Exploring the effects of Transcranial Direct Current Stimulation over the prefrontal cortex on working memory: A cluster analysis approach.

BACKGROUND: The interest in the use of anodal transcranial direct current stimulation (tDCS) for the enhancement of cognitive functioning has increased significantly in recent years. However, the efficacy of this technique remains to be established. OBJECTIVE: The current study explored the effects of anodal vs. sham tDCS over the left dorsolateral prefrontal cortex (DLPFC) during the performance of the digit span backwards task. METHODS: 30 healthy participants received 'offline' anodal tDCS (1.5 mA, 15 min) to the left DLPFC in an intra-individual, cross-over, sham-controlled experimental design. Memory span performance was assessed before (baseline), immediately after tDCS administration (T1) and 10 min post-T1 (T2). We applied cluster analysis in order to characterize individual responses to tDCS, and in order to identify naturally occurring subgroups that may be present. RESULTS: Analysis of all the subjects showed that anodal tDCS failed to improve memory span performance. Cluster analysis revealed the presence of a subgroup of 'responders' that significantly improved their performance after anodal (vs. sham) tDCS in T1 (47%) and T2 (46%). However, there was no significant improvement in performance after anodal tDCS compared to the best baseline performance. CONCLUSION: Our findings suggest that tDCS does not improve memory span performance and highlights the need for better ways to optimize methodological approaches in order to account for inter-individual variability and accurately assess the evidential value of tDCS-linked cognitive outcomes.