HPRHealth Psychology ResearchTBA2420-8124Health Psychology Research10.52965/001c.118447GeneralA Comparison between the Effectiveness of computerized Cognitive   Rehabilitation Training and transcranial Direct Current   Stimulation on Dialysis Patients’ Executive Functionshttps://healthpr.org/journal/HPR/12/1/10.52965/001c.118447FirouzanFatemeh,Sadeghi-FiroozabadiVahid,NejatiVahid,FathabadiJalil,FirouzanAhmad20241212024-06-16Purpose Executive function impairments are among the most common dialysis side effects. The present study aims to compare the efficiency of transcranial Direct Current Stimulation (tDCS) with computerized Cognitive Rehabilitation Training (cCRT) on dialysis patients’ executive functions. Research method The present study, a quasi-experimental effort, adopted a pre-test/post-test method that included a control (sham) group. Design The study sample consisted of 30 participants, selected through the convenience sampling method, and categorized into three groups of cCRT, tDCS, and sham participants. The cCRT participants were asked to complete 8 tasks in Captain’s Log MindPower Builder software. The tDCS participants were treated with a 0.06 mA/cm2 current with the anodal electrode on F3 and the cathodal electrode on Fp2. For the sham participants, the electrodes were put on the same regions but there was no current stimulation. The treatment lasted for 10 sessions carried out every other day. Results The results of MANCOVA showed no significant difference between the sham group and the cCRT group in any of the executive function items. . However, between the sham group and the tDCS group was detected a significant difference in spatial working memory (p < 0.05) and a marginally significant in cognitive flexibility (p = 0.091). No significant difference was reported between cCRT and tDCS groups in any item. Conclusion According to the findings of the study, given the efficacy of tDCS on spatial working memory and cognitive flexibility for dialysis patients, it can be used to improve these skills.computerized Cognitive Rehabilitation Training, transcranial Direct Current Stimulation, executive functions, dialysis patients

1. Webster AC, Nagler EV, Morton RL, Masson P. Chronic Kidney Disease. The Lancet. 2017;389(10075):1238-1252. doi:10.1016/s0140-6736(16)32064-5 2. Harris DC, Davies SJ, Finkelstein FO, et al. Increasing access to integrated ESKD care as part of universal health coverage. Kidney International. 2019;95(4):S1-S33. doi:10.1016/j.kint.2018.12.005 3. Hill NR, Fatoba ST, Oke JL, et al. Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis. PLOS ONE. 2016;11(7):e0158765. doi:10.1371/journal.pone.0158765 4. Khazaei M, Eslami Hasan Abadi Z, Keshvari Delavar M, Shamsizadeh M. Epidemiological Characteristics and Causes of End-stage Renal Disease in Hemodialysis Patients. International Journal of Epidemiologic Research. 2020;7(2):53-57. doi:10.34172/ijer.2020.11 5. Arnold R, Issar T, Krishnan AV, Pussell BA. Neurological complications in chronic kidney disease. JRSM Cardiovascular Disease. 2016;5:204800401667768. doi:10.1177/2048004016677687 6. Farragher JF, Stewart KE, Harrison TG, Engel L, Seaton SE, Hemmelgarn BR. Cognitive interventions for adults with chronic kidney disease: protocol for a scoping review. Systematic Reviews. 2020;9(1). doi:10.1186/s13643-020-01320-x 7. Polinder-Bos HA, García DV, Kuipers J, et al. Hemodialysis Induces an Acute Decline in Cerebral Blood Flow in Elderly Patients. Journal of the American Society of Nephrology. 2018;29(4):1317-1325. doi:10.1681/asn.2017101088 8. Farragher JF, Oliver MJ, Jain AK, Flanagan S, Koyle K, Jassal SV. PD Assistance and Relationship to Co-Existing Geriatric Syndromes in Incident Peritoneal Dialysis Therapy Patients. Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis. 2019;39(4):375-381. doi:10.3747/pdi.2018.00189 9. Brodski J, Rossell SL, Castle DJ, Tan EJ. A Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age-Related Changes. Journal of the International Neuropsychological Society. 2018;25(1):101-114. doi:10.1017/s1355617718000917 10. O’Lone E, Connors M, Masson P, et al. Cognition in People With End-Stage Kidney Disease Treated With Hemodialysis: A Systematic Review and Meta-analysis. American Journal of Kidney Diseases. 