HD-tDCS Improves Conflict Processing and General Behavioral Stability

HD-tDCS Improves Conflict Processing and General Behavioral Stability | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article HD-tDCS Improves Conflict Processing and General Behavioral Stability Ronghan Liu, Miao Wang, Qiang Liu, Xiujuan Jing, Qiang Hao, Hang Yu, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6202139/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Transcranial Direct Current Stimulation (tDCS) has been employed to enhance executive control (EC), thereby improving cognitive functions and mental health. However, the effects of tDCS on EC remain inconclusive, and the mechanisms involved in its impact on baseline and conflict processing are not well understood. This study applied high-definition tDCS (HD-tDCS) to the left dorsolateral prefrontal cortex to investigate the distinct effects of tDCS on baseline and conflict processing. Compared to the sham group, tDCS significantly reduced reaction time variability in both conditions and decreased mean reaction time and error rate in the conflict condition. These findings demonstrate significant enhancements in general behavioral stability and conflict processing, respectively. This study demonstrates a significant enhancement of tDCS on EC, elucidating the dual mechanisms of tDCS in modulating the baseline state and EC, providing valuable insights into the mechanisms of tDCS intervention on cognitive functions. Biological sciences/Neuroscience Biological sciences/Psychology Figures Figure 1 Figure 2 Figure 3 Figure 4 Introduction Executive control (EC) involves monitoring and resolving conflicts among expectations, stimuli, and responses 1 . It flexibly adjusts behaviors to meet task demands, encompassing goal maintenance, conflict resolution, error detection, and curiosity 2 , 3 . EC is integral to working memory, executive functions, language processing, and attention 4 – 7 . Impairments in EC are evident in various behavioral and mental disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), Major Depressive Disorder (MDD), and Autism Spectrum Disorder (ASD) lays a vital role in cognitive processing and mental health s approaches to enhance EC, including physical exercise, mindfulness meditation training, cognitive training, and physical stimulation methods 8 – 13 . Technological advancements have enabled the direct stimulation of specific brain regions using tDCS, offering a more precise and intuitive approach to enhancing EC 14 . The application of tDCS to the dorsolateral prefrontal cortex (DLPFC) for EC intervention has yielded varied outcomes. Some studies have shown improvements in EC 15 – 19 , while others have reported no significant effects 20 – 24 . The inconsistency in findings is often attributed to variations in stimulation parameters (e.g., stimulation technique, electrode size, and current intensity) and the state of participants 15 , 25 – 27 , 26 , 28 . A meta-analysis suggested that utilizing small electrodes and high current density yielded a greater positive effect on EC 20 . Furthermore, HD-tDCS has exhibited superior efficacy compared to conventional tDCS 26 . Recent studies have shown that the effects of tDCS are contingent on individuals' cognitive baseline prior to stimulation 28 , 29 . However, few studies have attributed these uncertain outcomes to cognitive activity itself. In the Flanker paradigm, EC is quantified by comparing performance differences between incongruent and congruent conditions, known as the conflict effect 30 . This means that any changes in performance in one condition can affect the measurement of EC, leading to mixed intervention effects. Most research has focused on how tDCS modulates the conflict effect, particularly in incongruent task. Some studies have indicated tDCS’s ability to reduce reaction times (RTs) in congruent tasks 31 , 32 . The differential effects of tDCS on congruent and incongruent conditions may underlie the instability of its effects on EC. Studies employing event-related designs in the Flanker task have faced two main challenges. First, presenting congruent and incongruent trials randomly has shown to reduce the conflict effect after incongruent trials and increase it after congruent trials, known as the congruency sequence effect (CSE) 33 , 34 . Recent research has revealed that tDCS targeting the DLPFC can lead to longer RTs for incongruent trials following congruent ones or a smaller conflict effect after incongruent trials 35 , 36 . This complexity obscures the mechanisms behind the intervention for conflict effects, hampering clear conclusions. Furthermore, the reliability of previous EC tests has been insufficient, with split-half reliability scores below 0.8, highlighting the need for improvement 37 – 40 . To address these issues, we employed a revised Flanker task to separate congruent and incongruent conditions. The task was conducted with a steady-state block design and has been demonstrated to be highly reliable in assessing EC 41 – 43 . The left DLPFC, a commonly targeted region in prior studies, was chosen based on its effectiveness. HD-tDCS was utilized for its improved spatial precision and to avoid confounding effects associated with traditional tDCS 26 , 44 . These procedures successfully separated two conditions, facilitating the assessment of intervention mechanisms on baseline state and conflict processing, respectively. Materials and methods Participants A total of 50 participants from Sichuan Normal University were involved in this study. Of these, 25 students (aged 18 to 24 years, mean age 20.84, 7 males, 18 females, all right-handed) participated in the left DLPFC tDCS experiment, while another 25 volunteers (aged 18 to 25 years, mean age 20.8, 6 males, 19 females) underwent the sham experiments, as the control group. There were no significant differences in age (t (48) = 0.064, p = 0.949) or gender (χ2 = 0.104, p = 0.747) distribution between the two groups. Informed consent was obtained from all participants, and the study was approved by the local ethics committee of Sichuan Normal University. HD-tDCS The study utilized a high-definition 64-channel transcranial direct current stimulation system (NeuStim NSS14, Neuracle, Changzhou, China). A total current of 1 mA was applied for 20 minutes during tDCS sessions, with five source electrodes positioned on the left DLPFC to achieve peak current density at F3 based on the 10–20 EEG system. The current ramp-up and ramp-down times at the start and end of the stimulation were both set to 15 seconds. In the sham condition, constant current was only administered during the initial and final 