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Aksu S, Soyata AZ, Şeker S, Akkaya G, Yılmaz Y, Kafalı T, Evren C, Umut G. Transcranial direct current stimulation combined with cognitive training improves decision making and executive functions in opioid use disorder: a triple-blind sham-controlled pilot study. J Addict Dis 2024; 42:154-165. [PMID: 36861945 DOI: 10.1080/10550887.2023.2168991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Opioid use disorder (OUD) is a chronic disorder with a considerable amount of morbidity and mortality. Despite remarkable improvement achieved by maintenance programs, an array of treatment goals were still unmet. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) improves decision making and cognitive functions in addictive disorders. tDCS paired with a decision making task was depicted to diminish impulsivity as well. The present study aimed to assess the effect of tDCS combined with cognitive training (CT) in OUD for the first time. In this triple-blind randomized sham-controlled pilot study, 38 individuals with OUD from the Buprenorphine-Naloxone Maintenance Therapy program were administered 20-minutes of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex with concomitant cognitive training. A selected test battery evaluating decision making under risk and ambiguity as well as executive functions, verbal fluency and working memory was utilized before and after the intervention. Greater improvements were observed in decision making under ambiguity (p = 0.016), set shifting ability and alternating fluency while no improvements were observed in decision making under risk in the active group, compared to sham. Deficits of decision making and executive functions have a pivotal role in the perpetuation and the relapse of the OUD. Alleviation of these impairments brought tDCS/CT forth as an expedient neuroscientifically-grounded treatment option that merits further exploration in OUD, Trial registration: NCT05568251.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Ahmet Zihni Soyata
- Psychiatry Outpatient Clinic, Başakşehir State Hospital, İstanbul, Turkey
| | - Sercan Şeker
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gözde Akkaya
- Department of Child Development, Istanbul Topkapı University, Istanbul, Turkey
| | - Yasemin Yılmaz
- Department of Psychology, İstanbul University, Istanbul, Turkey
| | - Tuğba Kafalı
- Department of Psychology, Akdeniz University, Antalya, Turkey
| | - Cüneyt Evren
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gökhan Umut
- Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM), Bakirkoy Training and Research Hospital for Psychiatry Neurology and Neurosurgery, Turkey, Istanbul
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Aksu S, Hasırcı Bayır BR, Sayman C, Soyata AZ, Boz G, Karamürsel S. Working memory ımprovement after transcranial direct current stimulation paired with working memory training ın diabetic peripheral neuropathy. Appl Neuropsychol Adult 2023:1-14. [PMID: 36630270 DOI: 10.1080/23279095.2022.2164717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Association of cognitive deficits and diabetic peripheral neuropathy (DPN) is frequent. Working memory (WM) deficits result in impairment of daily activities, diminished functionality, and treatment compliance. Mounting evidence suggests that transcranial Direct Current Stimulation (tDCS) with concurrent working memory training (WMT) ameliorates cognitive deficits. Emboldening results of tDCS were shown in DPN. The study aimed to evaluate the efficacy of anodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) coupled with cathodal right DLPFC with concurrent WMT in DPN for the first time. The present randomized triple-blind parallel-group sham-controlled study evaluated the efficacy of 5 sessions of tDCS over the DLPFC concurrent with WMT in 28 individuals with painful DPN on cognitive (primary) and pain-related, psychiatric outcome measures before, immediately after, and 1-month after treatment protocol. tDCS enhanced the efficacy of WMT on working memory and yielded lower anxiety levels than sham tDCS but efficacy was not superior to sham on other cognitive domains, pain severity, quality of life, and depression. tDCS with concurrent WMT enhanced WM and ameliorated anxiety in DPN without affecting other cognitive and pain-related outcomes. Further research scrutinizing the short/long-term efficacy with larger samples is accredited.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Türkiye
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
| | - Buse Rahime Hasırcı Bayır
- Department of Neurology, Health Sciences University, Haydarpaşa Numune Education and Research Hospital, Istanbul, Türkiye
| | - Ceyhun Sayman
- Translational Neurodevelopmental Neuroscience Phd Programme, Institute of Health Science, Istanbul University, Istanbul, Türkiye
| | - Ahmet Zihni Soyata
- Psychiatry Outpatient Clinic, Başakşehir State Hospital, İstanbul, Turkey
| | - Gökalp Boz
- Department of Psychology, Istanbul University, Istanbul, Türkiye
| | - Sacit Karamürsel
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye
- Department of Physiology, School of Medicine, Koc University, Istanbul, Türkiye
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Barham H, Büyükgök D, Aksu S, Soyata AZ, Bulut G, Eskicioğlu G, Baral Kulaksızoğlu I. Evidence for modulation of planning and working memory capacities by transcranial direct current stimulation in a sample of adults with attention deficit hyperactivity disorder. Neurosci Lett 2022; 790:136883. [PMID: 36152744 DOI: 10.1016/j.neulet.2022.136883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/11/2022] [Accepted: 09/19/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVE Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder that affects up to 2.8% of the adult population. Albeit pharmacological and behavioral therapies alleviate some core symptoms of ADHD, they do not avail cognitive dysfunction adequately. Executive dysfunction has been considered to have a principal role in ADHD and has previously been linked to activity alterations in the prefrontal cortex. Transcranial Direct Current Stimulation (tDCS) is a noninvasive brain stimulation technique that may modulate prefrontal cortex activity and induce neuroplasticity, with preliminary results in ADHD. The aim of the present study is to assess the effect of repeated tDCS on measures of executive functions in adults with ADHD. METHOD In this randomized double-blind sham-controlled study, 22 adults with ADHD were allocated into two groups and were administered five consecutive sessions of 2 mA active/sham tDCS over the dorsolateral prefrontal cortex (right anodal/left cathodal). A neuropsychological test battery was administered before the first session and immediately after the last session. RESULTS The maximum number of digits and the total number of correct trials in the Digit Span Backward test increased in the active group (p = 0.017). The total move score in the Tower of London test decreased (p = 0.033), suggesting better planning ability. However, no significant differences were observed on Stroop Test and Trail Making Test after tDCS. DISCUSSION The present study corroborates the modulating effects of tDCS on planning and working memory in a small group of adults with ADHD. Our results highlighted that cognitive functions are modulable using tDCS in adults with ADHD.
