TY - JOUR
T1 - Transcranial Direct Current Stimulation May Improve Cognitive-Motor Function in Functionally Limited Older Adults
AU - Manor, Brad
AU - Zhou, Junhong
AU - Harrison, Rachel
AU - Lo, On Yee
AU - Travison, Thomas G.
AU - Hausdorff, Jeffrey M.
AU - Pascual-Leone, Alvaro
AU - Lipsitz, Lewis
N1 - Publisher Copyright:
© The Author(s) 2018.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Objective. To determine the effects of a transcranial direct current stimulation (tDCS) intervention with the anode placed over the left dorsolateral prefrontal cortex (dlPFC) and cathode over the right supraorbital region, on cognition, mobility, and “dual-task” standing and walking in older adults with mild-to-moderate motor and cognitive impairments. Methods. A double-blinded, block-randomized, sham-controlled trial was conducted in 18 nondemented, ambulatory adults aged ⩾65 years with slow walking speed (⩽1.0 m/s) and “executive” dysfunction (Trail Making Test B score ⩽25th percentile of age- and education-matched norms). Interventions included ten 20-minute sessions of tDCS or sham stimulation. Cognition, mobility, and dual-task standing and walking were assessed at baseline, postintervention, and 2 weeks thereafter. Dual tasking was also assessed immediately before and after the first tDCS session. Results. Intervention compliance was high (mean ± SD = 9.5 ± 1.1 sessions) and no unexpected or serious side effects were reported. tDCS, compared with sham, induced improvements in the Montreal Cognitive Assessment total score (P =.03) and specifically within the executive function subscore of this test (P =.002), and in several metrics of dual-task standing and walking (P <.05). Each of these effects persisted for 2 weeks. tDCS had no effect on the Timed Up-and-Go test of mobility or the Geriatric Depression Scale. Those participants who exhibited larger improvements in dual-task standing posture following the first tDCS session exhibited larger cognitive-motor improvements following 2 weeks of tDCS (P <.04). Interpretation. tDCS intervention designed to stimulate the left dorsolateral prefrontal cortex may improve executive function and dual tasking in older adults with functional limitations.
AB - Objective. To determine the effects of a transcranial direct current stimulation (tDCS) intervention with the anode placed over the left dorsolateral prefrontal cortex (dlPFC) and cathode over the right supraorbital region, on cognition, mobility, and “dual-task” standing and walking in older adults with mild-to-moderate motor and cognitive impairments. Methods. A double-blinded, block-randomized, sham-controlled trial was conducted in 18 nondemented, ambulatory adults aged ⩾65 years with slow walking speed (⩽1.0 m/s) and “executive” dysfunction (Trail Making Test B score ⩽25th percentile of age- and education-matched norms). Interventions included ten 20-minute sessions of tDCS or sham stimulation. Cognition, mobility, and dual-task standing and walking were assessed at baseline, postintervention, and 2 weeks thereafter. Dual tasking was also assessed immediately before and after the first tDCS session. Results. Intervention compliance was high (mean ± SD = 9.5 ± 1.1 sessions) and no unexpected or serious side effects were reported. tDCS, compared with sham, induced improvements in the Montreal Cognitive Assessment total score (P =.03) and specifically within the executive function subscore of this test (P =.002), and in several metrics of dual-task standing and walking (P <.05). Each of these effects persisted for 2 weeks. tDCS had no effect on the Timed Up-and-Go test of mobility or the Geriatric Depression Scale. Those participants who exhibited larger improvements in dual-task standing posture following the first tDCS session exhibited larger cognitive-motor improvements following 2 weeks of tDCS (P <.04). Interpretation. tDCS intervention designed to stimulate the left dorsolateral prefrontal cortex may improve executive function and dual tasking in older adults with functional limitations.
KW - dual-task standing
KW - executive function
KW - older adults
KW - tDCS
UR - http://www.scopus.com/inward/record.url?scp=85053349776&partnerID=8YFLogxK
U2 - 10.1177/1545968318792616
DO - 10.1177/1545968318792616
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C2 - 30132389
AN - SCOPUS:85053349776
SN - 1545-9683
VL - 32
SP - 788
EP - 798
JO - Neurorehabilitation and Neural Repair
JF - Neurorehabilitation and Neural Repair
IS - 9
ER -