{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:24:32Z","timestamp":1769761472939,"version":"3.49.0"},"reference-count":44,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T00:00:00Z","timestamp":1626393600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"SRH F\u00f6rderstiftung Heidelberg, Germany","award":["2018-910012"],"award-info":[{"award-number":["2018-910012"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Cognitive impairments are a frequent and difficult to treat symptom in patients with schizophrenia and the strongest predictor for a successful reintegration in occupational and everyday life. Recent research suggests transcranial direct current stimulation (tDCS) to enhance cognition in this patient group. However, the question regarding its acute effectiveness on executive functions remains largely unanswered. Here, we examined in a randomized, double blind, sham-controlled repeated-measures design the impact of tDCS on performance in several executive functions in patients with schizophrenia, schizoaffective disorder or acute transient psychotic disorder.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Patients (N = 48) were tested twice using standardized, well-constructed and clinically validated neuropsychological tests assessing verbal working memory, response inhibition, mental flexibility and problem solving. In session 1 they solely underwent the neuropsychological assessment, whereas in session 2 they additionally received 2 mA of anodal tDCS stimulation over the left dorsolateral prefrontal cortex (DLPFC), cathode right supraorbital ridge, or sham stimulation for 20 minutes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Patients of both groups were not able to correctly discriminate the type of stimulation received confirming the success of the blinding procedure. However, analyzing the whole sample the change in performance from session 1 to session 2 was the same in the verum as in the sham condition (all <jats:italic>p<\/jats:italic> &gt;.5). Moreover, a subsequent exploratory analysis showed that performance in the response inhibition task was worse for patients that engaged in the task within 20 minutes after the end of the verum stimulation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Hence, 2 mA of anodal tDCS applied over the left DLPFC did not acutely enhance executive functions in patients with schizophrenia or related disorders but impaired performance in the response inhibition task shortly after. Future studies should continue to seek for effective stimulation configurations for this patient group.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Clinical trial registration<\/jats:title>\n<jats:p>The study is registered in the \u201cDeutsches Register Klinischer Studien DRKS\u201d, German Clinical Trial Register and has been allocated the following number: DRKS00022126.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0254695","type":"journal-article","created":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T17:28:48Z","timestamp":1626456528000},"page":"e0254695","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Acute effects of a single dose of 2 mA of anodal transcranial direct current stimulation over the left dorsolateral prefrontal cortex on executive functions in patients with schizophrenia\u2014A randomized controlled trial"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1546-1558","authenticated-orcid":true,"given":"Thomas M.","family":"Schilling","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena","family":"Bossert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miriam","family":"K\u00f6nig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustav","family":"Wirtz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Weisbrod","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steffen","family":"Aschenbrenner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,7,16]]},"reference":[{"issue":"10039","key":"pone.0254695.ref001","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/S0140-6736(15)01121-6","article-title":"Schizophrenia","volume":"388","author":"MJ Owen","year":"2016","journal-title":"Lancet"},{"issue":"8","key":"pone.0254695.ref002","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1016\/j.euroneuro.2013.03.012","article-title":"Treating impaired cognition in schizophrenia: the case for combining cognitive-enhancing drugs with cognitive remediation","volume":"23","author":"PG Michalopoulou","year":"2013","journal-title":"Eur Neuropsychopharmacol"},{"issue":"3","key":"pone.0254695.ref003","doi-asserted-by":"crossref","first-page":"239","DOI":"10.31887\/DCNS.2019.21.3\/amccleery","article-title":"Cognitive impairment in psychotic illness: prevalence, profile of impairment, developmental course, and treatment considerations","volume":"21","author":"A McCleery","year":"2019","journal-title":"Dialogues Clin Neurosci"},{"issue":"Suppl 2","key":"pone.0254695.ref004","doi-asserted-by":"crossref","first-page":"S33","DOI":"10.1093\/schbul\/sbr084","article-title":"Neurocognitive predictors of work outcome in recent-onset schizophrenia","volume":"37","author":"KH Nuechterlein","year":"2011","journal-title":"Schizophrenia bulletin"},{"issue":"5","key":"pone.0254695.ref005","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1001\/archpsyc.64.5.532","article-title":"Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia","volume":"64","author":"D Dickinson","year":"2007","journal-title":"Archives of general