Baseline cognition and Stimulation Site Shape the Effects of tDCS on Verbal Fluency in Older and Younger Adults

Abstract

Verbal fluency is a core measure of language and executive function often used in cognitive research. Transcranial direct current stimulation (tDCS) has been investigated for its potential to enhance verbal fluency; however, the results are variable. Discrepancies may indicate variations in electrode montage, stimulation site, measured fluency type, and individual cognitive profiles. In this preregistered, double-blind, sham-controlled study, 72 younger and 72 older adults received anodal tDCS to either the left inferior frontal gyrus (left IFG) or the left temporoparietal junction (left TPJ) while completing phonemic and semantic fluency tasks. Anodal stimulation of the left TPJ significantly improved phonemic fluency compared to sham (F(1,71) = 4.49, p = .038), with no effects observed for semantic fluency or left IFG stimulation. Additionally, stimulation response in the TPJ group was predicted by fluid intelligence, with lower scores associated with greater benefit (F(1,70) = 7.80, p = .007). Finally, stimulation to the left IFG improved response initiation but impaired sustained energization over the entire minute. These results suggest that the efficacy of focal tDCS for enhancing verbal fluency depends on both stimulation site and task demands, with the left TPJ showing selective benefits for phonemic fluency. Importantly, individual differences in fluid intelligence, but not age, moderated stimulation response, highlighting the role of cognitive capacity in neuromodulation outcomes. Together, these findings demonstrate a nuanced relationship between targeted excitation of the language network and verbal fluency, emphasizing the need for individualized approaches in cognitive enhancement interventions.