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The effect of the interval-between-sessions on prefrontal transcranial direct current stimulation (tDCS) on cognitive outcomes: a systematic review and meta-analysis

  • Psychiatry and Preclinical Psychiatric Studies - Review article
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Abstract

Recently, there has been wide interest in the effects of transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) on cognitive functioning. However, many methodological questions remain unanswered. One of them is whether the time interval between active and sham-controlled stimulation sessions, i.e. the interval between sessions (IBS), influences DLPFC tDCS effects on cognitive functioning. Therefore, a systematic review and meta-analysis was performed of experimental studies published in PubMed, Science Direct, and other databases from the first data available to February 2016. Single session sham-controlled within-subject studies reporting the effects of tDCS of the DLPFC on cognitive functioning in healthy controls and neuropsychiatric patients were included. Cognitive tasks were categorized in tasks assessing memory, attention, and executive functioning. Evaluation of 188 trials showed that anodal vs. sham tDCS significantly decreased response times and increased accuracy, and specifically for the executive functioning tasks, in a sample of healthy participants and neuropsychiatric patients (although a slightly different pattern of improvement was found in analyses for both samples separately). The effects of cathodal vs. sham tDCS (45 trials), on the other hand, were not significant. IBS ranged from less than 1 h to up to 1 week (i.e. cathodal tDCS) or 2 weeks (i.e. anodal tDCS). This IBS length had no influence on the estimated effect size when performing a meta-regression of IBS on reaction time and accuracy outcomes in all three cognitive categories, both for anodal and cathodal stimulation. Practical recommendations and limitations of the study are further discussed.

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Abbreviations

ACC:

Accuracy

DC:

Direct current

DLPFC:

Dorsolateral prefrontal cortex

ER:

Error rate

ES:

Effect size

IBS:

Interval between sessions

mA:

Micro-Ampère

NIBS:

Non-invasive brain stimulation

NMDA:

N-Methyl-d-Aspartate

RT:

Response time

SD:

Standard deviation

tDCS:

Transcranial direct current stimulation

TMS:

Transcranial magnetic stimulation

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Acknowledgments

M.A.V. (FWO08/PDO/168) is a postdoctoral research fellow of the Research Foundation Flanders (FWO). A.R.B. is supported by the following grants: 2013 NARSAD Young Investigator from the Brain & Behavior Research Foundation (Grant Number 20493), 2012 FAPESP Young Researcher from the São Paulo State Foundation (Grant Number 20911-5) and National Council for Scientific and Technological Development (CNPq, Grant Number 470904). This work was also supported by the Ghent University Multidisciplinary Research Partnership “The integrative neuroscience of behavioral control”.

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Authors and Affiliations

  1. Department of Psychiatry and Medical Psychology, University Hospital Ghent (UZ Ghent), Ghent University, 1K12F, De Pintelaan 185, 9000, Ghent, Belgium

    Josefien Dedoncker, Chris Baeken & Marie-Anne Vanderhasselt

  2. Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, Ghent, Belgium

    Josefien Dedoncker, Chris Baeken & Marie-Anne Vanderhasselt

  3. Service of Interdisciplinary Neuromodulation, Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of São Paulo, São Paulo, Brazil

    Andre R. Brunoni

  4. Faculty of Medicine and Pharmacy, Department of Psychiatry, University Hospital Brussel (UZ Brussel), Vrije Universiteit Brussel (VUB), Brussels, Belgium

    Chris Baeken & Marie-Anne Vanderhasselt

  5. Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium

    Marie-Anne Vanderhasselt

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  1. Josefien Dedoncker
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  2. Andre R. Brunoni
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Correspondence to Josefien Dedoncker.

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Dedoncker, J., Brunoni, A.R., Baeken, C. et al. The effect of the interval-between-sessions on prefrontal transcranial direct current stimulation (tDCS) on cognitive outcomes: a systematic review and meta-analysis. J Neural Transm 123, 1159–1172 (2016). https://doi.org/10.1007/s00702-016-1558-x

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