A Systematic Review of tACS Effects on Cognitive Functioning in Older Adults Across the Healthy to Dementia Spectrum.

IF 5.4 2区 心理学 Q1 NEUROSCIENCES
Jacob D Kraft, Benjamin M Hampstead
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Abstract

Transcranial alternating current stimulation (tACS) is a form of noninvasive brain stimulation that has experienced rapid growth within the aging population over the past decade due to its potential for modulating cognitive functioning across the "intact" to dementia spectrum. For this reason, we performed a systematic review of the literature to evaluate the efficacy of tACS on cognitive functioning in older adults, including those with cognitive impairment. Our review was completed in June 2023 using Psych INFO, Embase, PubMed, and Cochrane databases. Out of 479 screened articles, 21 met inclusion criteria and were organized according to clinical diagnoses. Seven out of nine studies targeted cognitively intact older adults and showed some type of cognitive improvement after stimulation, whereas nine out of twelve studies targeted clinical diagnoses and showed improved cognitive performance to varying degrees. Studies showed considerable heterogeneity in methodology, stimulation parameters, participant characteristics, choice of cognitive task, and analytic strategy, all of which reinforce the need for standardized reporting of tACS methods. Through this heterogeneity, multiple patterns are described, such as disease progression influencing tACS effects and the need for individualized tailoring. For clinical translation, it is imperative that the field (a) better understand the physiological effects of tACS in these populations, especially in respect to biomarkers, (b) document a causal relationship between tACS delivery and neurophysiological/cognitive effects, and (c) systematically establish dosing parameters (e.g., amplitude, stimulation frequency, number and duration of sessions, need for booster/maintenance sessions).

Abstract Image

从健康到痴呆的tACS对老年人认知功能影响的系统综述。
经颅交流刺激(tACS)是一种非侵入性大脑刺激形式,在过去十年中,由于其在“完整”至痴呆症范围内调节认知功能的潜力,在老龄化人群中经历了快速增长。因此,我们对文献进行了系统回顾,以评估tACS对老年人(包括认知障碍患者)认知功能的疗效。我们的综述于2023年6月使用Psych INFO、Embase、PubMed和Cochrane数据库完成。在479篇筛选文章中,21篇符合纳入标准,并根据临床诊断进行组织。九分之七的研究针对认知完整的老年人,并在刺激后显示出某种类型的认知改善,而十二分之九的研究针对临床诊断,并显示出不同程度的认知表现改善。研究表明,在方法论、刺激参数、参与者特征、认知任务选择和分析策略方面存在相当大的异质性,所有这些都加强了对tACS方法标准化报告的需求。通过这种异质性,描述了多种模式,例如影响tACS效应的疾病进展和个性化定制的必要性。对于临床翻译,该领域必须(a)更好地了解tACS在这些人群中的生理效应,特别是在生物标志物方面,(b)记录tACS递送与神经生理学/认知效应之间的因果关系,以及(c)系统地建立给药参数(例如,幅度、刺激频率、疗程的数量和持续时间、加强/维持疗程的需要)。
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来源期刊
Neuropsychology Review
Neuropsychology Review 医学-神经科学
CiteScore
11.00
自引率
1.70%
发文量
36
期刊介绍: Neuropsychology Review is a quarterly, refereed publication devoted to integrative review papers on substantive content areas in neuropsychology, with particular focus on populations with endogenous or acquired conditions affecting brain and function and on translational research providing a mechanistic understanding of clinical problems. Publication of new data is not the purview of the journal. Articles are written by international specialists in the field, discussing such complex issues as distinctive functional features of central nervous system disease and injury; challenges in early diagnosis; the impact of genes and environment on function; risk factors for functional impairment; treatment efficacy of neuropsychological rehabilitation; the role of neuroimaging, neuroelectrophysiology, and other neurometric modalities in explicating function; clinical trial design; neuropsychological function and its substrates characteristic of normal development and aging; and neuropsychological dysfunction and its substrates in neurological, psychiatric, and medical conditions. The journal''s broad perspective is supported by an outstanding, multidisciplinary editorial review board guided by the aim to provide students and professionals, clinicians and researchers with scholarly articles that critically and objectively summarize and synthesize the strengths and weaknesses in the literature and propose novel hypotheses, methods of analysis, and links to other fields.
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