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Randomized Controlled Trial
. 2019 Sep-Oct;12(5):1222-1228.
doi: 10.1016/j.brs.2019.06.003. Epub 2019 Jun 4.

Effects of 6-month at-home transcranial direct current stimulation on cognition and cerebral glucose metabolism in Alzheimer's disease

Jooyeon Jamie Im  1 , Hyeonseok Jeong  1 , Marom Bikson  2 , Adam J Woods  3 , Gozde Unal  2 , Jin Kyoung Oh  1 , Seunghee Na  4 , Jong-Sik Park  4 , Helena Knotkova  5 , In-Uk Song  6 , Yong-An Chung  7
Affiliations
Randomized Controlled Trial

Effects of 6-month at-home transcranial direct current stimulation on cognition and cerebral glucose metabolism in Alzheimer's disease

Jooyeon Jamie Im et al. Brain Stimul. 2019 Sep-Oct.

Abstract

Background: Although single or multiple sessions of transcranial direct current stimulation (tDCS) on the prefrontal cortex over a few weeks improved cognition in patients with Alzheimer's disease (AD), effects of repeated tDCS over longer period and underlying neural correlates remain to be elucidated.

Objective: This study investigated changes in cognitive performances and regional cerebral metabolic rate for glucose (rCMRglc) after administration of prefrontal tDCS over 6 months in early AD patients.

Methods: Patients with early AD were randomized to receive either active (n = 11) or sham tDCS (n = 7) over the dorsolateral prefrontal cortex (DLPFC) at home every day for 6 months (anode F3/cathode F4, 2 mA for 30 min). All patients underwent neuropsychological tests and brain 18F-fluoro-2-deoxyglucose positron emission tomography (FDG-PET) scans at baseline and 6-month follow-up. Changes in cognitive performances and rCMRglc were compared between the two groups.

Results: Compared to sham tDCS, active tDCS improved global cognition measured with Mini-Mental State Examination (p for interaction = 0.02) and language function assessed by Boston Naming Test (p for interaction = 0.04), but not delayed recall performance. In addition, active tDCS prevented decreases in executive function at a marginal level (p for interaction < 0.10). rCMRglc in the left middle/inferior temporal gyrus was preserved in the active group, but decreased in the sham group (p for interaction < 0.001).

Conclusions: Daily tDCS over the DLPFC for 6 months may improve or stabilize cognition and rCMRglc in AD patients, suggesting the therapeutic potential of repeated at-home tDCS.

Keywords: Alzheimer's disease; Cognition; Positron emission tomography; Regional cerebral metabolic rate for glucose; Transcranial direct current stimulation.

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Conflict of interest statement

All other authors declare no financial conflicts of interest.

Figures

Figure 1
Figure 1. Flow diagram.
tDCS, transcranial direct current stimulation.
Figure 2
Figure 2
Brain areas with significant group-by-time interaction effects of regional cerebral glucose metabolism are overlaid on the Montreal Neurological Institute (MNI) 152 template rendered in (a) 3D and (b) axial slices. Images are displayed in neurological convention. Color bar represents the voxel-level t-values.
Figure 3
Figure 3
Prediction of cortical current and electrical field during transcranial direct current stimulation using the F3-F4 montage (6 cm diameter electrodes, anode left) in two older adults of Asian ethnicity (S12, S13). A.1 and B.1 show the montage on the subjects, while A.2, A.3, B.2, and B.3 show the electric field maps (false color) and flux lines (black) generated across outer cortical regions.
See this image and copyright information in PMC

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