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How brain stimulation can boost

memory if paired with learning
Tessa Abagis is a graduate student in
cognition and cognitive neuroscience at
the University of Michigan.

Published in association with

Cognitive Neuroscience Society
an Aeon Partner

1,000 words

Edited by Pam Weintraub

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Dien H, USA, Friend of Aeon
 I n 47 CE, Scribonius Largus, court physician to the Roman emperor
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Claudius, described in his Compositiones a method for treating chronic
migraines: place torpedo fish on the scalps of patients to ease their pain with
electric shocks. Largus was on the right path; our brains are comprised of
electrical signals that influence how brain cells communicate with each other
and in turn affect cognitive processes such as memory, emotion and
attention.

e science of brain stimulation – altering electrical signals in the brain –

has, needless to say, changed in the past 2,000 years. Today we have a
handful of transcranial direct current stimulation (tDCS) devices that deliver
constant, low current to specific regions of the brain through electrodes on
the scalp, for users ranging from online video-gamers to professional athletes
and people with depression. Yet cognitive neuroscientists are still working to
understand just how much we can influence brain signals and improve
cognition with these techniques.

Brain stimulation by tDCS is non-invasive and inexpensive. Some scientists

think it increases the likelihood that neurons will fire, altering neural
connections and potentially improving the cognitive skills associated with
specific brain regions. Neural networks associated with attention control can
be targeted to improve focus in people with attention deficit-hyperactivity
disorder (ADHD). Or people who have a hard time remembering shopping
lists and phone numbers might like to target brain areas associated with
short-term (also known as working) memory in order to enhance this
cognitive process. However, the effects of tDCS are inconclusive across a
wide body of peer-reviewed studies, particularly after a single session. In fact,
some experts question whether enough electrical stimulation from the
technique is passing through the scalp into the brain to alter connections
between brain cells at all.

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Notably, the neuroscientist György Buzsáki at New York University

presented research conducted with cadavers, concluding that very little of
the current administered through tDCS actually travels into the brain,
perhaps under 10 per cent. Other researchers report the opposite. Recent
neuroimaging studies have shown significant increases in neurotransmitter
levels and bloodflow at the site of tDCS stimulation during a single session.
Still, in response to growing concern, many researchers have begun to
administer tDCS over a period of days for an additive effect. Studies have
shown enhanced treatment effects (yet no increase in side effects)
attributable to repeated sessions as opposed to a single session of tDCS.

Even more basic concerns about tDCS research need to be addressed;

particularly, tDCS protocols are rather inconsistent between research labs.
For example, one lab might administer tDCS for 20 minutes at the maximum
voltage of 2 mA while another lab might administer tDCS for 25 minutes at 1
mA, and another still might administer for 15 minutes at 1.5 mA. Combining
each of these studies into a literature review proves time-consuming and
confusing. We do not know yet what the optimal time and voltage levels are
for tDCS. Let’s say 1 mA is too low to initiate neural changes and improve
cognitive abilities. en handfuls of papers and years of research could turn
out to be quite uninformative.

Lately, the technology has been combined with cognitive training to achieve
long-term improvements. is is a natural progression of the work. It is
thought that tDCS allows neurons to fire more readily. en on top of that,
just like working out a muscle, a cognitive training task is an exercise that
will work out the neurons in brain regions heavily involved with employing
that cognitive process (muscles). To take advantage of both of these
techniques, shouldn’t we then encourage those neurons and brain regions to
work even harder during tDCS by engaging the specific brain areas being
targeted with a cognitive task? In fact, studies confirm this theory, and show
that heightened performance and longer-lasting improvements result from
the combination of cognitive training with tDCS. 

In a several-year collaboration between the Cognitive Neuroimaging Lab at

the University of Michigan and the Working Memory and Plasticity Lab at
the University of California at Irvine, we have been investigating working-
memory training in conjunction with tDCS. During the training task,
participants are asked to hold progressively more information in their
working memory while simultaneously undergoing tDCS. Although the
results are still limited and somewhat mixed, evidence suggests that the
combination of brain stimulation and training is more effective in improving
working memory than either technique alone. For the experimental tDCS
group, better performance could be measured even a year after our sessions,
an improvement not found with placebo controls. And our collaboration has
even uncovered a nuance of combined working-memory training and tDCS:
participants who began training with a lower baseline working memory
improved more than those who began with a higher baseline performance. 

Clearly there is much more work to do to understand tDCS and cognitive

training. To create more consistency in the literature, researchers will need to
investigate optimal parameters (such as time length and current intensity)
for tDCS as a form of cognitive and therapeutic enhancement. A next step is
to understand the underlying neural mechanisms of tDCS and cognitive
training, which will require a multidisciplinary approach using neuroimaging
techniques such as fMRI. is would then make it possible for researchers to
visualise (1) activation of brain regions due to tDCS, (2) activation due to
tDCS and a cognitive task, and even (3) changes in activation specifically
due to combined tDCS and cognitive training over cognitive training alone.

I am cautiously optimistic about the promise of tDCS; cognitive training

paired with tDCS specifically could lead to improvements in attention and
memory for people of all ages and make some huge changes in society.
Maybe we could help to stave off cognitive decline in older adults or enhance
cognitive skills, such as focus, in people such as airline pilots or soldiers, who
need it the most. Still, I am happy to report that we have at least moved on
from torpedo fish.

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