Effects of transcranial direct current stimulation paired with cognitive training on functional connectivity of the working memory network in older adults
Open accessAbstract
BACKGROUND: Working memory, a fundamental short-term cognitive process, is known to decline with advanced age even in healthy older adults. Normal age-related declines in working memory can cause loss of independence and decreased quality of life. Cognitive training has shown some potential at enhancing certain cognitive processes, although, enhancements are variable. Transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has shown promise at enhancing working memory abilities, and may further the benefits from cognitive training interventions. However, the neural mechanisms underlying tDCS brain-based enhancements remain unknown. OBJECTIVE/HYPOTHESIS: Assess the effects of a 2-week intervention of active-tDCS vs. sham paired with cognitive training on functional connectivity of the working memory network during an N-Back working memory task. METHODS: = 28; mean age = 74 ± 7.3) completed 10-sessions of cognitive training paired with active or sham-tDCS. Functional connectivity was evaluated at baseline and post-intervention during an N-Back task (2-Back vs. 0-Back). RESULTS: Active-tDCS vs. sham demonstrated a significant increase in connectivity between the left dorsolateral prefrontal cortex and right inferior parietal lobule at post-intervention during 2-Back. Target accuracy on 2-Back was significantly improved for active vs. sham at post-intervention. CONCLUSION: These results suggest pairing tDCS with cognitive training enhances functional connectivity and working memory performance in older adults, and thus may hold promise as a method for remediating age-related cognitive decline. Future studies evaluating optimal dose and long-term effects of tDCS on brain function will help to maximize potential clinical impacts of tDCS paired with cognitive training in older adults. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT02137122.
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Prior evidence shows enhanced cognitive performance in domains of working memory and episodic memory and evidence of transfer effects following active stimulation with cognitive training in older adults.
“This is surprising given prior evidence of enhanced cognitive performance in domains of working memory and episodic memory and evidence of transfer effects following active stimulation with cognitive training in older adults [33–36, 46, 47].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [33]
The Discussion reports improved working-memory performance with active stimulation plus cognitive training in older adults, and the Conclusion reports gains on an untrained working-memory task, supporting evidence of transfer. The cited paper does not report an episodic-memory improvement. Page numbers are unavailable in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredCombining tDCS with cognitive training has demonstrated additive effects on cognitive and functional abilities in younger and older adults.
“Combining tDCS with cognitive training has demonstrated additive effects on cognitive and functional abilities in younger [30–32] and older adults [33–36].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [33]
The Discussion reports that, in healthy older adults, active tDCS paired with cognitive training improved working-memory accuracy beyond sham tDCS paired with training. The study also found increased functional brain connectivity, but it did not demonstrate improvements in functional abilities such as everyday functioning. Its Limitations section says the results cannot be extended to young adults; the citing sentence attaches other references to that age group. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe commercially-available computerized cognitive training program used in ACT has produced performance gains in older adults.
“In the ACT study, the cognitive training intervention involved completing 40 hours of computerized tasks from a commercially-available program that have produced performance gains in older adults [33,65,66].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [33]
The design of the tDCS and cognitive training intervention in the ACT trial was based on a pilot study that demonstrated stimulation effects on working memory performance following two weeks of daily bifrontal tDCS (F3/F4, active stimulation = 2mA for 20 minutes) combined with cognitive training in older adults.
“The design of the tDCS and cognitive training intervention in the ACT trial was based on a pilot study that demonstrated stimulation effects on working memory performance following two weeks of daily bifrontal tDCS (F3/F4, active stimulation = 2mA for 20 minutes) combined with cognitive training in older adults [33].”
From Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial (2023) · cites this paper as [33]
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- Authors
- Nissim, N. R., O’Shea, A., Indahlastari, A., Kraft, J. N., von Mering, O., Aksu, S., Porges, E., Cohen, R., & Woods, A. J.
- Affiliations
- University of Florida Health (US)
- Corresponding author
- Woods, Adam J.
- ORCID
- Venue
- Frontiers in Aging Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2019-12-16
- Volume
- 11
- Pages
- 340-340
- ISSN
- 1663-4365 (ISSN-L)
- PMC
- PMC6961663
- OpenAlex
- W2996309028
- Cited by
- 99
- References
- 43
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 19 · 2023: 11 · 2022: 19 · 2021: 15 · 2020: 11
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Aging Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health
- National Institute on Aging
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- transcranial direct current stimulation, cognitive training, working memory, functional connectivity, older adults, age-related cognitive decline, dorsolateral prefrontal cortex, inferior parietal lobule, n-back task, non-invasive brain stimulation
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