Systematic review finds small short-term cognitive benefit from tDCS plus training
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Key Takeaway
Consider tDCS plus training for small, short-term cognitive benefit in impairment.
This systematic review and meta-analysis investigated the efficacy of transcranial direct current stimulation (tDCS) combined with cognitive training compared to cognitive training alone in individuals with cognitive impairment. The analysis included data from 1012 participants, though the specific setting was not reported. The primary outcome measured was cognitive function.
The meta-analysis demonstrated a small positive effect size for the combined intervention relative to training alone, with a standardized mean difference (SMD) of 0.36 and a 95% confidence interval ranging from 0.15 to 0.56. Absolute numbers for this outcome were not reported in the source data.
The authors highlight significant limitations, including high heterogeneity across the included studies and a loss of effect observed at follow-up. Adverse events, discontinuations, and tolerability were not reported. Furthermore, the review did not provide a certainty note or specific funding disclosures.
Given these constraints and the small magnitude of the observed benefit, the practice relevance is that tDCS combined with cognitive training may provide a small, short-term benefit for cognitive function. Clinicians should interpret these findings cautiously, noting that the clinical value is not definitively established.
View Original Abstract ↓
Background: Cognitive impairment poses a significant challenge to healthcare systems worldwide, impacting patient autonomy, social participation, and quality of life, while placing a considerable burden on caregivers. Non pharmacological interventions, particularly cognitive training and non invasive brain stimulation, have emerged as promising therapeutic strategies. Objective: This study aims to quantify the synergistic effects of transcranial direct current stimulation (tDCS) with cognitive training on cognitive function across a spectrum of pathologies that induce cognitive impairment. Methods: We conducted a systematic review and metaanalysis following PRISMA guidelines. We searched PubMed for randomized controlled trials that investigated the effect of combined tDCS and cognitive training compared with cognitive training alone. The analysis was based on the GRADE framework for systematic reviews and metaanalyses. Results: Across 27 studies including 1,012 participants, tDCS combined with cognitive training showed a small effect compared with cognitive training alone (SMD = 0.36, 95% CI: 0.15 0.56). The effect was found only immediately after the intervention and declined during follow-up. Conclusion: tDCS combined with cognitive training may provide a small, short term benefit for cognitive function, but high heterogeneity across studies and loss of effect at follow up underscore the need for larger, better standardized trials to clarify its clinical value.
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