Transcranial Direct Current Stimulation for Post Treatment Lyme Disease

Open to people ages 18-65

• History of diagnosis of Lyme disease by a health care provider, meeting criteria for either definite or probable or possible LD
• Willingness to provide documentation of prior LD testing and/or related medical records
• Total prior antibiotic treatment for LD was at least 2 courses of antibiotic therapy
• Have cognitive symptoms attributed to Lyme disease that have persisted or returned despite antibiotic therapy
• Current cognitive symptoms interfere with function and/or cause distress
• Have evidence of slowed processing speed on a screening measure
• Participant is willing to be off of antibiotic treatment for tick-borne disease for at least 4 weeks prior to final determination of study eligibility and for the duration of the 12-week study.
• Participant expresses willingness to not start new medications that might affect treatment outcome during the trial (unless medically necessary), and willingness to inform study staff regarding any changes in medication
• Live in the US or Canada and comfortable speaking English
• Age 18-65
• Stable and continuous access to internet service
• Adequate home facilities (enough space, access to quiet and distraction free area)
• Able to commit to the 12-week study period (4 weeks of training sessions and an 8-week post treatment visit)
• Estimated intellectual ability >= 85

Medical Illness: Any of the following:

• Unstable non-Lyme-related chronic medical illness over the last 12 months (e.g., cancer, acute myocardial infarction, labile hypertension)
• Any severe skin disorder or skin sensitive area near stimulation locations (e.g. forehead)

Neurologic: Any of the following:

• History of traumatic brain injury with persistent post-concussive symptoms
• History of seizure disorder or recent (<5 years) seizure history
• History of neurosurgery to the head
• Chronic headaches or migraines of moderate to severe intensity within the last month
• Post stroke deficits that may interfere with assessment
• Any progressive neurodegenerative disorder or other neurological disorders that may interfere with assessment at discretion of the investigator.

Psychiatric: Any of the following:

• History of intellectual disability, or other developmental neurological condition associated with cognitive impairment
• Current primary psychiatric disorder that would interfere with ability to participate
• Current alcohol or other substance use disorder
• Current suicide risk as assessed by the C-SSRS (any level)
• History of suicidal behavior over the last year
• History of a diagnosis of a psychotic disorder, mania or bipolar disorder
• Depression rating of moderate or severe at screening
• Currently taking opiate-based medications, dissociative drugs (prescribed or illicit), or other medication considered likely to interfere with treatment outcome at the discretion of the investigator. The use of a stable dose of benzodiazepines, anticholinergic agents and non-narcotic pain medications is permitted. The use of an occasional dose of these medications is also permitted, but not within 48 hours of neurocognitive study assessments.
• Participants whose current daily medication regimen has not been stable for a minimum of 4 weeks prior to final determination of study eligibility
• Medical device implanted in the head (such as a Deep Brain Stimulator) or in the neck (such as a Vagus Nerve Stimulator), or metal implants in the head or neck
• Inadequate visual or motor skills needed for regular computer use or to operate study equipment, or inability to provide informed consent
• Individuals who are pregnant or breastfeeding or planning to become pregnant
• Lifestyle Considerations: Participants not willing to refrain from beginning, resuming or increasing non study cognitive training or cognitive enhancing supplements/medications or other therapies that might affect treatment outcome