Background: Inhibitory control refers to a central cognitive capacity involved in the interruption and correction of actions. Dysfunctions in these cognitive control processes have been identified as major maintaining mechanisms in a range of mental disorders such as ADHD, binge eating disorder, obesity, and addiction. Improving inhibitory control by transcranial direct current stimulation (tDCS) could ameliorate symptoms in a broad range of mental disorders. Objective: The primary aim of this pre-registered meta-analysis was to investigate whether inhibitory control can be improved by tDCS in healthy and clinical samples. Additionally, several moderator variables were investigated. Methods: A comprehensive literature search was performed on PubMed/MEDLINE database, Web of Science, and Scopus. To achieve a homogenous sample, only studies that assessed inhibitory control in the go-/no-go (GNG) or stop-signal task (SST) were included, yielding a total of 75 effect sizes from 45 studies. Results: Results of the meta-analysis indicate a small but significant overall effect of tDCS on inhibitory control (g ¼ 0.21) which was moderated by target and return electrode placement as well as by the task. The small effect size was further reduced after correction for publication bias. Conclusion:Based on the studies included, our meta-analytic approach substantiates previously observed differences between brain regions, i.e., involvement of the right inferior frontal gyrus (rIFG) vs. the right dorsolateral prefrontal cortex (rDLPFC) in inhibitory control. Results indicate a small moderating effect of tDCS on inhibitory control in single-session studies and highlight the relevance of technical and behavioral parameters.

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Background Working memory (WM) impairment is characteristic for schizophrenia patients, lowering their occupational status and quality of life. Recent research suggests that non-invasive brain stimulation could have the potential to treat such cognitive deficits. One novel and promising approach is the transcranial alternating current stimulation (tACS) that could entrain the endogenous gamma oscillations in the dorsolateral prefrontal cortex (DLPFC), previously shown to be abnormal in schizophrenia patients and associated with WM deficits. Indeed, first studies demonstrated WM improvement in healthy participants following tACS at the gamma frequency (γ-tACS) to the DLPFC in healthy participants. However, till date, there is only one pilot study with ten schizophrenia patients, where cognitive enhancement was not evident. Here, we aimed to investigate the efficacy and feasibility of γ-tACS on simultaneous WM performance in schizophrenia patients with a bigger study sample and in regard of cognitive load Methods A total of fifteen patients with schizophrenia (N = 15, 8 female) participated in the current study. They underwent a pre-stimulation baseline, an active γ-tACS and a sham single-session in a double-blind, cross-over design. Stimulation was administered over the left DLPFC (F3, anode) and the contralateral region (F4, cathode) at a current of -1mA to 1mA (peek-to-peek) at 40 Hz for 20 min (48000 cycles). We assessed WM during stimulation using a verbal n-back task with three cognitive loads (1- to 3-back). Reaction times and discriminability index d prime served as primary study outcomes. Using several RM-ANOVAs, we compared working memory performance during γ-tACS and sham across all cognitive loads. Results Data analysis showed no significant main effect of γ-tACS compared to sham on both d prime values (p = .269) and reaction times (p = .166). However, we observed a significant stimulation x load interaction effect on reaction times (p = .043), suggesting that with increasing cognitive load participants responded slightly slower during active than during sham γ-tACS. Discussion The current work is one of the first to investigate the effects of γ-tACS to the DLPFC on simultaneous WM performance in schizophrenia patients. In line with previous research, we did not find any significant changes in cognition due to stimulation. Surprisingly, we observed a slight decrease in WM speed with higher cognitive load during active compared to sham tACS. Results are discussed in line of study protocol and tACS feasibility and emphasize the need for future research on the specific study design parameters.

ClinicalTrials.gov identifier: NCT02670291.