Transcranial Direct Current Stimulation (TDCS) Improved Cognitive Outcomes in a Cancer Survivor With Chemotherapy-induced Cognitive Difficulties

Knotková, Helena; Malamud, S.; Cruciani, Ricardo A.

doi:10.1016/j.brs.2014.05.007

Cited by 13 publications

(12 citation statements)

References 7 publications

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“…Chemotherapy-related cognitive impairment has been known for several decades, but there are no proven interventions that may ameliorate these side effects. In a recent case study, Knotkova and colleagues reported the effects of transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex in improving executive functions in patients receiving chemotherapy 26 . By precisely locating the brain regions impacted by chemotherapy, the current and future studies may provide potentially more precise targets for brain stimulation interventions.…”

Section: Discussionmentioning

confidence: 99%

Diminished gray matter density mediates chemotherapy dosage-related cognitive impairment in breast cancer patients

Chen

et al. 2018

Sci Rep

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To investigate chemotherapy dosage-related cognitive impairment and its neural mechanisms in breast cancer (BC) patients. Twenty-eight breast cancer patients after each chemotherapy cycle and matched 29 healthy control subjects underwent structural magnetic resonance imaging. Voxel-based morphometry analysis was performed to compare group differences in the gray matter for the whole brain. Furthermore, mediation analysis was conducted to explore the role of brain structures in chemotherapy dosage-related cognitive impairment. Voxel-based morphometry analysis was performed in gray matter for the whole brain of BC patients after chemotherapy. The results revealed that the gray matter density in the left inferior frontal gyrus, right middle frontal gyrus, right fusiform area, and bilateral cerebellum was decreased in the BC patients compared to controls. The number of chemotherapy cycles was negatively associated with general cognitive capacity, verbal fluency and digit span performance in the BC patients. In addition, decreased gray matter density in the right middle frontal gyrus could mediate the chemotherapy dosage effects on verbal fluency performance. These findings indicate that the dose-response relationship between chemotherapy and cognitive impairment may depend on the decreases in gray matter density of the frontal cortical structures.

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Section: Discussionmentioning

confidence: 99%

Diminished gray matter density mediates chemotherapy dosage-related cognitive impairment in breast cancer patients

Chen

et al. 2018

Sci Rep

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“…tDCS can manipulate brain activity underlying cognition [45,46], and meta-analyses have shown prefrontal stimulation can alter aspects of behavioral performance [47], although only one case report has described specific application in cancer survivorship. Authors applied five sessions of tDCS to the prefrontal cortex in a breast cancer survivor and found improved outcomes in a computerized neuropsychological battery of executive function [48]. Meanwhile, targeting prefrontal regions that are largely implicated in supporting attention [49] with tDCS may be beneficial given converging evidence of the susceptibility of attentional processes, in particular, following cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2020

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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.

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“…Transcranial direct current stimulation (tDCS) is a non-invasive and non-pharmacological intervention that may address multiple symptoms of chronic illness ( Nitsche and Paulus, 2000 ; Fregni et al, 2006a , b ; Rigonatti et al, 2008 ; Valle et al, 2009 ; Loo et al, 2012 ; Knotkova et al, 2014a , b ). tDCS is delivered via a battery-powered device with two or more electrodes that transfer electrical current of low intensity (usually 1–2 mA) to the surface of the head.…”

Section: Introductionmentioning

confidence: 99%

At-Home Transcranial Direct Current Stimulation (tDCS) With Telehealth Support for Symptom Control in Chronically-Ill Patients With Multiple Symptoms

Riggs

Patel

Paneri

et al. 2018

Front. Behav. Neurosci.

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Transcranial direct current stimulation (tDCS) delivered in multiple sessions can reduce symptom burden, but access of chronically ill patients to tDCS studies is constrained by the burden of office-based tDCS administration. Expanded access to this therapy can be accomplished through the development of interventions that allow at-home tDCS applications.Objective: We describe the development and initial feasibility assessment of a novel intervention for the chronically ill that combines at-home tDCS with telehealth support.Methods: In the developmental phase, the tDCS procedure was adjusted for easy application by patients or their informal caregivers at home, and a tDCS protocol with specific elements for enhanced safety and remote adherence monitoring was created. Lay language instructional materials were written and revised based on expert feedback. The materials were loaded onto a tablet allowing for secure video-conferencing. The telehealth tablet was paired with an at-home tDCS device that allowed for remote dose control via electronic codes dispensed to patients prior to each session. tDCS was delivered in two phases: once daily on 10 consecutive days, followed by an as needed regimen for 20 days. Initial feasibility of this tDCS-telehealth system was evaluated in four patients with advanced chronic illness and multiple symptoms. Change in symptom burden and patient satisfaction were assessed with the Condensed Memorial Symptom Assessment Scale (CMSAS) and a tDCS user survey.Results: The telehealth-tDCS protocol includes one home visit and has seven patient-tailored elements and six elements enhancing safety monitoring. Replicable electrode placement at home without 10–20 EEG measurement is achieved via a headband that holds electrodes in a pre-determined position. There were no difficulties with patients’ training, protocol adherence, or tolerability. A total of 60 tDCS sessions were applied. No session required discontinuation, and there were no adverse events. Data collection was feasible and there were no missing data. Satisfaction with the tDCS-telehealth procedure was high and the patients were comfortable using the system.Conclusion: At-home tDCS with telehealth support appears to be a feasible approach for the management of symptom burden in patients with chronic illness. Further studies to evaluate and optimize the protocol effectiveness for symptom-control outcomes are warranted.

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Transcranial Direct Current Stimulation (TDCS) Improved Cognitive Outcomes in a Cancer Survivor With Chemotherapy-induced Cognitive Difficulties

Cited by 13 publications

References 7 publications

Diminished gray matter density mediates chemotherapy dosage-related cognitive impairment in breast cancer patients

Diminished gray matter density mediates chemotherapy dosage-related cognitive impairment in breast cancer patients

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

At-Home Transcranial Direct Current Stimulation (tDCS) With Telehealth Support for Symptom Control in Chronically-Ill Patients With Multiple Symptoms

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