions in objective and subjective memory processes and how their contributions to metamemory accuracy vary with information on which subjective assessments are based.

Replacing tDCS with theta tACS provides selective, but not general WM benefits

Working memory (WM) can be improved after repeated training sessions paired with noninvasive neurostimulation techniques. Previously, we reported that WM training paired with tDCS succeeded behaviorally by enhancing anterior-posterior theta phase coherence and reducing alpha power. Here, in two experiments we tested several theta and alpha frequencies and two transcranial alternating current stimulation (tACS) montages in an effort to shortcut WM training while preserving behavioral gains. In Experiment 1, in separate sessions participants received online tACS at two frequencies derived from the previous study with the respective goal of improving and impairing WM performance. We selected the mean group peak value theta (7 Hz) to benefit WM and alpha (11 Hz) to impair WM. Stimulation (tACS) over right frontoparietal sites (F4-P4) during 3-back WM tasks (object, spatial) produced no behavioral consequences. In Experiment 2 we stimulated at a slower theta frequency (4.5 Hz), which was also significant in our prior study, and tested whether frontoparietal or bifrontal montages would be more effective at improving WM. This experiment revealed selectively improved object WM after right frontoparietal tACS alone. In summary, one session of tACS failed to produce the magnitude or breadth of WM gains observed after 4-10 tDCS-WM training sessions. In short, despite looking for loopholes we found little tACS savings.

Examining the Interactions Between Expectations and tDCS Effects on Motor and Cognitive Performance

Background: Despite a growing literature and commercial market, the effectiveness of transcranial direct current stimulation (tDCS) remains questionable. Notably, studies rarely examine factors such as expectations of outcomes, which may influence tDCS response through placebo-like effects. Here we sought to determine whether expectations could influence the behavioral outcomes of a tDCS intervention. Methods: Through an initial study and self-replication, we recruited 121 naïve young adults 18-34 years of age (M = 21.14, SD = 3.58; 88 women). We evaluated expectations of tDCS and of motor and cognitive performance at three times: (i) at baseline; (ii) after being primed to have High or Low expectations of outcomes; and (iii) after a single session of sham-controlled anodal tDCS over the left or right motor cortex. Before and after stimulation, participants performed the Grooved Pegboard Test and a choice reaction time task as measures of motor dexterity, response time, and response inhibition. Results: Repeated measures ANOVA revealed that participants had varying, largely uncertain, expectations regarding tDCS effectiveness at baseline. Expectation ratings significantly increased or decreased in response to High or Low priming, respectively, and decreased following the intervention. Response times and accuracy on motor and cognitive measures were largely unaffected by expectation or stimulation conditions. Overall, our analysis revealed no effect attributable to baseline expectations, belief of group assignment, or experimental condition on behavioral outcomes. Subjective experience did not differ based on expectation or stimulation condition. Conclusions: Our results suggest no clear effects of tDCS or of expectations on our performance measures, highlighting the need for further investigations of such stimulation methods.

A systematic review and meta-analysis of the effects of transcranial direct current stimulation (tDCS) on episodic memory

BACKGROUND

In the past decade, several studies have examined the effects of transcranial direct current stimulation (tDCS) on long-term episodic memory formation and retrieval. These studies yielded conflicting results, likely due to differences in stimulation parameters, experimental design and outcome measures.

OBJECTIVES

In this work we aimed to assess the robustness of tDCS effects on long-term episodic memory using a meta-analytical approach.

METHODS

We conducted four meta-analyses to analyse the effects of anodal and cathodal tDCS on memory accuracy and response times. We also used a moderator analysis to examine whether the size of tDCS effects varied as a function of specific stimulation parameters and experimental conditions.

RESULTS

Although all selected studies reported a significant effect of tDCS in at least one condition in the published paper, the results of the four meta-analyses showed only statistically non-significant close-to-zero effects. A moderator analysis suggested that for anodal tDCS, the duration of the stimulation and the task used to probe memory moderated the effectiveness of tDCS. For cathodal tDCS, site of stimulation was a significant moderator, although this result was based on only a few observations.

