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

Mathieu Figeys, Sheryn Villarey, Ada W S Leung, Jim Raso, Steven Buchan, Hubert Kammerer, David Rawani, Megan Kohls-Wiebe, Esther S Kim, Mathieu Figeys, Sheryn Villarey, Ada W S Leung, Jim Raso, Steven Buchan, Hubert Kammerer, David Rawani, Megan Kohls-Wiebe, Esther S Kim

Abstract

Background: Patients 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.

Objective: The purpose of this study was to determine the effects of tDCS on executive functioning in geriatric inpatients with symptoms of depression and/or anxiety.

Design: Pilot Randomized Controlled Trial.

Setting: Specialized geriatric wards in a tertiary rehabilitation hospital.

Methods: Thirty 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).

Results: tDCS 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.

Discussion: These 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 registration: www.clinicaltrials.gov, NCT04558177.

Keywords: anxiety; depression; executive functioning; geriatric; mental health; neuromodualtion; rehabilitation; transcranial direct current simulation.

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

© 2022 Figeys, Villarey, Leung, Raso, Buchan, Kammerer, Rawani, Kohls-Wiebe and Kim.

Figures

Figure 1
Figure 1
Implemented protocol. The study protocol implemented illustrating participant recruitment, consent, assessment, and tDCS procedures. SDMT, symbol digit modalities test; TMT-A, Trail Making Test Part A; TMT-B, Trail Making Test Part B; MoCA, Montreal Cognitive Assessment. tDCS electrode placement: the anode (red) was placed over F3, the cathode (blue) was placed over the right supraorbital region. Figure 1 was created with Biorender.com.
Figure 2
Figure 2
Changes in cognitive performance between anodal & sham stimulation groups. Note: * is significant at p < 0.05. Stroop Interference: Negative interference suggests a pathological impairment of inhibition, lower scores indicate greater impairment (60).

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