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Working memory improvement with non-invasive brain stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis

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Brunoni, André Russowsky, Vanderhasselt, Marie-Anne·2014·Brain and Cognition
DOI 10.1016/j.bandc.2014.01.008
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Abstract

Recent studies have used non-invasive brain stimulation (NIBS) techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), to increase dorsolateral prefrontal cortex (DLPFC) activity and, consequently, working memory (WM) performance. However, such experiments have yielded mixed results, possibly due to small sample sizes and heterogeneity of outcomes. Therefore, our aim was to perform a systematic review and meta-analyses on NIBS studies assessing the n-back task, which is a reliable index for WM. From the first data available to February 2013, we looked for sham-controlled, randomized studies that used NIBS over the DLPFC using the n-back task in PubMed/MEDLINE and other databases. Twelve studies (describing 33 experiments) matched our eligibility criteria. Active vs. sham NIBS was significantly associated with faster response times (RTs), higher percentage of correct responses and lower percentage of error responses. However, meta-regressions showed that tDCS (vs. rTMS) presented only an improvement in RT, and not in accuracy. This could have occurred in part because almost all tDCS studies employed a crossover design, possibly due to the reliable tDCS blinding. Study design was also associated with no improvement in correct responses in the active vs. sham groups. To conclude, rTMS of the DLPFC significantly improved all measures of WM performance whereas tDCS significantly improved RT, but not the percentage of correct and error responses. Mechanistic insights on the role of DLPFC in WM are further discussed, as well as how NIBS techniques could be used in neuropsychiatric samples presenting WM deficits, such as major depression, dementia and schizophrenia.

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  • Because the dorsolateral prefrontal cortex is laterally located and often close to the area of stimulation, working memory may be a cognitive function expected to benefit from non-invasive brain stimulation.

    “As the dorsolateral prefrontal cortex (DLPFC) is laterally located and often close to the area of stimulation, working memory may be a cognitive function expected to benefit from NIBS (Brunoni & Vanderhasselt, 2014; Miniussi & Rossini, 2011; Pope & Chris Miall, 2014; Tracy et al., 2015).”

    From Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis (2020) · cites this paper as Brunoni & Vanderhasselt, 2014

    The Introduction links DLPFC activity to working memory, and the Discussion reports that non-invasive prefrontal stimulation, particularly rTMS, is associated with working-memory improvement. The paper does not give the cited explanation that this benefit is expected because the DLPFC is laterally located and close to the area of stimulation. The indexed passages have section labels but no page numbers. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Preliminary evidence suggests that applying TBS to cognitively relevant areas such as the DLPFC modifies neurophysiology and can modulate cognitive performance.

    “Furthermore, preliminary evidence suggests applying TBS to cognitively relevant areas, such as the dorsolateral prefrontal cortex (DLPFC) modifies neurophysiology and can modulate cognitive performance (Brunoni & Vanderhasselt, 2014).”

    From Investigation of neurobiological responses to theta burst stimulation during recovery from mild traumatic brain injury (mTBI) (2023) · cites this paper as Brunoni & Vanderhasselt, 2014

    The Introduction describes how non-invasive stimulation can alter cortical activity, and the meta-analysis reports improved working-memory performance after rTMS over the DLPFC. However, the paper evaluates rTMS and tDCS, not theta-burst stimulation (TBS), so it does not establish the claim specifically for TBS. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

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Cited by

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Authors
Brunoni, A. R., & Vanderhasselt, M.-A.
Affiliations
  • Universidade de São Paulo (BR)
  • Ghent University (BE)
Corresponding author
  • Brunoni, André Russowsky
  • Vanderhasselt, Marie-Anne
ORCID
Venue
Brain and Cognition
Publisher
Elsevier BV
Published
2014-04
Volume
86
Pages
1-9
ISSN
0278-2626 (ISSN-L)
DOI
10.1016/j.bandc.2014.01.008
OpenAlex
W2028257011
Cited by
669
References
13
Citations by year
2026: 41 · 2025: 41 · 2024: 60 · 2023: 46 · 2022: 62 · 2021: 56 · 2020: 76 · 2019: 51 · 2018: 60 · 2017: 69 · 2016: 45 · 2015: 49 · 2014: 12
FWCI
4.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Brain and Cognition (publishedVersion)
  • PubMed (publishedVersion)
  • Ghent University Academic Bibliography (Ghent University) (submittedVersion, other-oa)
Topics
  • Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
Keywords
working memory, non-invasive brain stimulation, dorsolateral prefrontal cortex, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, n-back task, reaction time (psychology), accuracy, crossover design, neuropsychiatric disorders, major depressive disorder, dementia, schizophrenia
MeSH terms
Electric Stimulation, Female, Humans, Male, Memory, Short-Term, Prefrontal Cortex, Transcranial Magnetic Stimulation

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