Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury

Traumatic brain injury (TBI) often causes persistent deficits in cognitive flexibility and information updating. Cognitive flexibility refers to the brain's ability to adjust its thinking and behavior in response to changing circumstances, whereas information updating is the process of incorpor...

Full description

Saved in:
Bibliographic Details
Main Authors: Fatemeh Afsharian, Razieh Khorram Abadi, Reza Taheri, Saeid Abbasi Sarajehlou
Format: Article
Language:English
Published: Elsevier 2024-10-01
Series:Acta Psychologica
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0001691824004311
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850196759795466240
author Fatemeh Afsharian
Razieh Khorram Abadi
Reza Taheri
Saeid Abbasi Sarajehlou
author_facet Fatemeh Afsharian
Razieh Khorram Abadi
Reza Taheri
Saeid Abbasi Sarajehlou
author_sort Fatemeh Afsharian
collection DOAJ
description Traumatic brain injury (TBI) often causes persistent deficits in cognitive flexibility and information updating. Cognitive flexibility refers to the brain's ability to adjust its thinking and behavior in response to changing circumstances, whereas information updating is the process of incorporating new facts into current knowledge. Both cognitive flexibility and information updating are critical components of executive function, and their impairment can have a major influence on a person's capacity to operate independently and adjust to life's problems following a TBI. Understanding and addressing these specific cognitive processes is therefore critical in designing successful therapies for TBI patients. Previous studies have examined the effects of non-invasive brain stimulation and cognitive training separately. This study investigated the effects of combining transcranial direct current stimulation (tDCS) with computer-based cognitive training, comparing this combined intervention against a control group with no treatment, to assess improvements in two executive functions in TBI patients: cognitive flexibility and information updating. Thirty TBI patients, 2–12 weeks post-injury with impaired executive dysfunction, were randomized to an experimental or control group. The experimental group received ten 30-minute sessions over 2 weeks of anodal (A-tDCS), 2.0 mA to the prefrontal cortex while performing cognitive training tasks from the RehaCom software. The control group received no intervention during this period. Cognitive flexibility and information updating were assessed before and after the intervention period using the n-back working memory task, Wisconsin Sorting Card Test, and quantitative electroencephalography (qEEG) during eyes-closed state. Statistically significant differences in theta, alpha, beta, and gamma band power were observed between groups (p < .05, 4 < f < 6). Secondary outcomes indicated significant improvements in cognitive flexibility within Wisconsin Card Sorting Test and information updating performance within n-back task (p < .05, 7 < f < 20). The combination of tDCS and cognitive training may improve cognitive flexibility and information updating in TBI patients by enhancing plasticity and connectivity in prefrontal regions involved in these complex cognitive processes.
format Article
id doaj-art-6325f267be3442c38be19eaf2654fc72
institution OA Journals
issn 0001-6918
language English
publishDate 2024-10-01
publisher Elsevier
record_format Article
series Acta Psychologica
spelling doaj-art-6325f267be3442c38be19eaf2654fc722025-08-20T02:13:22ZengElsevierActa Psychologica0001-69182024-10-0125010455310.1016/j.actpsy.2024.104553Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injuryFatemeh Afsharian0Razieh Khorram Abadi1Reza Taheri2Saeid Abbasi Sarajehlou3Master of General Psychology, Persian Gulf University of Bushehr, Bushehr, IranClinical Psychology, Persian Gulf University of Bushehr, Bushehr, Iran; Corresponding author at: Clinical Psychology, Persian Gulf University of Bushehr, Bushehr 7516913817, Iran.Neurosurgery, Shiraz Neurosurgery Department, School of Medicine, SUMS, Iran; Shiraz Neuroscience Research Center, Shiraz Trauma Research Center, IranMaster of Clinical Psychology, Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, IranTraumatic brain injury (TBI) often causes persistent deficits in cognitive flexibility and information updating. Cognitive flexibility refers to the brain's ability to adjust its thinking and behavior in response to changing circumstances, whereas information updating is the process of incorporating new facts into current knowledge. Both cognitive flexibility and information updating are critical components of executive function, and their impairment can have a major influence on a person's capacity to operate independently and adjust to life's problems following a TBI. Understanding and addressing these specific cognitive processes is therefore critical in designing successful therapies for TBI patients. Previous studies have examined the effects of non-invasive brain stimulation and cognitive training separately. This study investigated the effects of combining transcranial direct current stimulation (tDCS) with computer-based cognitive training, comparing this combined intervention against a control group with no treatment, to assess improvements in two executive functions in TBI patients: cognitive flexibility and information updating. Thirty TBI patients, 2–12 weeks post-injury with impaired executive dysfunction, were randomized to an experimental or control group. The experimental group received ten 30-minute sessions over 2 weeks of anodal (A-tDCS), 2.0 mA to the prefrontal cortex while performing cognitive training tasks from the RehaCom software. The control group received no intervention during this period. Cognitive flexibility and information updating were assessed before and after the intervention period using the n-back working memory task, Wisconsin Sorting Card Test, and quantitative electroencephalography (qEEG) during eyes-closed state. Statistically significant differences in theta, alpha, beta, and gamma band power were observed between groups (p < .05, 4 < f < 6). Secondary outcomes indicated significant improvements in cognitive flexibility within Wisconsin Card Sorting Test and information updating performance within n-back task (p < .05, 7 < f < 20). The combination of tDCS and cognitive training may improve cognitive flexibility and information updating in TBI patients by enhancing plasticity and connectivity in prefrontal regions involved in these complex cognitive processes.http://www.sciencedirect.com/science/article/pii/S0001691824004311tDCSqEEGTBIRehaCom
spellingShingle Fatemeh Afsharian
Razieh Khorram Abadi
Reza Taheri
Saeid Abbasi Sarajehlou
Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
Acta Psychologica
tDCS
qEEG
TBI
RehaCom
title Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
title_full Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
title_fullStr Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
title_full_unstemmed Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
title_short Transcranial direct current stimulation combined with cognitive training improves two executive functions: Cognitive flexibility and information updating after traumatic brain injury
title_sort transcranial direct current stimulation combined with cognitive training improves two executive functions cognitive flexibility and information updating after traumatic brain injury
topic tDCS
qEEG
TBI
RehaCom
url http://www.sciencedirect.com/science/article/pii/S0001691824004311
work_keys_str_mv AT fatemehafsharian transcranialdirectcurrentstimulationcombinedwithcognitivetrainingimprovestwoexecutivefunctionscognitiveflexibilityandinformationupdatingaftertraumaticbraininjury
AT raziehkhorramabadi transcranialdirectcurrentstimulationcombinedwithcognitivetrainingimprovestwoexecutivefunctionscognitiveflexibilityandinformationupdatingaftertraumaticbraininjury
AT rezataheri transcranialdirectcurrentstimulationcombinedwithcognitivetrainingimprovestwoexecutivefunctionscognitiveflexibilityandinformationupdatingaftertraumaticbraininjury
AT saeidabbasisarajehlou transcranialdirectcurrentstimulationcombinedwithcognitivetrainingimprovestwoexecutivefunctionscognitiveflexibilityandinformationupdatingaftertraumaticbraininjury