Enhancing Cognition In Older Persons: A Pilot Clinical Trial Of Mindfulness-Based Stress Reduction (Mbsr) And Transcranial Direct Current Stimulation (Tdcs)

Introduction Low-burden and accessible interventions are needed to prevent cognitive decline in individuals at high-risk for decline. Mindfulness-Based Stress Reduction (MBSR) and transcranial direct current stimulation (tDCS) are two interventions which can be delivered remotely, improving their reach and scalability. This aim of this study is to assess the feasibility, safety and tolerability of combining MBSR with tDCS, and the preliminary efficacy on improving cognition, mood symptoms, social functioning and mindfulness. Methods We randomized 26 individuals aged 60 years or older with cognitive complaints and mood symptoms (Active: 12, mean age=68.34, SD=5.88; Sham: 14, mean age=69.04, SD=4.99). All participants completed an 8-week course of MBSR with active or sham tDCS. Participants attended weekly MBSR sessions, and completed daily at-home MBSR with tDCS. Cognition, depression, anxiety, social functioning and everyday mindfulness were assessed before and after treatment. Results MBSR+tDCS was safe and well-tolerated, though adherence to the interventions was mediocre. Both groups improved in cognition(F(1,20)=17.05, p=0.001) and anxiety(F(1,21)=7.05, p=0.02), with no effect of tDCS (cognition: F(1,20)=1.81, p=0.19); anxiety: F(1,20)=0.04, p=0.84). There was no change in depression or social functioning (p \u003e 0.5). Interestingly, while there was no significant difference between the two groups on everyday mindfulness (F(1,21)=3.68, p=0.07), the effect size of difference between the groups was 0.55, favoring active tDCS. Conclusions Our findings suggest it is feasible and safe to combine tDCS with MBSR in older depressed and anxious adults, including during remote, at-home use. Active tDCS may facilitate the learning of mindfulness. Future research should focus on improving adherence to MBSR with tDCS and then determining efficacy using larger samples. Funding This study was supported primarily by the National Institute of Mental Health (R25 MH112473 to Washington University) and the Canadian Institutes of Health Research (Canada Research Chair Grant #: 950-230879 to the University of Toronto). Magstim/Newronika loaned equipment for the project. Additional funding was provided by the Paula J. Clayton MD Hawthorne Foundation Research Award, the Taylor Family Institute for Innovative Psychiatric Research, and the Center for Brain Research in Mood Disorders.