Transcranial Direct Current Stimulation May Improve Cognitive-Motor Function in Functionally Limited Older Adults

Brad Manor*, Junhong Zhou, Rachel Harrison, On Yee Lo, Thomas G. Travison, Jeffrey M. Hausdorff, Alvaro Pascual-Leone, Lewis Lipsitz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

62 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)788-798
Number of pages11
JournalNeurorehabilitation and Neural Repair
Volume32
Issue number9
DOIs
StatePublished - 1 Sep 2018

Funding

FundersFunder number
MMAAP
NCATS NIHUL1 RR025758
U.S.-Israel Binational Science Foundation
National Institute on AgingK01 AG044543, R01 AG041785, R01 AG025037, T32 AG023480
National Center for Research Resources
National Center for Advancing Translational SciencesUL1TR001102
Harvard University
Harvard Catalyst
Dr. Ralph and Marian Falk Medical Research Trust
Claude D. Pepper Older Americans Independence Center, University of California San FranciscoP30-AG013679
Milstein Medical Asian American Partnership Foundation

    Keywords

    • dual-task standing
    • executive function
    • older adults
    • tDCS

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