‌اثربخشی تحریک الکتریکی فراجمجمه‌ای قشر پیش‌پیشانی بر توجه، حافظه کاری،تصمیم‌گیری، شناخت اجتماعی و کیفیت زندگی در سالمندان

نوع مقاله : مقاله پژوهشی

نویسندگان

گروه روانشناسی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شهید مدنی آذربایجان، تبریز، ایران.

چکیده

فعالیت شناختی و کیفیت زندگی نشانگر‌ها‌ی مهمی در ارزیابی سلامت روان هستند و بهبود آنها منعکس کننده حفظ و ارتقای سلامت فیزیکی و روانی در سالمندان است. بنابراین پژوهش حاضر با هدف بررسی اثربخشی تحریک الکتریکی قشر پیش پیشانی مغزی بر توجه، حافظه کاری، تصمیم‌گیری، شناخت اجتماعی و کیفیت زندگی سالمندان انجام گرفت. این پژوهش از نوع نیمه‌آزمایشی با طرح پیش‌آزمون-پس‌آزمون با گروه کنترل بود. جامعه آماری شامل تمامی سالمندان بالای 60 سال ساکن شهرستان تبریز در سال 1402 بود که از میان آنها نمونه 40 نفر که معیارهای ورود به پژوهش را داشتند به روش در دسترس انتخاب و به صورت تصادفی در دو گروه آزمایشی و کنترل گمارش شدند. گروه آزمایشی به مدت 20 جلسه یک روز درمیان تحت تحریک الکتریکی مغزی بر روی پیش‌پیشانی با شدت 1 میلی آمپر دریافت نمودند و گروه کنترل در این زمان هیچ مداخله‌ای دریافت نکرد. از آزمون ارزیابی خودکار عصب روانشناختی کمبریج، جهت ارزیابی عملکرد شناختی و پرسش‌نامه کیفیت زندگی 36 گویه‌ای سازمان بهداشت جهانی جهت کیفیت زندگی در پیش‌آزمون و پس‌آزمون استفاده شد. از روش تحلیل آماری آنکوا در نرم‌افزار SPSS نسخه 24 جهت تجزیه و تحلیل آماری داده‌ها‌ استفاده گردید. نتایج آزمون آنکوا نشان دهنده تفاوت معنی‌دار در میانگین توجه، حافظه کاری، تصمیم‌گیری، شناخت اجتماعی بین دو گروه آزمایشی و کنترل در پس‌آزمون بود (۰۵/۰P<). به این معنی که تحریک الکتریکی قشر پیش پیشانی موجب بهبود توجه، حافظه کاری و تصمیم‌گیری و شناخت اجتماعی و همچنین بهبود کیفیت زندگی در گروه آزمایش به نسبت گروه کنترل شده است. یافته‌ها‌ی پژوهشی نشان دهنده اثربخشی تحریک الکتریکی مغزی بر روی قشر پیش پیشانی در بازتوانی عملکردهای شناختی در سالمندان است، این رویکرد درمانی را می‌توان به عنوان یک راهکار موثر در بهبود سلامت عملکرد شناختی و کیفیت زندگی استفاده گردد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

The Effectiveness of Transcranial Direct Current Stimulation over Prefrontal Cortex on Attention, Working Memory, Decision-Making, Social Cognition and Quality of Life in Older Adults

نویسندگان [English]

  • Bakhtiar Moslemi
  • Gholamreza Chalabianloo
Psychology Department, Humanitarian and Psychology Faculty, Azarbaijan Shahid Madani University, Tabriz, Iran
چکیده [English]

