tES in Dementia: From Pathophysiology to Treatment

The use of noninvasive brain stimulation techniques (NIBS) has gathered substantial interest in the study of dementia, from the early detection of its pathophysiological course, up to its use in stimulating spared cognitive functions in elderly adults. In the present book chapter, we will provide a brief walkthrough on the most recent relevant findings on the use of transcranial electrical stimulation (tES) along the aging curve, from healthy to pathological states. We will consider how different stimulation approaches have been implemented to provide insight into the complex mechanisms of neurodegeneration and which have been the steps forward in trying to advantage the individual in respect of the pathology. In this regard, we will consider evidence from cognitive and motor stimulation, covering a broad spectrum of modalities used to prompt individual resilience to degeneration. Last, we will suggest future possible directions in the field of brain stimulation, considering the fast technological advancement that is bringing us the possibility to target multiple areas or networks at once, or to control for stimulation using predictive “closed-loop” algorithms tuning the electrical waveforms based on ongoing brain oscillations. Despite adjunctive studies being needed to clarify the underlying mechanisms of action of tES, promising results have been gathered that might directly impact patients and drive future advancement in the field.