15 seconds of the stimulation. To minimize discomfort from current injection, an appropriate amount of conductive paste was used on the electrode sites. Procedure Participants were randomly assigned to either the tDCS group or the sham group. Each participant underwent two sessions for the experimental tasks: baseline and conflict. Task sequencing was counterbalanced using the ABBA method, with a 72-hour gap between sessions. Prior to each task, the tDCS group received 10 minutes of stimulation, followed by concurrent stimulation during the task for another 10 minutes. The sham group underwent a similar procedure, albeit without real stimulation. Following task completion, participants filled out a somatic symptom questionnaire. Procedure details and questionnaire are shown in Fig. 1 and Supplementary Table 1. Task and stimuli Presented using E-Prime 2.0.10 on a 14-inch monitor. Participants fixated on the screen at a fixed distance of 60 centimeters. The Flanker task utilized a steady-state block design. Congruent and incongruent conditions were presented in separate blocks, with tasks administered at a fixed frequency of 0.5 Hz. Each trial commenced with a 500 ms blank screen, followed by the simultaneous display of the target and flankers until the participant's response within a maximum duration of 1500 ms. Post-response, the stimuli vanished, and a blank screen appeared for 1500 ms minus the RT before the subsequent trial initiation. Each trial had a duration of 2 seconds, with a total of 300 trials per condition (Fig. 1 ). Statistical analysis The split-half reliability analysis involved a permutation test on the collected data, where half of the trials were randomly selected and correlated with the remaining half. This process was iterated 10,000 times to calculate the average correlation coefficient for determining split-half reliability. Interpretation of reliability indices: values below 0.70 are considered problematic, those between 0.70 and 0.80 are deemed borderline, and values exceeding 0.80 are considered acceptable 45 . The conflict effect is assessed through EC scores, derived from the difference between the mean RT of incongruent and congruent conditions. A lower EC score signifies enhanced EC proficiency 30 . A 2×2 mixed-model ANOVA was conducted to assess the impact of tDCS on EC scores, RTs, RT standard deviation, and accuracy. Stimulation conditions (tDCS/sham) were considered a between-subjects variable, while congruency (incongruent/congruent) was a within-subjects variable. Partial eta squared (η²p) was used as the effect size estimate for each ANOVA model. Post-hoc t tests were conducted for significant differences, with Bonferroni correction applied to all p values. Independent samples t-tests were used to compare EC scores between the tDCS and sham groups. A 2×2 mixed-model ANOVA was utilized to compare the variances in side effects of electrical stimulation across various condition. Results HD-tDCS Reduces Conflict Effects An independent samples t-test revealed a significant difference in EC scores (the difference in RT/ Accuracy between incongruent and congruent trials) between the tDCS group and the sham group (RT: t (48) = -2.035, p = 0.047, Cohen’s d = -0.576; Accuracy: t (48) = 3.443, p = 0.001, Cohen’s d = 0.974). The results are presented in Fig. 2. HD-tDCS Promotes Behavioral Stability A 2×2 mixed-model ANOVA on RTSD showed a significant main effect of congruency (F (1, 48) = 17.182, p < 0.001, η² p = 0.264). Post-hoc analysis indicated that RTSD for the congruent task was significantly lower than for the incongruent task (t (48) = -4.145, p (bonf) < 0.001, Cohen’s d = -0.610). Furthermore, a main effect of stimulation was observed (F (1, 48) = 8.678, p = 0.005, η² p = 0.153), showing that RTSD in the tDCS condition was significantly lower than in the sham condition (t (48) = -2.946, p (bonf) = 0.005, Cohen’s d = -0.712). However, no significant interaction between congruency and stimulation condition was found. Please refer to Fig. 3 for detailed results. HD-tDCS Enhances Efficiency in Conflict Processing A 2×2 mixed-model ANOVA on RTs (Stimulation conditions were considered a between-subjects variable, while congruency was a within-subjects variable) revealed a significant main effect of congruency (F (1, 48) = 549.539, p < 0.001, η² p = 0.920), stimulation (F (1, 48) = 7.089, p = 0.011, η² p = 0.129), and a significant congruency × stimulation interaction (F (1, 48) = 4.198, p = 0.046, η² p = 0.080). Subsequent t-tests indicated that tDCS significantly reduced RT for the incongruent task only (t (46) = -3.252, p (bonf) = 0.011, Cohen’s d = -0.920). The findings are illustrated in Fig. 3. Similarly, a 2×2 mixed-model ANOVA on the accuracy showed a significant main effect of congruency (F (1, 48) = 31.204, p < 0.001, η² p = 0.394), and a significant congruency × stimulation interaction (F (1, 48) = 10.085, p = 0.003, η² p = 0.174). Follow-up t-tests revealed that tDCS significantly reduced RT for the incongruent task only (t (46) = 2.786, p (bonf) = 0.040, Cohen’s d = 0.788). Refer to Fig. 3 for detailed results. High Reliability of the Test After performing a permutation test, the EC score (incongruent RT - congruent RT) demonstrated an average split-half reliability of r = 0.969. The tDCS group exhibited an average split-half reliability of 0.945, while the sham group presented an average split-half reliability of 0.971. Regarding the RT, the average split-half reliability of the test was r = 0.996. Both the tDCS group and the sham group showed identical average split-half reliability scores of 0.996. All conditions exhibited split-half reliability coefficients exceeding 0.8, indicating high test reliability. Refer to Fig. 4 for detailed results. Side effects of electrical stimulation The only adverse effects observed across the two stimulation conditions was pricking sensation (mean score > 2; tDCS-congruent: t (49) = 3.615, p< 0.001, Cohen’s d = 0.511; tDCS-incongruent: t (49) = 3.500, p< 0.001, Cohen’s d = 0.495). The ANOVA results revealed non-significant main effects of stimulation and task type on all side effects, with no interactions observed (Fs 0.05), suggesting that somatic sensations do not impact the intervention effects. The findings are illustrated in Supplementary Table 2. Discussion This study aims to investigate the distinct mechanisms of tDCS on baseline and conflict processing. HD-tDCS was utilized for precise interventions, in conjunction with a reliable EC test employing a steady-state block design within a Flanker task. This design enables the independent evaluation of baseline and conflict processing mechanisms. The findings indicate that tDCS reduced RT variability in both baseline and conflict processing, suggesting a general improvement on behavioral stability. After excluding the influence of the baseline, clear evidence shows that tDCS improves the efficiency of EC. To the best of our knowledge, this study is the first to differentiate between baseline and conflict processing in EC, thereby clarifying the mechanisms by which tDCS affects EC. HD-tDCS Promotes Behavioral Stability Our study demonstrates that HD-tDCS effectively reduces RT variability in baseline and conflict processing, contrasting with prior research on DLPFC interventions for enhancing EC 46 . Breitling et al.