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Combining transcranial direct current stimulation with a motor-cognitive task: the impact on dual-task walking costs in older adults.

Journal of neuroengineering and rehabilitation
January 1, 1970
Nofar Schneider et al. (9 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether tDCS applied during walking reduces dual-task costs in older adults and compared its effects when applied during seated rest or sham stimulation.

Results Summary

tDCS delivered during challenging walking reduced dual-task costs to gait speed and improved other gait measures and cognitive performance, while tDCS during seated rest or sham stimulation showed no significant effects. Postural sway was unaffected by tDCS.

Population

25 healthy older adults (mean age 73.9 ± 5.2 years)

Effective Dosage

20 minutes of anodal tDCS targeting M1 and lDLPFC

Duration

Single 20-minute session per condition

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
tDCS while walking in a complex environment (tDCS + walking)
decrease
dual-task cost to gait speed
25 healthy older adults (73.9 ± 5.2 years)
p = 0.004
reduced
#1
tDCS while seated (tDCS + seated)
no change
dual-task cost to gait speed
25 healthy older adults (73.9 ± 5.2 years)
p = 0.173
did not influence
#2
walking in a complex environment with sham tDCS (sham + walking)
no change
dual-task cost to gait speed
25 healthy older adults (73.9 ± 5.2 years)
p = 0.826
did not influence
#3
tDCS while walking in a complex environment (tDCS + walking)
decrease
dual-task cost to other gait measures
25 healthy older adults (73.9 ± 5.2 years)
-
reduced
#4
tDCS while walking in a complex environment (tDCS + walking)
increase
Stroop performance
25 healthy older adults (73.9 ± 5.2 years)
-
improved
#5
tDCS
no change
sway
25 healthy older adults (73.9 ± 5.2 years)
-
was not affected
#6
Abstract

BACKGROUND: The performance of a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults. Previous studies have demonstrated that transcranial direct current stimulation (tDCS) may improve certain types of dual-task performance, and, that tDCS delivered during the performance of a task may augment the benefits of stimulation, potentially reducing motor-cognitive interference. However, it is not yet known if combining multi-target tDCS with the simultaneous performance of a task related to the tDCS targets reduces or increases dual-task walking costs among older adults. The objectives of the present work were (1) To examine whether tDCS applied during the performance of a task that putatively utilizes the brain networks targeted by the neuro-stimulation reduces dual-task costs, and (2) to compare the immediate after-effects of tDCS applied during walking, during seated-rest, and during sham stimulation while walking, on dual-task walking costs in older adults. We also explored the impact on postural sway and other measures of cognitive function. METHODS: A double-blind, 'within-subject' cross-over pilot study evaluated the effects of 20 min of anodal tDCS targeting both the primary motor cortex (M1) and the left dorsolateral prefrontal cortex (lDLPFC) in 25 healthy older adults (73.9 ± 5.2 years). Three stimulation conditions were assessed in three separate sessions: (1) tDCS while walking in a complex environment (tDCS + walking), (2) tDCS while seated (tDCS + seated), and (3) walking in a complex environment with sham tDCS (sham + walking). The complex walking condition utilized virtual reality to tax motor and cognitive abilities. During each session, usual-walking, dual-task walking, quiet standing sway, and cognitive function (e.g., Stroop test) were assessed before and immediately after stimulation. Dual-task costs to gait speed and other measures were computed. RESULTS: The dual-task cost to gait speed was reduced after tDCS + walking (p = 0.004) as compared to baseline values. Neither tDCS + seated (p = 0.173) nor sham + walking (p = 0.826) influenced this outcome. Similar results were seen for other gait measures and for Stroop performance. Sway was not affected by tDCS. CONCLUSIONS: tDCS delivered during the performance of challenging walking decreased the dual-task cost to walking in older adults when they were tested just after stimulation. These results support the existence of a state-dependent impact of neuro-modulation that may set the stage for a more optimal neuro-rehabilitation. TRIAL REGISTRATION: Clinical Trials Gov Registrations Number: NCT02954328.

Medical Subject Headings (MeSH)
AgedAged, 80 and overBrainCognitionDouble-Blind MethodFemaleHumansMalePilot ProjectsStroop TestTranscranial Direct Current StimulationWalking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality88/10
Citation Metrics
Total Citations30
Citations/Year7.5
Relative Citation Ratio3.85
NIH Percentile89.5%
Research Impact Scores
APT Score0.75
Weight Score1.90
Normalized Score0.72
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