CONCLUSIONS

To warrant theoretical advancement and practical implications, more rigorous research is needed to fully understand whether tDCS reliably modulates episodic memory, and the specific circumstances under which this modulation does, and does not, occur.

Safety of Transcranial Direct Current Stimulation of Frontal, Parietal, and Cerebellar Regions in Fasting Healthy Adults

(1) Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that has been investigated in a large number of studies in terms of it is effects on brain function, safety of use, and future implications. The principal aim of this study was to investigate the safety of 1.5-mA tDCS of three brain areas, that is, frontal, partial, and cerebellar cortices, in fasting healthy individuals during the month of Ramadan. (2) Methods: In a single-blinded, sham-controlled study, we assessed the safety of a 20-min tDCS current (1.5 mA, 35 cm²) over the right frontal, parietal, and cerebellar cortex areas after 8 h of fasting in healthy right-handed adult subjects using a standard safety questionnaire. (3) Results: A total of 49 subjects completed the tDCS sessions and safety questionnaire. None of the sessions were stopped due to pain or discomfort during stimulation. Moreover, no subject experienced serious adverse events such as seizures or loss of consciousness. (4) Conclusions: There was no significant difference in the frequency or type of side effects between active and sham stimulation sessions. The tDCS protocol applied in this study was found to be safe in fasting healthy adults.

tDCS Facilitation of Picture Naming: Item-Specific, Task General, or Neither?

The aim of the present study was to clarify the conditions under which anodal tDCS applied to left hemisphere language sites may facilitate picture naming latencies in healthy young adults. We built upon previous studies by directly testing for item-specific and generalized effects of tDCS through manipulation of item-familiarization and through testing for both online and offline effects of stimulation, in the same paradigm. In addition, we tested for the robustness of these effects by comparing two left hemisphere sites critical for lexical retrieval. Twenty-eight healthy young adults completed two testing sessions receiving either anodal (1.5 mA, 20 min) or sham stimulation (1.5 mA, 30 s) in each session. Half of the participants received tDCS over the left inferior frontal region and the other half over the left posterior superior temporal region. All participants were asked to a name a set of pictures and their response latencies were compared at three time points (before, during, and after the end of stimulation). The stimulus set was constructed so that some items were presented at all time points, some before and after stimulation, and some during stimulation only. A parsimonious linear mixed effects model (LMM) revealed robust repetition priming effects as latencies were reliably faster for previously named items in all conditions. However, active tDCS did not produce any additional facilitation in relation to sham, and even led to slower performance in the IFG group when the stimulated items differed from those tested at baseline and post-test. Our findings add to the present debate about the efficacy of single-session tDCS for modulation of lexical retrieval in healthy young adults. We conclude that future research should take a more systematic, step-wise approach to the application of tDCS to the study of language and that more sensitive experimental paradigms, which include a training element, are more adapted to the study of cognitive processes in populations with optimal levels of cortical excitability.

Non-invasive brain stimulation in information systems research: A proof-of-concept study

One of the founding experiments in the field of Neuro-Information-Systems (NeuroIS), which aims at exploring the neural correlates of the technology acceptance model, suggests that perceived ease of use (PEoU) is associated with activity in the dorsolateral prefrontal cortex (DLPFC) while perceived usefulness is associated with activity in the insula, caudate nucleus and anterior cingulate cortex. To further assess the link between DLPFC and PEoU, transcranial direct current stimulation (tDCS) was applied over bilateral DLPFC (F3 and F4) immediately before an online shopping task. Forty-two participants were divided in three stimulation groups: left anodal/right cathodal, left cathodal/right anodal and sham. No change in PEoU was observed post stimulation but participants in the left anodal/right cathodal stimulation group took longer to make a purchase compared to sham stimulation and had different visual fixation patterns over the buy buttons. This is, to our knowledge, the first use of non-invasive brain stimulation in the field of NeuroIS. Although the involvement of DLPFC in PEoU could not be confirmed, the present study suggests that non-invasive brain stimulation may be a useful research tool in NeuroIS.