psychiatry"},{"issue":"3","key":"pone.0254695.ref006","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1037\/a0014708","article-title":"Neurocognition in first-episode schizophrenia: a meta-analytic review","volume":"23","author":"RI Mesholam-Gately","year":"2009","journal-title":"Neuropsychology"},{"issue":"1","key":"pone.0254695.ref007","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1006\/cogp.1999.0734","article-title":"The unity and diversity of executive functions and their contributions to complex \"Frontal Lobe\" tasks: a latent variable analysis","volume":"41","author":"A Miyake","year":"2000","journal-title":"Cognitive psychology"},{"key":"pone.0254695.ref008","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.cortex.2016.04.023","article-title":"Unity and diversity of executive functions: Individual differences as a window on cognitive structure","volume":"86","author":"NP Friedman","year":"2017","journal-title":"Cortex"},{"key":"pone.0254695.ref009","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1146\/annurev-psych-113011-143750","article-title":"Executive functions","volume":"64","author":"A Diamond","year":"2013","journal-title":"Annu Rev Psychol"},{"issue":"6","key":"pone.0254695.ref010","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1017\/S0033291708004558","article-title":"Working memory in schizophrenia: a meta-analysis","volume":"39","author":"NF Forbes","year":"2009","journal-title":"Psychol Med"},{"issue":"1\u20133","key":"pone.0254695.ref011","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.schres.2010.11.008","article-title":"The MCCB impairment profile for schizophrenia outpatients: results from the MATRICS psychometric and standardization study","volume":"126","author":"RS Kern","year":"2011","journal-title":"Schizophrenia research"},{"issue":"1","key":"pone.0254695.ref012","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.biopsych.2008.04.027","article-title":"Executive functioning component mechanisms and schizophrenia","volume":"64","author":"JG Kerns","year":"2008","journal-title":"Biol Psychiatry"},{"issue":"2","key":"pone.0254695.ref013","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1093\/oxfordjournals.schbul.a006876","article-title":"Moderator variables of executive functioning in schizophrenia: meta-analytic findings","volume":"27","author":"M Johnson-Selfridge","year":"2001","journal-title":"Schizophrenia bulletin"},{"issue":"3","key":"pone.0254695.ref014","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1176\/appi.neuropsych.11060139","article-title":"The functional neuroanatomy of decision-making","volume":"24","author":"MH Rosenbloom","year":"2012","journal-title":"J Neuropsychiatry Clin Neurosci"},{"issue":"7","key":"pone.0254695.ref015","doi-asserted-by":"crossref","first-page":"1790","DOI":"10.1016\/j.cortex.2012.10.014","article-title":"Are core component processes of executive function dissociable within the frontal lobes? Evidence from humans with focal prefrontal damage","volume":"49","author":"A Tsuchida","year":"2013","journal-title":"Cortex"},{"issue":"9","key":"pone.0254695.ref016","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.biopsych.2008.03.031","article-title":"Meta-analysis of gray matter anomalies in schizophrenia: application of anatomic likelihood estimation and network analysis","volume":"64","author":"DC Glahn","year":"2008","journal-title":"Biol Psychiatry"},{"issue":"8","key":"pone.0254695.ref017","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1001\/archgenpsychiatry.2009.91","article-title":"Meta-analysis of 41 functional neuroimaging studies of executive function in schizophrenia","volume":"66","author":"MJ Minzenberg","year":"2009","journal-title":"Archives of general psychiatry"},{"issue":"1","key":"pone.0254695.ref018","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1093\/schbul\/sbn162","article-title":"Working memory and DLPFC inefficiency in schizophrenia: the FBIRN study","volume":"35","author":"SG Potkin","year":"2009","journal-title":"Schizophrenia bulletin"},{"issue":"5","key":"pone.0254695.ref019","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/j.brs.2016.06.004","article-title":"Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016","volume":"9","author":"M Bikson","year":"2016","journal-title":"Brain Stimul"},{"issue":"1","key":"pone.0254695.ref020","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.clinph.2016.10.087","article-title":"Evidence-based guidelines on the therapeutic use of transcranial direct current stimulation (tDCS)","volume":"128","author":"JP Lefaucheur","year":"2017","journal-title":"Clin Neurophysiol"},{"issue":"Pt 3","key":"pone.0254695.ref021","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1111\/j.1469-7793.2000.t01-1-00633.x","article-title":"Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation","volume":"527","author":"MA Nitsche","year":"2000","journal-title":"J Physiol"},{"issue":"10","key":"pone.0254695.ref022","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1212\/WNL.57.10.1899","article-title":"Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans","volume":"57","author":"MA Nitsche","year":"2001","journal-title":"Neurology"},{"issue":"4","key":"pone.0254695.ref023","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.neucli.2019.07.013","article-title":"Mechanisms of action of tDCS: A brief and practical overview","volume":"49","author":"JP Lefaucheur","year":"2019","journal-title":"Neurophysiol