(2016) demonstrated that anodal tDCS on the right inferior frontal gyrus can decrease variability in individuals with ADHD during conflict processing 46 . Similarly, Qiao et al. (2022) found that 0.05 Hz oscillatory tDCS (O-tDCS) on the left DLPFC improved the stability of sustained attention 47 . These results collectively suggest that tDCS may enhance the stability of cognitive functions in general, possibly by optimizing attentional resource allocation, therefore allowing participants to focus more effectively on task-relevant stimuli 17 , 47 . Pre-task tDCS also positively impacts both superficial and deep PFC structures, facilitating network activity during subsequent cognitive tasks. This enhanced connectivity for cognitive demands, coupled with reduced default mode network activity, may aid in reconfiguring functional brain networks to meet cognitive challenges effectively 48 . Our study demonstrates that tDCS can influence baseline performance, which is essential for accurately evaluating intervention effects. Previous research has shown that tDCS can decrease RTs under baseline conditions, suggesting its ability to modify baseline states 31 , 32 . The findings of our study may be attributed to the use of a steady-state design, which entrains attention and perception by presenting stimuli at a constant frequency, resulting in improved performance and greater consistency in behavioral responses 49 . Given that tDCS can modify baseline states, ignoring changes in baseline states could introduce confounding intervention outcomes 18 , 21 , 23 , 24 . HD-tDCS Enhances the Efficiency of Conflict Processing In this study, HD-tDCS targeting the left DLPFC significantly enhanced the efficiency of conflict processing, showing a substantial effect. Our findings align with previous research that underscores the critical role of the left DLPFC in EC 15 , 16 , 32 , 50 – 52 . For instance, Dubreuil-Vall et al. investigated the effects of tDCS on both the left and right DLPFC in healthy individuals and patients with ADHD, revealing that stimulating the left DLPFC significantly reduced RTs in inconsistent trials, while right DLPFC stimulation and sham produced no significant impact 15 , 16 . Using HD-tDCS targeted at the left DLPFC, some studies effectively modulated cognitions in a region-specific manner 44 , 53 . Within the tDCS group, we observed a significant decrease in both RTs and error rates, indicating enhanced EC. These results provide robust and precise evidence for the pivotal role of the left DLPFC in facilitating EC. Steady-State Block Design Improves the Reliability of EC Tests The study utilized the steady-state block design and demonstrated its efficacy in enhancing the reliability of EC tests. This finding is consistent with our prior research (r = 0.916; r = 0.906) involving healthy adults 41 , 42 . In contrast, MacLeod et al. (2010) summarized 15 studies and reported an average split-half reliability for EC of 0.66 40 , while more recent studies have also reported split-half reliabilities below 0.8 37,54,55 . The improved reliability of the steady-state block design may be attributed to the brain's sensitivity to task protocols. Unlike non-steady-state designs (e.g., with varying inter-trial intervals), steady-state designs present stimuli at a fixed frequency, creating a stable and predictable environment for the brain 42 , 49 , 56 . This approach reduces expectation fluctuations between trials, enhancing task reliability 57 . Block designs, as opposed to event-related designs (e.g., with randomized conditions), offer greater result stability due to their higher statistical power and improved signal-to-noise ratio 58 , 59 . Moreover, the block design effectively segregates baseline and conflict processing, ensuring consistency in trial types within each block and minimizing the influence of CSE. Conclusion The study elucidates two different mechanisms by which HD-tDCS enhances EC. Initially, tDCS exerted a general enhancement in behavioral stability, a factor often overlooked in previous studies, warranting consideration in future intervention research. Moreover, tDCS improved the efficiency of conflict resolution, providing clear evidence for the causal role of the left DLPFC in EC. The steady-state block paradigm ensures the high reliability of this study, emphasizing the crucial role of cognitive measurement methods in intervention research. Limitations of the study Several limitations should be noted. First, two distinct mechanisms of HD-tDCS on EC were uncovered by behavioral data. The lack of neural function markers hinders a thorough interpretation of the underlying processes. Additionally, this study solely measured online behavioral performance during stimulation, without assessing performance before and after stimulation. 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Supplementary Files SupplementaryInformation.docx Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 14 Apr, 2025 Reviews received at journal 10 Apr, 2025 Reviews received at journal 07 Apr, 2025 Reviewers agreed at journal 27 Mar, 2025 Reviewers agreed at journal 27 Mar, 2025 Reviewers invited by journal 27 Mar, 2025 Editor assigned by journal 20 Mar, 2025 Editor invited by journal 20 Mar, 2025 Submission checks completed at journal 18 Mar, 2025 First submitted to journal 11 Mar, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6202139","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":434864367,"identity":"6e740d07-45af-4a32-9fe3-41ff216bec63","order_by":0,"name":"Ronghan Liu","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Ronghan","middleName":"","lastName":"Liu","suffix":""},{"id":434864368,"identity":"a98ef4c8-ae2c-4d51-abeb-c13d75003614","order_by":1,"name":"Miao Wang","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Miao","middleName":"","lastName":"Wang","suffix":""},{"id":434864369,"identity":"c8f58020-d863-45da-86ea-cf19206327a5","order_by":2,"name":"Qiang