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

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. 

References
Adams, K. B., Sanders, S., & Auth, E. A. (2004). Loneliness and depression in independent living retirement communities: risk and resilience factors. Aging & Mental Health, 8(6), 475-485. https://doi.org/10.1080/13607860410001725054
Aliasgharpour, M., & Eibpoosh, S. (2013). Quality of life in elderly living in Kahrizak hospice and its relation to the different factors. Iranian journal of, 25(75) 70-60. [Persian] http://npwjm.ajaums.ac.ir/article-1-58-fa.html [Persian]
 Andrews, SC., Hoy, KE., Enticott, PG., Daskalakis, ZJ., & Fitzgerald. PB. (2011). Improving working memory: The effect of combining cognitive activity and anodal transcranial direct current stimulation to the left dorsolateral prefrontal cortex. Brain Stimulation, 4(2): 84-9.  https://doi.org/10.1016/j.brs.2010.06.004
An, T. G., Kim, S. H., & Kim, K. U. (2017). Effect of transcranial direct current stimulation of stroke patients on depression and quality of life. Journal of Physical Therapy Science, 29(3), 505-507. https://doi.org/10.1589/jpts.29.505
Azari Peshkanari, L. (1390). The effect of the medial part of the prefrontal cortex on aesthetic judgment using direct electrical stimulation of the brain from the skull (tDCS) (Master's Thesis). Cognitive Sciences Research Institute. [Persian]
Balconi, M., & Vitaloni S. (2012). The tDCS effect on alpha brain oscillation for correct vs. incorrect object use. The contribution of the left DLPFC. Neuroscience Letters, 517(1) 25-9. https://doi.org/10.1016/j.neulet.2012.04.010
Bayat Mokhtari, B., Agha Yousefi., A. Zare, H., & Nejati, V. (2017). The considering of the impact of transcranial direct current stimulation (TDCS) and phonological awareness training on improvement of the visual aspect function of the working memory in children with dyslexia. Neuropsychology, 2(3), 50-67. https://sid.ir/paper/266871/fa [Persian]
Boggio, P. S., Zaghi, S., & Fregni, F. (2009). Modulation of emotions associated with images of human pain using anodal transcranial direct current stimulation (tDCS). Neuropsychologia, 47(1), 212-217. https://doi.org/10.1016/j.neuropsychologia.2008.07.022
Boggio, P. S., Campanhã, C., Valasek, C. A., Fecteau, S., Pascual‐Leone, A., & Fregni, F. (2010). Modulation of decision‐making in a gambling task in older adults with transcranial direct current stimulation. European Journal of Neuroscience, 31(3), 593-597. https://doi.org/10.1111/j.1460-9568.2010.07080.x
Boggio, P. S., Ferrucci, R., Rigonatti, S. P., Covre, P., Nitsche, M., Pascual-Leone, A., & Fregni, F. (2015). Effects of transcranial direct current stimulation on working memory in patients with Parkinson's disease. Journal of the Neurological Sciences, 249(1), 31-38. https://doi.org/10.1016/j.jns.2006.05.062
Brown, T., & Chien, C. W. (2010). Top-down or bottom-up occupational therapy assessment: which way do we go. British Journal of Occupational Therapy, 73(3), 95-95. https://doi.org/030802210X1268233009033
Carrigan, N., & Barkus, E. (2016). A systematic review of cognitive failures in daily life: Healthy populations. Journal of Neuroscience & Biobehavioral Reviews, 63, 29-42. https://doi.org/10.1016/j.neubiorev.2016.01.010
Chang, S. H., Crogan, N. L., & Wung, S. F. (2007). The self-care self-efficacy enhancement program for Chinese nursing home elders. Journal of Geriatric Nursing, 28(1), 31-36. https://doi.org/10.1016/j.gerinurse.2006.11.006.
Charvet L, Shaw M, Dobbs B, Frontario A, Sherman K, Bikson M, et al. (2018). Remotely supervised transcranial direct current stimulation increases the benefit of at‐home cognitive training in multiple sclerosis. Neuromodulation: Technology at the Neural Interface. 21(4): 383-9. https://doi.org/10.1111/ner.12583
Clare, L., & Woods, R. T. (2004). Cognitive training and cognitive rehabilitation for people with early-stage Alzheimer's disease: A review. Neuropsychological rehabilitation, 14(4), 385-401. https://doi.org/10.1080/09602010443000074
Cubelli, R., & De Bastiani, P. (2011). 150 years after Leborgne: why is Paul Broca so important in the history of Neuropsychology, 47 (2), 146-147. https://doi.org/10.1016/j.cortex.2010.11.004.
