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Lei L, Lai CSW, Lee TMC, Lam CLM. The effect of transcranial direct current and magnetic stimulation on fear extinction and return of fear: A meta-analysis and systematic review. J Affect Disord 2024; 362:263-286. [PMID: 38908557 DOI: 10.1016/j.jad.2024.06.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 05/31/2024] [Accepted: 06/17/2024] [Indexed: 06/24/2024]
Abstract
BACKGROUND We conducted a meta-analysis and qualitative review on the randomized controlled trials investigating the effects of transcranial direct current stimulation and transcranial magnetic stimulation on fear extinction and the return of fear in non-primate animals and humans. METHODS The meta-analysis was conducted by searching PubMed, Web of science, PsycINFO, and Cochrane Library and extracting fear response in the active and sham groups in the randomized controlled trials. The pooled effect size was quantified by Hedges' g using a three-level meta-analytic model in R. RESULTS We identified 18 articles on the tDCS effect and 5 articles on the TMS effect, with 466 animal subjects and 621 human subjects. Our findings show that tDCS of the prefrontal cortex significantly inhibit fear retrieval in animal models (Hedges' g = -0.50). In human studies, TMS targeting the dorsolateral/ventromedial prefrontal cortex has an inhibiting effect on the return of fear (Hedges' g = -0.24). LIMITATIONS The limited number of studies and the heterogeneous designs of the selected studies made cross-study and cross-species comparison difficult. CONCLUSIONS Our findings shed light on the optimal non-invasive brain stimulation protocols for targeting the neural circuitry of threat extinction in humans.
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Affiliation(s)
- Letian Lei
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Clinical Psychology and Affective Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Cora S W Lai
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China; Advanced Biomedical Instrumentation Centre, Hong Kong Science Park, Shatin, New Territories, Hong Kong SAR, China
| | - Tatia M C Lee
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Neuropsychology and Human Neuroscience, The University of Hong Kong, Hong Kong, China
| | - Charlene L M Lam
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Laboratory of Clinical Psychology and Affective Neuroscience, The University of Hong Kong, Hong Kong, China.
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Lima AE, Telles JP, Dantas J, Fernandes AC, Ribeiro GBS, Barbosa VL, Castro-Lima H. Transcranial direct current stimulation improves seizures frequency in drug-resistant epilepsy: A systematic-review and meta-analysis of randomized controlled trials. Epilepsy Behav 2024; 159:109974. [PMID: 39096796 DOI: 10.1016/j.yebeh.2024.109974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Revised: 07/20/2024] [Accepted: 07/25/2024] [Indexed: 08/05/2024]
Affiliation(s)
- A E Lima
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil.
| | - J P Telles
- Department of Neurology, Universidade de São Paulo, São Paulo, Brazil
| | - J Dantas
- Federal University of Rio Grande do Norte, Natal, Brazil
| | - A C Fernandes
- Instituto Internacional de Neurociências Edmond e Lily Safra, Natal, Brazil
| | - G B S Ribeiro
- Department of Neurology, Universidade de Campinas, Campinas, Brazil
| | - V L Barbosa
- Universidade Estadual do Centro Oeste do Paraná, Guarapuava, Brazil
| | - H Castro-Lima
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
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Lapenta OM, Rêgo GG, Boggio PS. Transcranial electrical stimulation for procedural learning and rehabilitation. Neurobiol Learn Mem 2024; 213:107958. [PMID: 38971460 DOI: 10.1016/j.nlm.2024.107958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
Procedural learning is the acquisition of motor and non-motor skills through a gradual process that increases with practice. Impairments in procedural learning have been consistently demonstrated in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Considering that noninvasive brain stimulation modulates brain activity and boosts neuroplastic mechanisms, we reviewed the effects of coupling transcranial direct current stimulation (tDCS) with training methods for motor and non-motor procedural learning to explore tDCS potential use as a tool for enhancing implicit learning in healthy and clinical populations. The review covers tDCS effects over i. motor procedural learning, from basic to complex activities; ii. non-motor procedural learning; iii. procedural rehabilitation in several clinical populations. We conclude that targeting the primary motor cortex and prefrontal areas seems the most promising for motor and non-motor procedural learning, respectively. For procedural rehabilitation, the use of tDCS is yet at an early stage but some effectiveness has been reported for implicit motor and memory learning. Still, systematic comparisons of stimulation parameters and target areas are recommended for maximising the effectiveness of tDCS and its robustness for procedural rehabilitation.
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Affiliation(s)
- Olivia Morgan Lapenta
- Psychological Neuroscience Laboratory, Psychology Research Center, School of Psychology, University of Minho - Rua da Universidade, 4710-057 Braga, Portugal.
| | - Gabriel Gaudencio Rêgo
- Social and Cognitive Neuroscience Laboratory, Mackenzie Presbyterian University - Rua Piauí, 181, 01241-001 São Paulo, Brazil; National Institute of Science and Technology on Social and Affective Neuroscience (INCT-SANI), São Paulo, Brazil
| | - Paulo Sérgio Boggio
- Social and Cognitive Neuroscience Laboratory, Mackenzie Presbyterian University - Rua Piauí, 181, 01241-001 São Paulo, Brazil; National Institute of Science and Technology on Social and Affective Neuroscience (INCT-SANI), São Paulo, Brazil
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Rodrigues da Silva PH, Leffa DT, Luethi MS, Silva RF, Ferrazza CP, Picon FA, Grevet EH, Bau CHD, Rovaris DL, Razza LB, Caumo W, Camprodon JA, Rohde LAP, Brunoni AR. Baseline brain volume predicts home-based transcranial direct current stimulation effects on inattention in adults with attention-deficit/hyperactivity disorder. J Psychiatr Res 2024; 177:403-411. [PMID: 39089118 DOI: 10.1016/j.jpsychires.2024.07.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 07/22/2024] [Accepted: 07/27/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Home-based transcranial direct current stimulation (Hb-tDCS) is a non-invasive brain stimulation technique that utilizes low-intensity electric currents delivered via scalp electrodes to modulate brain activity. It holds significant promise for addressing inattention in adults with attention-deficit/hyperactivity disorder (ADHD). However, its effectiveness varies among individuals, and predicting outcomes remains uncertain, partially due to the influence of individual differences in ADHD-related brain anatomy. METHODS We analyzed data from a subsample, composed by twenty-nine adult patients with ADHD, of the Treatment of Inattention Symptoms in Adult Patients with ADHD (TUNED) trial. Fourteen patients underwent active anodal right cathodal left dorsolateral prefrontal cortex (DLPFC) Hb-tDCS for 4 weeks and fifteen received sham-related tDCS intervention. Inattention outcome was evaluated at both baseline and endpoint (4th week). Baseline structural measures of the DLPFC, anterior cingulate cortex (ACC) and subcortical structures, previously associated with ADHD, were quantified. Several linear mixed models, with a three-way interaction between the fixed predictors brain volume or thickness, time, and treatment were calculated. Multiple comparison corrections were applied using the Benjamini-Hochberg method. RESULTS Baseline volume of the left DLPFC regions middle frontal gyrus (t (25) = 3.33, p-adjusted = 0.045, Cohen's d = 1.33, 95% CI = [0.45, 2.19]), inferior frontal gyrus (orbital part) (t (25) = 3.10, p-adjusted = 0.045, Cohen's d = 1.24, 95% CI = [0.37, 2.08]), and of the left ACC supragenual (t (25) = 3.15, p-adjusted = 0.045, Cohen's d = 1.26, 95% CI = [0.39, 2.11]) presented significant association with the inattentive score improvement only in the active tDCS group. More specifically, the smaller these regions were, the more the symptoms improved following anodal right cathodal left DLPFC Hb-tDCS. CONCLUSION Hb-tDCS was associated with greater improvement in brain areas related to attention regulation. Brain MRI can be potentially used to predict clinical response to tDCS in ADHD adults.
