A Pilot Study of Cognitive Training with and Without Transcranial Direct Current Stimulation to Improve Cognition in Older Persons with HIV-related Cognitive Impairment

Overview

Journal Neuropsychiatr Dis Treat

Publisher Dove Medical Press

Specialty Psychiatry

Date 2016 Nov 9

PMID 27822047

Citations 13

Authors

Raymond L Ownby

Amarilis Acevedo

Affiliations

Soon will be listed here.

Abstract

Background: In spite of treatment advances, HIV infection is associated with cognitive deficits. This is even more important as many persons with HIV infection age and experience age-related cognitive impairments. Both computer-based cognitive training and transcranial direct current stimulation (tDCS) have shown promise as interventions to improve cognitive function. In this study, we investigate the acceptability and efficacy of cognitive training with and without tDCS in older persons with HIV.

Patients And Methods: In this single-blind randomized study, participants were 14 individuals of whom 11 completed study procedures (mean age =51.5 years; nine men and two women) with HIV-related mild neurocognitive disorder. Participants completed a battery of neuropsychological and self-report measures and then six 20-minute cognitive training sessions while receiving either active or sham anodal tDCS over the left dorsolateral prefrontal cortex. After training, participants completed the same measures. Success of the blind and participant reactions were assessed during a final interview. Assessments were completed by an assessor blind to treatment assignment. Pre- and post-training changes were evaluated via analysis of covariance yielding estimates of effect size.

Results: All participants believed that they had been assigned to active treatment; nine of the 11 believed that the intervention had improved their cognitive functioning. Both participants who felt the intervention was ineffective were assigned to the sham condition. None of the planned tested interactions of time with treatment was significant, but 12 of 13 favored tDCS (=0.08). All participants indicated that they would participate in similar studies in the future.

Conclusion: Results show that both cognitive training via computer game playing and tDCS were well accepted by older persons with HIV infection. Results are suggestive that tDCS may improve cognitive function in persons with HIV infection. Further study of tDCS as an intervention for HIV-related cognitive dysfunction is warranted.

Citing Articles

Advances in assessment and cognitive neurorehabilitation of HIV-related neurocognitive impairment.

Fischer E, Renaud A, Grivaz P, Di Liberto G, Ryvlin P, Cavassini M Brain Commun. 2024; 7(1):fcae399.

PMID: 39726816 PMC: 11670355. DOI: 10.1093/braincomms/fcae399.

Non-pharmaceutical interventions for people living with HIV with cognitive impairment: A scoping review.

Stuart L, Alford K, Vera J PLoS One. 2024; 19(11):e0314185.

PMID: 39585885 PMC: 11588236. DOI: 10.1371/journal.pone.0314185.

Brain plasticity and adolescent HIV: A randomised controlled trial protocol investigating behavioural and hemodynamic responses in attention cognitive rehabilitation therapy.

Zondo S, Cockcroft K, Ferreira-Correia A MethodsX. 2024; 13:102808.

PMID: 39022176 PMC: 11252933. DOI: 10.1016/j.mex.2024.102808.

The Effects of Transcranial Direct Current Stimulation (tDCS) in HIV Patients-A Review.

Chmiel J, Kurpas D, Rybakowski F, Leszek J J Clin Med. 2024; 13(11).

PMID: 38892999 PMC: 11173062. DOI: 10.3390/jcm13113288.

The cognitive remediation of attention in HIV-associated neurocognitive disorders (HAND): A meta-analysis and systematic review.

Zondo S F1000Res. 2024; 12:1133.

PMID: 38778812 PMC: 11109681. DOI: 10.12688/f1000research.132166.1.

References

Vance D, Fazeli P, Ross L, Wadley V, Ball K . Speed of processing training with middle-age and older adults with HIV: a pilot study. J Assoc Nurses AIDS Care. 2012; 23(6):500-10. PMC: 3422374. DOI: 10.1016/j.jana.2012.01.005. View

Acharya J, Hani A, Cheek J, Thirumala P, Tsuchida T . American Clinical Neurophysiology Society Guideline 2: Guidelines for Standard Electrode Position Nomenclature. J Clin Neurophysiol. 2016; 33(4):308-11. DOI: 10.1097/WNP.0000000000000316. View

Brunoni A, Tortella G, Bensenor I, Lotufo P, Carvalho A, Fregni F . Cognitive effects of transcranial direct current stimulation in depression: Results from the SELECT-TDCS trial and insights for further clinical trials. J Affect Disord. 2016; 202:46-52. DOI: 10.1016/j.jad.2016.03.066. View

Wendelken L, Valcour V . Impact of HIV and aging on neuropsychological function. J Neurovirol. 2012; 18(4):256-63. PMC: 3661281. DOI: 10.1007/s13365-012-0094-1. View

