Variability of response to exercise‐primed tDCS in those with mild cognitive impairment and Alzheimer’s disease (the EXPRESS study): a preliminary analysis
Bibliographic record
Abstract
Abstract Background Studies investigating the use of transcranial direct current stimulation (tDCS) to improve outcomes in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) have reported mixed findings. Such variability may be explained by inter‐individual differences such as demographics or disease pathology. Given the increased prevalence of cardiovascular risk factors with aging and the potential changes in neurobiology of those exhibiting additional vascular etiology, we evaluate the influence of etiology on tDCS outcomes in patients with mild AD or MCI. Method Participants were diagnosed with mild or major neurocognitive disorder due to AD or mixed AD/vascular disease according to The Diagnostic and Statistical Manual of Mental Disorders (DSM–5) criteria. Participants completed a 2‐week, blinded, randomized trial examining the effects of exercise primed tDCS where they were randomized to receive either exercise with tDCS, exercise with sham tDCS, or tDCS only. Cognitive tests assessing episodic memory (ADAS‐Cog Word Recognition and Word Recall Tasks) and working memory (N‐Back) were administered before and after intervention. Independent t‐tests were used to assess for differences in demographics between groups, and paired t‐tests were used to evaluate the influence of etiology on tDCS outcomes. Result Of the 28 participants (17 males [58.6%], mean [±SD] age 74.8±8.9 years, education 16.3±2.2 years) included, 17 participants had mixed vascular/AD etiology and 11 participants had AD (without vascular) etiology. Both groups did not differ significant in demographics. Participants with mixed vascular/AD etiology showed significant improvement in episodic memory (Word Recognition 1.71±2.97, t(16) = 2.365, p = 0.031; Word Recall 0.65±1.12, t(16) = 2.257, p = 0.038), while those without vascular etiology did not (Word Recognition 0.36±2.80, t(10) = 0.43, p = 0.676; Word Recall ‐0.09±0.63, t(10) = ‐0.472, p = 0.647). No significant improvement in working memory in either group was observed. Conclusion Factors such as etiology should be taken into consideration when considering the efficacy of tDCS on improving cognition in patients diagnosed with AD/MCI. Further analyses upon unblinding will confirm whether patients with mixed AD/vascular etiology respond differently to tDCS.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".