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Affiliation(s)
- Pedro Henrique Rodrigues da Silva
- Departamento de Psiquiatria da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, Brazil; Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
| | | | - Matthias S Luethi
- Departamento de Psiquiatria da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, Brazil
| | | | | | | | - Eugenio Horacio Grevet
- Department of Psychiatry and Legal Medicine, Faculty of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Claiton Henrique Dotto Bau
- Department of Genetics and Graduate Program in Genetics and Molecular Biology, Instituto de Biociências, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; ADHD and Developmental Psychiatry Programs, Hospital de Clínicas de Porto Alegre, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Diego Luiz Rovaris
- Department of Physiology and Biophysics, Instituto de Ciências Biomédicas Universidade de São Paulo, São Paulo, Brazil
| | - Lais B Razza
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, 9000, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000, Ghent, Belgium
| | - Wolnei Caumo
- Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil; Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil; Department of Surgery, School of Medicine, Universidade Federal Do Rio Grande Do Sul, Porto Alegre, Brazil
| | - Joan A Camprodon
- Division of Neuropsychiatry and Neuromodulation, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | | | - André R Brunoni
- Departamento de Psiquiatria da Faculdade de Medicina da Universidade de São Paulo (USP), São Paulo, Brazil
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Zhang N, Nitsche MA, Miao Y, Xiong Z, Vicario CM, Qi F. Transcranial Direct-Current Stimulation Over the Primary Motor Cortex and Cerebellum Improves Balance and Shooting Accuracy in Elite Ice Hockey Players. Int J Sports Physiol Perform 2024:1-8. [PMID: 39179224 DOI: 10.1123/ijspp.2024-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/25/2024] [Accepted: 06/05/2024] [Indexed: 08/26/2024]
Abstract
PURPOSE To investigate the effects of transcranial direct-current stimulation (tDCS) applied over the primary motor cortex (M1) and cerebellum on balance control and shooting accuracy in elite ice hockey players. METHODS Twenty-one elite ice hockey players underwent anodal tDCS over the M1 (a-tDCSM1), anodal tDCS over the cerebellum (a-tDCSCB), concurrent dual-site anodal tDCS over the M1 and the cerebellum (a-tDCSM1+CB), and sham stimulation (tDCSSHAM). Before and after receiving tDCS (2 mA for 15 min), participants completed an ice hockey shooting-accuracy test, Pro-Kin balance test (includes stance test and proprioceptive assessment), and Y-balance test in randomized order. RESULTS For static balance performance, the ellipse area in the 2-legged stance with eyes open and the 1-legged stance with the dominant leg significantly improved following a-tDCSM1, a-tDCSCB, and concurrent dual-site a-tDCSM1+CB, compared with tDCSSHAM (all P < .05, Cohen d = 0.64-1.06). In dynamic balance performance, the average trace error of the proprioceptive assessment and the composite score of the Y-balance test with the dominant leg significantly improved following a-tDCSM1 and concurrent dual-site a-tDCSM1+CB (all P < .05, Cohen d = 0.77-1.00). For the ice hockey shooting-accuracy test, shooting-accuracy while standing on the unstable platform significantly increased following a-tDCSM1 (P = .010, Cohen d = 0.81) and a-tDCSCB (P = .010, Cohen d = 0.92) compared with tDCSSHAM. CONCLUSION tDCS could potentially be a valuable tool in enhancing static and dynamic balance and shooting accuracy on unstable platforms in elite ice hockey players.
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Affiliation(s)
- Na Zhang
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
| | - Yu Miao
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
| | - Zheng Xiong
- China Ice Sports College, Beijing Sport University, Beijing, BJ, China
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Fengxue Qi
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
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Lasogga L, Gramegna C, Müller D, Habel U, Mehler DMA, Gur RC, Weidler C. Meta-analysis of variance in tDCS effects on response inhibition. Sci Rep 2024; 14:19197. [PMID: 39160262 PMCID: PMC11333595 DOI: 10.1038/s41598-024-70065-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2024] [Accepted: 08/12/2024] [Indexed: 08/21/2024] Open
Abstract
Deficiencies in response inhibition are associated with numerous mental health conditions, warranting innovative treatments. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, modulates cortical excitability and has shown promise in improving response inhibition. However, tDCS effects on response inhibition often yield contradictory findings. Previous research emphasized the importance of inter-individual factors that are mostly ignored in conventional meta-analyses of mean effects. We aimed to fill this gap and promote the complementary use of the coefficient of variation ratio and standardized mean effects. The systematic literature search included single-session and sham-controlled tDCS studies utilizing stop-signal task or Go-NoGo tasks, analyzing 88 effect sizes from 53 studies. Considering the impact of inter-individual factors, we hypothesized that variances increase in the active versus sham tDCS. However, the results showed that variances between both groups did not differ. Additionally, analyzing standardized mean effects supported previous research showing an improvement in the stop-signal task but not in the Go-NoGo task following active tDCS. These findings suggest that inter-individual differences do not increase variances in response inhibition, implying that the heterogeneity cannot be attributed to higher variance in response inhibition during and after active tDCS. Furthermore, methodological considerations are crucial for tDCS efficacy.
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Affiliation(s)
- Luca Lasogga
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, North Rhine-Westphalia, Germany.
- , Office 117, Wendlingweg 2, 52074, Aachen, Germany.
| | - Chiara Gramegna
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Dario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, North Rhine-Westphalia, Germany
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, North Rhine-Westphalia, Germany
- Institute of Neuroscience and Medicine, JARA-Institute Brain Structure Function Relationship (INM 10), Research Center Jülich, Wilhelm-Johnen-Straße, 52438, Jülich, Germany
| | - David M A Mehler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, North Rhine-Westphalia, Germany
- Institute for Translational Psychiatry, University of Münster, 48149, Münster, Germany
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff University, Cardiff, CF24 4HQ, UK
| | - Ruben C Gur
- Brain Behavior Laboratories, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, USA
| | - Carmen Weidler
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, North Rhine-Westphalia, Germany
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Hu M, Nitsche MA, Lv Y, Han H, Lin X, Qi F. The effects of repetitive transcranial magnetic and transcranial direct current stimulation on memory functions in older adults with mild cognitive impairment: a systematic review and meta-analysis. Front Hum Neurosci 2024; 18:1436448. [PMID: 39206423 PMCID: PMC11350562 DOI: 10.3389/fnhum.2024.1436448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Mild cognitive impairment (MCI) is a condition that impairs activities of daily living, and often transforms to dementia. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) show promise in improving cognitive functions in MCI patients. In this meta-analysis, we aimed to compare the effects of rTMS and tDCS on memory functions in MCI patients. We explored eight databases from their inception to March 16, 2024. We obtained 11 studies with 406 patients with MCI. We used the standardized mean difference (SMD) with a 95% confidence interval (CI) to synthesize the effect size. rTMS and tDCS significantly improved memory functions in MCI patients (SMD = 0.61; 95% CI: 0.41-0.82; p < 0.00001; I2 = 22%). In subgroup analysis of number of stimulation sessions, both rTMS and tDCS over 10 sessions (SMD = 0.84; 95% CI: 0.50-1.17, p < 0.00001, I2 = 0%) significantly improved the memory function in MCI patients. The subgroup analyses on different stimulation types (SMD = 0.78; 95% CI: 0.51-1.06; p < 0.00001; I2 = 0%) and treatment persistent effects (SMD = 0.93; 95% CI: 0.51-1.35, p < 0.0001, I2 = 0%) showed that rTMS was more effective than tDCS. rTMS with a stimulation frequency of 10 Hz (SMD = 0.86; 95% CI: 0.51-1.21; p < 0.00001; I2 = 0%) and over 10 sessions (SMD = 0.98; 95% CI: 0.58-1.38; p < 0.00001; I2 = 0%) at multiple sites (SMD = 0.97; 95% CI: 0.44-1.49; p = 0.0003; I2 = 0%) showed a great improvement in the memory performance of patients with MCI. rTMS was more likely to appear temporary side effects (risk ratio (RR) = 3.18, 95% CI: 1.29-7.83, p = 0.01). This meta-analysis suggests that rTMS and tDCS are safe and efficient tools to improve memory functions in patients with MCI, while rTMS had a larger effect than tDCS. rTMS with a stimulation frequency of 10 Hz targeted on multiple sites over 10 sessions showed the greatest effect. We could not conclude parameters of tDCS because of insufficient data. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024558991.
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Affiliation(s)
- Mengdie Hu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
| | - Yanxin Lv
- Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
| | - Hairong Han
- Blood Purification Department, The Eighth People’s Hospital of Jinan, Shandong, China
| | - Xu Lin
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
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Boda MR, Otieno LA, Smith AE, Goldsworthy MR, Sidhu SK. Metaplastic neuromodulation via transcranial direct current stimulation has no effect on corticospinal excitability and neuromuscular fatigue. Exp Brain Res 2024; 242:1999-2012. [PMID: 38940961 PMCID: PMC11252223 DOI: 10.1007/s00221-024-06874-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation tool with potential for managing neuromuscular fatigue, possibly due to alterations in corticospinal excitability. However, inconsistencies in intra- and inter- individual variability responsiveness to tDCS limit its clinical use. Emerging evidence suggests harnessing homeostatic metaplasticity induced via tDCS may reduce variability and boost its outcomes, yet little is known regarding its influence on neuromuscular fatigue in healthy adults. We explored whether cathodal tDCS (ctDCS) prior to exercise combined with anodal tDCS (atDCS) could augment corticospinal excitability and attenuate neuromuscular fatigue. 15 young healthy adults (6 males, 22 ± 4 years) participated in four pseudo-randomised neuromodulation sessions: sham stimulation prior and during exercise, sham stimulation prior and atDCS during exercise, ctDCS prior and atDCS during exercise, ctDCS prior and sham stimulation during exercise. The exercise constituted an intermittent maximal voluntary contraction (MVC) of the right first dorsal interosseous (FDI) for 10 min. Neuromuscular fatigue was quantified as an attenuation in MVC force, while motor evoked potential (MEP) amplitude provided an assessment of corticospinal excitability. MEP amplitude increased during the fatiguing exercise, whilst across time, force decreased. There were no differences in MEP amplitudes or force between neuromodulation sessions. These outcomes highlight the ambiguity of harnessing metaplasticity to ameliorate neuromuscular fatigue in young healthy individuals.
