High-definition transcranial direct current stimulation (HD-tDCS) for the enhancement of working memory – A systematic review and meta-analysis of healthy adults
Brain stimulation, vol. 15, pp. 1475–1485
Abstract
BACKGROUND: High-definition transcranial direct current stimulation (HD-tDCS) administers weak electric current through multiple electrodes, enabling focal brain stimulation. An increasing number of studies investigate the effects of anodal HD-tDCS on the enhancement of working memory (WM). The effectiveness of the technique is, however, still unclear. OBJECTIVE/HYPOTHESIS: This systematic review analyzed the current literature on anodal HD-tDCS for WM enhancement, investigating its effectiveness and the influence of different moderators to allow for comparison with conventional tDCS. METHODS: Following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines, a comprehensive literature review was conducted using PubMed, Web of Science, and Scopus. Sixteen single- or double-blind, sham-controlled studies were included in the review. Eleven studies were included in the meta-analysis, focusing solely on stimulation of the left prefrontal cortex (PFC). RESULTS: No significant effect of anodal HD-tDCS on the left PFC for WM accuracy (g = 0.23, p = 0.08), and reaction time (g = 0.03, p = 0.75 after trim-and-fill) was found. Further analysis revealed heterogeneity in the accuracy results. Here, moderator analysis indicated a significant difference between studies that repeatedly used HD-tDCS enhanced WM training and studies with one-time use of HD-tDCS (p < 0.001), the latter having a smaller effect size. Another moderator was the research design, with differences between within-subjects-, and between-subjects designs (p < 0.05). Within-subject studies showed lower effect sizes and substantially lower heterogeneity. Qualitative analysis reinforced this finding and indicated that the motivation of the participant to engage in the task also moderates the effectiveness of HD-tDCS. CONCLUSION: This review highlights the importance of inter-individual differences and the setup for the effectiveness of anodal, HD-tDCS augmented WM training. Limited evidence for increased sensitivity of HD-tDCS to these factors as compared to conventional tDCS is provided.
Authors 4
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Dario Müller corresponding Aachen Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, North Rhine-Westphalia, Germany. Electronic address: darmueller@ukaachen.de
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, North Rhine-Westphalia, Germany
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Forschungszentrum Jülich · Jülich Aachen Research Alliance · RWTH Aachen University
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, North Rhine-Westphalia, Germany; Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Straße, 52438, Jülich, Germany
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, North Rhine-Westphalia, Germany
Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Straße, 52438, Jülich, Germany
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Affiliation as printed
Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
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Carmen Weidler Aachen Department of Psychiatry, Psychotherapy and Psychosomatics Faculty of Medicine
Affiliation as printed
Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, Aachen, 52074, North Rhine-Westphalia, Germany
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