Enhancing Cognition in Older Persons with Depression or Anxiety with a Combination of Mindfulness-Based Stress Reduction (MBSR) and Transcranial Direct Current Stimulation (tDCS): Results of a Pilot Randomized Clinical Trial

Abstract

Objectives Individuals with subjective memory complaints and symptoms of depression and/or anxiety are at high risk for further cognitive decline, and possible progression to dementia. Low-burden interventions to help slow or prevent cognitive decline in this high-risk group are needed. The objective of this study is to assess the feasibility of combining Mindfulness-Based Stress Reduction (MBSR) with transcranial direct current stimulation (tDCS) to increase putative benefits of MBSR for cognitive function and everyday mindfulness in depressed or anxious older adults with subjective cognitive decline. Methods We conducted a two-site pilot double-blind randomized sham-controlled trial, combining active MBSR with either active or sham tDCS. The intervention included weekly in-class group sessions at the local university hospital and daily at-home practice. Anodal tDCS was applied for 30 min during MBSR meditative practice, both in-class and at-home. Results Twenty-six individuals with subjective cognitive complaints and symptoms of depression and/or anxiety were randomized to active ( n = 12) or sham tDCS ( n = 14). The combination of MBSR and tDCS was safe and well tolerated, though at-home adherence and in-class attendance were variable. While they were not statistically significant, the largest effect sizes for active vs. sham tDCS were for everyday mindfulness ( d = 0.6) and social functioning ( d = 0.9) ( F (1,21) = 3.68, p = 0.07 and F (1,21) = 3.9, p = 0.06, respectively). Conclusions Our findings suggest that it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Furthermore, tDCS may enhance MBSR via transferring its meditative learning and practice into increases in everyday mindfulness. Future studies need to improve adherence to MBSR with tDCS. Trial Registration ClinicalTrials.gov (NCT03653351 and NCT03680664). Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01764-9.

Transcranial-Direct-Current-Stimulation Accelerates Motor Recovery After Cortical Infarction in Mice: The Interplay of Structural Cellular Responses and Functional Recovery

“…Stroke is a leading cause of death and disability in our society, primarily as specific therapeutic rehabilitation strategies remain limited. 1-4 The potential of novel non-invasive brain stimulation methods, for example, transcranial direct current stimulation (tDCS), to promote recovery in human patients has been investigated for decades and is widely considered promising after stroke and other conditions, 5-14 although large randomized clinical trials are lacking. Furthermore, the neurobiological mechanisms underlying non-invasive brain stimulation remain poorly understood, and standardized protocols have not been established.…”

tDCS over the left prefrontal Cortex improves mental flexibility and inhibition in geriatric inpatients with symptoms of depression or anxiety: A pilot randomized controlled trial

“…Twenty eligible participants were included in the final sample ( n = 10 in each group), consistent with similar sample sizes of older adults with multi-session tDCS interventions in MCI and depression ( 54 , 56 ). Participant recruitment and data collection were stopped early because of the emergence of SARS-CoV-2.…”

A prospective cohort study of the impact of outpatient Intensive Cardiac Rehabilitation on depression and cardiac self-efficacy

“…We speculate that some of the improvements in ICR may also result from the education/healthy mind interventions that are a part of ICR (but not CR). Mindfulness and stress management have been shown to have distinct benefits on cognition in older adults [ 20 ] and in patients with CVD [ 21 ]. Thus, our study lays the groundwork for a future randomized trial between ICR and CR investigating the relationship with mental health.…”