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Affiliation(s)
- Madison R Boda
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Lavender A Otieno
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
| | - Ashleigh E Smith
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Mitchell R Goldsworthy
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia
- Behaviour-Brain-Body Research Centre, Justice and Society, University of South Australia, Adelaide, South Australia, Australia
- Hopwood Centre for Neurobiology, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Simranjit K Sidhu
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, 5005, Australia.
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9
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Zhang X, Huang M, Yu Y, Zhong X, Dai S, Dai Y, Jiang C. Is Transcranial Direct Current Stimulation Effective for Cognitive Dysfunction in Substance Use Disorders? A Systematic Review. Brain Sci 2024; 14:754. [PMID: 39199449 PMCID: PMC11352984 DOI: 10.3390/brainsci14080754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Revised: 07/13/2024] [Accepted: 07/25/2024] [Indexed: 09/01/2024] Open
Abstract
Patients with substance use disorders (SUDs) often suffer from cognitive dysfunction (CD), affecting their quality of life and daily functioning. Current treatments, including pharmacotherapy and psychotherapy, have limited efficacy and notable side effects. Transcranial direct current stimulation (tDCS), a non-invasive technique that modulates cortical activity, shows promise in improving cognitive function with minimal side effects and low cost, and could potentially serve as a valuable adjunct to existing therapies. This systematic review aims to evaluate the literature on the effectiveness of tDCS for CD in SUD patients to inform clinical practice and future research. Following PRISMA guidelines, the review includes studies that used tDCS for SUD-related CD. The criteria for inclusion encompassed participants aged 18 and older with a diagnosis of SUD, the use of tDCS (either conventional or high-definition), control groups receiving sham stimulation or no intervention, and cognitive outcome measures for substance-related cognitive function using validated tools. Databases searched were Ovid MEDLINE, PubMed, Web of Science, Embase, Scopus, and PsycINFO, with specific keywords. Twenty-two studies met the criteria, suggesting tDCS can improve cognitive functions in SUD patients, though results varied. Effectiveness may depend on the brain area targeted, stimulation parameters, task requirements, and individual differences. tDCS shows potential in treating SUD-related CD, but further research is needed to optimize stimulation protocols and address study variability. Future studies should use functional magnetic resonance imaging to explore the brain mechanisms by which tDCS improves cognitive function in SUDs and focus on larger, long-term trials to confirm efficacy and refine tDCS treatment parameters.
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Affiliation(s)
- Xinbi Zhang
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
| | - Mingming Huang
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
| | - Ying Yu
- Key Laboratory of Sport Training of General Administration of Sport of China, Beijing Sport University, Beijing 100084, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing 100084, China
| | - Xiaoke Zhong
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Physical Education and Sport Science, Fujian Normal University, No. 18, Wulongjiang Middle Avenue, Shangjie Town, Minhou County, Fuzhou 350108, China
| | - Shengyu Dai
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
| | - Yuanfu Dai
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
| | - Changhao Jiang
- The Center of Neuroscience and Sports, Capital University of Physical Education and Sports, Beijing 100191, China; (X.Z.)
- School of Kinesiology and Health, Capital University of Physical Education and Sports, Beijing 100191, China
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10
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Wilkins EW, Young RJ, Houston D, Kawana E, Lopez Mora E, Sunkara MS, Riley ZA, Poston B. Non-Dominant Hemisphere Excitability Is Unaffected during and after Transcranial Direct Current Stimulation of the Dominant Hemisphere. Brain Sci 2024; 14:694. [PMID: 39061434 PMCID: PMC11274959 DOI: 10.3390/brainsci14070694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/05/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Transcranial direct current stimulation (tDCS) increases primary motor cortex (M1) excitability and improves motor performance when applied unilaterally to the dominant hemisphere. However, the influence of tDCS on contralateral M1 excitability both during and after application has not been quantified. The purpose was to determine the influence of tDCS applied to the dominant M1 on the excitability of the contralateral non-dominant M1. This study employed a double-blind, randomized, SHAM-controlled, within-subject crossover experimental design. Eighteen young adults performed two experimental sessions (tDCS, SHAM) in counterbalanced order separated by a one-week washout. Transcranial magnetic stimulation (TMS) was used to quantify the excitability of the contralateral M1 to which anodal tDCS was applied for 20 min with a current strength of 1 mA. Motor evoked potential (MEP) amplitudes were assessed in 5 TMS test blocks (Pre, D5, D10, D15, and Post). The Pre and Post TMS test blocks were performed immediately before and after tDCS application, whereas the TMS test blocks performed during tDCS were completed at the 5, 10, and 15 min stimulation timepoints. MEPs were analyzed with a 2 condition (tDCS, SHAM) × 5 test (Pre, D5, D10, D15, Post) within-subject ANOVA. The main effect for condition (p = 0.213), the main effect for test (p = 0.502), and the condition × test interaction (p = 0.860) were all not statistically significant. These results indicate that tDCS does not modulate contralateral M1 excitability during or immediately after application, at least under the current set of common tDCS parameters of stimulation.
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Affiliation(s)
- Erik W. Wilkins
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV 89154, USA;
- Interdisciplinary Ph.D. Program in Neuroscience, University of Nevada, Las Vegas, NV 89154, USA;
| | - Richard J. Young
- Interdisciplinary Ph.D. Program in Neuroscience, University of Nevada, Las Vegas, NV 89154, USA;
| | - Daniel Houston
- School of Medicine, University of Nevada, Las Vegas, NV 89154, USA; (D.H.); (E.K.); (E.L.M.)
| | - Eric Kawana
- School of Medicine, University of Nevada, Las Vegas, NV 89154, USA; (D.H.); (E.K.); (E.L.M.)
| | - Edgar Lopez Mora
- School of Medicine, University of Nevada, Las Vegas, NV 89154, USA; (D.H.); (E.K.); (E.L.M.)
| | - Meghana S. Sunkara
- Department of Biology, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | - Zachary A. Riley
- Department of Kinesiology, Indiana University Purdue University Indianapolis, Indianapolis, IN 46202, USA;
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada, Las Vegas, NV 89154, USA;
- Interdisciplinary Ph.D. Program in Neuroscience, University of Nevada, Las Vegas, NV 89154, USA;
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11
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Borzooee B, Aghayan S, Hassani-Abharian P, Emamian MH. Effect of Transcranial Direct Current Stimulation on Craving, Cognitive Functions, and Serum Brain-Derived Neurotrophic Factor Level in Individuals on Maintenance Treatment for Opioid Use Disorder, A Randomized Sham-Controlled Trial. J ECT 2024:00124509-990000000-00184. [PMID: 38981034 DOI: 10.1097/yct.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
OBJECTIVES To investigate the effects of transcranial direct current stimulation (tDCS) on brain-derived neurotrophic factor (BDNF) levels, craving, and executive functions in individuals on maintenance treatment for opioid use. METHODS We randomized 70 right-handed men aged 18-55 years into 2 groups: the intervention group and the sham group. The intervention was 10 sessions of 2 mA stimulation over 5 days. Each session in the sham group ended after 30 seconds. Craving was measured using the Desire for Drug Questionnaire (DDQ), Obsessive Compulsive Drug Use Scale (OCDUS), and visual analog scale (VAS). The measurements were taken before and after the intervention, as well as 2 months later. BDNF was measured before and after the intervention. Repeated-measures analysis of variance, the generalized estimating equation model, and independent t test were used for data analysis. RESULTS The mean differences (95% confidence intervals) in pre and post craving scores in the intervention group were (12.71 [9.10 to 16.32], P = 0.167) for VAS, (1.54 [1.12 to 1.96], P = 0.012) for OCDUS, and (1.71 [1.27 to 2.15], P = 0.125) for DDQ. These measures in the control group were -0.44 (-1.19 to 0.30), 0.01 (-0.21 to 0.23), and 0.126 (-0.11 to 0.36), respectively. BDNF serum levels significantly increased after the intervention (difference, 0.84 [0.69 to 0.99], P < 0.001); however, this change was not significant in the generalized estimating equation model. The effect of tDCS on craving was significant in OCDUS, but not significant in VAS and DDQ. CONCLUSIONS The tDCS reduces craving and improves executive functions in the short term. BDNF serum level was not associated with tDCS.
