Opposite pattern of transcranial direct current stimulation effects in middle-aged and older adults: Behavioral and neurophysiological evidence.

Introduction: Episodic memory (EM) exhibits an age-related decline, with overall increased impairment after the age of 65. The application of transcranial direct current stimulation (tDCS) to ameliorate cognitive decline in ageing has been extensively investigated, but its efficacy has been reported with mixed results. In this study, we aimed to assess whether age contributes to interindividual variability in tDCS efficacy. Methods: Thirty-eight healthy adults between 50 and 81 years old received anodal tDCS over the left prefrontal cortex during images encoding and then performed an EM recognition task while event-related potentials (ERPs) were recorded. Results: Our results showed an opposite pattern of effect between middle-aged (50-64 years) and older (65-81 years) adults. Specifically, performance in the recognition task after tDCS was enhanced in older adults and was worsened in middle-aged adults. Moreover, ERPs acquired during the recognition task showed that two EM components related to familiarity and post-retrieval monitoring, i.e., Early Frontal and Late Frontal Old-New effects, respectively, were significantly reduced in middle-aged adults after anodal tDCS. Discussion: These results support an age-dependent effect of prefrontal tDCS on EM processes and its underlying electrophysiological substrate, with opposing modulatory trajectories along the aging lifespan.

Combined anodal transcranial direct current stimulation and behavioural naming treatment improves language performance in patients with post-stroke aphasia.

PRIMARY OBJECTIVE: During the last decade, studies using anodal transcranial Direct Current Stimulation (atDCS) have yielded promising results in patients with aphasia. The main aim of the present pilot study was to assess the effects of combined atDCS over the left posterior perisylvian region and behavioral naming training on the behavioral outcomes of language comprehension and production of patients with post-stroke aphasia. RESEARCH DESIGN: A 2 × 2 quasi-experimental design was conducted, optimal to compare changes after treatment in experimental versus control group. METHODS AND PROCEDURES: Ten patients with post-stroke aphasia were enrolled in this study: half received atDCS on the left posterior perisylvian region while they underwent a 2-week behavioral naming training. The other half received sham stimulation. The outcomes were measured using the abbreviated form of the Boston Diagnostic Aphasia Examination and analyzed using ANOVAs. MAIN OUTCOMES AND RESULTS: Both groups improved their performance in Oral comprehension, Narrative writing and Language Competence Index, but only those that received anodal tDCS presented better results in the Naming category after the treatment. CONCLUSIONS: AtDCS on the left posterior perisylvian area seems to be a promising tool for boosting the outcomes of behavioral naming therapy in patients with post-stroke aphasia.

Transcranial direct current stimulation (tDCS). An effective tool for improving episodic memory in young people? / Estimulación transcraneal por corriente eléctrica directa (tDCS). ¿Una herramienta efectiva para mejorar la memoria episódica en jóvenes?

The main aim of the present study was to determine the effects of anodal vs sham tDCS administered on F3 (DLPFC) during the encoding phase of an episodic memory task, on the accuracy rate (AR) and reaction time (RT) measured in the immediate and delayed recall phases of the task, in a group of 23 healthy young participants.A randomized double-blind sham-controlled study of tDCS was carried out. The results evidenced significant main effects for factors Block, Session, and Delay on the AR and on RT, but not for the Group factor. Robust intra-session and inter-session learning effects but no Group (anodal vs sham tDCS) effect in episodic memory performance or in pre-post intervention neuropsychological tests were found. However, participants who received anodal tDCS showed shorter RT in the 24 hours delay interval and maintained it one week later, while those who received sham tDCS did not show the 24 hours RT shortening and even showed a RT increase one week later. These results could indicate a subtle modulatory effect of anodal tDCS on memory decay along delay intervals.The experimental protocol showed its potential utility to be used in samples of healthy elderly or mild cognitive impairment participants.(AU)

El objetivo principal del presente estudio fue determinar los efectos de la tDCS anódica vs placebo, administrada sobre F3 (CPFDL), durante la fase de codificación de una tarea de memoria episódica, sobre la tasa de aciertos (TA) y el tiempo de reacción (TR) medidos en las fases de recuerdo inmediato y demorado de la tarea, en un grupo de 23 participantes jóvenes sanos.Se realizó un estudio doble ciego aleatorizado. Los resultados evidenciaron efectos principales significativos para los factores Bloque, Sesión y Demora en la TA y en el TR, pero no para el factor del Grupo. Se encontraron efectos robustos de aprendizaje intrasesión e intersesiones, pero ningún efecto Grupo (tDCS anódica vs placebo) en el rendimiento de la memoria episódica o en los tests neuropsicológicos pre-post intervención. Sin embargo, los participantes que recibieron tDCS anódica mostraron un TR acortado en el intervalo de demora de 24 horas que mantuvieron una semana más tarde, mientras que los que recibieron tDCS placebo no mostraron acortamiento del TR a las 24 horas, pero si un aumento del TR una semana después. Estos resultados podrían indicar un sutil efecto modulador de la tDCS anódica en el decaimiento de la memoria en los intervalos de demora.El protocolo experimental mostró su utilidad potencial para ser utilizado en muestras de participantes mayores sanos o con deterioro cognitivo leve.(AU)

The importance of age in the search for ERP biomarkers of aMCI.