2016;67(6):925-935. doi:10.1053/j.ajkd.2015.12.028 11. Berger I, Wu S, Masson P, et al. Cognition in chronic kidney disease: a systematic review and meta-analysis. BMC Medicine. 2016;14(1). doi:10.1186/s12916-016-0745-9 12. American Psychological Association. Apa Dictionary of Psychology. American Psychological Association; 2018. https://dictionary.apa.org/executive-functions 13. Cortés Pascual A, Moyano Muñoz N, Quílez Robres A. The Relationship Between Executive Functions and Academic Performance in Primary Education: Review and Meta-Analysis. Frontiers in Psychology. 2019;10. doi:10.3389/fpsyg.2019.01582 14. Zelazo PD. Executive Function and Psychopathology: A Neurodevelopmental Perspective. Annual Review of Clinical Psychology. 2020;16(1):431-454. doi:10.1146/annurev-clinpsy-072319-024242 15. Brodski J, Rossell SL, Castle DJ, Tan EJ. Systematic Review of Cognitive Impairments Associated With Kidney Failure in Adults Before Natural Age- Related Changes. J Int Neuropsychol Soc. 2019;25(1):101-114. doi:10.1017/S1355617718000917 16. Brock LL, Brock CD, Thiedke CC. Executive Function and Medical Non-Adherence: A Different Perspective. The International Journal of Psychiatry in Medicine. 2011;42(2):105-115. doi:10.2190/pm.42.2.a 17. Zuccalà G, Pedone C, Cesari M, et al. The effects of cognitive impairment on mortality among hospitalized patients with heart failure. The American Journal of Medicine. 2003;115(2):97-103. doi:10.1016/s0002-9343(03)00264-x 18. van Zwieten A, Wong G, Ruospo M, et al. Associations of Cognitive Function and Education Level With All-Cause Mortality in Adults on Hemodialysis: Findings From the COGNITIVE-HD Study. American Journal of Kidney Diseases. 2019;74(4):452-462. doi:10.1053/j.ajkd.2019.03.424 19. Farooq MU, Min J, Goshgarian C, Gorelick PB. Pharmacotherapy for Vascular Cognitive Impairment. CNS Drugs. 2017;31(9):759-776. doi:10.1007/s40263-017-0459-3 20. Birks JS, Harvey RJ. Donepezil for dementia due to Alzheimer’s disease. Cochrane Database of Systematic Reviews. 2018;2018(6). doi:10.1002/14651858.cd001190.pub3 21. Cicerone KD, Goldin Y, Ganci K, et al. Evidence-Based Cognitive Rehabilitation: Systematic Review of the Literature From 2009 Through 2014. Archives of Physical Medicine and Rehabilitation. 2019;100(8):1515-1533. doi:10.1016/j.apmr.2019.02.011 22. Bogdanova Y, Yee MK, Ho VT, Cicerone KD. Computerized Cognitive Rehabilitation of Attention and Executive Function in Acquired Brain Injury: A Systematic Review. Journal of Head Trauma Rehabilitation. 2016;31(6):419-433. doi:10.1097/htr.0000000000000203 23. Nejati V. Principles of Cognitive Rehabilitation. Elsevier Science & Technology; 2022. doi:10.1016/B978-0-443-18750-6.00004-3 24. Nejati V, Peyvandi A. The impact of time perception remediation on cold and hot executive functions and behavioral symptoms in children with ADHD. Child Neuropsychol. Published online 2023:1-16. doi:10.1080/09297049.2023.2252962 25. Nejati V. Program for attention rehabilitation and strengthening (PARS) improves executive functions in children with attention deficit-hyperactivity disorder (ADHD). Res Dev Disabil. 2021;113:103937. 26. Nejati V, Derakhshan Z. Attention Training Improves Executive Functions and Ameliorates Behavioral Symptoms in Children with Attention-Deficit Hyperactivity Disorder: Implication of Tele-Cognitive-Rehabilitation in the Era of Coronavirus Disease. Games Health J. Published online 2023. doi:10.1089/g4h.2023.0002 27. Nejati V. Balance-based Attentive Rehabilitation of Attention Networks (BARAN) improves executive functions and ameliorates behavioral symptoms in children with ADHD. Complement Ther Med. Published online 2021:102759. doi:10.1016/j.ctim.2021.102759 28. Nejati V. Cognitive rehabilitation in children with attention deficit-hyperactivity disorder: Transferability to untrained cognitive domains and behavior. Asian J Psychiatr. 2020;49:101949. 