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Affiliation(s)
| | - Shahrokh Aghayan
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud
| | - Peyman Hassani-Abharian
- Department of Cognitive Psychology and Cognitive Rehabilitation, Institute for Cognitive Science Studies, Tehran
| | - Mohammad Hassan Emamian
- Ophthalmic Epidemiology Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
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12
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Santander T, Leslie S, Li LJ, Skinner HE, Simonson JM, Sweeney P, Deen KP, Miller MB, Brunye TT. Towards optimized methodological parameters for maximizing the behavioral effects of transcranial direct current stimulation. Front Hum Neurosci 2024; 18:1305446. [PMID: 39015825 PMCID: PMC11250584 DOI: 10.3389/fnhum.2024.1305446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 06/12/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) administers low-intensity direct current electrical stimulation to brain regions via electrodes arranged on the surface of the scalp. The core promise of tDCS is its ability to modulate brain activity and affect performance on diverse cognitive functions (affording causal inferences regarding regional brain activity and behavior), but the optimal methodological parameters for maximizing behavioral effects remain to be elucidated. Here we sought to examine the effects of 10 stimulation and experimental design factors across a series of five cognitive domains: motor performance, visual search, working memory, vigilance, and response inhibition. The objective was to identify a set of optimal parameter settings that consistently and reliably maximized the behavioral effects of tDCS within each cognitive domain. Methods We surveyed tDCS effects on these various cognitive functions in healthy young adults, ultimately resulting in 721 effects across 106 published reports. Hierarchical Bayesian meta-regression models were fit to characterize how (and to what extent) these design parameters differentially predict the likelihood of positive/negative behavioral outcomes. Results Consistent with many previous meta-analyses of tDCS effects, extensive variability was observed across tasks and measured outcomes. Consequently, most design parameters did not confer consistent advantages or disadvantages to behavioral effects-a domain-general model suggested an advantage to using within-subjects designs (versus between-subjects) and the tendency for cathodal stimulation (relative to anodal stimulation) to produce reduced behavioral effects, but these associations were scarcely-evident in domain-specific models. Discussion These findings highlight the urgent need for tDCS studies to more systematically probe the effects of these parameters on behavior to fulfill the promise of identifying causal links between brain function and cognition.
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Affiliation(s)
- Tyler Santander
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Sara Leslie
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Luna J. Li
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Henri E. Skinner
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Jessica M. Simonson
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Patrick Sweeney
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Kaitlyn P. Deen
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Michael B. Miller
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Tad T. Brunye
- U. S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
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13
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Tseng PT, Zeng BY, Wang HY, Zeng BS, Liang CS, Chen YCB, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Li DJ, Lin PY, Chen YW, Hsu CW, Hung KC, Shiue YL, Li CT. Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta-analysis of randomized controlled trials. Acta Psychiatr Scand 2024; 150:5-21. [PMID: 38616056 DOI: 10.1111/acps.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Despite its high lifetime prevalence rate and the elevated disability caused by posttraumatic stress disorder (PTSD), treatments exhibit modest efficacy. In consideration of the abnormal connectivity between the dorsolateral prefrontal cortex (DLPFC) and amygdala in PTSD, several randomized controlled trials (RCTs) addressing the efficacy of different noninvasive brain stimulation (NIBS) modalities for PTSD management have been undertaken. However, previous RCTs have reported inconsistent results. The current network meta-analysis (NMA) aimed to compare the efficacy and acceptability of various NIBS protocols in PTSD management. METHODS We systematically searched ClinicalKey, Cochrane Central Register of Controlled Trials, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov to identify relevant RCTs. The targeted RCTs was those comparing the efficacy of NIBS interventions, such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and transcutaneous cervical vagal nerve stimulation, in patients with PTSD. The NMA was conducted using a frequentist model. The primary outcomes were changes in the overall severity of PTSD and acceptability (to be specific, rates of dropouts for any reason). RESULTS We identified 14 RCTs that enrolled 686 participants. The NMA demonstrated that among the investigated NIBS types, high-frequency rTMS over bilateral DLPFCs was associated with the greatest reduction in overall PTSD severity. Further, in comparison with the sham controls, excitatory stimulation over the right DLPFC with/without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms, including depression and anxiety symptoms, and overall PTSD severity. CONCLUSIONS This NMA demonstrated that excitatory stimulation over the right DLPFC with or without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms. TRIAL REGISTRATION PROSPERO CRD42023391562.
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Affiliation(s)
- Ping-Tao Tseng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Yan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Wang
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yang-Chieh Brian Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
- Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
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14
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Tabari F, Patron C, Cryer H, Johari K. HD-tDCS over left supplementary motor area differentially modulated neural correlates of motor planning for speech vs. limb movement. Int J Psychophysiol 2024; 201:112357. [PMID: 38701898 DOI: 10.1016/j.ijpsycho.2024.112357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 05/05/2024]
Abstract
The supplementary motor area (SMA) is implicated in planning, execution, and control of speech production and limb movement. The SMA is among putative generators of pre-movement EEG activity which is thought to be neural markers of motor planning. In neurological conditions such as Parkinson's disease, abnormal pre-movement neural activity within the SMA has been reported during speech production and limb movement. Therefore, this region can be a potential target for non-invasive brain stimulation for both speech and limb movement. The present study took an initial step in examining the application of high-definition transcranial direct current stimulation (HD-tDCS) over the left SMA in 24 neurologically intact adults. Subsequently, event-related potentials (ERPs) were recorded while participants performed speech and limb movement tasks. Participants' data were collected in three counterbalanced sessions: anodal, cathodal and sham HD-tDCS. Relative to sham stimulation, anodal, but not cathodal, HD-tDCS significantly attenuated ERPs prior to the onset of the speech production. In contrast, neither anodal nor cathodal HD-tDCS significantly modulated ERPs prior to the onset of limb movement compared to sham stimulation. These findings showed that neural correlates of motor planning can be modulated using HD-tDCS over the left SMA in neurotypical adults, with translational implications for neurological conditions that impair speech production. The absence of a stimulation effect on ERPs prior to the onset of limb movement was not expected in this study, and future studies are warranted to further explore this effect.
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Affiliation(s)
- Fatemeh Tabari
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Celeste Patron
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Hope Cryer
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA
| | - Karim Johari
- Human Neurophysiology and Neuromodulation Lab, Communication Sciences and Disorders, Louisiana State University, Baton Rouge, LA, USA.
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15
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Ikarashi H, Otsuru N, Gomez-Tames J, Hirata A, Nagasaka K, Miyaguchi S, Sakurai N, Ohno K, Kodama N, Onishi H. Modulation of pain perception through transcranial alternating current stimulation and its nonlinear relationship with the simulated electric field magnitude. Eur J Pain 2024; 28:1018-1028. [PMID: 38318653 DOI: 10.1002/ejp.2249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Oscillatory activities observed in multiple regions are closely associated with the experience of pain. Specifically, oscillatory activities within the theta- and beta-frequency bands, observed in the left dorsolateral prefrontal cortex (DLPFC), have been implicated in pain perception among healthy individuals and those with chronic pain. However, their physiological significance remains unclear. METHODS We explored the modulation of pain perception in healthy individuals by theta- and beta-band transcranial alternating current stimulation (tACS) over the left DLPFC and examined the relationship between the modulation effect and magnitude of the electric field elicited by tACS in the left DLPFC using computational simulation. RESULTS Our findings revealed that both theta- and beta-tACS increased the heat pain threshold during and after stimulation. Notably, the simulated electric field magnitude in the left DLPFC exhibited an inverted U-shaped relationship with the pain modulation effect for theta-tACS. CONCLUSIONS Our study findings suggested that there would be an optimal electric field strength to produce a high analgesic effect for theta-tACS. SIGNIFICANCE The application of theta- and beta-tACS interventions targeting the left DLPFC might facilitate the treatment of chronic pain. Furthermore, the attainment of effective pain modulation via theta-tACS over the DLPFC warrants the use of optimal stimulus intensity.