Liu","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Liu","suffix":""},{"id":434864370,"identity":"f4eb60f3-3f91-4634-819e-37926e4188bb","order_by":3,"name":"Xiujuan Jing","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Xiujuan","middleName":"","lastName":"Jing","suffix":""},{"id":434864371,"identity":"ffd5e1b8-7f06-4ae4-843d-e2aa7c54a1bf","order_by":4,"name":"Qiang Hao","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Qiang","middleName":"","lastName":"Hao","suffix":""},{"id":434864372,"identity":"aec44b94-0b74-4fd5-934e-fbf11d306b09","order_by":5,"name":"Hang Yu","email":"","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":false,"prefix":"","firstName":"Hang","middleName":"","lastName":"Yu","suffix":""},{"id":434864373,"identity":"3a253ff3-f40b-4db6-afb6-b9df919f755b","order_by":6,"name":"Yifeng Wang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsklEQVRIiWNgGAWjYFACxocPGAwgTAkitTAbG5CsxQyukjgtBjeS2Sp/FNjlGRxgPnibh8Eujygtt3kMkosNDrAlW/MwJBcT1GJ2I//YbQaDA4kbDvCYSfMwHEhsIKwlma3wB1gL/zfitTDwQGxhI06L/ZnHzNJAvyTOPMxmbDkHyCCoRbI9mfHjjz92iX3Hmx/eeFNhR1gLg0AClMEMIgwIqgcC/gPEqBoFo2AUjIIRDQDr6zmoAIC9nwAAAABJRU5ErkJggg==","orcid":"","institution":"Sichuan Normal University","correspondingAuthor":true,"prefix":"","firstName":"Yifeng","middleName":"","lastName":"Wang","suffix":""}],"badges":[],"createdAt":"2025-03-11 10:38:23","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6202139/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6202139/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":79793947,"identity":"17f1e3fb-8da7-468e-8269-78d1f2c4073e","added_by":"auto","created_at":"2025-04-02 21:11:04","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":58386,"visible":true,"origin":"","legend":"\u003cp\u003eExperimental procedure. a) Participants underwent two separate sessions for the baseline and conflict tasks, with a minimum 72-hour interval between sessions. Each session consisted of 10 minutes of anodal stimulation or sham, followed by 10 minutes of task performance with concurrent stimulation or sham. Participants completed a somatic sensation questionnaire immediately after task completion. b) The Flanker task in a steady-state block design includes congruent and incongruent conditions blocks.\u003c/p\u003e","description":"","filename":"Picture1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/f1df2fe940a885d606351d0c.jpg"},{"id":79793549,"identity":"3f40d4dd-9661-4d68-8c82-ac22dfa5c93f","added_by":"auto","created_at":"2025-04-02 20:55:04","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":12836,"visible":true,"origin":"","legend":"\u003cp\u003eHD-tDCS Reduce Conflict Effects. a) the difference in EC score (incongruent RT-congruent RT) between HD-tDCS and sham conditions; b) the difference in EC score (incongruent ACC-congruent ACC) between HD-tDCS and sham conditions. *: p \u0026lt; 0.05, **: p \u0026lt; 0.01, ***: = p \u0026lt; 0.001.\u003c/p\u003e","description":"","filename":"Picture2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/c73343900c974520dc21265f.jpg"},{"id":79793686,"identity":"23315a59-e110-406f-8610-e5e1b815c7eb","added_by":"auto","created_at":"2025-04-02 21:03:04","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":27902,"visible":true,"origin":"","legend":"\u003cp\u003eThe different mechanisms by which HD-tDCS improves baseline and conflict processing include:\u003c/p\u003e\n\u003cp\u003ea)HD-tDCS significantly reduced the standard deviation of RTs in both congruent and incongruent conditions; b) HD-tDCS significantly decreased RTs in the incongruent condition; and c) HD-tDCS significantly improved accuracy in the incongruent condition. *: p \u0026lt; 0.05, **: p \u0026lt; 0.01, ***: = p \u0026lt; 0.001.\u003c/p\u003e","description":"","filename":"Picture3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/77ab1bbd97314aa93d4c86c2.jpg"},{"id":79793553,"identity":"f6782fad-d4d7-4a00-9ea6-b2950a691a17","added_by":"auto","created_at":"2025-04-02 20:55:04","extension":"jpg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":33167,"visible":true,"origin":"","legend":"\u003cp\u003eHigh Reliability of the Test include:\u003c/p\u003e\n\u003cp\u003ea)The split-half reliability calculated from the EC scores (incongruent RT-congruent RT) of the tDCS group and the sham group; b) The split-half reliability calculated from the Reaction time of the tDCS group and the sham group.\u003c/p\u003e","description":"","filename":"Picture4.jpg","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/d43128fcb7afe5e7e899a5b6.jpg"},{"id":79794075,"identity":"71b42c11-5a02-448b-bc94-2f9b46f360f5","added_by":"auto","created_at":"2025-04-02 21:19:08","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":804490,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/048fe56e-493a-4bd4-9e96-a7db9d50fea3.pdf"},{"id":79793684,"identity":"8eff1e22-babe-43c0-81a5-7a7f45efc16a","added_by":"auto","created_at":"2025-04-02 21:03:04","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":15491,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryInformation.docx","url":"https://assets-eu.researchsquare.com/files/rs-6202139/v1/360bf2aea1dd4c2ba8a19d9a.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"HD-tDCS Improves Conflict Processing and General Behavioral Stability","fulltext":[{"header":"Introduction","content":"\u003cp\u003eExecutive control (EC) involves monitoring and resolving conflicts among expectations, stimuli, and responses \u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e. It flexibly adjusts behaviors to meet task demands, encompassing goal maintenance, conflict resolution, error detection, and curiosity \u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e. EC is integral to working memory, executive functions, language processing, and attention \u003csup\u003e\u003cspan additionalcitationids=\"CR5 CR6\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Impairments in EC are evident in various behavioral and mental disorders, such as Attention Deficit Hyperactivity Disorder (ADHD), Major Depressive Disorder (MDD), and Autism Spectrum Disorder (ASD) lays a vital role in cognitive processing and mental health s approaches to enhance EC, including physical exercise, mindfulness meditation training, cognitive training, and physical stimulation methods \u003csup\u003e\u003cspan additionalcitationids=\"CR9 CR10 CR11 CR12\" citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Technological advancements have enabled the direct stimulation of specific brain regions using tDCS, offering a more precise and intuitive approach to enhancing EC \u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe application of tDCS to the dorsolateral prefrontal