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A Systematic Review of tACS Effects on Cognitive Functioning in Older Adults Across the Healthy to Dementia Spectrum

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Abstract

Transcranial alternating current stimulation (tACS) is a form of noninvasive brain stimulation that has experienced rapid growth within the aging population over the past decade due to its potential for modulating cognitive functioning across the “intact” to dementia spectrum. For this reason, we performed a systematic review of the literature to evaluate the efficacy of tACS on cognitive functioning in older adults, including those with cognitive impairment. Our review was completed in June 2023 using Psych INFO, Embase, PubMed, and Cochrane databases. Out of 479 screened articles, 21 met inclusion criteria and were organized according to clinical diagnoses. Seven out of nine studies targeted cognitively intact older adults and showed some type of cognitive improvement after stimulation, whereas nine out of twelve studies targeted clinical diagnoses and showed improved cognitive performance to varying degrees. Studies showed considerable heterogeneity in methodology, stimulation parameters, participant characteristics, choice of cognitive task, and analytic strategy, all of which reinforce the need for standardized reporting of tACS methods. Through this heterogeneity, multiple patterns are described, such as disease progression influencing tACS effects and the need for individualized tailoring. For clinical translation, it is imperative that the field (a) better understand the physiological effects of tACS in these populations, especially in respect to biomarkers, (b) document a causal relationship between tACS delivery and neurophysiological/cognitive effects, and (c) systematically establish dosing parameters (e.g., amplitude, stimulation frequency, number and duration of sessions, need for booster/maintenance sessions).

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Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study. Organizational spreadsheets can be made available upon request.

Notes

  1. (tACS OR “transcranial alternating current stimulation” OR “sinusoidal current”) AND (elderly OR “older adults” OR “healthy aging” OR aged OR 65 + OR “65yrs & older” OR dementia OR “mild cognitive impairment” OR “mild neurocognitive impairment” OR “major cognitive impairment” OR “major neurocognitive impairment” OR alzheimer OR “parkinson's disease” OR “lewy body dementia” OR “frontotemporal dementia” OR “primary progressive aphasia” OR “cognitively healthy” OR “cognitively intact” OR 55 +) AND (“cognitive function” OR attention OR intelligence OR perception OR “decision making” OR learning OR “executive function” OR memory).

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Funding

The authors acknowledge grant funding from the National Institutes on Aging (R35 AG072262) to BMH.

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JDK and BMH both completed the literature review, wrote the manuscript, contributed to tables, and reviewed the final manuscript.

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Correspondence to Jacob D. Kraft.

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BMH is an Associate Editor for Neuropsychology Review. No other interests (e.g., funding, employment, financial, non-financial) are present.

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Kraft, J.D., Hampstead, B.M. A Systematic Review of tACS Effects on Cognitive Functioning in Older Adults Across the Healthy to Dementia Spectrum. Neuropsychol Rev (2023). https://doi.org/10.1007/s11065-023-09621-3

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