# Effects of Neuromodulation and Cognitive Training for Suicide in Veterans (ENACTS)

> **NIH VA I21** · MINNEAPOLIS VA  MEDICAL CENTER · 2022 · —

## Abstract

Impaired executive function, such as impaired decision making and impulsivity, has been identified as an
important contributor to the transition from suicidal ideation to suicide attempt. To address the epidemic of
Veteran suicide in the United States, we propose to test the feasibility, acceptability, and preliminary
effectiveness of a five day transcranial direct current stimulation (tDCS) augmented executive functioning
training intervention. This intervention will be delivered to high suicide risk inpatients who have been
hospitalized following a suicide attempt. The ultimate goal is to reduce future suicide events (ideation,
attempts, deaths) and improve quality of life (e.g. social relationships, health resource utilization).
Our intervention combines two existing interventions: tDCS and cognitive training. tDCS is a simple, low cost,
easy to use non-invasive neuromodulation technology demonstrated to enhance brain plasticity and accelerate
learning. Executive function training is a proven intervention that improves executive functioning in clinical
populations. When tDCS and executive function training are combined, learning rate, executive functioning,
and transfer to other functions is improved compared with executive function training alone.
We propose to test the feasibility and acceptability of a five day intervention consisting of ten sessions of tDCS
augmented executive function training in a high suicide risk population: Veterans admitted to a hospital
following a suicide attempt. Inpatients have the highest risk of suicide attempts within the initial weeks following
discharge with 50% occuring within 12 weeks of discharge. This suggests that the time prior to hospital
discharge could be a critical intervention period. Additionally, we will collect longitudinal and daily real-time data
on help-seeking, suicide risk, and related factors in the month after discharge using Ecological Momentary
Assessment (EMA). Given that help-seeking and suicide risk fluctuate during the week, EMA offers an
improvement over existing research that relies on retrospective and cross-sectional methods. Our Aims are:
Aim 1: Determine feasibility and acceptability of the tDCS augmented executive function training intervention.
Feedback will be obtained from patients and clinical staff through questionnaires, interviews, and debriefs to
examine their experience and satisfaction with the intervention and study methods. We will also use
participants’ performance data to assess engagement with, and ease of use of, the training exercises.
Aim 2: Assess preliminary effects of the intervention on 1) the behavioral treatment target of executive
functioning, and 2) reduction in suicide events (ideation, attempts, deaths) and improvement in quality of life.
Variability and precision estimates (95% confidence intervals) will be calculated.
Aim 3: Explore between- and within-person variability of cognitive factors (executive function task
performance), help-seeking, a...

## Key facts

- **NIH application ID:** 10486332
- **Project number:** 1I21RX004104-01
- **Recipient organization:** MINNEAPOLIS VA  MEDICAL CENTER
- **Principal Investigator:** CASEY S GILMORE
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-06-01 → 2024-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10486332

## Citation

> US National Institutes of Health, RePORTER application 10486332, Effects of Neuromodulation and Cognitive Training for Suicide in Veterans (ENACTS) (1I21RX004104-01). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10486332. Licensed CC0.

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