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Author Notes:

Corresponding author. Tel.: 11-734-763-9259; Fax: 11-734-936- 9262. E-mail address: bhampste@med.umich.edu

All authors played a role in study design.

B.M.H. drafted and finalized the manuscript with input of all authors.

The authors wish to thank Mr Oliver Calhoun for his assistance with manuscript preparation.

The authors wish to thank Mr Oliver Calhoun for his assistance with manuscript preparation.

The contents of this manuscript do not represent the views of the Department of Veterans Affairs or the United States Government.

The authors have no conflicts of interest to disclose.

The VA Ann Arbor Healthcare System's Institutional Research Board approved this study.

All participants provided informed and written consent.

Any protocol amendments will be approved by the VA AAHS IRB and necessary modifications made to www.clinicaltrials.gov.


Research Funding:

Primary funding was provided by Merit Review Award (IRX001534 to BMH), Rehabilitation Research & Development, Office of Research and Development, Department of Veteran's Affairs. Partial support from Michigan Alzheimer's Disease Core Center (5P30AG053760-5), National Institute on Aging, National Institutes of Health is also acknowledged.


  • Aging
  • Alzheimer's disease
  • Cognitive rehabilitation
  • Cognitive training
  • Dementia
  • Learning
  • Memory
  • Neuromodulation
  • Neurorehabilitation
  • Neurostimulation
  • fMRI
  • tDCS

Combined mnemonic strategy training and high-definition transcranial direct current stimulation for memory deficits in mild cognitive impairment


Journal Title:

Alzheimer's and Dementia: Translational Research and Clinical Interventions


Volume 3, Number 3


, Pages 459-470

Type of Work:

Article | Final Publisher PDF


Introduction Memory deficits characterize Alzheimer's dementia and the clinical precursor stage known as mild cognitive impairment. Nonpharmacologic interventions hold promise for enhancing functioning in these patients, potentially delaying functional impairment that denotes transition to dementia. Previous findings revealed that mnemonic strategy training (MST) enhances long-term retention of trained stimuli and is accompanied by increased blood oxygen level–dependent signal in the lateral frontal and parietal cortices as well as in the hippocampus. The present study was designed to enhance MST generalization, and the range of patients who benefit, via concurrent delivery of transcranial direct current stimulation (tDCS). Methods This protocol describes a prospective, randomized controlled, four-arm, double-blind study targeting memory deficits in those with mild cognitive impairment. Once randomized, participants complete five consecutive daily sessions in which they receive either active or sham high definition tDCS over the left lateral prefrontal cortex, a region known to be important for successful memory encoding and that has been engaged by MST. High definition tDCS (active or sham) will be combined with either MST or autobiographical memory recall (comparable to reminiscence therapy). Participants undergo memory testing using ecologically relevant measures and functional magnetic resonance imaging before and after these treatment sessions as well as at a 3-month follow-up. Primary outcome measures include face-name and object-location association tasks. Secondary outcome measures include self-report of memory abilities as well as a spatial navigation task (near transfer) and prose memory (medication instructions; far transfer). Changes in functional magnetic resonance imaging will be evaluated during both task performance and the resting-state using activation and connectivity analyses. Discussion The results will provide important information about the efficacy of cognitive and neuromodulatory techniques as well as the synergistic interaction between these promising approaches. Exploratory results will examine patient characteristics that affect treatment efficacy, thereby identifying those most appropriate for intervention.

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© 2017

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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