{"doi":"10.1016/j.brs.2024.02.009","title":"In patients with late-life depression and cognitive decline, adding tDCS to cognitive training does not significantly affect depressive symptoms but shows potential benefits on cognition as measured by fMRI","abstract":"Cognitive impairment often coexists with depression in older individuals, leading to increased risk of hospitalization, functional decline, and dementia [[1]Steffens D.C. Otey E. Alexopoulos G.S. Butters M.A. Cuthbert B. Ganguli M. et al.Perspectives on depression, mild cognitive impairment, and cognitive decline.Arch Gen Psychiatr. 2006; 63: 130-138https://doi.org/10.1001/archpsyc.63.2.130Crossref PubMed Scopus (236) Google Scholar]. Despite the heightened risk of dementia in patients with depression and cognitive deficit, current treatments for late-life depression are extremely limited. Older individuals are less responsive to antidepressants compared with younger individuals, and pharmacological treatment often encounters challenges due to adverse effects and polypharmacy. The challenge of treating older patients with both cognitive impairment and depression has led to exploration of alternative treatments, including noninvasive neuromodulation. One promising approach is transcranial direct current stimulation (tDCS), involving the application of low-intensity direct current to the scalp to modulate cortical excitability. Brain-derived neurotrophic factor (BDNF), a crucial factor influencing neuronal adaptability and synaptic efficacy, is suggested to mediate the impact of tDCS on mood and cognition [[2]Fritsch B. Reis J. Martinowich K. Schambra H.M. Ji Y. Cohen L.G. et al.Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning.Neuron. 2010; 66: 198-204https://doi.org/10.1016/j.neuron.2010.03.035Abstract Full Text Full Text PDF PubMed Scopus (1060) Google Scholar,[3]Podda M.V. Cocco S. Mastrodonato A. Fusco S. Leone L. Barbati S.A. et al.Anodal transcranial direct current stimulation boosts synaptic plasticity and memory in mice via epigenetic regulation of Bdnf expression.Sci Rep. 2016; 622180https://doi.org/10.1038/srep22180Crossref Scopus (163) Google Scholar]. This proposition has intrigued researchers, prompting exploration of combining tDCS with cognitive training as an alternative treatment option for depression with cognitive impairment, to enhance overall treatment efficacy. Recent trials combining cognitive training and tDCS were limited to healthy older adults, or patients with mild cognitive impairment (MCI) without depression [[4]Horne K.S. Filmer H.L. Nott Z.E. Hawi Z. Pugsley K. Mattingley J.B. et al.Evidence against benefits from cognitive training and transcranial direct current stimulation in healthy older adults.Nat Human Behav. 2021; 5: 146-158https://doi.org/10.1038/s41562-020-00979-5Crossref Scopus (20) Google Scholar,[5]Martin D.M. McClintock S.M. Forster J.J. Lo T.Y. Loo C.K. Cognitive enhancing effects of rTMS administered to the prefrontal cortex in patients with depression: a systematic review and meta-analysis of individual task effects.Depress Anxiety. 2017; 34: 1029-1039https://doi.org/10.1002/da.22658Crossref PubMed Scopus (104) Google Scholar]. Therefore, the effect of tDCS on individuals with depression and associated cognitive impairments is unknown. Here, we evaluated the effects of combining tDCS with cognitive training on both depression and cognitive function in patients with late-life depression and cognitive decline. Additionally, we measured BDNF levels, and brain functional connectivity (FC) utilizing resting-state functional magnetic resonance imaging (fMRI). In brief, we studied 24 patients (mean age = 75.4 ± 7.9) experiencing depression and cognitive decline. They were randomly assigned to either a sham or active tDCS group, targeting the left dorsolateral prefrontal cortex (DLPFC) during group cognitive training for 5 weeks (Fig. S1). The primary outcome measure was the change in Hamilton Depression Scale (HAM-D) score. General cognition and multidomain cognitive function were measured using the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (CERAD-K). Serum BDNF levels","journal":"Brain stimulation","year":2024,"id":455349,"datarank":0.34779610686710344,"base_score":1.9459101490553132,"endowment":1.9459101490553132,"self_citation_contribution":0.29188652235829704,"citation_network_contribution":0.05590958450880638,"self_endowment_contribution":0.29188652235829704,"citer_contribution":0.05590958450880638,"corpus_percentile":null,"corpus_rank":null,"citation_count":6,"citer_count":5,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9642,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":298361,"name":"Yu Fang","orcid":"0000-0002-0287-5279","position":1,"is_corresponding":false},{"id":663178,"name":"Greg O. Cron","orcid":"0000-0003-1117-9678","position":2,"is_corresponding":false},{"id":1279180,"name":"Jaeseok Heo","orcid":"0000-0003-1678-6573","position":3,"is_corresponding":false},{"id":1279181,"name":"Eun-Jin Jung","orcid":"0000-0002-2175-9345","position":4,"is_corresponding":false},{"id":1279182,"name":"Deokjong Lee","orcid":"0000-0002-5425-4677","position":5,"is_corresponding":false},{"id":1279548,"name":"HyunJeong Kim","orcid":null,"position":6,"is_corresponding":false},{"id":1209637,"name":"Eosu Kim","orcid":"0000-0001-9472-9465","position":7,"is_corresponding":false},{"id":1279183,"name":"Jin Young Park","orcid":"0000-0002-5351-9549","position":8,"is_corresponding":false},{"id":411819,"name":"Jin Hyung Lee","orcid":"0000-0001-7540-1018","position":9,"is_corresponding":false},{"id":1279179,"name":"Jung-Hee Ha","orcid":"0000-0002-4217-3570","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:03:17.458329Z","pmid":"38367933","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}