Cardoso-Leite P, Bavelier D . Video game play, attention, and learning: how to shape the development of attention and influence learning?. Curr Opin Neurol. 2014; 27(2):185-91. DOI: 10.1097/WCO.0000000000000077. View

Galvez V, Alonzo A, Martin D, Mitchell P, Sachdev P, Loo C . Hypomania induction in a patient with bipolar II disorder by transcranial direct current stimulation (tDCS). J ECT. 2011; 27(3):256-8. DOI: 10.1097/YCT.0b013e3182012b89. View

Clark V, Coffman B, Mayer A, Weisend M, Lane T, Calhoun V . TDCS guided using fMRI significantly accelerates learning to identify concealed objects. Neuroimage. 2010; 59(1):117-28. PMC: 3387543. DOI: 10.1016/j.neuroimage.2010.11.036. View

Fagerlund A, Freili J, Danielsen T, Aslaksen P . No Effect of 2 mA Anodal tDCS Over the M1 on Performance and Practice Effect on Grooved Pegboard Test and Trail Making Test B. eNeuro. 2015; 2(4). PMC: 4596020. DOI: 10.1523/ENEURO.0072-14.2015. View

Cody S, Vance D . The neurobiology of HIV and its impact on cognitive reserve: A review of cognitive interventions for an aging population. Neurobiol Dis. 2016; 92(Pt B):144-56. DOI: 10.1016/j.nbd.2016.01.011. View

10.

Shimizu E, Hashimoto K, Okamura N, Koike K, Komatsu N, Kumakiri C . Alterations of serum levels of brain-derived neurotrophic factor (BDNF) in depressed patients with or without antidepressants. Biol Psychiatry. 2003; 54(1):70-5. DOI: 10.1016/s0006-3223(03)00181-1. View

11.

Fritsch B, Reis J, Martinowich K, Schambra H, Ji Y, Cohen L . Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning. Neuron. 2010; 66(2):198-204. PMC: 2864780. DOI: 10.1016/j.neuron.2010.03.035. View

12.

Valcour V, Shikuma C, Shiramizu B, Watters M, Poff P, Selnes O . Higher frequency of dementia in older HIV-1 individuals: the Hawaii Aging with HIV-1 Cohort. Neurology. 2004; 63(5):822-7. PMC: 1382180. DOI: 10.1212/01.wnl.0000134665.58343.8d. View

13.

Hinkin C, Hardy D, Mason K, Castellon S, Durvasula R, Lam M . Medication adherence in HIV-infected adults: effect of patient age, cognitive status, and substance abuse. AIDS. 2004; 18 Suppl 1:S19-25. PMC: 2886736. DOI: 10.1097/00002030-200418001-00004. View

14.

Hinkin C, Castellon S, Hardy D, Farinpour R, Newton T, Singer E . Methylphenidate improves HIV-1-associated cognitive slowing. J Neuropsychiatry Clin Neurosci. 2001; 13(2):248-54. DOI: 10.1176/jnp.13.2.248. View

15.

Tremblay S, Lepage J, Latulipe-Loiselle A, Fregni F, Pascual-Leone A, Theoret H . The uncertain outcome of prefrontal tDCS. Brain Stimul. 2014; 7(6):773-83. PMC: 4342747. DOI: 10.1016/j.brs.2014.10.003. View

16.

Fregni F, Boggio P, Nitsche M, Bermpohl F, Antal A, Feredoes E . Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory. Exp Brain Res. 2005; 166(1):23-30. DOI: 10.1007/s00221-005-2334-6. View

17.

Floel A, Suttorp W, Kohl O, Kurten J, Lohmann H, Breitenstein C . Non-invasive brain stimulation improves object-location learning in the elderly. Neurobiol Aging. 2011; 33(8):1682-9. DOI: 10.1016/j.neurobiolaging.2011.05.007. View

18.

Hinkin C, Castellon S, Durvasula R, Hardy D, Lam M, Mason K . Medication adherence among HIV+ adults: effects of cognitive dysfunction and regimen complexity. Neurology. 2002; 59(12):1944-50. PMC: 2871670. DOI: 10.1212/01.wnl.0000038347.48137.67. View

19.

Nitsche M, Boggio P, Fregni F, Pascual-Leone A . Treatment of depression with transcranial direct current stimulation (tDCS): a review. Exp Neurol. 2009; 219(1):14-9. DOI: 10.1016/j.expneurol.2009.03.038. View

20.

Brunoni A, Ferrucci R, Fregni F, Boggio P, Priori A . Transcranial direct current stimulation for the treatment of major depressive disorder: a summary of preclinical, clinical and translational findings. Prog Neuropsychopharmacol Biol Psychiatry. 2012; 39(1):9-16. DOI: 10.1016/j.pnpbp.2012.05.016. View