cortex (DLPFC) for EC intervention has yielded varied outcomes. Some studies have shown improvements in EC \u003csup\u003e\u003cspan additionalcitationids=\"CR16 CR17 CR18\" citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e, while others have reported no significant effects \u003csup\u003e\u003cspan additionalcitationids=\"CR21 CR22 CR23\" citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. The inconsistency in findings is often attributed to variations in stimulation parameters (e.g., stimulation technique, electrode size, and current intensity) and the state of participants \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan additionalcitationids=\"CR26\" citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e\u003c/sup\u003e. A meta-analysis suggested that utilizing small electrodes and high current density yielded a greater positive effect on EC \u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e\u003c/sup\u003e. Furthermore, HD-tDCS has exhibited superior efficacy compared to conventional tDCS \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e\u003c/sup\u003e. Recent studies have shown that the effects of tDCS are contingent on individuals' cognitive baseline prior to stimulation \u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eHowever, few studies have attributed these uncertain outcomes to cognitive activity itself. In the Flanker paradigm, EC is quantified by comparing performance differences between incongruent and congruent conditions, known as the conflict effect \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. This means that any changes in performance in one condition can affect the measurement of EC, leading to mixed intervention effects. Most research has focused on how tDCS modulates the conflict effect, particularly in incongruent task. Some studies have indicated tDCS\u0026rsquo;s ability to reduce reaction times (RTs) in congruent tasks \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. The differential effects of tDCS on congruent and incongruent conditions may underlie the instability of its effects on EC.\u003c/p\u003e \u003cp\u003eStudies employing event-related designs in the Flanker task have faced two main challenges. First, presenting congruent and incongruent trials randomly has shown to reduce the conflict effect after incongruent trials and increase it after congruent trials, known as the congruency sequence effect (CSE) \u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e,\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e. Recent research has revealed that tDCS targeting the DLPFC can lead to longer RTs for incongruent trials following congruent ones or a smaller conflict effect after incongruent trials \u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e,\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e\u003c/sup\u003e. This complexity obscures the mechanisms behind the intervention for conflict effects, hampering clear conclusions. Furthermore, the reliability of previous EC tests has been insufficient, with split-half reliability scores below 0.8, highlighting the need for improvement \u003csup\u003e\u003cspan additionalcitationids=\"CR38 CR39\" citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eTo address these issues, we employed a revised Flanker task to separate congruent and incongruent conditions. The task was conducted with a steady-state block design and has been demonstrated to be highly reliable in assessing EC \u003csup\u003e\u003cspan additionalcitationids=\"CR42\" citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e\u003c/sup\u003e. The left DLPFC, a commonly targeted region in prior studies, was chosen based on its effectiveness. HD-tDCS was utilized for its improved spatial precision and to avoid confounding effects associated with traditional tDCS \u003csup\u003e\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u003c/sup\u003e. These procedures successfully separated two conditions, facilitating the assessment of intervention mechanisms on baseline state and conflict processing, respectively.\u003c/p\u003e"},{"header":"Materials and methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eA total of 50 participants from Sichuan Normal University were involved in this study. Of these, 25 students (aged 18 to 24 years, mean age 20.84, 7 males, 18 females, all right-handed) participated in the left DLPFC tDCS experiment, while another 25 volunteers (aged 18 to 25 years, mean age 20.8, 6 males, 19 females) underwent the sham experiments, as the control group. There were no significant differences in age (t (48)\u0026thinsp;=\u0026thinsp;0.064, p\u0026thinsp;=\u0026thinsp;0.949) or gender (χ2\u0026thinsp;=\u0026thinsp;0.104, p\u0026thinsp;=\u0026thinsp;0.747) distribution between the two groups. Informed consent was obtained from all participants, and the study was approved by the local ethics committee of Sichuan Normal University.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eHD-tDCS\u003c/h3\u003e\n\u003cp\u003eThe study utilized a high-definition 64-channel transcranial direct current stimulation system (NeuStim NSS14, Neuracle, Changzhou, China). A total current of 1 mA was applied for 20 minutes during tDCS sessions, with five source electrodes positioned on the left DLPFC to achieve peak current density at F3 based on the 10\u0026ndash;20 EEG system. The current ramp-up and ramp-down times at the start and end of the stimulation were both set to 15 seconds. In the sham condition, constant current was only administered during the initial and final 15 seconds of the stimulation. To minimize discomfort from current injection, an appropriate amount of conductive paste was used on the electrode sites.\u003c/p\u003e\n\u003ch3\u003eProcedure\u003c/h3\u003e\n\u003cp\u003eParticipants were randomly assigned to either the tDCS group or the sham group. Each participant underwent two sessions for the experimental tasks: baseline and conflict. Task sequencing was counterbalanced using the ABBA method, with a 72-hour gap between sessions. Prior to each task, the tDCS group received 10 minutes of stimulation, followed by concurrent stimulation during the task for another 10 minutes. The sham group underwent a similar procedure, albeit without real stimulation. Following task completion, participants filled out a somatic symptom questionnaire. Procedure details and questionnaire are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and Supplementary Table\u0026nbsp;1.