De Luca, C. R., Wood, S. J., Anderson, V., Buchanan, J. A., Proffitt, T. M., Mahony, K., & Pantelis, C. (2003). Normative data from the CANTAB. I: development of executive function over the lifespan. Journal of Clinical and Experimental Neuropsychology, 25(2), 242-254. https://doi.org/10.1076/jcen.25.2.242.13639
Dockery, C. A., Hueckel-Weng, R., Birbaumer, N., & Plewnia, C. (2009). Enhancement of planning ability by transcranial direct current stimulation. Journal of Neuroscience, 29(22), 7271-7277. https://doi.org/10.1523/JNEUROSCI.0065-09.2009
Dotchin C, Mkenda S, Olakehinde O, Kisoli A, Paddick S, Ogunniyi A. (2014). Cognitive Stimulation Therapy (CST) as a sustainable intervention for dementia in low-resource settings: a pilot study in Nigeria and Tanzania as part of the idea (identification and interventions for dementia in elderly Africans) project. Alzheimers Dement, 10(4) 856-867. https://www.cambridge.org/core/journals/international-psychogeriatrics
Elmer, S., Burkard, M., Renz, B., Meyer, M., & Jancke, L. (2009). Direct current induced short-term modulation of the left dorsolateral prefrontal cortex while learning auditory presented nouns. Behavioral and Brain Functions, 5(1), 1-7. https://doi.org/10.1186/1744-9081-5-29
Erfani Khanghahi, M., & Ebadi Fard Azar, F. (2018). Systematic review and meta-analysis of the quality of life in iranian elderly people using LEIPAD questionnaire. Payavand Salamat, 11(5), 588-597. http://payavard.tums.ac.ir/article-1-6411-en.html [Persian]
Feeser, M., Prehn, K., Kazzer, P., Mungee, A., & Bajbouj, M. (2014). Transcranial direct current stimulation enhances cognitive control during emotion regulation. Brain Stimulation, 7(1), 105-112. https://doi.org/10.1016/j.brs.2013.08.006
Feng, H., Li, G., Xu, C., Ju, C., & Qiu, X. (2016). Training Rehabilitation as an Effective Treatment for Patients with Vascular Cognitive Impairment with No Dementia. Journal of Rehabilitation Nursing, 42(5), 290-297. https://doi.org/10.1002/rnj.271
Ferreira, G., Silva-Filho, E., de Oliveira, A., de Lucena, C., Lopes, J., & Pegado, R. (2020). Transcranial direct current stimulation improves quality of life and physical fitness in diabetic polyneuropathy: a pilot double blind randomized controlled trial. Journal of Diabetes & Metabolic Disorders, 19, 327-335. https://doi.org/10.1007/s40200-020-00513-4
Fregni, F., Boggio, P. S., Nitsche, M. A., Rigonatti, S. P., & Pascual‐Leone, A. (2006). Cognitive effects of repeated sessions of transcranial direct current stimulation in patients with depression. Depression and Anxiety, 23(8), 482-484. https://doi.org/10.1106/da.1106
Gallagher, R., Sullivan, A., Burke, R., Hales, S., Sharpe, P., & Tofler, G. (2016). Quality of life, social support and cognitive impairment in heart failure patients without diagnosed dementia. International Journal of Nursing Practice, 22(2), 179-188. https://doi.org/10.1111/ijn.12402
Gazzaley A, & Nobre A. (2012). Top-down modulation bridging selective attention and working memory. Trends in Cognitive Sciences, 16(2). 129–135. https://doi.org/10.1016/j.tics.2011.11.014
Gotay, C. C., Korn, E. L., McCabe, M. S., Moore, T. D., & Cheson, B. D. (1992). Quality-of-life assessment in cancer treatment protocols: research issues in protocol development. JNCI: Journal of the National Cancer Institute, 84(8), 575-579. https://doi.org/10.1093/jnci/84.8.575
Gomez Palacio Schjetnan, A., Faraji, J., Metz, G. A., Tatsuno, M., & Luczak, A. (2013). Transcranial direct current stimulation in stroke rehabilitation: a review of recent advancements. Stroke Research and Treatment, 6(2), 243-251. [Persian] https://doi.org/10.1155/2013/170256
Hecht, D., Walsh, V., & Lavidor, M. (2010). Transcranial direct current stimulation facilitates decision making in a probabilistic guessing task. Journal of Neuroscience, 30(12), 4241-4245. https://doi.org/10.1523/JNEUROSCI.2924-09.2010
