tDCS over the left prefrontal Cortex improves mental flexibility and inhibition in geriatric inpatients with symptoms of depression or anxiety: A pilot randomized controlled trial

Abstract

BackgroundPatients with depression and/or anxiety are commonly seen in inpatient geriatric settings. Both disorders are associated with an increased risk of cognitive impairments, notably in executive functioning. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, involves the administration of a low-dose electrical current to induce neuromodulation, which ultimately may act on downstream cognitive processing.ObjectiveThe purpose of this study was to determine the effects of tDCS on executive functioning in geriatric inpatients with symptoms of depression and/or anxiety.DesignPilot Randomized Controlled Trial.SettingSpecialized geriatric wards in a tertiary rehabilitation hospital.MethodsThirty older-aged adults were recruited, of which twenty completed ten-to-fifteen sessions of 1.5 mA anodal or sham tDCS over the left dorsolateral prefrontal cortex. Cognitive assessments were administered at baseline and following the tDCS protocol; analyses examined the effects of tDCS on cognitive performance between groups (anodal or sham tDCS).ResultstDCS was found to increase inhibitory processing and cognitive flexibility in the anodal tDCS group, with significant changes on the Stroop test and Trail Making Test-Part B. No significant changes were observed on measures of attention or working memory.DiscussionThese results provide preliminary evidence that tDCS-induced neuromodulation may selectively improve cognitive processing in older adults with symptoms of depression and/or anxiety.Clinical Trials Registrationwww.clinicaltrials.gov, NCT04558177

Neuromodulation in Geriatric Depression: The Role of TMS and tDCS

“…About tDCS, we reported potentials good effects in reduc-reducing negative outcomes associated with older depression, such as cognitive dysfunction [45] and mood problems [47] whereas one work did not find significant improvements from tDCS in working and cognitive function [46]. In older people with functional limitations, tDCS has been proved to improve executive functions and dual tasking [57].…”

“…Participants were divided in two groups: the one receiving anodal (n=10, M=6, F=4, mean age=77,10±6,98), while the second (n=10, M=4, F=6,mean age=72,50±7,46) sham tDCs over the left dorsolateral prefrontal cortex. It was reported that tDCS increases inhibitory processing and cognitive flexibility in the anodal tDCS group, whereas no relevant changes in attention or working memory measurements were observed [45]. A similar work analyzed 33 participants with previous single or recurrent episodes of MDD, evaluated through the SCID-IV and MADRS.…”