Alzheimer's Disease (AD) has become a major health issue in recent decades, and there is now growing interest in amnestic mild cognitive impairment (aMCI), an intermediate stage between healthy aging and dementia, usually AD. Event-related brain potential (ERP) studies have sometimes failed to detect differences between aMCI and control participants in the Go-P3 (or P3b, related to target classification processes in a variety of tasks) and NoGo-P3 (related to response inhibition processes, mainly in Go/NoGo tasks) ERP components. The aim of the present study was to evaluate whether the age factor, which is not usually taken into account in ERP studies, modulates group differences in these components. With this aim, we divided two groups of volunteer participants, 34 subjects with aMCI (51-87 years) and 31 controls (52-86 years), into two age subgroups: 69 years or less and 70 years or more. We recorded brain activity while the participants performed a distraction-attention auditory-visual (AV) task. Task performance was poorer in the older than in the younger group, and aMCI participants produced fewer correct responses than the matched controls; but no interactions of the age and group factors on performance were found. On the other hand, Go-P3 and NoGo-N2 latencies were longer in aMCI participants than in controls only in the younger subgroup. Thus, the younger aMCI participants categorized the Go stimuli in working memory and processed the NoGo stimuli (which required response inhibition) slower than the corresponding controls. Finally, the combination of the number of hits, Go-P3 latency and NoGo-N2 latency yielded acceptable sensitivity and specificity scores (0.70 and 0.92, respectively) as regards distinguishing aMCI participants aged 69 years or less from the age-matched controls. The findings indicate age should be taken into account in the search for aMCI biomarkers.

Effects of Mild Cognitive Impairment on the Event-Related Brain Potential Components Elicited in Executive Control Tasks.

We summarize here the findings of several studies in which we analyzed the event-related brain potentials (ERPs) elicited in participants with mild cognitive impairment (MCI) and in healthy controls during performance of executive tasks. The objective of these studies was to investigate the neural functioning associated with executive processes in MCI. With this aim, we recorded the brain electrical activity generated in response to stimuli in three executive control tasks (Stroop, Simon, and Go/NoGo) adapted for use with the ERP technique. We found that the latencies of the ERP components associated with the evaluation and categorization of the stimuli were longer in participants with amnestic MCI than in the paired controls, particularly those with multiple-domain amnestic MCI, and that the allocation of neural resources for attending to the stimuli was weaker in participants with amnestic MCI. The MCI participants also showed deficient functioning of the response selection and preparation processes demanded by each task.

Neurocognitive and Behavioral Indexes for Identifying the Amnestic Subtypes of Mild Cognitive Impairment.

Early identification of amnestic mild cognitive impairment (aMCI) subtypes is important for early diagnosis and prognosis of Alzheimer's disease. Healthy, single-domain (sdaMCI) and multiple-domain aMCI (mdaMCI) participants performed an auditory-visual distraction-attention task. Event-related brain potentials (ERPs) were recorded while the participants performed the task to evaluate Go/NoGo N2 and P3 ERP components. The results showed the expected behavioral and cognitive decline in mdaMCI participants relative to controls (fewer hits, longer reaction times [RTs], slightly smaller Go-N2 and NoGo-N2 amplitudes), while sdaMCI participants showed some decline (slightly longer RTs, smaller Go- and NoGo-N2 amplitudes) along with some unexpected results (a late positive slow wave, PSW) and good levels of execution. In addition, some of these parameters proved to be useful markers. Thus, the number of hits was the best marker for diagnosing mdaMCI participants (distinguishing them from controls, from sdaMCI participants, and from both groups together), while the PSW amplitude was the best marker for diagnosing sdaMCI participants (distinguishing them from controls, and from control & mdaMCI participants).

Involuntary Capture and Voluntary Reorienting of Attention Decline in Middle-Aged and Old Participants.