Cognitive function and quality of life (QOL) are crucial indicators in health assessment, and their enhancement reflects the maintenance and improvement of both physical and mental health in older adults. Therefore, this study aimed to investigate the effectiveness of transcranial direct current stimulation (tDCS) over the prefrontal cortex on attention, working memory, decision-making, social cognition, and QOL in older adults. This quasi-experimental study employed a pretest-posttest design with a control group. The study population consisted of older adults aged over 60 residing in Tabriz, Iran in 2023, among whom, 40 individuals meeting the inclusion criteria were selected through convenience sampling and randomly assigned to experimental and control groups. The experimental group received 1mA tDCS over the prefrontal cortex for 20 sessions every other day, while the control group received no intervention during the same period. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was utilized to assess cognitive function, and the Quality of Life Questionnaire-Short Form (QOL-SF 36) was administered to evaluate QOL at pretest and posttest phases. Analysis of covariance (ANCOVA) was conducted using SPSS-24 software for statistical analysis. The results revealed a significant difference between the means of attention, working memory, decision-making, social cognition, and QOL in the experimental and control groups at the post-test phase (P<.05). Thus, electrical stimulation of the prefrontal cortex led to improvements in attention, working memory, decision-making, social cognition, and QOL, thereby enhancing cognitive performance and improving QOL in the experimental group compared to the control group. The findings suggest that tDCS over the prefrontal cortex enhances cognitive function in older adults, indicating its potential as an effective and beneficial method to improve cognitive performance and QOL in this population.
EXTENDED ABSTRACT
Introduction
Given the increasing population of older adults in the near future, understanding the status of this age group in various domains, including health and mental well-being, particularly cognitive functions and quality of life, has become more important than ever. Psychological changes resulting from aging encompass chronic declines in cognitive functions such as attention, working memory, decision-making, and social cognition, which make the daily interactions of older adults difficult and diminish their quality of life. Researchers have reported the positive effects of neurocognitive interventions in treating cognitive impairments, concluding that electrical stimulation of the left dorsolateral prefrontal cortex can enhance cognitive functions. Therefore, considering the significance of cognitive functions in older adults and the existing literature in this field, the objective of the present study was to investigate the effectiveness of transcranial direct current stimulation over the prefrontal cortex on attention, working memory, decision-making, social cognition, and quality of life in older adults.
Method
The current research was a quasi-experimental study with pretest-posttest design with a control group. The statistical population comprises all older individuals aged 60 and above living in East Azerbaijan Province, Iran in 2023, among whom 40 older individuals were selected using convenience sampling and according to inclusion and exclusion criteria, and randomly allocated into experimental and control groups. Inclusion criteria for each group were (1) age over 60 years, (2) willingness to participate and cooperate in the research, and (3) psychological health. Exclusion criteria included (1) history of heart and brain stroke, (2) specific psychological disorders, (3) history of epilepsy and seizures, Alzheimer's, and other dementia-related diseases. Participants completed the Cambridge Neuropsychological Test Automated Battery (CANTAB) assessment and the 36-item WHO Quality of Life questionnaire (WHO SF-36). The obtained data from the questionnaires were analyzed using one-way analysis of covariance (ANCOVA) in SPSS version- 24.
 Results
The findings were analyzed in two sections of descriptive and inferential. Prior to the inferential analysis, the normality of the data in attention, working memory, decision-making, social cognition, and quality of life variables in both pretest and posttest phases was confirmed using Shapiro-Wilk test. Meanwhile, homogeneity of variance was confirmed based on the obtained significance level using Levene's test. Additionally, the assumption of homogeneity of regression slopes, indicating the absence of significant interaction between the pretest group, was confirmed based on the obtained significance level. Therefore, the research data provided the basis for covariance assumptions.
Based on the results presented in Table 1, transcranial direct current stimulation over the prefrontal cortex had a significant and positive effect on attention, active memory, decision-making, social cognition, and quality of life. Furthermore, considering the calculated effect size and its significance, it can be inferred that 54% of the variance in attention, 35% of the variance in working memory, 47% of the variance in decision-making, 29% of the variance in social cognition, and 62% of the variance in quality of life were explained by the intervention based on transcranial direct current stimulation over the prefrontal cortex.
Conclusion
Improving living conditions, healthcare, and increasing life expectancy and hope for life have been consequences of aging in societies. Cognitive impairments and declining quality of life are common changes during the aging process, encompassing a wide range of issues. One of the innovative interventions in treating psychological problems and preserving cognitive functions in older adults is transcranial electrical stimulation. Anodal stimulation of the left dorsolateral prefrontal cortex in older adults leads to increased brain activity and arousal, as well as increased blood flow to the brain region, enhancing processing of high-level and complex cognitive processes and improving executive functions, attention, decision-making, and social cognition. Improving cognitive functions in older adults helps them to effectively and independently engage in various aspects of life. By enhancing cognitive performance, older adults feel more capable, independent, and confident, leading to greater physical, mental, and psychological health, and this sense of capability and empowerment provides a better lifestyle for them, ultimately improving their quality of life. The results of this study confirm this theory and indicate that transcranial electrical stimulation significantly affected cognitive function and quality of life in older adults.
Ethical Consideration
Ethical Code
The research project has been approved by the Research Center of Shahid Madani University and the National Fund for Research and Technology Development.
Financial Support
The current research is derived from a post-doctoral research project in psychology and is financially supported by the National Fund for Research and Technology Development in collaboration with Shahid Madani University of Azerbaijan.
Authors’ Contributions
B.M: Conceptualization, methodology, resources, software, data curation, validation, writing- original draft; G.C: Formal analysis, supervision, writingreview & editing, project administration.
Conflict of Interest
The author had no conflicts of interest.
Acknowledgments
The esteemed Research Vice-Chancellor of Shahid Madani University of Azerbaijan and the National Fund for Research and Technology Development are acknowledged for their financial support and collaboration in the implementation of the current research project. 

