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Transcranial direct current stimulation as an adjunct to cognitive training for older adults with mild cognitive impairment: A randomized controlled trial - 12/10/21

Doi : 10.1016/j.rehab.2021.101536 
Pablo Cruz Gonzalez a, Kenneth N.K. Fong a, , Ted Brown b
a Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR 
b Department of Occupational Therapy, Monash University–Peninsula Campus, Frankston, 3199 Victoria, Australia 

Corresponding author.

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Highlights

Cognitive training (CT) with or without transcranial direct current stimulation (tDCS) enhanced global cognition and everyday memory.
tDCS combined with CT was not superior to sham tDCS paired with CT and CT alone in its effects on domain-specific cognitive outcomes.
tDCS+CT improved the processing speed of task-specific outcomes more than sham tDCS+CT and CT alone.
tDCS seems to be a potential effective adjunct to CT activities.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Cognitive training (CT) for individuals with mild cognitive impairment (MCI) may not be optimal for enhancing cognitive functioning. Coupling CT with transcranial direct current stimulation (tDCS) may maximize the strength of transmission across synaptic circuits in pathways that are stimulated by CT. The synergistic effects arising from this combination could be superior to those with administration of CT alone.

Objectives

To investigate whether the receiving tDCS combined with CT is superior to CT alone on domain-specific and task-specific cognitive outcomes in older adults with MCI.

Methods

This double-blind, sham-controlled randomized trial included 67 older adults with MCI assigned to 3 groups: 1) tDCS combined with CT (tDCS+CT), 2) sham tDCS combined with CT (sham tDCS+CT) and 3) CT alone. Nine sessions of computerized CT were administered to the 3 groups for 3 weeks. In addition, tDCS and sham tDCS was delivered to the left dorsolateral prefrontal cortex to the tDCS+CT and sham tDCS+CT groups, respectively, simultaneously with CT. Standardized cognitive assessments were performed at baseline, post-intervention, and at 6-week follow-up. Participants’ performance in the CT tasks was rated every session.

Results

The 3 groups showed improvements in global cognition and everyday memory (P<0.017) after the intervention and at follow-up, with larger effect sizes in the tDCS+CT than other groups (d>0.94) but with no significant differences between groups. Regarding CT outcomes, the groups showed significant differences in favour of the tDCS+CT group in decreasing the completion and reaction times of working memory and attention activities (P<0.017).

Conclusions

tDCS combined with CT was not superior to sham tDCS with CT and CT alone in its effects on domain-specific cognitive outcomes, but it did provide comparatively larger effect sizes and improve the processing speed of task-specific outcomes.

ClinicalTrials.gov

NCT03441152.

Le texte complet de cet article est disponible en PDF.

Keywords : Mild Cognitive Impairment, Cognitive Rehabilitation, Cognitive Training, Non-invasive Brain Stimulation, Transcranial Direct Current Stimulation


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Vol 64 - N° 5

Article 101536- septembre 2021 Retour au numéro
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