Hedden, T., & Gabrieli, J. D. (2004). Insights into the ageing mind: a view from cognitive neuroscience. Nature Reviews Neuroscience, 5(2), 87-96. https://doi.org/10.1038/nrn1323
Hone-Blanchet, A., Edden, R. A., & Fecteau, S. (2016). Online effects of transcranial direct current stimulation in real time on human prefrontal and striatal metabolites. Biological Psychiatry, 80(6), 432-438. https://doi.org/10.1016/j.biopsych.2015.11.008
Inouye, K., & Pedrazzani, E. S. (2007). Educational status, social economic status and evaluation of some dimensions of octogenarians’ quality of life. Revista Latino-Americana de Enfermagem, 15 (4), 742-747. https://doi.org/10.1590/S0104-11692007000700005
Javadi, A. H., & Walsh, V. (2012). Transcranial direct current stimulation (tDCS) of the left dorsolateral prefrontal cortex modulates declarative memory. Brain stimulation, 5(3), 231-241. https://doi.org/10.1016/j.brs.2011.06.007
Javadi, A. H., & Cheng, P. (2013). Transcranial direct current stimulation (tDCS) enhances reconsolidation of long-term memory. Brain Stimulation, 6(4), 668-674. https://doi.org/10.1016/j.brs.2012.10.007
Kalache, A., Aboderin, I., & Hoskins, I. (2009). Compression of morbidity and active ageing: key priorities for public health policy in the 21st century. Bulletin of the World Health Organization, 80 (3), 2-14.
Kang, E. K., Baek, M. J., Kim, S., & Paik, N. J. (2009). Non-invasive cortical stimulation improves post-stroke attention decline. Restorative Neurology and Neuroscience, 27(6), 647-652. https://doi.org/10.3233/RNN-2009-0514  
Klingberg, T. (2010). Training and plasticity of working memory. Trends in Cognitive Sciences. 7(14), 317-324. https://doi.org/10.1016/j.tics.2010.05.002
Kochaki, G., Hojjati, H., & Thanago, A. (2011). The relationship between loneliness and life satisfaction in the elderly (Gorgan and Gonbad cities). Journal of Research Development in Nursing & Midwifery, 9(1), 68-61. https://sid.ir/paper/231466/fa [Persian]
Koenigs, M., Tranel, D., & Damasio, A. R. (2007). The lesion method in cognitive neuroscience. The Handbook of Psychophysiology, 4(2), 139-158.
Kuehne, M., Heimrath, K., Heinze, H. J., & Zaehle, T. (2015). Transcranial direct current stimulation of the left dorsolateral prefrontal cortex shifts preference of moral judgments. PLoS One, 10(5), Article: e0127061. https://doi.org/10.1371/journal.pone.0127061
Kuo, M. F., Paulus, W., & Nitsche, M. A. (2014). Therapeutic effects of non-invasive brain stimulation with direct currents (tDCS) in neuropsychiatric diseases. Neuroimage, 85, 948-960. https://doi.org/10.1016/j.neuroimage.2013.05.117
Ladeira, A., Fregni, F., Campanhã, C., Valasek, C. A., De Ridder, D., Brunoni, A. R., & Boggio, P. S. (2011). Polarity-dependent transcranial direct current stimulation effects on central auditory processing. PLoS One, 6(9), Article e25399 https://doi.org/10.1371/journal.pone.0025399
Leenus, D. J. F., Cuypers, K., Vanvlijmen, D., & Meesen, R. L. J. (2015). The effect of anodal transcranial direct current stimulation on multi-limb coordination performance. Neuroscience, 290, 11-17. https://doi.org/10.1016/j.neuroscience.2014.12.053
Leite, J., Carvalho, S., Fregni, F., & Gonçalves, O. F. (2011). Task-specific effects of tDCS-induced cortical excitability changes on cognitive and motor sequence set shifting performance. PloS one, 6(9), Article: e24140. https://doi.org/10.1371/journal.pone.0024140
Luciana, M., & Nelson, C. A. (2002). Assessment of neuropsychological function through use of the Cambridge Neuropsychological Testing Automated Battery: performance in 4-to 12-year-old children. Developmental neuropsychology, 22(3), 595-624. https://doi.org/10.1207/S15326942DN2203-3