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Affiliation(s)
- Huzeyfe Barham
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey; Psychiatry Clinic, Moodist Psychiatry and Neurology Hospital, Istanbul, Turkey.
| | - Deniz Büyükgök
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serkan Aksu
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey; Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
| | | | - Gamze Bulut
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Gaye Eskicioğlu
- Department of Psychology, Istanbul University, Istanbul, Turkey
| | - Işın Baral Kulaksızoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
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Aksu S, Uslu A, İşçen P, Tülay EE, Barham H, Soyata AZ, Demirtas-Tatlidede A, Yıldız GB, Bilgiç B, Hanağası H, Woods AJ, Karamürsel S, Uyar FA. Does transcranial direct current stimulation enhance cognitive performance in Parkinson's disease mild cognitive impairment? An event-related potentials and neuropsychological assessment study. Neurol Sci 2022; 43:4029-4044. [PMID: 35322340 DOI: 10.1007/s10072-022-06020-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/16/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Parkinson's disease-mild cognitive impairment (PD-MCI) is garnering attention as a key interventional period for cognitive impairment. Currently, there are no approved treatments for PD-MCI and encouraging results of transcranial direct current stimulation (tDCS) combined with other interventions have been proposed, though the efficacy and neural mechanisms of tDCS alone have not been studied in PD-MCI yet. OBJECTIVES The present double-blind, randomized, sham-controlled study assessed the effects of tDCS over the dorsolateral prefrontal cortex on cognitive functions via neuropsychological and electrophysiological evaluations in individuals with PD-MCI for the first time. METHOD Twenty-six individuals with PD-MCI were administered 10 sessions of active (n = 13) or sham (n = 13) prefrontal tDCS twice a day, for 5 days. Changes were tested through a comprehensive neuropsychological battery and event-related potential recordings, which were performed before, immediately, and 1 month after the administrations. RESULTS Neuropsychological assessment showed an improvement in delayed recall and executive functions in the active group. N1 amplitudes in response to targets in the oddball test-likely indexing attention and discriminability and NoGo N2 amplitudes in the continuous performance test-likely indexing cognitive control and conflict monitoring increased in the active group. Active stimulation elicited higher benefits 1 month after the administrations. CONCLUSION The present findings substantiate the efficacy of tDCS on cognitive control and episodic memory, along with the neural underpinnings of cognitive control, highlighting its potential for therapeutic utility in PD-MCI. TRIAL REGISTRATION NCT 04,171,804. Date of registration: 21/11/2019.
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Affiliation(s)
- Serkan Aksu
- Department of Physiology, Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey.
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
- Department of Physiology, Faculty of Medicine, Muğla Sıtkı Koçman University, Muğla, Turkey.