\u003c/p\u003e\n\u003ch3\u003eTask and stimuli\u003c/h3\u003e\n\u003cp\u003ePresented using E-Prime 2.0.10 on a 14-inch monitor. Participants fixated on the screen at a fixed distance of 60 centimeters. The Flanker task utilized a steady-state block design. Congruent and incongruent conditions were presented in separate blocks, with tasks administered at a fixed frequency of 0.5 Hz. Each trial commenced with a 500 ms blank screen, followed by the simultaneous display of the target and flankers until the participant's response within a maximum duration of 1500 ms. Post-response, the stimuli vanished, and a blank screen appeared for 1500 ms minus the RT before the subsequent trial initiation. Each trial had a duration of 2 seconds, with a total of 300 trials per condition (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e\u003c/p\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eThe split-half reliability analysis involved a permutation test on the collected data, where half of the trials were randomly selected and correlated with the remaining half. This process was iterated 10,000 times to calculate the average correlation coefficient for determining split-half reliability. Interpretation of reliability indices: values below 0.70 are considered problematic, those between 0.70 and 0.80 are deemed borderline, and values exceeding 0.80 are considered acceptable \u003csup\u003e\u003cspan citationid=\"CR45\" class=\"CitationRef\"\u003e45\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eThe conflict effect is assessed through EC scores, derived from the difference between the mean RT of incongruent and congruent conditions. A lower EC score signifies enhanced EC proficiency \u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eA 2\u0026times;2 mixed-model ANOVA was conducted to assess the impact of tDCS on EC scores, RTs, RT standard deviation, and accuracy. Stimulation conditions (tDCS/sham) were considered a between-subjects variable, while congruency (incongruent/congruent) was a within-subjects variable. Partial eta squared (η\u0026sup2;p) was used as the effect size estimate for each ANOVA model. Post-hoc t tests were conducted for significant differences, with Bonferroni correction applied to all p values. Independent samples t-tests were used to compare EC scores between the tDCS and sham groups.\u003c/p\u003e \u003cp\u003eA 2\u0026times;2 mixed-model ANOVA was utilized to compare the variances in side effects of electrical stimulation across various condition.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec8\"\u003e\n \u003cdiv id=\"Sec9\"\u003e\n \u003ch2\u003eHD-tDCS Reduces Conflict Effects\u003c/h2\u003e\n \u003cp\u003eAn independent samples t-test revealed a significant difference in EC scores (the difference in RT/ Accuracy between incongruent and congruent trials) between the tDCS group and the sham group (RT: t (48) = -2.035, p\u0026thinsp;=\u0026thinsp;0.047, Cohen\u0026rsquo;s d = -0.576; Accuracy: t (48)\u0026thinsp;=\u0026thinsp;3.443, p\u0026thinsp;=\u0026thinsp;0.001, Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.974). The results are presented in Fig.\u0026nbsp;2.\u003c/p\u003e\n \u003c/div\u003e\n\u003c/div\u003e\n\u003ch3\u003eHD-tDCS Promotes Behavioral Stability\u003c/h3\u003e\n\u003cp\u003eA 2\u0026times;2 mixed-model ANOVA on RTSD showed a significant main effect of congruency (F (1, 48)\u0026thinsp;=\u0026thinsp;17.182, p \u0026lt; 0.001, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.264). Post-hoc analysis indicated that RTSD for the congruent task was significantly lower than for the incongruent task (t (48) = -4.145, p\u003csub\u003e(bonf)\u003c/sub\u003e \u0026lt; 0.001, Cohen\u0026rsquo;s d = -0.610). Furthermore, a main effect of stimulation was observed (F (1, 48)\u0026thinsp;=\u0026thinsp;8.678, p\u0026thinsp;=\u0026thinsp;0.005, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.153), showing that RTSD in the tDCS condition was significantly lower than in the sham condition (t (48) = -2.946, p\u003csub\u003e(bonf)\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.005, Cohen\u0026rsquo;s d = -0.712). However, no significant interaction between congruency and stimulation condition was found. Please refer to Fig.\u0026nbsp;3 for detailed results.\u003c/p\u003e\n\u003cdiv id=\"Sec11\"\u003e\n \u003ch2\u003eHD-tDCS Enhances Efficiency in Conflict Processing\u003c/h2\u003e\n \u003cp\u003eA 2\u0026times;2 mixed-model ANOVA on RTs (Stimulation conditions were considered a between-subjects variable, while congruency was a within-subjects variable) revealed a significant main effect of congruency (F (1, 48)\u0026thinsp;=\u0026thinsp;549.539, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.920), stimulation (F (1, 48)\u0026thinsp;=\u0026thinsp;7.089, p\u0026thinsp;=\u0026thinsp;0.011, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.129), and a significant congruency \u0026times; stimulation interaction (F (1, 48)\u0026thinsp;=\u0026thinsp;4.198, p\u0026thinsp;=\u0026thinsp;0.046, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.080). Subsequent t-tests indicated that tDCS significantly reduced RT for the incongruent task only (t (46) = -3.252, p\u003csub\u003e(bonf)\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.011, Cohen\u0026rsquo;s d = -0.920). The findings are illustrated in Fig.\u0026nbsp;3.\u003c/p\u003e\n \u003cp\u003eSimilarly, a 2\u0026times;2 mixed-model ANOVA on the accuracy showed a significant main effect of congruency (F (1, 48)\u0026thinsp;=\u0026thinsp;31.204, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.394), and a significant congruency \u0026times; stimulation interaction (F (1, 48)\u0026thinsp;=\u0026thinsp;10.085, p\u0026thinsp;=\u0026thinsp;0.003, \u0026eta;\u0026sup2;\u003csub\u003ep\u003c/sub\u003e = 0.174). Follow-up t-tests revealed that tDCS significantly reduced RT for the incongruent task only (t (46)\u0026thinsp;=\u0026thinsp;2.786, p\u003csub\u003e(bonf)\u003c/sub\u003e\u0026thinsp;=\u0026thinsp;0.040, Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.788). Refer to Fig. 3 for detailed results.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec12\"\u003e\n \u003ch2\u003eHigh Reliability of the Test\u003c/h2\u003e\n \u003cp\u003eAfter performing a permutation test, the EC score (incongruent RT - congruent RT) demonstrated an average split-half reliability of r\u0026thinsp;=\u0026thinsp;0.969. The tDCS group exhibited an average split-half reliability of 0.945, while the sham group presented an average split-half reliability of 0.971. Regarding the RT, the average split-half reliability of the test was r\u0026thinsp;=\u0026thinsp;0.996. Both the tDCS group and the sham group showed identical average split-half reliability scores of 0.996. All conditions exhibited split-half reliability coefficients exceeding 0.8, indicating high test reliability. Refer to Fig. 4 for detailed results.