Mameli, F., Mrakic-Sposta, S., Vergari, M., Fumagalli, M., Macis, M., Ferrucci, R., & Priori, A. (2010). Dorsolateral prefrontal cortex specifically processes general–but not personal–knowledge deception: multiple brain networks for lying. Behavioural Brain Research, 211(2), 164-168. https://doi.org/10.1016/j.bbr.2010.03.024
Mancuso, L. E., Ilieva, I. P., Hamilton, R. H., & Farah, M. J. (2016). Does transcranial direct current stimulation improve healthy working memory? a meta-analytic review. Journal of Cognitive Neuroscience, 28(8), 1063-1089. https://doi.org/10.1162/jocn_a_00956
Masoudi, R., Soleimani, M. A., Hashminiya, A. M., Ghorbani, M., Hasanpour Dehkordi, A., & Bahrami, N. (2008). The effect of the family-centered empowerment model on the quality of life of the elderly. Scientific Journal of Qazvin University of Medical Sciences, 14 (1), 58-64. https://sid.ir/paper/423354/fa [Persian]
McInnis, G. J., & White, J. H. (2011). A phenomenological exploration of loneliness in the older adult. Archives of Psychiatric Nursing, 17 (3), 128-139. https://doi.org/10.1053/apnu.2001.23751
Mengarelli, F., Spoglianti, S., Avenanti, A., & Di Pellegrino, G. (2015). Cathodal tDCS over the left prefrontal cortex diminishes choice-induced preference change. Cerebral Cortex, 25(5), 1219-1227. https://doi.org/10.1093/cercor/bht314
Minati, L., Campanhã, C., Critchley, H. D., & Boggio, P. S. (2012). Effects of transcranial direct-current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) during a mixed-gambling risky decision-making task. Cognitive Neuroscience, 3(2), 80-88. https://doi.org/10.1080/17588928.2011.628382
Moreira, N. B., Silva, L. P., & Rodacki, A. L. F. (2020). Aquatic exercise improves functional capacity, perceptual aspects, and quality of life in older adults with musculoskeletal disorders and risk of falling: A randomized controlled trial. Experimental Gerontology, 142, Article: 111135.https://doi.10.1016/j.exger.2020.111135
Moslemi, B., Azmodeh, M., Tabatabaei, M., & Alivandi Vafa, M. (2019). The Effect of Transcranial Direct Current Stimulation on Dorsolateral Prefrontal Cortex: A Review of its Role on Cognitive Functions. The Neuroscience Journal of Shefaye Khatam, 8(1), 129-144. http://dx.doi.org/10.29252/shefa.8.1.129 [Persian]
Motamedi, A., Barjali, A., & Sadeghpour, M. (2017). Predicting the psychological well-being of the elderly based on the ability to manage stress and social support. Iranian journal of aging, 13(1), 109-98. http://dx.doi.org/10.21859/sija.13.1.98 [Persian]
Motohashi, N., Yamaguchi, M., Fujii T., & Kitahara, Y. (2013). Mood and cognitive function following repeated transcranial direct current stimulation in healthy volunteers: a preliminary report. Neuroscience Research. 77(1-2): 64-9. https://doi.org/10.1016/j.neures.2013.06.001
Nejati, V., Ashayeri, H. (2009). Quality of life related to health in elderly. Journal of psychology and psychiatry in Iran, 14(1) 61-56. [Persian]
Neu, D., Kajosch, H., Peigneux, P., Verbanck, P., Linkowski, P., & Le Bon, O. (2011). Cognitive impairment in fatigue and sleepiness associated conditions. Psychiatry research, 189(1), 128-134. https://doi.org/10.1016/j.psychres.2010.12.005
Nitsche, M. A., Boggio, P. S., Fregni, F., & Pascual-Leone, A. (2014). Treatment of depression with transcranial direct current stimulation (tDCS): a review. Experimental Neurology, 219(1), 14-19. https://doi.org/10.1016/j.expneurol.2009.03.038
Ohn, SH., Park, C., Yoo, W., Ko, M., Choi, K.P., & Kim, G. (2008). Time-dependent effect of transcranial direct current stimulation on the enhancement of working memory. Neuroreport, 19, 43–47. https://doi.org/10.1097/WNR.0b013e3282f2adfd
Pestalozzi, M.I., Di Pietro, M., Martins Gaytanidis, C., Spierer, L., Schnider, A., Chouiter, L., Colombo, F., Annoni, J.M. & Jost, L.B., (2018). Effects of prefrontal transcranial direct current stimulation on lexical access in chronic poststroke aphasia. Neurorehabilitation and Neural Repair, 32(10), 913-923. https://doi.org/10.1177/1545968318801551
