Transcranial Direct Current Stimulation (tDCS) as Adjunctive Therapy to Cognitive Stimulation in Medical Students With Depression

Cognitive training has demonstrated the potential to produce broad benefits in functional cognitive. As a fundamental and essential cognitive skill and essential, working memory supports complex thinking, but has limited capacity. Therefore, working memory training interventions have become popular as a means of potentially improve cognitive skills related to working memory for those who need it (Au et al.,2016) Transcranial direct current stimulation is one of the most widely studied techniques in neuromodulation non-invasive neuromodulation. With a very good safety profile and low cost, it has been widely used to modulate cognition and behavior in both experimental and clinical settings A growing body of literature, including randomized controlled trials, reports the clinical benefits of tDCS for many clinical benefits of tDCS for many psychiatric symptoms, such as depression, anxiety, psychosis, addiction, and cognitive function. tDCS has considerable potential as a treatment because of its relative cost, portability, safety, and ease of use compared with other neuromodulation methods. Early studies evaluated the effects of tDCS on the motor cortex; although more recent research has also focused on its effects on the dorsolateral prefrontal cortex (DLPFC), particularly for treating psychiatric disorders and modulating cognitive performance.

Side effects, such as itching, burning sensation or headache are common, but generally mild and without long-term impact.

Therefore, tDCS compares favorably with other therapeutic approaches such as antidepressants or transcranial magnetic simulation (TMS).

Transcranial direct current stimulation (tDCS), which has shown potential to modulate cortical excitability and cortical activity of the brain, by transmitting a weak electrical current to the brain, has been found as a possible way to improve working memory, sustained attention, motor learning, multitasking. Therefore, cognitive enhancement through tDCS has attracted increased attention over the last decade. A considerable number of single-session studies using tDCS have studies using tDCS have revealed potential benefits for improving participants' performance on working memory tasks. In a particularly anodal tDCS (a-tDCS) applied to the left dorsolateral prefrontal cortex, increased accuracy of response of the working memory task performed at the same time as the stimulation. However, no significant effect appeared when they applied anodal stimulation to the primary motor cortex and cathodal stimulation to the primary motor cortex and cathodal stimulation on the left CPFdl. These findings indicate that the potentiating effect of tDCS on working memory recall depends on the polarity of stimulation and is specific to the site of stimulation . Many subsequent studies compared factors such as electrode placement electrode placement, current density, and duration of stimulation that may affect the efficacy of tDCS and found that anodal stimulation of the left prefrontal tended to improve MT performance. Neuroimaging studies utilizing EEG and functional near-infrared spectroscopy (fNIRS) have provided evidence that tDCS may alter brain activities. In addition to studies related to working memory, tDCS has also shown potential to mitigate decreased vigilance and improve multitasking performance.

Based on the assumption that tDCS has the potential to modulate neuronal excitability and synaptic plasticity, several studies have explored the effect of tDCS on training cognitive training in the last 3 years. One study in a non-human primate model found that tDCS, together with multi-session learning, facilitated associative learning and altered functional connectivity when analyzing behavioral outcomes and local field potential. In a study of three-session working memory training, implemented in healthy adults, the advantage of working memory training combined with a working memory training combined with a-tDCS was not only present immediately following training, but also in the follow-up session up to 9 months after training. The benefits related to A-tDCS remained stable even up to one year after the original intervention, in a study of working memory training paired with 7-day tDCS in healthy young adults. Improved cortical efficiency and connectivity was also demonstrated in a study that found a significant improvement in cortical working memory through working memory training paired to -tDCS in healthy young adults.