| | - Atilla Uslu
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Pınar İşçen
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emine Elif Tülay
- Department of Software Engineering, Faculty of Engineering, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Huzeyfe Barham
- Department of Psychiatry, Kırklareli Research and Training Hospital, Kırklareli, Turkey
| | | | | | | | - Başar Bilgiç
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Haşmet Hanağası
- Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Adam J Woods
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, McKnight Brain Institute, Cognitive Aging and Memory Clinical Translational Research Program, University of Florida, Gainesville, USA
| | - Sacit Karamürsel
- Department of Physiology, School of Medicine, Koç University, Istanbul, Turkey
| | - Fatma Aytül Uyar
- Department of Physiology, Graduate School of Health Sciences, Istanbul University, Istanbul, Turkey
- Department of Physiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Bakirhan A, Sahiner SY, Sahiner V, Çeti̇n Ş, Balcı Şengül MC, Kuş S, Canan F, Erdoğan A, Murat Kuloğlu M, Şahin Ş, Elboğa G, Zi̇ya Şahin A, Ünal A, Altındağ A, Tahsin Kılıç OH, Dogan T, Kaygisiz G, Ezgi Bal Z, Solmaz M, Adali Aker D, Akin E, Kose S, Özturan DD, Güz HÖ, Naldan ME, Karayağmurlu A, Cevizci MN, Kara D, Ahiskalioğlu EO, Aydın P, Marangoz Y, Sarı BA, Barış Z, Özçay F, Mutluer BT, Yener Orum TG, Şahan E, Sertcelik S, Yılmaz H, Özbaran NB, Palamar M, Biler ED, Yi̇lmaz E, Tamam L, Altın M, Ozaktac IF, Sarıdogan AS, Yavlal F, Tahincioğlu C, Karaş H, Ebadi H, Sogucak S, Karaca S, Canan F, Kuloglu M, Canan F, Karaca S, Kuloglu M, Karaca S, Sogucak S, Canan F, Kuloglu M, Karaca S, Canan F, Kuloglu M, Öznur T, Bolu A, Öznur H, Atik S, Çelik C, Uzun Ö, Bakirhan A, Sahiner V, Göka E, Utkan T, Şahin TD, Yazir Y, Halbutoğulları ZS, Gocmez SS, Arıcıoğlu F, Gülbahar ÖSB, Mahmood A, Zsoldos E, Allan CL, Topiwala A, Ebmeier KP, Lee JS, Kim JH, Lee SK, Ünal G, Dokumacı AH, Yerer MBA, Özkartal C, Arıcıoğlu F, Altun HK, Keser İ, Mart M, Tezcan D, Tümkaya S, Ateşci FÇ, Baygın C, Memiş ÇÖ, Doğan B, Sevinçok L, Karakuş G, Tamam L, Özkartal CŞ, Arıcıoğlu F, Tüzün E, Keleş R, Kandemir C, Şirvancı S, Küçükali Cİ, Can ÖD, Üçel Uİ, Özkay ÜD, Ulupınar E, Turan N, Can ÖD, Can NÖ, Can ÖD, Arıcıoğlu F, Baştaşkın T, Özkartal CŞ, Tüzün E, Küçükali Cİ, Utkan T, Arıcıoğlu F, Yalçınkaya C, Kandemir C, Şirvancı S, Özkartal CŞ, Utkan T, Arıcıoğlu F, Arkan G, Özkartal CŞ, Utkan T, Can NÖ, Özkay Y, Levent S, Turan N, Alyu F, Öztürk Y, Sadek B, Khan N, Łażewska D, Kononowicz KK, Boztaş MH, Arslan D, Koç A, Aygün DÖ, Ensari H, Akın E, Kose S, Ceylan V, Turkcapar MH, Ceylan V, Kose S, Akin E, Turkcapar MH, Kose S, Yalcin M, Akin E, Ceylan V, Turkcapar H, Aker DA, Kose S, Solmaz M, Bal ZE, Akın E, Kose S, Celikel FC, Akin E, Yalcin M, Ceylan V, Sevinçer GM, Kaya A, Akın E, Bozkurt S, Kose S, Kose S, Tekintas NS, Durmus FB, Akin E, Sayar K, Sarıoğlu FK, Erbay LG, Karlıdağ R, Sekmen E, Karalök ZS, Göker Z, Çöp E, Dinç G, Bozkurt ÖH, Üneri ÖŞ, Ataoğlu S, Ankaralı H, Ankaralı S, Ataoğlu BB, Ölmez SB, Çelebi E, Ataoğlu S, Ataoğlu BB, Ankaralı H, Pasin Ö, Ölmez SB, Samancı R, Ataoğlu S, Ankaralı H, Ataoğlu BB, Ölmez SB, Ayyıldız D, Fiş NP, Özayhan HY, Çalışkan AM, İnanlı İ, Öztürk Hİ, Etli T, Eren İ, Sarı BA, Taner HA, Kilicaslan F, Ayaydin H, Aytekin AI, Saka M, Aydin S, Garip B, Kayir H, Uğurlu GK, Uğurlu M, Haydanlı AM, Çayköylü A, Kaymak SU, Apaydın ZK, Uğurlu GK, Uğurlu M, Çayköylü A, Can SS, Haydanlı AM, Apaydın ZK, Bozkurt A, Akbaş S, Tander B, Kara C, Bıçakçı Ü, Toz Hİ, Yalçi̇n Ö, Sapmaz ŞY, Erkuran HÖ, Karaarslan D, Öztürk M, Ülker GY, Demirgören BS, Köroğlu E, Aydemir Ö, Sapmaz ŞY, Yalın N, Kavurma C, Öztekin S, Pilan BŞ, Emiroğlu NI, Köroğlu E, Aydemir Ö, Sapmaz ŞY, Ergin D, Celasin NŞ, Bilaç Ö, Öztürk M, Kararslan D, Tarakçıoğlu MC, Aydemir Ö, Acar G, Bademli K, Lök N, Soyata AZ, Karaytug MO, Keskin N, Tamam L, Ozpoyraz N, Demirkol ME. 9th International Congress on Psychopharmacology & 5th International Symposium on Child and Adolescent Psychopharmacology. PSYCHIAT CLIN PSYCH 2017. [DOI: 10.1080/24750573.2017.1308707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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