Pripfl, J., Neumann, R., Köhler, U., & Lamm, C. (2013). Effects of transcranial direct current stimulation on risky decision making are mediated by ‘hot’and ‘cold’decisions, personality, and hemisphere. European Journal of Neuroscience, 38(12), 3778-3785. https://doi.org/10.1111/ejn.12375
Qanbarzadeh, M., Rostami, R., & Hatami, J. (2021). Determining the effectiveness of transcranial direct stimulation combined with reading training on working memory and reading performance of dyslexic children: Evidence from event-related potentials. Quarterly Journal of Applied Psychological Research, 12(1), 59-81. https://doi.org/10.22059/japr.2021.298078.643442 [Persian]
Robbins, T. W., James, M., Owen, A. M., Sahakian, B. J., McInnes, L., & Rabbitt, P. (1994). Cambridge Neuropsychological Test Automated Battery (CANTAB): a factor analytic study of a large sample of normal elderly volunteers. Dementia and Geriatric Cognitive Disorders, 5(5), 266-281. https://doi.org/10.1159/000106735
Samartin-Veiga, N., González-Villar, A. J., Pidal-Miranda, M., Vázquez-Millán, A., & Carrillo-De-La-Peña, M. T. (2022). Active and sham transcranial direct current stimulation (tDCS) improved quality of life in female patients with fibromyalgia. Quality of Life Research, 31(8), 2519-2534. https://doi.org/10.1007/s11136-022-03106-1
Schlaug, G., Renga, V., & Nair, D. (2008). Transcranial direct current stimulation in stroke recovery. Archives of Neurology, 65(12), 1571-1576. https://doi.org/10.1001/archneur.65.12.1571
Seidler, R. D., Bernard, J. A., Burutolu, T. B., Fling, B. W., Gordon, M. T., Gwin, J. T., & Lipps, D. B. (2010). Motor control and aging: links to age-related brain structural, functional, and biochemical effects. Neuroscience & Biobehavioral Reviews, 34(5), 721-733. https://doi.org/10.1016/j.neubiorev.2009.10.005
Sguizzatto, G. T., Garcez-Leme, L. E., & Casimiro, L. (2006). Evaluation of the quality of life among elderly female athletes. Sao Paulo Medical Journal, 124 (8), 30-45. https://doi.org/10.1590/S1516-31802006000500014
Smittenaar, P., Prichard, G., FitzGerald, T. H., Diedrichsen, J., & Dolan, R. J. (2014). Transcranial direct current stimulation of right dorsolateral prefrontal cortex does not affect model-based or model-free reinforcement learning in humans. PloS one, 9(1), Article: e86850. https://doi.org/10.1371/journal.pone.0086850
Thomson, J. M., Doruk, D., Mascio, B., Fregni, F., & Cerruti, C. (2015). Transcranial direct current stimulation modulates efficiency of reading processes. Frontiers in Human Neuroscience, 9, 114. https://doi.org/10.3389/fnhum.2015.00114
Vanderhasselt, M. A., De Raedt, R., Brunoni, A. R., Campanhã, C., Baeken, C., Remue, J., & Boggio, P. S. (2013). tDCS over the left prefrontal cortex enhances cognitive control for positive affective stimuli. PloS one, 8(5), Article: e62219. https://doi.org/10.1371/journal.pone.0062219
Woods, B., Thorgrimsen, L., Spector, A., Royan, L., & Orrell, M. (2016). Improved quality of life and cognitive stimulation therapy in dementia. Aging and Mental Health, 10(3), 219-226. https://doi.org/10.1080/13607860500431652
Yamanaka, K., Kawano, Y., Noguchi, D., Nakaaki, S., Watanabe, N., Amano, T., & Spector, A. (2013). Effects of cognitive stimulation therapy Japanese version (CST-J) for people with dementia: a single-blind, controlled clinical trial. Aging & Mental Health, 17(5), 579-586. https://doi.org/10.1080/13607863.2013.777395
Yates, L. A., Yates, J., Orrell, M., Spector, A., & Woods, B. (2018). Cognitive stimulation therapy for dementia. Clinics in geriatric medicine, 34(4), 653-665.
Zeng, Y., Tan, M., Kohyama, J., Sneddon, M., Watson, J. B., Sun, Y. E., & Xie, C. W. (2011). Epigenetic enhancement of BDNF signaling rescues synaptic plasticity in aging. 17800-17810. https://doi.org/10.1523/JNEUROSCI.3878-11.2011