B-04 Combining tDCS and Cognitive Training for People with Severe Mental Illness: Preliminary Feasibility and Acceptability Findings

Abstract

Abstract Objective Technological advances in neuromodulation and cognitive remediation provide opportunities to develop novel interventions, though a critical first determination is whether such treatments are feasible and acceptable to participants. This study evaluated a combined transcranial direct current stimulation (tDCS) and computerized cognitive training intervention for individuals with severe mental illness; we examined participant recruitment, retention, and adherence to the interventions, along with qualitative feedback. Method Participants included adults with schizophrenia-spectrum or bipolar disorder and impaired working memory (performance ≤1 standard deviation below average of healthy individuals on a spatial span or letter-number span test). In this randomized crossover study, all participants received the combined intervention (ten tDCS sessions in the clinic concurrent with cognitive training), and ten hours of at-home training, and completed neuropsychological and clinical assessments at three time points. Results To date, thirteen participants provided informed consent. Seven participants were screened out; five exceeded the cognitive cutoff and one did not meet the diagnostic criterion. No remaining participants have withdrawn prior to study completion. Four participants completed all tDCS sessions, and one completed 80%. No tDCS session has been discontinued. At-home training has proven more challenging; only one participant completed all ten hours, and three did not complete any at all. Participant feedback has been positive; all expressed satisfaction with both treatments though some said symptoms or busy schedules interfered with at-home training. Conclusions Combining tDCS with computerized cognitive training appears feasible and acceptable. Strategic recruitment efforts to capture those with cognitive impairment appears necessary, as well as troubleshooting barriers to at-home training.