Related Experiment Video
Updated: Mar 23, 2026
High-definition Transcranial Direct Current Stimulation over Right Dorsolateral Prefrontal Cortex to Enhance Metacognitive Sensitivity
Published on: September 26, 2025
Acute Cortical Excitability Change is Associated with Long-Term Working Memory Improvement by HD-tDCS Treatment in
Kai Chen1, Xingxing Li1, Ran Tang1
1Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University (Ningbo Kangning Hospital), Ningbo Key Laboratory for Physical Diagnosis and Treatment of Mental and Psychological Disorders, No.1 Zhuangyu Road, Zhenhai District, Ningbo, Zhejiang 315201, China.
Background And Hypothesis:
Working memory (WM) deficits are a core cognitive impairment in schizophrenia (SCZ). High-definition transcranial direct current stimulation (HD-tDCS) targeting the dorsolateral prefrontal cortex (DLPFC) has shown promise for improving WM, yet biomarkers indicating its efficacy remain limited. We hypothesized that HD-tDCS would enhance WM in SCZ and that changes in transcranial magnetic stimulation combined with electroencephalography (TMS-EEG) metrics can serve as potential biomarkers of treatment response.
Study Design:
Sixty-three SCZ patients were randomized to receive either active (n = 32) or sham (n = 31) HD-tDCS. WM was assessed using the accuracy (ACC) and reaction time (RT) of the 2-back task before and after the 20-day intervention. TMS-EEG was conducted before and after the first HD-tDCS session to measure cortical responses. Changes in global mean field amplitude (GMFA) components were analyzed for their association with WM improvement.
Study Results:
Active HD-tDCS significantly improved ACC (P<.001) and reduced RT (P<.001), whereas performance remained unchanged in the sham (all P>.05). A single session of active HD-tDCS reduced the N45 amplitude (P=.038), with no significant differences observed in the sham (all P>.05). The N45 reduction correlated with the ACC improvement (r = -0.452, P=.009). Stepwise regression confirmed the N45 reduction as a significant contributor of ACC improvement (β = -0.03, t = -2.15, P=.040).
Conclusions:
HD-tDCS effectively improved WM in SCZ patients. Reduction in N45 amplitude may serve as a neurophysiological marker of HD-tDCS treatment response.