The main aim of this study was to examine the effects of aging on event-related brain potentials (ERPs) associated with the automatic detection of unattended infrequent deviant and novel auditory stimuli (Mismatch Negativity, MMN) and with the orienting to these stimuli (P3a component), as well as the effects on ERPs associated with reorienting to relevant visual stimuli (Reorienting Negativity, RON). Participants were divided into three age groups: (1) Young: 21-29 years old; (2) Middle-aged: 51-64 years old; and (3) Old: 65-84 years old. They performed an auditory-visual distraction-attention task in which they were asked to attend to visual stimuli (Go, NoGo) and to ignore auditory stimuli (S: standard, D: deviant, N: novel). Reaction times (RTs) to Go visual stimuli were longer in old and middle-aged than in young participants. In addition, in all three age groups, longer RTs were found when Go visual stimuli were preceded by novel relative to deviant and standard auditory stimuli, indicating a distraction effect provoked by novel stimuli. ERP components were identified in the Novel minus Standard (N-S) and Deviant minus Standard (D-S) difference waveforms. In the N-S condition, MMN latency was significantly longer in middle-aged and old participants than in young participants, indicating a slowing of automatic detection of changes. The following results were observed in both difference waveforms: (1) the P3a component comprised two consecutive phases in all three age groups-an early-P3a (e-P3a) that may reflect the orienting response toward the irrelevant stimulation and a late-P3a (l-P3a) that may be a correlate of subsequent evaluation of the infrequent unexpected novel or deviant stimuli; (2) the e-P3a, l-P3a, and RON latencies were significantly longer in the Middle-aged and Old groups than in the Young group, indicating delay in the orienting response to and the subsequent evaluation of unattended auditory stimuli, and in the reorienting of attention to relevant (Go) visual stimuli, respectively; and (3) a significantly smaller e-P3a amplitude in Middle-aged and Old groups, indicating a deficit in the orienting response to irrelevant novel and deviant auditory stimuli.

Information processing becomes slower and predominantly serial in aging: Characterization of response-related brain potentials in an auditory-visual distraction-attention task.

The aim of this study was to evaluate the effects of aging and attentional capture provoked by novel auditory stimuli on behavior (reaction time [RT], hits) and on response-related brain potentials (preRFP, CRN, postRFP, parietalRP) to target visual stimuli. Twenty-two young, 27 middle-aged, and 24 old adults performed an auditory-visual distraction-attention task. The RTs and latencies of preRFP, postRFP and parietalRT were longer in old and middle-aged than in young participants, reflecting the well-established age-related slowing of processing and performance. The inter-peak latencies (P3b-preRFP, preRFP-parietalRP, parietalRP-postRFP) were also longer in old and middle-aged than in young participants, further indicating an age-related tendency to increased predominance of serial (rather than parallel) processing of information, and that preRFP, CRN, postRFP, and parietalRP represent different cognitive processes from those indexed by the stimulus-related P3b. Finally, a distraction effect in performance (all three groups) and in postRFP latency (only middle-aged group) was also observed.

Effects of aging and involuntary capture of attention on event-related potentials associated with the processing of and the response to a target stimulus.

The main aim of the present study was to assess whether aging modulates the effects of involuntary capture of attention by novel stimuli on performance, and on event-related potentials (ERPs) associated with target processing (N2b and P3b) and subsequent response processes (stimulus-locked Lateralized Readiness Potential -sLRP- and response-locked Lateralized Readiness Potential -rLRP-). An auditory-visual distraction-attention task was performed by 77 healthy participants, divided into three age groups (Young: 21-29, Middle-aged: 51-64, Old: 65-84 years old). Participants were asked to attend to visual stimuli and to ignore auditory stimuli. Aging was associated with slowed reaction times, target stimulus processing in working memory (WM, longer N2b and P3b latencies) and selection and preparation of the motor response (longer sLRP and earlier rLRP onset latencies). In the novel relative to the standard condition we observed, in the three age groups: (1) a distraction effect, reflected in a slowing of reaction times, of stimuli categorization in WM (longer P3b latency), and of motor response selection (longer sLRP onset latency); (2) a facilitation effect on response preparation (later rLRP onset latency), and (3) an increase in arousal (larger amplitudes of all ERPs evaluated, except for N2b amplitude in the Old group). A distraction effect on the stimulus evaluation processes (longer N2b latency) were also observed, but only in middle-aged and old participants, indicating that the attentional capture slows the stimulus evaluation in WM from early ages (from 50 years onwards, without differences between middle-age and older adults), but not in young adults.

Effects of amnestic mild cognitive impairment on N2 and P3 Go/NoGo ERP components.

Although many studies have demonstrated decline in attention and executive function (especially in inhibitory control) in healthy aging and Alzheimer's disease (AD), similar studies concerning mild cognitive impairment (MCI) are scarce. In the present study, we evaluated how the cognitive decline associated with amnestic MCI (aMCI) affects these processes, analyzing the N2 and P3 components of event-related potentials (ERPs) during the response (Go) and inhibition of response (NoGo) to different stimuli. ERPs were analyzed in 63 healthy and 30 aMCI adults (aged 50 to 87 years) during performance of a Go/NoGo auditory-visual attention-distraction task. aMCI adults showed poorer execution (longer response times and fewer correct responses) and smaller Go-N2 and NoGo-N2 amplitudes than control adults, whereas P3 amplitudes and N2 and P3 latencies did not differ between the groups. These results show that aMCI is associated with decline in executive function and stimuli evaluation in working memory.