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کلیدواژه‌ها [English]

  • transcranial direct current stimulation
  • cognitive function
  • quality of life
  • older adults
آذری پیشکناری، ل. (1390). تأثیر ناحیة میانی قشر پیش پیشانی بر قضاوت زیبایی شناختی با استفاده از روش تحریک الکتریکی مستقیم مغز از روی جمجمه(tDCS) (پایان نامة کارشناسی ارشد چاپ نشده). پژوهشکدة علوم شناختی.
بیات مختاری، ل.، آقایوسفی، ع.، زارع، ح.، و نجاتی، و. (1396). ‌تأثیر تحریک مستقیم الکتریکی مغز از روی جمجمه (TDCS) و آموزش آگاهی واج شناختی بر بهبود عملکرد بعد دیداری حافظه کاری کودکان نارساخوان. عصب روانشناسی، 3(2 (پیاپی 8) )، 67-50. 
کوچکی، گ.، حجتی، ح.، و ثناگو، ا. (1391). ارتباط احساس تنهایی با رضایت از زندگی در سالمندان (شهرهای گرگان و گنبد). مجله توسعه پژوهش در پرستاری و مامایی، 9 (1)، 68-61. 
عرفانی خانقای، م.، و عبادی فرد آذر، ف. (1397). بررسی سیستماتیک و فراتحلیل کیفیت زندگی سالمندان ایرانی با استفاده از پرسش‌نامه LEIPAD. پیوند سلامت، 11(5)، 597-588.
علی اصغر پور، م.، و عیب‌پوش، س. (1390). کیفیت زندگی سالمندان مقیم آسایشگاه کهریزک و ارتباط آن با عوامل مختلف. نشریه پرستاری ایران, 25(75), 70-60.‎
قنبرزاده, م.، رستمی، ر.، و حاتمی، ج. (1400). تعیین اثربخشی تحریک مستقیم فراجمجمه‌ای همراه با آموزش خواندن بر حافظۀ فعال و عملکرد خواندن کودکان نارساخوان: شواهدی از پتانسیل‌های وابسته به رویداد. فصل‌نامه پژوهش‌های کاربردی  روان‌شناختی, 12(1), 81-59.‎ 
مسعودی، ر.، سلیمانی، م. ع.، هاشمی‌نیا، ع. م.، قربانی، م.، حسنپور دهکردی، ع.، و بهرامی، ن. (1389). ‌تأثیر الگوی توانمندسازی خانواده-محور بر کیفیت زندگی سالمندان. مجله علمی دانشگاه علوم پزشکی و خدمات بهداشتی درمانی قزوین، 14 (1)، 64-58.
مسلمی، ب.، آزموده، م.، طباطبایی، م.، علیوندی وف، م. (1400). ‌تأثیر تحریک الکتریکی مغزی بر ناحیه پیش پیشانی پشتی- جانبی: مروری بر نقش آن در عملکرد‌ها‌ی شناختی. مجله شفای خاتم، 8 (1)، 144-129.
معتمدی، ع.، برجعلی، ا.، و صادقپور، م. (1397). پیش‌بینی بهزیستی  روان‌شناختی سالمندان بر اساس توان مدیریت استرس و حمایت اجتماعی. مجله سالمندی ایران، 13(1)، 109-98. 
نجاتی، و.، و عشایری، ح. (1387). کیفیت زندگی مرتبط با سلامت در سالمندان شهرستان کاشان. مجله روانپزشکی و روانشناسی بالینی ایران (اندیشه و رفتار)، 14(1)، 56-61..  
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