Brambilla Michela, Dinkelbach Lars, Bigler Annelien, Williams Joseph, Zokaei Nahid, Cohen Kadosh Roi, Brem Anna-Katharine
Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.
Biomedical and Clinical Sciences Department, Center for Research and Treatment on Cognitive Dysfunctions, "Luigi Sacco" Hospital, University of Milan, Milan, Italy.
Front Neurol. 2021 Mar 9;12:625359. doi: 10.3389/fneur.2021.625359. eCollection 2021.
Aging is associated with a decline in attentional and executive abilities, which are linked to physiological, structural, and functional brain changes. A variety of novel non-invasive brain stimulation methods have been probed in terms of their neuroenhancement efficacy in the last decade; one that holds significant promise is transcranial random noise stimulation (tRNS) that delivers an alternate current at random amplitude and frequency. The aim of this study was to investigate whether repeated sessions of tRNS applied as an add-on to cognitive training (CT) may induce long-term near and far transfer cognitive improvements. In this sham-controlled, randomized, double-blinded study forty-two older adults (age range 60-86 years) were randomly assigned to one of three intervention groups that received 20 min of 0.705 mA tRNS ( = 14), 1 mA tRNS ( = 14), or sham tRNS ( = 19) combined with 30 min of CT of executive functions (cognitive flexibility, inhibitory control, working memory). tRNS was applied bilaterally over the dorsolateral prefrontal cortices for five sessions. The primary outcome (non-verbal logical reasoning) and other cognitive functions (attention, memory, executive functions) were assessed before and after the intervention and at a 1-month follow-up. Non-verbal logical reasoning, inhibitory control and reaction time improved significantly over time, but stimulation did not differentially affect this improvement. These changes occurred during CT, while no further improvement was observed during follow-up. Performance change in logical reasoning was significantly correlated with age in the group receiving 1 mA tRNS, indicating that older participants profited more from tRNS than younger participants. Performance change in non-verbal working memory was significantly correlated with age in the group receiving sham tRNS, indicating that in contrast to active tRNS, older participants in the sham group declined more than younger participants. CT induced cognitive improvements in all treatment groups, but tRNS did not modulate most of these cognitive improvements. However, the effect of tRNS depended on age in some cognitive functions. We discuss possible explanations leading to this result that can help to improve the design of future neuroenhancement studies in older populations.
衰老与注意力和执行能力的下降有关,而这些能力与大脑的生理、结构和功能变化相关。在过去十年中,人们对各种新型非侵入性脑刺激方法的神经增强效果进行了探索;其中一种具有重大前景的方法是经颅随机噪声刺激(tRNS),它以随机的幅度和频率传递交流电。本研究的目的是调查将重复的tRNS疗程作为认知训练(CT)的附加疗法是否能诱导长期的近迁移和远迁移认知改善。在这项假对照、随机、双盲研究中,42名老年人(年龄范围60 - 86岁)被随机分配到三个干预组之一,分别接受20分钟的0.705 mA tRNS(n = 14)、1 mA tRNS(n = 14)或假tRNS(n = 19),并结合30分钟的执行功能CT训练(认知灵活性、抑制控制、工作记忆)。tRNS双侧施加于背外侧前额叶皮质,共进行五个疗程。在干预前后以及1个月随访时评估主要结局(非言语逻辑推理)和其他认知功能(注意力、记忆、执行功能)。非言语逻辑推理、抑制控制和反应时间随时间显著改善,但刺激并未对这种改善产生差异影响。这些变化发生在CT训练期间,随访期间未观察到进一步改善。在接受1 mA tRNS的组中,逻辑推理的表现变化与年龄显著相关,表明老年参与者比年轻参与者从tRNS中获益更多。在接受假tRNS的组中,非言语工作记忆的表现变化与年龄显著相关,这表明与主动tRNS组相比,假刺激组中的老年参与者比年轻参与者下降得更多。CT在所有治疗组中都诱导了认知改善,但tRNS并未调节这些认知改善中的大多数。然而,tRNS的效果在某些认知功能上取决于年龄。我们讨论了导致这一结果的可能解释,这有助于改进未来针对老年人群的神经增强研究设计。