Optimizing Transcranial Direct Current Stimulation Protocols to Promote Long-Term Learning

Abstract

Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation that has the potential to induce polarity-specific changes in neural activity within targeted brain regions. There is growing interest in the use of this technology for the enhancement of higher cognitive functions, and application of tDCS directly before or concomitant with task performance has shown promise in modulating a range of behavioral outcomes, including motor skill acquisition, working memory performance, and implicit and explicit learning. The proposed mechanism for the observed enhancements is a temporary and targeted shift in the excitability of the cortical regions that subserve the relevant tasks, lasting from minutes up to about an hour after cessation of stimulation. Although empirical work does support at least a partial role for this mechanism, an arguably more potent but relatively underexplored phenomenon is thought to occur in the hours or days after stimulation—that is, a facilitation of consolidative processes. Here, we review the literature describing the nature of tDCS-enhanced consolidation and argue that some of the mixed results among the single-session studies that currently dominate the extant literature may be explained by a failure to take advantage of these potentially powerful offline effects. Accordingly, we further contend that the full potential of tDCS cannot be truly realized without a longitudinal design which allows for tDCS to act directly upon learning by promoting consolidation between sessions. Finally, we review preliminary evidence that these consolidation effects can be even further enhanced via strategically spaced out stimulation sessions, which take advantage of a long-held tenet in the literature that distributed learning produces better outcomes than massed learning. We conclude by proposing potential study designs to encourage the use of tDCS as more than merely a method to promote temporary enhancement, but also a technique to enhance long-term learning.