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Affiliation(s)
- H Ikarashi
- Graduate School, Niigata University of Health and Welfare, Niigata, Japan
| | - N Otsuru
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - J Gomez-Tames
- Department of Electromechanical Engineering, Nagoya Institute of Technology, Nagoya, Aichi, Japan
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Aichi, Japan
| | - A Hirata
- Department of Electromechanical Engineering, Nagoya Institute of Technology, Nagoya, Aichi, Japan
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya, Aichi, Japan
| | - K Nagasaka
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - S Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - N Sakurai
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - K Ohno
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - N Kodama
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - H Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
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16
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Jung J, Salazar Fajardo JC, Kim S, Kim B, Oh S, Yoon B. Effect of Transcranial Direct Current Stimulation with Balance Training in a Middle-Aged Population: Randomized Double-Blind Sham-Controlled Trial. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024; 30:662-670. [PMID: 38237128 DOI: 10.1089/jicm.2023.0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
Introduction: The first signs of deteriorated balance impairment begin during middle age. Early intervention could delay the fall risk in older populations; hence, addressing balance deficits during this age is crucial. The authors aimed to determine the effects of transcranial direct current stimulation (tDCS) combined with balance training (BT) on the improvement of static and dynamic balance in a middle-aged population, along with the participants' safety and satisfaction. Methods: Participants (n = 28) were randomized into two groups: active tDCS (active tDCS + BT) and sham tDCS (sham tDCS + BT). Both groups received the intervention thrice a week for 6 weeks. Dynamic and static balance were assessed by sway rate changes with eyes open and closed, and the functional reach test and a postintervention survey were conducted to assess participants' safety and satisfaction. Results: The active tDCS group showed significantly greater static and dynamic balance improvements in sway scores. The surveys demonstrated the safety of the program and satisfaction of 80% of the participants with the combined intervention. Conclusion: tDCS could be used in a middle-aged population as part of regular BT to improve balance and minimize the risk of balance deficits in older populations while ensuring patient safety and satisfaction. This study is a subanalysis of a larger clinical trial that included young adults as well (Clinical trial number: KCT0007414).
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Affiliation(s)
- Juho Jung
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
| | - Jhosedyn Carolaym Salazar Fajardo
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
| | - Seongkuk Kim
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
- BK21FOUR R&E Center for Learning Health Systems, Korea University, Seongbuk-gu, Seoul, Korea
| | - Byeongsu Kim
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
- BK21FOUR R&E Center for Learning Health Systems, Korea University, Seongbuk-gu, Seoul, Korea
| | - Sejun Oh
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
| | - BumChul Yoon
- Department of Public Health, Major of Rehabilitation Science, College of Health Science, Korea University, Seongbuk-gu, Seoul, Korea
- Department of Health Sciences, Graduate School, Korea University, Seongbuk-gu, Seoul, Korea
- BK21FOUR R&E Center for Learning Health Systems, Korea University, Seongbuk-gu, Seoul, Korea
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17
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Mugnol-Ugarte L, Bortolini T, Yao B, Mikkelsen M, Carneiro Monteiro M, Andorinho de Freitas Ferreira AC, Bramatti I, Melo B, Hoefle S, Meireles F, Moll J, Pobric G. Transcranial electrical stimulation modulates emotional experience and metabolites in the prefrontal cortex in a donation task. Sci Rep 2024; 14:14271. [PMID: 38902321 PMCID: PMC11190244 DOI: 10.1038/s41598-024-64876-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 06/13/2024] [Indexed: 06/22/2024] Open
Abstract
Understanding the neural, metabolic, and psychological mechanisms underlying human altruism and decision-making is a complex and important topic both for science and society. Here, we investigated whether transcranial Direct Current Stimulation (tDCS) applied to two prefrontal cortex regions, the ventromedial prefrontal cortex (vmPFC, anode) and the right dorsolateral prefrontal cortex (DLPFC, cathode) can induce changes in self-reported emotions and to modulate local metabolite concentrations. We employed in vivo quantitative MR Spectroscopy in healthy adult participants and quantified changes in GABA and Glx (glutamate + glutamine) before and after five sessions of tDCS delivered at 2 mA for 20 min (active group) and 1 min (sham group) while participants were engaged in a charitable donation task. In the active group, we observed increased levels of GABA in vmPFC. Glx levels decreased in both prefrontal regions and self-reported happiness increased significantly over time in the active group. Self-reported guiltiness in both active and sham groups tended to decrease. The results indicate that self-reported happiness can be modulated, possibly due to changes in Glx concentrations following repeated stimulation. Therefore, local changes may induce remote changes in the reward network through interactions with other metabolites, previously thought to be unreachable with noninvasive stimulation techniques.
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Affiliation(s)
- Luiza Mugnol-Ugarte
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
| | - Tiago Bortolini
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Bo Yao
- Department of Psychology, Lancaster University, Lancaster, United Kingdom
| | - Mark Mikkelsen
- Department of Radiology, Weill Cornell Medicine, New York, United States of America
| | - Marina Carneiro Monteiro
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | | | - Ivanei Bramatti
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Bruno Melo
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Sebastian Hoefle
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Fernanda Meireles
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Jorge Moll
- Cognitive Neuroscience and Neuroinformatics Unit, The D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil
| | - Gorana Pobric
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, United Kingdom
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18
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Sloane KL, Hamilton RH. Transcranial Direct Current Stimulation to Ameliorate Post-Stroke Cognitive Impairment. Brain Sci 2024; 14:614. [PMID: 38928614 PMCID: PMC11202055 DOI: 10.3390/brainsci14060614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Post-stroke cognitive impairment is a common and disabling condition with few effective therapeutic options. After stroke, neural reorganization and other neuroplastic processes occur in response to ischemic injury, which can result in clinical improvement through spontaneous recovery. Neuromodulation through transcranial direct current stimulation (tDCS) is a promising intervention to augment underlying neuroplasticity in order to improve cognitive function. This form of neuromodulation leverages mechanisms of neuroplasticity post-stroke to optimize neural reorganization and improve function. In this review, we summarize the current state of cognitive neurorehabilitation post-stroke, the practical features of tDCS, its uses in stroke-related cognitive impairment across cognitive domains, and special considerations for the use of tDCS in the post-stroke patient population.
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Affiliation(s)
- Kelly L. Sloane
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Roy H. Hamilton
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Meinzer M, Shahbabaie A, Antonenko D, Blankenburg F, Fischer R, Hartwigsen G, Nitsche MA, Li SC, Thielscher A, Timmann D, Waltemath D, Abdelmotaleb M, Kocataş H, Caisachana Guevara LM, Batsikadze G, Grundei M, Cunha T, Hayek D, Turker S, Schlitt F, Shi Y, Khan A, Burke M, Riemann S, Niemann F, Flöel A. Investigating the neural mechanisms of transcranial direct current stimulation effects on human cognition: current issues and potential solutions. Front Neurosci 2024; 18:1389651. [PMID: 38957187 PMCID: PMC11218740 DOI: 10.3389/fnins.2024.1389651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/15/2024] [Indexed: 07/04/2024] Open
Abstract
Transcranial direct current stimulation (tDCS) has been studied extensively for its potential to enhance human cognitive functions in healthy individuals and to treat cognitive impairment in various clinical populations. However, little is known about how tDCS modulates the neural networks supporting cognition and the complex interplay with mediating factors that may explain the frequently observed variability of stimulation effects within and between studies. Moreover, research in this field has been characterized by substantial methodological variability, frequent lack of rigorous experimental control and small sample sizes, thereby limiting the generalizability of findings and translational potential of tDCS. The present manuscript aims to delineate how these important issues can be addressed within a neuroimaging context, to reveal the neural underpinnings, predictors and mediators of tDCS-induced behavioral modulation. We will focus on functional magnetic resonance imaging (fMRI), because it allows the investigation of tDCS effects with excellent spatial precision and sufficient temporal resolution across the entire brain. Moreover, high resolution structural imaging data can be acquired for precise localization of stimulation effects, verification of electrode positions on the scalp and realistic current modeling based on individual head and brain anatomy. However, the general principles outlined in this review will also be applicable to other imaging modalities. Following an introduction to the overall state-of-the-art in this field, we will discuss in more detail the underlying causes of variability in previous tDCS studies. Moreover, we will elaborate on design considerations for tDCS-fMRI studies, optimization of tDCS and imaging protocols and how to assure high-level experimental control. Two additional sections address the pressing need for more systematic investigation of tDCS effects across the healthy human lifespan and implications for tDCS studies in age-associated disease, and potential benefits of establishing large-scale, multidisciplinary consortia for more coordinated tDCS research in the future. We hope that this review will contribute to more coordinated, methodologically sound, transparent and reproducible research in this field. Ultimately, our aim is to facilitate a better understanding of the underlying mechanisms by which tDCS modulates human cognitive functions and more effective and individually tailored translational and clinical applications of this technique in the future.
