The facilitative effect of transcranial direct current stimulation on visuospatial working memory in patients with diabetic polyneuropathy: A pre-post sham-controlled study

Yi Jen Wu, Philip Tseng, Han Wei Huang, Jon Fan Hu, Chi Hung Juan, Kuei Sen Hsu, Chou Ching Lin

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Diabetes mellitus can lead to diabetic polyneuropathy (DPN) and cognitive deficits that manifest as peripheral and central neuropathy, respectively. In this study we investigated the relationship between visuospatial working memory (VSWM) capacity and DPN severity, and attempted to improve VSWM in DPN patients via the use of transcranial direct current stimulation (tDCS). Sixteen DPN patients and 16 age- and education-matched healthy control subjects received Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) and Montreal Cognitive Assessment (MOCA) for baseline cognitive assessment. A forward- and backward-recall computerized Corsi block tapping task (CBT), both with and without a concurrent motor interference task was used to measure VSWM capacity. Each DPN patient underwent a pre-treatment CBT, followed by tDCS or sham treatment, then a post-treatment CBT on two separate days. We found that although patients with severe DPN (Dyck’s grade 2a or 2b) showed comparable general intelligence scores on WAIS-IV as their age- and education-matched healthy counterparts, they nonetheless showed mild cognitive impairment (MCI) on MOCA and working memory deficit on digit-span test of WAIS-IV. Furthermore, patients’ peripheral nerve conduction velocity (NCV) was positively correlated with their VSWM span in the most difficult CBT condition that involved backward-recall with motor interference such that patients with worse NCV also had lower VSWM span. Most importantly, anodal tDCS over the right DLPFC was able to improve low-performing patients’ VSWM span to be on par with the high-performers, thereby eliminating the correlation between NCV and VSWM. In summary, these findings suggest that (1) MCI and severe peripheral neuropathy can coexist with unequal severity in diabetic patients, the positive correlation of VSWM and NCV suggests a link between peripheral and central neuropathies, and (3) anodal tDCS over the right DLPFC can improve DPN patients ’ VSWM, particularly for the low-performing patients.

Original languageEnglish
JournalFrontiers in Human Neuroscience
Volume10
Issue numberSEP2016
DOIs
Publication statusPublished - Sep 28 2016

Fingerprint

Diabetic Neuropathies
Short-Term Memory
Neural Conduction
Peripheral Nervous System Diseases
Intelligence
Transcranial Direct Current Stimulation
Education
Memory Disorders
Peripheral Nerves
Diabetes Mellitus
Healthy Volunteers
Placebos

Keywords

  • Corsi block tapping task
  • Diabetic polyneuropathy
  • Dorsolateral prefrontal cortex
  • Mild cognitive impairment
  • Nerve conduction velocity
  • Transcranial direct current stimulation
  • Visuospatial working memory

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Neurology
  • Psychiatry and Mental health
  • Biological Psychiatry
  • Behavioral Neuroscience

Cite this

The facilitative effect of transcranial direct current stimulation on visuospatial working memory in patients with diabetic polyneuropathy : A pre-post sham-controlled study. / Wu, Yi Jen; Tseng, Philip; Huang, Han Wei; Hu, Jon Fan; Juan, Chi Hung; Hsu, Kuei Sen; Lin, Chou Ching.

In: Frontiers in Human Neuroscience, Vol. 10, No. SEP2016, 28.09.2016.

Research output: Contribution to journalArticle

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