Cognitive outcomes after tDCS in schizophrenia patients with prominent negative symptoms: Results from the placebo-controlled STARTS trial

Schizophr Res. 2021 Sep:235:44-51. doi: 10.1016/j.schres.2021.07.008. Epub 2021 Jul 22.


Cognitive deficits and negative symptoms in schizophrenia are associated with poor functional outcomes and limited in terms of treatment. The Schizophrenia Treatment With Electric Transcranial Stimulation (STARTS) trial has shown efficacy of transcranial direct current stimulation (tDCS) for improving negative symptoms. In this secondary analysis, we investigate its effects on cognitive performance. In STARTS, a double-blinded, sham-controlled, randomized clinical trial, patients were treated with twice-daily, 20-min, 2-mA fronto-temporal tDCS over 5 days or sham-tDCS. In 90 patients, we evaluated the cognitive performance up to 12 weeks post-treatment. We found that active-tDCS showed no beneficial effects over sham-tDCS in any of the tests. Based on a 5-factor cognitive model, improvements of executive functions and delayed memory were observed in favor of sham-tDCS. Overall, the applied active-tDCS protocol, primarily designed to improve negative symptoms, did not promote cognitive improvement. We discuss possible protocol modification potentially required to increase tDCS effects on cognition. identifier: NCT02535676.

Keywords: Cognition; Cognitive factors; Negative symptoms; Noninvasive brain stimulation; Schizophrenia; Transcranial direct current stimulation (tDCS).

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cognition
  • Cognitive Dysfunction*
  • Double-Blind Method
  • Humans
  • Schizophrenia* / complications
  • Schizophrenia* / therapy
  • Transcranial Direct Current Stimulation*

Associated data