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Affiliation(s)
- Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Alireza Shahbabaie
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Daria Antonenko
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Felix Blankenburg
- Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Rico Fischer
- Department of Psychology, University of Greifswald, Greifswald, Germany
| | - Gesa Hartwigsen
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Wilhelm Wundt Institute for Psychology, Leipzig University, Leipzig, Germany
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dortmund, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
- Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Bielefeld, Germany
| | - Shu-Chen Li
- Chair of Lifespan Developmental Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Axel Thielscher
- Section for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Dagmar Waltemath
- Core Unit Data Integration Center, University Medicine Greifswald, Greifswald, Germany
| | | | - Harun Kocataş
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | | | - Giorgi Batsikadze
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Miro Grundei
- Neurocomputation and Neuroimaging Unit, Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Teresa Cunha
- Section for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Dayana Hayek
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Sabrina Turker
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Wilhelm Wundt Institute for Psychology, Leipzig University, Leipzig, Germany
| | - Frederik Schlitt
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Yiquan Shi
- Chair of Lifespan Developmental Neuroscience, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Asad Khan
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dortmund, Germany
| | - Michael Burke
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund, Dortmund, Germany
| | - Steffen Riemann
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Filip Niemann
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE Site Greifswald), Greifswald, Germany
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20
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Meek AW, Greenwell DR, Nishio H, Poston B, Riley ZA. Anodal M1 tDCS enhances online learning of rhythmic timing videogame skill. PLoS One 2024; 19:e0295373. [PMID: 38870202 PMCID: PMC11175489 DOI: 10.1371/journal.pone.0295373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/16/2024] [Indexed: 06/15/2024] Open
Abstract
Transcranial direct current stimulation (tDCS) has been shown to modify excitability of the primary motor cortex (M1) and influence online motor learning. However, research on the effects of tDCS on motor learning has focused predominantly on simplified motor tasks. The purpose of the present study was to investigate whether anodal stimulation of M1 over a single session of practice influences online learning of a relatively complex rhythmic timing video game. Fifty-eight healthy young adults were randomized to either a-tDCS or SHAM conditions and performed 2 familiarization blocks, a 20-minute 5 block practice period while receiving their assigned stimulation, and a post-test block with their non-dominant hand. To assess performance, a performance index was calculated that incorporated timing accuracy elements and incorrect key inputs. The results showed that M1 a-tDCS enhanced the learning of the video game based skill more than SHAM stimulation during practice, as well as overall learning at the post-test. These results provide evidence that M1 a-tDCS can enhance acquisition of skills where quality or success of performance depends on optimized timing between component motions of the skill, which could have implications for the application of tDCS in many real-world contexts.
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Affiliation(s)
- Anthony W. Meek
- School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, United States of America
| | - Davin R. Greenwell
- School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, United States of America
| | - Hayami Nishio
- Department of Human Physiology, University of Oregon, Eugene, WA, United States of America
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States of America
| | - Zachary A. Riley
- School of Health and Human Sciences, Indiana University Indianapolis, Indianapolis, IN, United States of America
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21
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Imperio CM, Chua EF. Lack of effects of online HD-tDCS over the left or right DLPFC in an associative memory and metamemory monitoring task. PLoS One 2024; 19:e0300779. [PMID: 38848375 PMCID: PMC11161112 DOI: 10.1371/journal.pone.0300779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 06/09/2024] Open
Abstract
Neuroimaging studies have shown that activity in the prefrontal cortex correlates with two critical aspects of normal memory functioning: retrieval of episodic memories and subjective "feelings-of-knowing" about our memory. Brain stimulation can be used to test the causal role of the prefrontal cortex in these processes, and whether the role differs for the left versus right prefrontal cortex. We compared the effects of online High-Definition transcranial Direct Current Stimulation (HD-tDCS) over the left or right dorsolateral prefrontal cortex (DLPFC) compared to sham during a proverb-name associative memory and feeling-of-knowing task. There were no significant effects of HD-tDCS on either associative recognition or feeling-of-knowing performance, with Bayesian analyses showing moderate support for the null hypotheses. Despite past work showing effects of HD-tDCS on other memory and feeling-of-knowing tasks, and neuroimaging showing effects with similar tasks, these findings add to the literature of non-significant effects with tDCS. This work highlights the need to better understand factors that determine the effectiveness of tDCS, especially if tDCS is to have a successful future as a clinical intervention.
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Affiliation(s)
- Casey M Imperio
- The Graduate Center of the City University of New York, New York, New York, United States of America
| | - Elizabeth F Chua
- The Graduate Center of the City University of New York, New York, New York, United States of America
- Brooklyn College of the City University of New York, New York, New York, United States of America
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22
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Yaseri A, Roozbeh M, Kazemi R, Lotfinia S. Brain stimulation for patients with multiple sclerosis: an umbrella review of therapeutic efficacy. Neurol Sci 2024; 45:2549-2559. [PMID: 38289559 DOI: 10.1007/s10072-024-07365-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/25/2024] [Indexed: 05/12/2024]
Abstract
Multiple sclerosis patients often experience various symptoms that can greatly impact their quality of life. There are various brain stimulation techniques that have been evaluated for their ability to reduce the symptoms of multiple sclerosis. However, there is inconsistency in the specific stimulation methods used and the symptoms targeted in the existing research. This umbrella review conducted in order to evaluate the effectiveness of brain stimulation and identify limitations and gaps for further research. In this umbrella review, we conducted a searched on Web of Knowledge, PubMed, and Scopus database. We specifically looked for reviews, with or without meta-analyses, that have investigated the effects of brain stimulation methods on symptoms of multiple sclerosis. All articles were examined by AMSTAR 2 (A Measure Tool to Assess Systematic Review 2). We identified 155 articles, of which 14 were eligible for inclusion. Of those, five were qualitative studies and nine were meta-analyses. Among the included studies, four examined the use of deep brain stimulation, while ten investigated the therapeutic potential of noninvasive brain stimulation. Considering the heterogeneity of studies, the current evidence suggests that repetitive transcranial magnetic stimulation may be effective in treating pain and improving motor function, while transcranial direct current stimulation may be useful in alleviating fatigue and enhancing certain aspects of cognitive performance. Deep brain stimulation, on the other hand, appears to be effective in reducing tremors. However, further research is warranted to validate these findings and address the existing limitations in the field.
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Affiliation(s)
- Aram Yaseri
- School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Mehrdad Roozbeh
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Kazemi
- Department of Cognitive Psychology, Institute for Cognitive Science Studies, Tehran, Iran
| | - Shahab Lotfinia
- Department of Clinical Psychology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran.
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23
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Kraft JN, Indahlastari A, Boutzoukas EM, Hausman HK, Hardcastle C, Albizu A, O'Shea A, Evangelista ND, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, DeKosky ST, Hishaw GA, Wu S, Marsiske M, Cohen R, Alexander GE, Porges E, Woods AJ. The impact of a tDCS and cognitive training intervention on task-based functional connectivity. GeroScience 2024; 46:3325-3339. [PMID: 38265579 PMCID: PMC11009202 DOI: 10.1007/s11357-024-01077-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/15/2024] [Indexed: 01/25/2024] Open
Abstract
Declines in several cognitive domains, most notably processing speed, occur in non-pathological aging. Given the exponential growth of the older adult population, declines in cognition serve as a significant public health issue that must be addressed. Promising studies have shown that cognitive training in older adults, particularly using the useful field of view (UFOV) paradigm, can improve cognition with moderate to large effect sizes. Additionally, meta-analyses have found that transcranial direct current stimulation (tDCS), a non-invasive form of brain stimulation, can improve cognition in attention/processing speed and working memory. However, only a handful of studies have looked at concomitant tDCS and cognitive training, usually with short interventions and small sample sizes. The current study assessed the effect of a tDCS (active versus sham) and a 3-month cognitive training intervention on task-based functional connectivity during completion of the UFOV task in a large older adult sample (N = 153). We found significant increased functional connectivity between the left and right pars triangularis (the ROIs closest to the electrodes) following active, but not sham tDCS. Additionally, we see trending behavioral improvements associated with these functional connectivity changes in the active tDCS group, but not sham. Collectively, these findings suggest that tDCS and cognitive training can be an effective modulator of task-based functional connectivity above and beyond a cognitive training intervention alone.
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Affiliation(s)
- Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- McKnight Brain Institute and Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, USA
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- McKnight Brain Institute and Department of Neurology, University of Florida, Gainesville, FL, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, 1249 Center Drive, Gainesville, FL, 32603, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
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24
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Claaß LV, Hedrich A, Reinelt J, Sehm B, Villringer A, Schlagenhauf F, Kaminski J. Influence of noninvasive brain stimulation on connectivity and local activation: a combined tDCS and fMRI study. Eur Arch Psychiatry Clin Neurosci 2024; 274:827-835. [PMID: 37597023 PMCID: PMC11127864 DOI: 10.1007/s00406-023-01666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/31/2023] [Indexed: 08/21/2023]
Abstract
The effect of transcranial direct current stimulation (tDCS) on neurobiological mechanisms underlying executive function in the human brain remains elusive. This study aims at examining the effect of anodal and cathodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) in comparison with sham stimulation on resting-state connectivity as well as functional activation and working memory performance. We hypothesized perturbed fronto-parietal resting-state connectivity during stimulation and altered working memory performance combined with modified functional working memory-related activation. We applied tDCS with 1 mA for 21 min over the DLPFC inside an fMRI scanner. During stimulation, resting-state fMRI was acquired and task-dependent fMRI during working memory task performance was acquired directly after stimulation. N = 36 healthy subjects were studied in a within-subject design with three different experimental conditions (anodal, cathodal and sham) in a double-blind design. Seed-based functional connectivity analyses and dynamic causal modeling were conducted for the resting-state fMRI data. We found a significant stimulation by region interaction in the seed-based ROI-to-ROI resting-state connectivity, but no effect on effective connectivity. We also did not find an effect of stimulation on task-dependent signal alterations in working memory activation in our regions of interest and no effect on working memory performance parameters. We found effects on measures of seed-based resting-state connectivity, while measures of effective connectivity and task-based connectivity did not show any stimulation effect. We could not replicate previous findings of tDCS stimulation effects on behavioral outcomes. We critically discuss possible methodological limitations and implications for future studies.