\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec13\"\u003e\n \u003ch2\u003eSide effects of electrical stimulation\u003c/h2\u003e\n \u003cp\u003eThe only adverse effects observed across the two stimulation conditions was pricking sensation (mean score\u0026thinsp;\u0026gt;\u0026thinsp;2; tDCS-congruent: t (49)\u0026thinsp;=\u0026thinsp;3.615, p\u0026lt; 0.001, Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.511; tDCS-incongruent: t (49)\u0026thinsp;=\u0026thinsp;3.500, p\u0026lt; 0.001, Cohen\u0026rsquo;s d\u0026thinsp;=\u0026thinsp;0.495). The ANOVA results revealed non-significant main effects of stimulation and task type on all side effects, with no interactions observed (Fs\u0026thinsp;\u0026lt;\u0026thinsp;3.27, ps\u0026thinsp;\u0026gt;\u0026thinsp;0.05), suggesting that somatic sensations do not impact the intervention effects. The findings are illustrated in Supplementary Table\u0026nbsp;2.\u003c/p\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aims to investigate the distinct mechanisms of tDCS on baseline and conflict processing. HD-tDCS was utilized for precise interventions, in conjunction with a reliable EC test employing a steady-state block design within a Flanker task. This design enables the independent evaluation of baseline and conflict processing mechanisms. The findings indicate that tDCS reduced RT variability in both baseline and conflict processing, suggesting a general improvement on behavioral stability. After excluding the influence of the baseline, clear evidence shows that tDCS improves the efficiency of EC. To the best of our knowledge, this study is the first to differentiate between baseline and conflict processing in EC, thereby clarifying the mechanisms by which tDCS affects EC.\u003c/p\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eHD-tDCS Promotes Behavioral Stability\u003c/h2\u003e \u003cp\u003eOur study demonstrates that HD-tDCS effectively reduces RT variability in baseline and conflict processing, contrasting with prior research on DLPFC interventions for enhancing EC \u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e. Breitling et al.(2016) demonstrated that anodal tDCS on the right inferior frontal gyrus can decrease variability in individuals with ADHD during conflict processing \u003csup\u003e\u003cspan citationid=\"CR46\" class=\"CitationRef\"\u003e46\u003c/span\u003e\u003c/sup\u003e. Similarly, Qiao et al. (2022) found that 0.05 Hz oscillatory tDCS (O-tDCS) on the left DLPFC improved the stability of sustained attention \u003csup\u003e\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e. These results collectively suggest that tDCS may enhance the stability of cognitive functions in general, possibly by optimizing attentional resource allocation, therefore allowing participants to focus more effectively on task-relevant stimuli \u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e,\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e\u003c/sup\u003e. Pre-task tDCS also positively impacts both superficial and deep PFC structures, facilitating network activity during subsequent cognitive tasks. This enhanced connectivity for cognitive demands, coupled with reduced default mode network activity, may aid in reconfiguring functional brain networks to meet cognitive challenges effectively \u003csup\u003e\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003cp\u003eOur study demonstrates that tDCS can influence baseline performance, which is essential for accurately evaluating intervention effects. Previous research has shown that tDCS can decrease RTs under baseline conditions, suggesting its ability to modify baseline states \u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. The findings of our study may be attributed to the use of a steady-state design, which entrains attention and perception by presenting stimuli at a constant frequency, resulting in improved performance and greater consistency in behavioral responses \u003csup\u003e\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e\u003c/sup\u003e. Given that tDCS can modify baseline states, ignoring changes in baseline states could introduce confounding intervention outcomes \u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e,\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eHD-tDCS Enhances the Efficiency of Conflict Processing\u003c/h2\u003e \u003cp\u003eIn this study, HD-tDCS targeting the left DLPFC significantly enhanced the efficiency of conflict processing, showing a substantial effect. Our findings align with previous research that underscores the critical role of the left DLPFC in EC \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e,\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e,\u003cspan additionalcitationids=\"CR51\" citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e52\u003c/span\u003e\u003c/sup\u003e. For instance, Dubreuil-Vall et al. investigated the effects of tDCS on both the left and right DLPFC in healthy individuals and patients with ADHD, revealing that stimulating the left DLPFC significantly reduced RTs in inconsistent trials, while right DLPFC stimulation and sham produced no significant impact \u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e. Using HD-tDCS targeted at the left DLPFC, some studies effectively modulated cognitions in a region-specific manner \u003csup\u003e\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e,\u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e53\u003c/span\u003e\u003c/sup\u003e. Within the tDCS group, we observed a significant decrease in both RTs and error rates, indicating enhanced EC. These results provide robust and precise evidence for the pivotal role of the left DLPFC in facilitating EC.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eSteady-State Block Design Improves the Reliability of EC Tests\u003c/h2\u003e \u003cp\u003eThe study utilized the steady-state block design and demonstrated its efficacy in enhancing the reliability of EC tests. This finding is consistent with our prior research (r\u0026thinsp;=\u0026thinsp;0.916; r\u0026thinsp;=\u0026thinsp;0.906) involving healthy adults \u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e,\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e. In contrast, MacLeod et al. (2010) summarized 15 studies and reported an average split-half reliability for EC of 0.66 \u003csup\u003e40\u003c/sup\u003e, while more recent studies have also reported split-half reliabilities below 0.8 \u003csup\u003e37,54,55\u003c/sup\u003e. The improved reliability of the steady-state block design may be attributed to the brain's sensitivity to task protocols.