To assess safety, adherence, and feasibility of a remotely supervised, home-based tDCS program paired with individualized cognitive-linguistic exercises in individuals with MCI or early AD receiving anti-amyloid treatment.
Mild cognitive impairment (MCI) and early Alzheimer’s disease (AD) progressively affect memory, language, and executive function, but there are few interventions that preserve daily functioning. Recent longitudinal studies suggest that transcranial direct current stimulation (tDCS), when paired with cognitive exercises, may improve cognition, mood, and slow functional decline. As part of an innovative care program, a telehealth-delivered, prescription-based tDCS protocol was implemented to complement standard anti-amyloid infusion therapy and promote cognitive preservation.
Five participants with MCI completed daily, Monday–Friday, 30-minute home-based tDCS sessions over a two-month protocol (2.0 mA), with the option to continue treatment at program completion. Based on each participant’s primary clinical presentation (language-predominant and non-language cognitive profiles), stimulation was either bifrontal targeting the dorsolateral prefrontal cortex (DLPFC) or left frontotemporal (anode F7). Paired cognitive activities consisted of computer-based training programs (BrainHQ, Elevate), one-on-one tailored cognitive-linguistic rehabilitation, or a combination of both. Sessions were remotely monitored for safety, adherence, and usability, with caregiver support provided at home.
All participants completed the program without adverse events. Adherence exceeded 90%, with high tolerability and satisfaction. Participants completing extended treatment up to five months maintained stable cognitive-linguistic performance despite progressive disease.
Telehealth-delivered tDCS, offered as part of innovative care alongside anti-amyloid infusion therapy, is feasible, safe, and well tolerated in MCI and early AD. This real-world model supports accessibility, caregiver engagement, and sustained participation, providing a scalable framework for future controlled trials.
Relevance: This study demonstrates the feasibility of integrating tDCS into real-world clinical care for MCI and early AD, highlighting its potential to complement disease-modifying therapies and extend access to brain stimulation through telehealth delivery.