Combined cognitive and neuromodulation intervention in physiological and pathological aging: effects on frontal executive functions

Objectives:The present work aimed at investigating the potential for optimizing cognitive skills in aging of an integrated neurocognitive enhancement protocol, which combined prefrontal transcranial electrical stimulation and computerized cognitive training targeting higher executive functions. Background and Aims:Aging, besides being characterized by increased psycho-physical frailty, is now considered a dynamic process showing potential for adaptive modifications of neural and cognitive processes. Such compensatory mechanisms might be fostered by appropriate neurocognitive interventions, via both cognitive training and non-invasive brain stimulation to promote neural plasticity. The opportunities offered by the integration of different techniques are, however, still understudied. Therefore, we devised and tested an integrated neurocognitive enhancement protocol in both physiological and pathological aging. Materials and Methods:Participants (21 healthy elderly and 22 patients presenting clinical signs of Alzheimer’s Disease) underwent standardized electrophysiological and neuropsychological assessment before and after training. Participants were divided into an experimental group, which trained with computerized exercises while being administered bilateral prefrontal neuromodulation, and a control group, which only trained with computerized exercises. Results and Conclusions:Pre-/post-training comparisons highlighted different profiles of cognitive improvement between patients and healthy controls. Furthermore, combining cognitive training with prefrontal neuromodulation seemed to strengthen such pattern of observed outcomes. Finally, we observed increased markers of EEG reactivity in the experimental group, suggesting a specific effect of the combined neurocognitive intervention on the sensitivity to environmental information. Intensive neurocognitive empowerment protocols might help improving cognitive skills in elderly people in line with the role of prefrontal cortex in supporting executive control.