Abstract
BACKGROUND: Despite the effectiveness of specialized therapies, people with borderline personality disorder (BPD) continue to face substantial psychosocial challenges, which may be partially attributed to neuropsychological deficits arising from imbalances in the corticolimbic system. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex (DLPFC) could enhance impulse control, emotional regulation, and cognitive functions; thus, we sought to explore the effectiveness of tDCS combined with online cognitive training on cognitive functions, BPD symptoms, and psychosocial functioning among patients with BPD. METHODS: This open-label study recruited adults with BPD who were not undergoing psychotherapy. Participants completed informational psychoeducation sessions, followed by 10 daily sessions of 20-minute tDCS over 2 weeks. Stimulation involved a continuous 2-mA current with the anode over the left DLPFC and the cathode over the right DLPFC. During each session, participants simultaneously engaged in online cognitive training using the Lumosity app (aspredicted.org no. 206 001). RESULTS: We included 29 participants. We noted significant improvements in cognitive functions, including the Towers of London task (Cohen d = -0.38 to -0.78), the Corsi Block-Tapping direct and total scores (d = -0.41 and -0.42, respectively), and the Stroop Interference and Alternance tests (d = 0.80 and 0.94, respectively). Emotional dysregulation showed a substantial reduction (d = 0.44), while impulsivity did not change significantly. Symptoms of BPD decreased (d = 0.69), while general functioning (d = 0.33) and the internal component of BPD functioning improved (d = -0.51). LIMITATIONS: Although these preliminary findings are encouraging, further controlled studies are necessary to validate the efficacy and long-term effect of the intervention. CONCLUSION: This combined approach appears to be well tolerated and produced promising short-term improvements in cognitive performance, BPD symptoms, and overall functioning. The results underscore the relevance of the left DLPFC in developing neuropsychologically integrative interventions for BPD.