Mindfulness-based training with transcranial direct current stimulation modulates neuronal resource allocation in working memory: A randomized pilot study with a nonequivalent control group

Mindfulness-based training (MBT) and transcranial electrical stimulation (TES) methods such as direct current stimulation (tDCS) have demonstrated promise for the augmentation of cognitive abilities. The current study investigated the potential compatibility of concurrent “electrical” MBT and tDCS (or eMBT) by testing its combined effects on behavioral and neurophysiological indices of working memory (WM) and attentional resource allocation. Thirty-four healthy participants were randomly assigned to either a MBT task with tDCS group (eMBT) or an active control training task with sham tDCS (Control) group. Training lasted 4-weeks, with up to twenty MBT sessions and with up to eight of those sessions that were eMBT sessions. Electroencephalography was acquired during varying WM load conditions using the n-back task (1-, 2-, 3-back), along with performance on complex WM span tasks (operation and symmetry span) and fluid intelligence measures (Ravens and Shipley) before and after training. Improved performance was observed only on the 3-back and spatial span tasks for eMBT but not the Control group. During 3-back performance in the eMBT group, an increase in P3 amplitude and theta power at electrode site Pz was also observed, along with a simultaneous decrease in frontal midline P3 amplitude and theta power compared to the Control group. These results are consistent with the neural efficiency hypothesis, where higher cognitive capacity was associated with more distributed brain activity (i.e., increase in parietal and decrease in frontal amplitudes). Future longitudinal studies are called upon to further examine the direct contributions of tDCS on MBT by assessing the differential effects of electrode montage, polarity, current strength and a direct contrast between the eMBT and MBT conditions on performance and neuroimaging outcome data. While preliminary, the current results provided evidence for the potential compatibility of using eMBT to modulate WM capacity through the allocation of attention and its neurophysiological correlates.

Transcranial direct current brain stimulation decreases impulsivity in ADHD

BACKGROUND

Impulsivity is a core deficit in attention deficit hyperactivity disorder (ADHD). Transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) has been shown to modulate cognitive control circuits and could enhance DLPFC activity, leading to improved impulse control in ADHD.

OBJECTIVE

Hypothesis: We predicted 2.0 mA anodal stimulation (tDCS) versus sham stimulation applied over the left DLPFC would improve Conners Continuous Performance Task (CPT) scores. Our secondary hypothesis predicted that stop signal task (SST) reaction time (SSRT) would decrease with tDCS (versus sham).

METHODS

Thirty-seven participants completed two periods of three tDCS (or sham) sessions two weeks apart in a within-subject, double-blind, counterbalanced order. Participants performed a fractal N-back training task concurrent with tDCS (or sham) stimulation. Participants completed the CPT and SST at the beginning of treatment (baseline), at the end of the treatment, and at a 3-day post-stimulation follow-up.

RESULTS

There was a significant stimulation condition by session interaction for CPT false positive scores (χ² = 15.44, p < 0.001) driven by a decrease in false positive errors from baseline to end of treatment in the tDCS group (β = -0.36, 95% Confidence Interval (CI) -0.54 to -0.18, p < 0.001). This effect did not persist at follow-up (β = -0.13, p > 0.05). There was no significant stimulation condition by session interaction effect on CPT true positive errors or response time (ps > 0.05). No significant change in SSRT performance was observed (p > 0.05).

CONCLUSION

These findings suggest that stimulation of the left DLPFC with tDCS can improve impulsivity symptoms in ADHD, supporting the therapeutic potential for tDCS in adult ADHD patients.

Transcranial direct current stimulation (tDCS) facilitates overall visual search response times but does not interact with visual search task factors

