The effect of transcranial direct current stimulation on cognitive performance in youth with persistent cognitive symptoms following concussion: a controlled pilot study

ABSTRACT

Objective

Explore the feasibility, tolerability, and early efficacy of transcranial direct current stimulation (tDCS) as a therapeutic intervention for youth with cognitive persistent post-concussion symptoms (PPCS).

Hypothesis

tDCS improves performance on a dual task working memory (WM) paradigm in youth with cognitive PPCS.

Participants

Twelve youth experiencing cognitive PPCS.

Design

A quasi-randomized pilot trial was used to explore the tolerability of, and performance differences on, a dual N-Back WM task paired with active or sham tDCS over 3 sessions.

Measures

Accuracy and reaction time on WM task and self-report of tDCS tolerability.

Results

Trends toward increases in accuracy from Day 1 to 3 seen in both groups. Active tDCS group performed better than sham on Day 2 in N-Back level N2 (p = .019), and marginally better than the sham group on Day 3 in level N3 (p = .26). Participants reported tDCS as tolerable; compared to the active tDCS group, the sham group reported more “considerable” (p = .078) and “strong” symptoms (p = .097).

Conclusion

tDCS is a promising tool for enhancing WM performance and is a feasible and tolerable adjunct to behavioral interventions in youth with cognitive PPCS. A clinical trial to demonstrate efficacy is warranted.

KEYWORDS:

• Post concussional syndrome
• pediatric
• memory
• executive functioning
• concussion
• cognitive rehabilitation

Acknowledgments

The authors thank Nicolas Iuorio for assistance with coding throughout the development of the dual-task paradigm, and Shrika Vejandla for assistance with data analysis and visualization.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Canada Foundation for Innovation under Grant John R. Evans Leaders Fund from the Canadian Foundation for Innovation #35595; the Ontario Research Fund Leaders Opportunity Fund; Canadian Institutes of Health Research Canada Graduate Scholarship – Master’s; and the Bloorview Research Institute Holland Bloorview Kimel Family Graduate Student Scholarship in Paediatric Rehabilitation.