29. Nejati V, Derakhshan Z, Mohtasham A. The effect of comprehensive working memory training on executive functions and behavioral symptoms in children with attention deficit- hyperactivity disorder (ADHD). Asian J Psychiatr. Published online 2023:103469. doi:10.1016/j.ajp.2023.103469 30. Nejati V, Khankeshlooyee N, Pourshahriar H. Remediation of theory of mind in children with autism spectrum disorders: Effectiveness and transferability of training effects to behavioral symptoms. Clin Child Psychol Psychiatry. Published online 2023. doi:10.1177/13591045231208580 31. Dardiotis E, Nousia A, Siokas V, et al. Efficacy of computer-based cognitive training in neuropsychological performance of patients with multiple sclerosis: a systematic review and meta-analysis. Multiple Sclerosis and Related Disorders. Published online 2013. doi:10.1016/j.msard.2017.12.017 32. Amato MP, Goretti B, Viterbo RG, et al. Computer-assisted rehabilitation of attention in patients with multiple sclerosis: results of a randomized, double-blind trial. Multiple sclerosis (Houndmills, Basingstoke, England). 2014;20(1):91-98. doi:10.1177/1352458513501571 33. Rilo O, Peña J, Ojeda N, et al. Integrative group-based cognitive rehabilitation efficacy in multiple sclerosis: a randomized clinical trial. Disability and Rehabilitation. 2016;40(2):208-216. doi:10.1080/09638288.2016.1250168 34. Chandler MJ, Parks AC, Marsiske M, Rotblatt LJ, Smith GE. Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychology Review. 2016;26(3):225-251. doi:10.1007/s11065-016-9330-4 35. Fonteneau C, Mondino M, Arns M, et al. Sham tDCS: A hidden source of variability? Reflections for further blinded, controlled trials. Brain Stimulation. 2019;12(3):668-673. doi:10.1016/j.brs.2018.12.977 36. Imburgio MJ, Orr JM. Effects of prefrontal tDCS on executive function: Methodological considerations revealed by meta-analysis. Neuropsychologia. 2018;117:156-166. doi:10.1016/j.neuropsychologia.2018.04.022 37. CANTAB Cognitive Research Software. Cambridge Cognition. 2022. Accessed October 2, 2022. https://www.cambridgecognition.com/cantab/ 38. Achenbach TM, Ivanova MY, Rescorla LA. Empirically based assessment and taxonomy of psychopathology for ages 1½–90+ years: Developmental, multi-informant, and multicultural findings. Comprehensive Psychiatry. 2017;79:4-18. doi:10.1016/j.comppsych.2017.03.006 39. de Vries LP, van de Weijer MP, Ligthart L, et al. A Comparison of the ASEBA Adult Self Report (ASR) and the Brief Problem Monitor (BPM/18-59). Behavior Genetics. 2020;50(5):363-373. doi:10.1007/s10519-020-10001-3 40. Captain’s Log MindPower Builder – BrainTrain, Inc. 2022. Accessed October 3, 2022. https://www.braintrain.com/captains-log-mindpower-builder/ 41. Thair H, Holloway AL, Newport R, Smith AD. Transcranial Direct Current Stimulation (tDCS): A Beginner’s Guide for Design and Implementation. Frontiers in Neuroscience. Published online 2017:11. doi:10.3389/fnins.2017.00641 42. Chung CS, Pollock A, Campbell T, Durward BR, Hagen S. Cognitive rehabilitation for executive dysfunction in adults with stroke or other adult non-progressive acquired brain damage. Cochrane Database of Systematic Reviews. Published online 2013. doi:10.1002/14651858.cd008391.pub 43. Chen CX, Mao RH, Li SX, Zhao YN, Zhang M. Effect of visual training on cognitive function in stroke patients. International Journal of Nursing Sciences. 2015;2(4):329-333. doi:10.1016/j.ijnss.2015.11.002 44. Imburgio MJ, Orr JM. Effects of prefrontal tDCS on executive function: Methodological considerations revealed by meta-analysis. Neuropsychologia. 2018;117:156-166. doi:10.1016/j.neuropsychologia.2018.04.022 45. Boggio PS, Ferrucci R, Rigonatti SP, et al. Effects of transcranial direct current stimulation on working memory in patients with Parkinson’s disease. Journal of the Neurological Sciences. 2006;249(1):31-38. doi:10.1016/j.jns.2006.05.062 46. Sacco K, Galetto V, Dimitri D, et al. Concomitant Use of Transcranial Direct Current Stimulation and Computer-Assisted Training for the Rehabilitation of Attention in Traumatic Brain Injured Patients: Behavioral and Neuroimaging Results. Frontiers in Behavioral Neuroscience. 2016;10. doi:10.3389/fnbeh.2016.00057 47. Park IS, Yoon JG. The effect of computer-assisted cognitive rehabilitation and repetitive transcranial magnetic stimulation on cognitive function for stroke patients. Journal of Physical Therapy Science. 2015;27(3):773-776. doi:10.1589/jpts.27.773