Transcranial Direct Current Stimulation for Post Treatment Lyme Disease

Eligibility Criteria

• * 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
• * 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.
• * 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