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Affiliation(s)
- Luise Victoria Claaß
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Annika Hedrich
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Janis Reinelt
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Day Clinic for Cognitive Neurology, University Hospital at the University of Leipzig, Liebigstraße 16, 04103, Leipzig, Germany
- Berlin School of Mind and Brain, MindBrainBody Institute, Humboldt-Universität zu Berlin, Unter den Linden 6, 10999, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Jakob Kaminski
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany.
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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25
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Palm U, Obergfell M, Rabenstein A, Björklund J, Koller G, Padberg F, Rüther T. Transcranial direct current stimulation combined with a brief intervention for smoking cessation: a randomized double-blind clinical trial. Eur Arch Psychiatry Clin Neurosci 2024; 274:1001-1011. [PMID: 37955682 PMCID: PMC11127809 DOI: 10.1007/s00406-023-01705-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/15/2023] [Indexed: 11/14/2023]
Abstract
Non-invasive brain stimulation methods are currently being evaluated for treatment of addictive disorders. Some evidence indicates that modulating left and right prefrontal brain activity by transcranial direct current stimulation (tDCS) can reduce craving and relapse rates in tobacco addiction. Therefore, this study investigated the effects of active and sham tDCS as an add-on treatment to a standardized brief intervention for smoking cessation. This randomized, double-blind study included 36 participants (22 women and 14 men) with nicotine dependence according to ICD-10 criteria. At five visits on alternate days, participants underwent a 20-min active or sham tDCS over the left dorsolateral prefrontal cortex and subsequently participated in a 10-min brief intervention for smoking cessation. Patients were followed up after 3 months. On each treatment day and at follow-up, abstinence was assessed as the smoking status nonsmoker and craving was assessed with the German version of the Questionnaire on Smoking Urges. At each visit, the number of cigarettes smoked per day was recorded and carbon monoxide in expired air and cotinine in saliva were measured. At follow-up, a study-specific questionnaire was used to assess tobacco use. All 36 participants completed the treatment sessions, but one participant in each group was lost to follow-up. Abstinence rates were not significantly different between the groups at any of the study visits, but craving was significantly lower in the active group at tDCS session 5 compared with session 1. tDCS combined with a brief intervention may support smoking cessation, but studies need to evaluate whether longer and more intensive treatment can achieve significant, sustainable effects.
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Affiliation(s)
- Ulrich Palm
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
- Medical Park Chiemseeblick, Bernau-Felden, Germany
| | - Mark Obergfell
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Andrea Rabenstein
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Jonas Björklund
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Gabi Koller
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany
| | - Tobias Rüther
- Department of Psychiatry and Psychotherapy, LMU University Hospital Munich, Nußbaumstraße 7, 80336, Munich, Germany.
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Schroeder PA, Nuerk HC, Svaldi J. High-definition turns timing-dependent: Different behavioural consequences during and following cathodal high-definition transcranial direct current stimulation (HD tDCS) in a magnitude classification task. Eur J Neurosci 2024; 59:2967-2978. [PMID: 38566366 DOI: 10.1111/ejn.16321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 02/09/2024] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
Neuromodulation with transcranial direct current stimulation (tDCS) can transiently alter neural activity, but its spatial precision is low. High-definition (HD) tDCS was introduced to increase spatial precision by placing additional electrodes over the scalp. Initial evaluations of HD tDCS indicated polarity-specific neurophysiological effects-similar to conventional tDCS albeit with greater spatial precision. Here, we compared the effects of cathodal tDCS or HD tDCS in a 4 × 1 configuration over prefrontal cortex (PFC) regions on behavioural outcomes in a magnitude classification task. We report results on overall performance, on the numerical distance effect as a measure of numerical processing, and on the spatial-numerical associations of response codes (SNARC) effect, which was previously affected by prefrontal tDCS. Healthy volunteers (n = 68) received sham or cathodal HD tDCS at 1 mA over the left dorsolateral prefrontal cortex (DLPFC) or the left inferior frontal gyrus (IFG). Results were compared to an identical protocol with conventional cathodal tDCS to the left PFC versus sham (n = 64). Mixed effects models showed performance gains relative to sham tDCS in all conditions after tDCS (i.e. 'offline'), whereas montages over PFC and DLPFC already showed performance gains during tDCS (i.e. 'online'). In contrast to conventional tDCS, HD tDCS did not reduce the SNARC effect. Neither condition affected numerical processing, as expected. The results suggest that HD tDCS with cathodal polarity might require further adjustments (i.e. regarding tDCS intensity) for effective modulations of cognitive-behavioural performance, which could be achieved by individualised current density in electric field modelling.
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Affiliation(s)
- Philipp A Schroeder
- Department of Psychology, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
| | - Hans-Christoph Nuerk
- Department of Psychology, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
| | - Jennifer Svaldi
- Department of Psychology, University of Tübingen, Tübingen, Germany
- German Center for Mental Health (DZPG), Tübingen, Germany
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Ehrhardt SE, Wards Y, Rideaux R, Marjańska M, Jin J, Cloos MA, Deelchand DK, Zöllner HJ, Saleh MG, Hui SCN, Ali T, Shaw TB, Barth M, Mattingley JB, Filmer HL, Dux PE. Neurochemical Predictors of Generalized Learning Induced by Brain Stimulation and Training. J Neurosci 2024; 44:e1676232024. [PMID: 38531634 PMCID: PMC11112648 DOI: 10.1523/jneurosci.1676-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/22/2024] [Accepted: 03/08/2024] [Indexed: 03/28/2024] Open
Abstract
Methods of cognitive enhancement for humans are most impactful when they generalize across tasks. However, the extent to which such "transfer" is possible via interventions is widely debated. In addition, the contribution of excitatory and inhibitory processes to such transfer is unknown. Here, in a large-scale neuroimaging individual differences study with humans (both sexes), we paired multitasking training and noninvasive brain stimulation (transcranial direct current stimulation, tDCS) over multiple days and assessed performance across a range of paradigms. In addition, we varied tDCS dosage (1.0 and 2.0 mA), electrode montage (left or right prefrontal regions), and training task (multitasking vs a control task) and assessed GABA and glutamate concentrations via ultrahigh field 7T magnetic resonance spectroscopy. Generalized benefits were observed in spatial attention, indexed by visual search performance, when multitasking training was combined with 1.0 mA stimulation targeting either the left or right prefrontal cortex (PFC). This transfer effect persisted for ∼30 d post intervention. Critically, the transferred benefits associated with right prefrontal tDCS were predicted by pretraining concentrations of glutamate in the PFC. Thus, the effects of this combined stimulation and training protocol appear to be linked predominantly to excitatory brain processes.