Whether transcranial direct current stimulation (tDCS) affects mental functions, and how any such effects arise from its neural effects, continue to be debated. We investigated whether tDCS applied over the visual cortex (Oz) with a vertex (Cz) reference might affect response times (RTs) in a visual search task. We also examined whether any significant tDCS effects would interact with task factors (target presence, discrimination difficulty, and stimulus brightness) that are known to selectively influence one or the other of the two information processing stages posited by current models of visual search. Based on additive factor logic, we expected that the pattern of interactions involving a significant tDCS effect could help us colocalize the tDCS effect to one (or both) of the processing stages. In Experiment 1 (n = 12), anodal tDCS improved RTs significantly; cathodal tDCS produced a nonsignificant trend toward improvement. However, there were no interactions between the anodal tDCS effect and target presence or discrimination difficulty. In Experiment 2 (n = 18), we manipulated stimulus brightness along with target presence and discrimination difficulty. Anodal and cathodal tDCS both produced significant improvements in RTs. Again, the tDCS effects did not interact with any of the task factors. In Experiment 3 (n = 16), electrodes were placed at Cz and on the upper arm, to test for a possible effect of incidental stimulation of the motor regions under Cz. No effect of tDCS on RTs was found. These findings strengthen the case for tDCS having real effects on cerebral information processing. However, these effects did not clearly arise from either of the two processing stages of the visual search process. We suggest that this is because tDCS has a DIFFUSE, pervasive action across the task-relevant neuroanatomical region(s), not a discrete effect in terms of information processing stages.

Null Effects on Working Memory and Verbal Fluency Tasks When Applying Anodal tDCS to the Inferior Frontal Gyrus of Healthy Participants

Transcranial direct current stimulation (tDCS) is a technique used to modify cognition by modulating underlying cortical excitability via weak electric current applied through the scalp. Although many studies have reported positive effects with tDCS, a number of recent studies highlight that tDCS effects can be small and difficult to reproduce. This is especially the case when attempting to modulate performance using single applications of tDCS in healthy participants. Possible reasons may be that optimal stimulation parameters have yet to be identified, and that individual variation in cortical activity and/or level of ability confound outcomes. To address these points, we carried out a series of experiments in which we attempted to modulate performance in fluency and working memory probe tasks using stimulation parameters which have been associated with positive outcomes: we targeted the left inferior frontal gyrus (LIFG) and compared performance when applying a 1.5 mA anodal current for 25 min and with sham stimulation. There is evidence that LIFG plays a role in these tasks and previous studies have found positive effects of stimulation. We also compared our experimental group (N = 19–20) with a control group receiving no stimulation (n = 24). More importantly, we also considered effects on subgroups subdivided according to memory span as well as to more direct measures of executive function abilities and motivational levels. We found no systematic effect of stimulation. Our findings are in line with a growing body of evidence that tDCS produces unreliable effects. We acknowledge that our findings speak to the conditions we investigated, and that alternative protocols (e.g., multiple sessions, clinical samples, and different stimulation polarities) may be more effective. We encourage further research to explore optimal conditions for tDCS efficacy, given the potential benefits that this technique poses for understanding and enhancing cognition.

Frontoparietal tDCS Benefits Visual Working Memory in Older Adults With Low Working Memory Capacity

Working memory (WM) permits maintenance of information over brief delays and is an essential executive function. Unfortunately, WM is subject to age-related decline. Some evidence supports the use of transcranial direct current stimulation (tDCS) to improve visual WM. A gap in knowledge is an understanding of the mechanism characterizing these tDCS linked effects. To address this gap, we compared the effects of two tDCS montages designed on visual working memory (VWM) performance. The bifrontal montage was designed to stimulate the heightened bilateral frontal activity observed in aging adults. The unilateral frontoparietal montage was designed to stimulate activation patterns observed in young adults. Participants completed three sessions (bilateral frontal, right frontoparietal, sham) of anodal tDCS (20 min, 2 mA). During stimulation, participants performed a visual long-term memory (LTM) control task and a visual WM task. There was no effect of tDCS on the LTM task. Participants receiving right unilateral tDCS showed a WM benefit. This pattern was most robust in older adults with low WM capacity. To address the concern that the key difference between the two tDCS montages could be tDCS over the posterior parietal cortex (PPC), we included new analyses from a previous study applying tDCS targeting the PPC paired with a recognition VWM task. No significant main effects were found. A subsequent experiment in young adults found no significant effect of either tDCS montage on either task. These data indicate that tDCS montage, age and WM capacity should be considered when designing tDCS protocols. We interpret these findings as suggestive that protocols designed to restore more youthful patterns of brain activity are superior to those that compensate for age-related changes.