Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia

Abstract Cognitive impairments in schizophrenia significantly impact daily functioning and quality of life, posing a major therapeutic challenge. While both cognitive training and transcranial direct current stimulation (tDCS) have shown promise in improving cognitive function, their combined effect...

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Main Authors: Tobias Schwippel, Sanvi Korsapathy, Ibrahim Hajiyev, Aylin Utlu, Simone Weller, Daniel Kamp, Christian Plewnia
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Schizophrenia
Online Access:https://doi.org/10.1038/s41537-025-00647-5
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author Tobias Schwippel
Sanvi Korsapathy
Ibrahim Hajiyev
Aylin Utlu
Simone Weller
Daniel Kamp
Christian Plewnia
author_facet Tobias Schwippel
Sanvi Korsapathy
Ibrahim Hajiyev
Aylin Utlu
Simone Weller
Daniel Kamp
Christian Plewnia
author_sort Tobias Schwippel
collection DOAJ
description Abstract Cognitive impairments in schizophrenia significantly impact daily functioning and quality of life, posing a major therapeutic challenge. While both cognitive training and transcranial direct current stimulation (tDCS) have shown promise in improving cognitive function, their combined effects remain underexplored. This double-blind, sham-controlled, randomized clinical trial investigated whether adaptive working memory training (aWMT) paired with anodal tDCS to the right dorsolateral prefrontal cortex (DLPFC) enhances cognitive outcomes in schizophrenia. Twenty-eight individuals with schizophrenia or schizoaffective disorder completed ten sessions of aWMT with concurrent 2 mA anodal or sham tDCS. Cognitive improvements were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline, three days after training, and at follow-ups one month, and three months later. Clinical measures evaluated psychopathology, depression, and quality of life. Anodal tDCS significantly improved working memory performance during training, with gains partially sustained at follow-ups. Short-term transfer effects with large effect sizes were observed in the BACS, although clinical symptoms and quality of life remained unaffected. While preliminary, these findings indicate that tDCS could support cognitive training outcomes in schizophrenia. Larger randomized controlled trials are needed to confirm transfer effects and determine the long-term benefits of this approach. If proven effective, integrating tDCS into cognitive remediation therapies could represent an innovative strategy to address cognitive deficits in schizophrenia.
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spelling doaj-art-e34ef1c7b7a34c6596adeac29119bcda2025-08-20T03:05:09ZengNature PortfolioSchizophrenia2754-69932025-07-011111910.1038/s41537-025-00647-5Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophreniaTobias Schwippel0Sanvi Korsapathy1Ibrahim Hajiyev2Aylin Utlu3Simone Weller4Daniel Kamp5Christian Plewnia6Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of TübingenDepartment of Psychiatry, University of North Carolina at Chapel HillDepartment of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of TübingenDepartment of Psychiatry and Psychotherapy, LVR Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-Universität DüsseldorfDepartment of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of TübingenDepartment of Psychiatry and Psychotherapy, LVR Klinikum Düsseldorf, Medical Faculty, Heinrich-Heine-Universität DüsseldorfDepartment of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of TübingenAbstract Cognitive impairments in schizophrenia significantly impact daily functioning and quality of life, posing a major therapeutic challenge. While both cognitive training and transcranial direct current stimulation (tDCS) have shown promise in improving cognitive function, their combined effects remain underexplored. This double-blind, sham-controlled, randomized clinical trial investigated whether adaptive working memory training (aWMT) paired with anodal tDCS to the right dorsolateral prefrontal cortex (DLPFC) enhances cognitive outcomes in schizophrenia. Twenty-eight individuals with schizophrenia or schizoaffective disorder completed ten sessions of aWMT with concurrent 2 mA anodal or sham tDCS. Cognitive improvements were assessed using the Brief Assessment of Cognition in Schizophrenia (BACS) at baseline, three days after training, and at follow-ups one month, and three months later. Clinical measures evaluated psychopathology, depression, and quality of life. Anodal tDCS significantly improved working memory performance during training, with gains partially sustained at follow-ups. Short-term transfer effects with large effect sizes were observed in the BACS, although clinical symptoms and quality of life remained unaffected. While preliminary, these findings indicate that tDCS could support cognitive training outcomes in schizophrenia. Larger randomized controlled trials are needed to confirm transfer effects and determine the long-term benefits of this approach. If proven effective, integrating tDCS into cognitive remediation therapies could represent an innovative strategy to address cognitive deficits in schizophrenia.https://doi.org/10.1038/s41537-025-00647-5
spellingShingle Tobias Schwippel
Sanvi Korsapathy
Ibrahim Hajiyev
Aylin Utlu
Simone Weller
Daniel Kamp
Christian Plewnia
Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
Schizophrenia
title Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
title_full Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
title_fullStr Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
title_full_unstemmed Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
title_short Investigating the effects of transcranial direct current stimulation (tDCS) on working memory training in individuals with schizophrenia
title_sort investigating the effects of transcranial direct current stimulation tdcs on working memory training in individuals with schizophrenia
url https://doi.org/10.1038/s41537-025-00647-5
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