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Combined Cognitive Training and Transcranial Direct Current Stimulation in Neuropsychiatric Disorders: A Systematic Review and Meta-Analysis

Published:October 12, 2022DOI:https://doi.org/10.1016/j.bpsc.2022.09.014

      Abstract

      Background

      Treatments for cognitive dysfunction in neuropsychiatric conditions are urgently needed. Cognitive training and transcranial direct current stimulation (tDCS) hold promise, and there is growing interest in combined or multi-modal treatments though studies to date have small samples and inconsistent results.

      Methods

      A systematic review and meta-analysis was completed. Retained studies included cognitive training combined with active or sham tDCS in a neuropsychiatric population and reported a post-treatment cognitive outcome. Meta-analyses included effect sizes comparing cognitive training + active tDCS and cognitive training + sham tDCS in five cognitive domains. Risk of bias in included studies and across studies were explored.

      Results

      Fifteen studies were included; ten in neurodegenerative disorders and five in psychiatric disorders (n=629). There were several tDCS montages though two-thirds of studies placed the anode over left dorsolateral prefrontal cortex. A wide variety of cognitive training types and outcome measures were reported. There was a small, statistically significant effect of combined treatment on measures of attention/working memory, as well as small and non-statistically significant effects favoring combined treatment on global cognition and language. There was no evidence of bias in individual studies, but some evidence of non-reporting or small-study bias across studies.

      Conclusions

      These results may provide preliminary support for the efficacy of combined cognitive training and tDCS on measures of attention/working memory. More data are needed, particularly via studies that explicitly align the cognitive ability of interest, stimulation target, training type, and outcome measures.

      Keywords

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