Combining Transcranial Direct Current Stimulation With Tai Chi to Improve Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial

Ying-Yi Liao; Mu-N Liu; Han-Cheng Wang; Vincent Walsh; Chi Ieong Lau

doi:10.3389/fnagi.2021.766649

Combining Transcranial Direct Current Stimulation With Tai Chi to Improve Dual-Task Gait Performance in Older Adults With Mild Cognitive Impairment: A Randomized Controlled Trial

Front Aging Neurosci. 2021 Dec 13:13:766649. doi: 10.3389/fnagi.2021.766649. eCollection 2021.

Authors

Ying-Yi Liao¹, Mu-N Liu^{2

3

4

5}, Han-Cheng Wang^{6

7}, Vincent Walsh⁸, Chi Ieong Lau^{6

8

9

10

11}

Affiliations

¹ Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
² Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁵ Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States.
⁶ Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
⁷ College of Medicine, National Taiwan University, Taipei, Taiwan.
⁸ Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
⁹ Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan.
¹⁰ College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan.
¹¹ Department of Neurology, University Hospital, Taipai, Macao SAR, China.

Abstract

Introduction: Engaging in a secondary task while walking increases motor-cognitive interference and exacerbates fall risk in older adults with mild cognitive impairment (MCI). Previous studies have demonstrated that Tai Chi (TC) may improve cognitive function and dual-task gait performance. Intriguingly, with emerging studies also indicating the potential of transcranial direct current stimulation (tDCS) in enhancing such motor-cognitive performance, whether combining tDCS with TC might be superior to TC alone is still unclear. The purpose of this study was to investigate the effects of combining tDCS with TC on dual-task gait in patients with MCI. Materials and Methods: Twenty patients with MCI were randomly assigned to receive either anodal or sham tDCS, both combined with TC, for 36 sessions over 12 weeks. Subjects received 40 min of TC training in each session. During the first 20 min, they simultaneously received either anodal or sham tDCS over the left dorsolateral prefrontal cortex. Outcome measures included dual-task gait performance and other cognitive functions. Results: There were significant interaction effects between groups on the cognitive dual task walking. Compared to sham, the anodal tDCS group demonstrated a greater improvement on cadence and dual task cost of speed. Conclusion: Combining tDCS with TC may offer additional benefits over TC alone in enhancing dual-task gait performance in patients with MCI. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [TCTR20201201007].

Keywords: Tai Chi; dual-task gait; executive function; mild cognitive impairment; tDCS.