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In this multicenter, double\u2010blinded, randomized, and sham\u2010controlled study, we examined the effects of modulating the excitability of the left dorsolateral prefrontal cortex (L\u2010DLPFC) and the primary sensorimotor cortex (SM1) on dual\u2010task performance \u201ccosts\u201d to standing and walking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty\u2010seven older adults without overt illness or disease completed 4 separate study visits during which they received 20 minutes of transcranial direct current stimulation (tDCS) optimized to facilitate the excitability of the L\u2010DLPFC and SM1 simultaneously, or each region separately, or neither region (sham). Before and immediately after stimulation, participants completed a dual\u2010task paradigm in which they were asked to stand and walk with and without concurrent performance of a serial\u2010subtraction task.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>tDCS simultaneously targeting the L\u2010DLPFC and SM1, as well as tDCS targeting the L\u2010DLPFC alone, mitigated dual\u2010task costs to standing and walking to a greater extent than tDCS targeting SM1 alone or sham (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.02). Blinding efficacy was excellent and participant subjective belief in the type of stimulation received (real or sham) did not contribute to the observed functional benefits of tDCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>These results demonstrate that in older adults, dual\u2010task decrements may be amenable to change and implicate L\u2010DPFC excitability as a modifiable component of the control system that enables dual\u2010task standing and walking. tDCS may be used to improve resilience and the ability of older results to walk and stand under challenging conditions, potentially enhancing everyday functioning and reducing fall risks. ANN NEUROL 2021;90:428\u2013439<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.26156","type":"journal-article","created":{"date-parts":[[2021,7,3]],"date-time":"2021-07-03T07:02:27Z","timestamp":1625295747000},"page":"428-439","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Targeted <scp>tDCS<\/scp> Mitigates Dual\u2010Task Costs to Gait and Balance in Older Adults"],"prefix":"10.1002","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7931-7646","authenticated-orcid":false,"given":"Junhong","family":"Zhou","sequence":"first","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife  Boston MA"},{"name":"Beth Israel Deaconess Medical Center  Boston MA"},{"name":"Harvard Medical School  Boston MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brad","family":"Manor","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for 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