Clin"},{"issue":"4","key":"pone.0254695.ref024","doi-asserted-by":"crossref","first-page":"1273","DOI":"10.1113\/JP272738","article-title":"Systematic evaluation of the impact of stimulation intensity on neuroplastic after-effects induced by transcranial direct current stimulation","volume":"595","author":"A Jamil","year":"2017","journal-title":"J Physiol"},{"key":"pone.0254695.ref025","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.schres.2018.06.032","article-title":"Improving working memory in schizophrenia: Effects of 1mA and 2mA transcranial direct current stimulation to the left DLPFC","volume":"202","author":"I Papazova","year":"2018","journal-title":"Schizophrenia research"},{"issue":"1\u20133","key":"pone.0254695.ref026","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.schres.2014.03.006","article-title":"An investigation into the effects of tDCS dose on cognitive performance over time in patients with schizophrenia","volume":"155","author":"KE Hoy","year":"2014","journal-title":"Schizophrenia research"},{"issue":"5","key":"pone.0254695.ref027","doi-asserted-by":"crossref","first-page":"e0197023","DOI":"10.1371\/journal.pone.0197023","article-title":"Single transcranial direct current stimulation in schizophrenia: Randomized, cross-over study of neurocognition, social cognition, ERPs, and side effects","volume":"13","author":"Y Rassovsky","year":"2018","journal-title":"PLoS One"},{"issue":"9","key":"pone.0254695.ref028","doi-asserted-by":"crossref","first-page":"2490","DOI":"10.1093\/brain\/awx170","article-title":"Stimulating thought: a functional MRI study of transcranial direct current stimulation in schizophrenia","volume":"140","author":"ND Orlov","year":"2017","journal-title":"Brain"},{"issue":"5","key":"pone.0254695.ref029","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.cortex.2012.05.022","article-title":"Dorsolateral prefrontal contributions to human working memory","volume":"49","author":"AK Barbey","year":"2013","journal-title":"Cortex"},{"key":"pone.0254695.ref030","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.brainres.2011.05.053","article-title":"The functional neuroanatomy of decision making: prefrontal control of thought and action","volume":"1428","author":"CG Coutlee","year":"2012","journal-title":"Brain Res"},{"issue":"4","key":"pone.0254695.ref031","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.tics.2013.12.003","article-title":"Inhibition and the right inferior frontal cortex: one decade on","volume":"18","author":"AR Aron","year":"2014","journal-title":"Trends Cogn Sci"},{"key":"pone.0254695.ref032","volume-title":"Wiener Testsystem: Testset Kognitive Basistestung (CogBat)","author":"S Aschenbrenner","year":"2012"},{"key":"pone.0254695.ref033","volume-title":"Task Switching\u2014SWITCH","author":"D Gmehlin","year":"2012"},{"key":"pone.0254695.ref034","volume-title":"Tower of London\u2014Freiburger Version","author":"CP Kaller","year":"2015"},{"key":"pone.0254695.ref035","volume-title":"N-Back Verbal","author":"D Schellig","year":"2009"},{"key":"pone.0254695.ref036","volume-title":"HIBIT-R Response Inhibition\u2014Revidierte Fassung","author":"M Weisbrod","year":"2013"},{"key":"pone.0254695.ref037","volume-title":"Mehrfachwahl-Wortschatz-Intelligenztest MWT-B","author":"S Lehrl","year":"2005"},{"key":"pone.0254695.ref038","volume-title":"Beck Depressions- Inventar (BDI-II)","author":"M Hautzinger","year":"2006"},{"issue":"1","key":"pone.0254695.ref039","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3758\/BF03207704","article-title":"Calculation of signal detection theory measures","volume":"31","author":"H Stanislaw","year":"1999","journal-title":"Behav Res Methods Instrum Comput"},{"issue":"2","key":"pone.0254695.ref040","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences","volume":"39","author":"F Faul","year":"2007","journal-title":"Behavior research methods"},{"key":"pone.0254695.ref041","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"D Cohen","year":"1988","edition":"2"},{"key":"pone.0254695.ref042","doi-asserted-by":"crossref","first-page":"259","DOI":"10.3389\/fpsyt.2017.00259","article-title":"Parameter-Based Evaluation of Attentional Impairments in Schizophrenia and Their Modulation by Prefrontal Transcranial Direct Current Stimulation","volume":"8","author":"N Gogler","year":"2017","journal-title":"Front Psychiatry"},{"key":"pone.0254695.ref043","doi-asserted-by":"crossref","first-page":"23982128211007769","DOI":"10.1177\/23982128211007769","article-title":"Hot and cold executive functions in the brain: A prefrontal-cingular network","volume":"5","author":"MA Salehinejad","year":"2021","journal-title":"Brain Neurosci Adv"},{"key":"pone.0254695.ref044","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.neuroscience.2017.10.042","article-title":"Interaction of the Left Dorsolateral Prefrontal Cortex (l-DLPFC) and Right Orbitofrontal Cortex (OFC) in Hot and Cold Executive Functions: Evidence from Transcranial Direct Current Stimulation (tDCS)","volume":"369","author":"V Nejati","year":"2018","journal-title":"Neuroscience"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0254695","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,16]],"date-time":"2021-07-16T17:29:49Z","timestamp":1626456589000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0254695"}},"subtitle":[],"editor":[{"given":"Mohammad Ali","family":"Salehinejad","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2021,7,16]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0254695","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,16]]}}}