\u003c/p\u003e \u003cp\u003eUnlike non-steady-state designs (e.g., with varying inter-trial intervals), steady-state designs present stimuli at a fixed frequency, creating a stable and predictable environment for the brain \u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e,\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e,\u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e56\u003c/span\u003e\u003c/sup\u003e. This approach reduces expectation fluctuations between trials, enhancing task reliability \u003csup\u003e\u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e57\u003c/span\u003e\u003c/sup\u003e. Block designs, as opposed to event-related designs (e.g., with randomized conditions), offer greater result stability due to their higher statistical power and improved signal-to-noise ratio \u003csup\u003e\u003cspan citationid=\"CR58\" class=\"CitationRef\"\u003e58\u003c/span\u003e,\u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e59\u003c/span\u003e\u003c/sup\u003e. Moreover, the block design effectively segregates baseline and conflict processing, ensuring consistency in trial types within each block and minimizing the influence of CSE.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe study elucidates two different mechanisms by which HD-tDCS enhances EC. Initially, tDCS exerted a general enhancement in behavioral stability, a factor often overlooked in previous studies, warranting consideration in future intervention research. Moreover, tDCS improved the efficiency of conflict resolution, providing clear evidence for the causal role of the left DLPFC in EC. The steady-state block paradigm ensures the high reliability of this study, emphasizing the crucial role of cognitive measurement methods in intervention research.\u003c/p\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eLimitations of the study\u003c/h2\u003e \u003cp\u003eSeveral limitations should be noted. First, two distinct mechanisms of HD-tDCS on EC were uncovered by behavioral data. The lack of neural function markers hinders a thorough interpretation of the underlying processes. Additionally, this study solely measured online behavioral performance during stimulation, without assessing performance before and after stimulation. Future research should compare task performance during both online and offline stimulation phases to investigate the temporal effects of tDCS on EC.\u003c/p\u003e \u003c/div\u003e "},{"header":"Declarations","content":"\u003cp\u003e \u003cstrong\u003eCompeting interests\u003c/strong\u003e \u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eR.H.L.was responsible for data acquisition, analysis, and interpretation and wrote the main manuscript text; Q.L, and X.J.J. revised it substantively. Q.H., M.W and H.Y performed the experiment; Y.F.W. contributed substantively to this concept and revised it substantively. All authors reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data that support the findings of this study are available from the corresponding author on request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003ePetersen, S. E. \u0026amp; Posner, M. I. The Attention System of the Human Brain: 20 Years After. \u003cem\u003eAnnu. Rev. Neurosci.\u003c/em\u003e \u003cb\u003e35\u003c/b\u003e, 73\u0026ndash;89 (2012).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEngle, R. W., Kane, M. J. \u0026amp; Executive Attention Working Memory Capacity, and a Two-Factor Theory of Cognitive Control. \u003cem\u003ePsychol. Learn. Motivation\u003c/em\u003e. \u003cb\u003e44\u003c/b\u003e, 145\u0026ndash;199 (2003).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHaykin, S., Fatemi, M., Setoodeh, P. \u0026amp; Xue, Y. Cognitive Control. \u003cem\u003eProc. 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Neurosci.\u003c/em\u003e \u003cb\u003e13\u003c/b\u003e, 690\u0026ndash;702 (2013).\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-6202139/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6202139/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eTranscranial Direct Current Stimulation (tDCS) has been employed to enhance executive control (EC), thereby improving cognitive functions and mental health. However, the effects of tDCS on EC remain inconclusive, and the mechanisms involved in its impact on baseline and conflict processing are not well understood. This study applied high-definition tDCS (HD-tDCS) to the left dorsolateral prefrontal cortex to investigate the distinct effects of tDCS on baseline and conflict processing. Compared to the sham group, tDCS significantly reduced reaction time variability in both conditions and decreased mean reaction time and error rate in the conflict condition. These findings demonstrate significant enhancements in general behavioral stability and conflict processing, respectively. This study demonstrates a significant enhancement of tDCS on EC, elucidating the dual mechanisms of tDCS in modulating the baseline state and EC, providing valuable insights into the mechanisms of tDCS intervention on cognitive functions.\u003c/p\u003e","manuscriptTitle":"HD-tDCS Improves Conflict Processing and General Behavioral Stability","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-04-02 20:54:59","doi":"10.21203/rs.3.rs-6202139/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-04-14T05:50:32+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-10T18:26:59+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-07T10:17:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"118754181814851297373974381938654647580","date":"2025-03-27T13:29:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"283135948542202951586667404542227475489","date":"2025-03-27T10:52:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-03-27T08:08:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-03-20T05:41:42+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-03-20T05:37:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-03-18T10:57:28+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-03-11T10:32:55+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"94a31203-6569-47a3-975b-efcd1f870277","owner":[],"postedDate":"April 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[{"id":46304857,"name":"Biological sciences/Neuroscience"},{"id":46304858,"name":"Biological sciences/Psychology"}],"tags":[],"updatedAt":"2025-08-07T04:08:21+00:00","versionOfRecord":[],"versionCreatedAt":"2025-04-02 20:54:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6202139","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6202139","identity":"rs-6202139","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}