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Affiliation(s)
- Shane E Ehrhardt
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Yohan Wards
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Reuben Rideaux
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland 4072, Australia
- School of Psychology, The University of Sydney, Sydney, New South Wales 2050, Australia
| | - Małgorzata Marjańska
- Department of Radiology, Centre for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota 55455
| | - Jin Jin
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland 4072, Australia
- Siemens Healthcare Pty Ltd., Brisbane, Queensland 4006, Australia
| | - Martijn A Cloos
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Dinesh K Deelchand
- Department of Radiology, Centre for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minnesota 55455
| | - Helge J Zöllner
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
| | - Muhammad G Saleh
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201
| | - Steve C N Hui
- The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287
| | - Tonima Ali
- School of Biomedical Engineering, The University of Sydney, Sydney, New South Wales 2050, Australia
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales 2050, Australia
| | - Thomas B Shaw
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland 4072, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Markus Barth
- Centre for Advanced Imaging, The University of Queensland, St Lucia, Queensland 4072, Australia
- School of Information Technology and Electrical Engineering, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Jason B Mattingley
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland 4072, Australia
- Canadian Institute for Advanced Research (CIFAR), Toronto, Ontario M5G 1M1, Canada
| | - Hannah L Filmer
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, St Lucia, Queensland 4072, Australia
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Metelski N, Gu Y, Quinn L, Friel KM, Gordon AM. Safety and efficacy of non-invasive brain stimulation for the upper extremities in children with cerebral palsy: A systematic review. Dev Med Child Neurol 2024; 66:573-597. [PMID: 37528530 DOI: 10.1111/dmcn.15720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
AIM To evaluate available evidence examining safety and efficacy of non-invasive brain stimulation (NIBS) on upper extremity outcomes in children with cerebral palsy (CP). METHOD We electronically searched 12 sources up to May 2023 using JBI and Cochrane guidelines. Two reviewers selected articles with predetermined eligibility criteria, conducted data extraction, and assessed risk of bias using the Cochrane Risk of Bias criteria. RESULTS Nineteen studies were included: eight using repetitive transcranial magnetic stimulation (rTMS) and 11 using transcranial direct current stimulation (tDCS). Moderate certainty evidence supports the safety of rTMS and tDCS for children with CP. Very low to moderate certainty evidence suggests that rTMS and tDCS result in little to no difference in upper extremity outcomes. INTERPRETATION Evidence indicates that NIBS is a safe and feasible intervention to target upper extremity outcomes in children with CP, although it also indicates little to no significant impact on upper extremity outcomes. These findings are discussed in relation to the heterogeneous participants' characteristics and stimulation parameters. Larger studies of high methodological quality are required to inform future research and protocols for NIBS.
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Affiliation(s)
- Nicole Metelski
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Yu Gu
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, New York, and Weill Cornell Medicine, New York, New York, USA
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
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29
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Kim T, Kang DW, Salazar Fajardo JC, Jang H, Um YH, Kim S, Wang SM, Kim D, Lim HK. Safety and feasibility of optimized transcranial direct current stimulation in patients with mild cognitive impairment due to Alzheimer's disease: a multicenter study protocol for a randomized controlled trial. Front Neurol 2024; 15:1356073. [PMID: 38660096 PMCID: PMC11040101 DOI: 10.3389/fneur.2024.1356073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) may effectively preserve and improve cognitive function in patients with mild cognitive impairment (MCI). Research has shown that Individual brain characteristics can influence the effects of tDCS. Computer three-dimensional brain modeling based on magnetic resonance imaging (MRI) has been suggested as an alternative for determining the most accurate tDCS electrode position based on the patients' individual brain characteristics to enhance tDCS effects. Therefore, this study aims to determine the feasibility and safety of applying tDCS treatment using optimized and personalized tDCS electrode positions in patients with Alzheimer's disease (AD)-induced MCI using computer modeling and compare the results with those of a sham group to improve cognitive function. Method A prospective active-sham group feasibility study was set to recruit 40 participants, who will be randomized into Optimized-tDCS and Sham-tDCS groups. The parameters for tDCS will be 2 mA (disk electrodes R = 1.5 cm) for 30 min during two sets of 15 sessions (2 weeks of resting period in between), using two electrodes in pairs. Using computer modeling, the tDCS electrode positions of each participant will be personalized. Outcome measurements are going to be obtained at three points: baseline, first post-test, and second post-test. The AD assessment scale-cognitive subscale (ADAS-Cog) and the Korean version of Mini-Mental State Examination (K-MMSE), together with other secondary outcomes and safety tests will be used. Discussion For the present study, we hypothesize that compared to a sham group, the optimized personalized tDCS application would be effective in improving the cognitive function of patients with AD-induced MCI and the participants would tolerate the tDCS intervention without any significant adverse effects.Clinical trial registration: https://cris.nih.go.kr, identifier [KCT0008918].
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Affiliation(s)
- TaeYeong Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | - Hanna Jang
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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30
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Buccilli B. Exploring new horizons: Emerging therapeutic strategies for pediatric stroke. Exp Neurol 2024; 374:114701. [PMID: 38278205 DOI: 10.1016/j.expneurol.2024.114701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/31/2023] [Accepted: 01/23/2024] [Indexed: 01/28/2024]
Abstract
Pediatric stroke presents unique challenges, and optimizing treatment strategies is essential for improving outcomes in this vulnerable population. This review aims to provide an overview of new, innovative, and potential treatments for pediatric stroke, with a primary objective to stimulate further research in this field. Our review highlights several promising approaches in the realm of pediatric stroke management, including but not limited to stem cell therapy and robotic rehabilitation. These innovative interventions offer new avenues for enhancing functional recovery, reducing long-term disability, and tailoring treatments to individual patient needs. The findings of this review underscore the importance of ongoing research and development of innovative treatments in pediatric stroke. These advancements hold significant clinical relevance, offering the potential to improve the lives of children affected by stroke by enhancing the precision, efficacy, and accessibility of therapeutic interventions. Embracing these innovations is essential in our pursuit of better outcomes and a brighter future for pediatric stroke care.
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Affiliation(s)
- Barbara Buccilli
- Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, 1 Gustave L. Levy Pl, New York, NY 10029, United States of America.
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31
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Willmot N, Leow LA, Filmer HL, Dux PE. Exploring the intra-individual reliability of tDCS: A registered report. Cortex 2024; 173:61-79. [PMID: 38382128 DOI: 10.1016/j.cortex.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 02/23/2024]
Abstract
Transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has become an important tool for the study of in-vivo brain function due to its modulatory effects. Over the past two decades, interest in the influence of tDCS on behaviour has increased markedly, resulting in a large body of literature spanning multiple domains. However, the effect of tDCS on human performance often varies, bringing into question the reliability of this approach. While reviews and meta-analyses highlight the contributions of methodological inconsistencies and individual differences, no published studies have directly tested the intra-individual reliability of tDCS effects on behaviour. Here, we conducted a large scale, double-blinded, sham-controlled registered report to assess the reliability of two single-session low-dose tDCS montages, previously found to impact response selection and motor learning operations, across two separate time periods. Our planned analysis found no evidence for either protocol being effective nor reliable. Post-hoc explorative analyses found evidence that tDCS influenced motor learning, but not response selection learning. In addition, the reliability of motor learning performance across trials was shown to be disrupted by tDCS. These findings are amongst the first to shed light specifically on the intra-individual reliability of tDCS effects on behaviour and provide valuable information to the field.
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Affiliation(s)
- Nicholas Willmot
- Department of Defence, Edinburgh, SA, Australia; School of Psychology, The University of Queensland, St Lucia, QLD, Australia.
| | - Li-Ann Leow
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Hannah L Filmer
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
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32
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Jiang S, Jones M, von Bastian CC. TDCS over PPC or DLPFC does not improve visual working memory capacity. COMMUNICATIONS PSYCHOLOGY 2024; 2:20. [PMID: 39242793 PMCID: PMC11332112 DOI: 10.1038/s44271-024-00067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/13/2024] [Indexed: 09/09/2024]
Abstract
Non-invasive brain stimulation has been highlighted as a possible intervention to induce cognitive benefits, including on visual working memory (VWM). However, findings are inconsistent, possibly due to methodological issues. A recent high-profile study by Wang et al.1 reported that anodal transcranial direct current stimulation (tDCS) over posterior parietal cortex (PPC), but not over dorsolateral prefrontal cortex (DLPFC), selectively improved VWM capacity but not precision, especially at a high VWM load. Thus, in the current pre-registered conceptual replication study, we accounted for the key potential methodological issues in the original study and tested an adequate number of participants required to demonstrate the previously reported effects (n = 48 compared to n = 20). Participants underwent counterbalanced PPC, DLPFC and sham stimulation before completing 360 trials of a continuous orientation-reproduction task with a slight variation of task stimuli and setup. We found no evidence for the selective effect of PPC stimulation. Instead, our results showed that tDCS effects were absent regardless of stimulation region and VWM load, which was largely supported by substantial to strong Bayesian evidence. Therefore, our results challenge previously reported benefits of single-session anodal PPC-tDCS on VWM.
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Affiliation(s)
- Shuangke Jiang
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK.
| | - Myles Jones
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK
| | - Claudia C von Bastian
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK.
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33
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McDonald MA, Meckes SJ, Shires J, Berryhill ME, Lancaster CL. Augmenting Virtual Reality Exposure Therapy for Social and Intergroup Anxiety With Transcranial Direct Current Stimulation. J ECT 2024; 40:51-60. [PMID: 38009966 PMCID: PMC10920400 DOI: 10.1097/yct.0000000000000967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVES Exposure therapy is a cornerstone of social anxiety treatment, yet not all patients respond. Symptoms in certain social situations, including intergroup (ie, out-group) contexts, may be particularly resistant to treatment. Exposure therapy outcomes may be improved by stimulating neural areas associated with safety learning, such as the medial prefrontal cortex (mPFC). The mPFC also plays an important role in identifying others as similar to oneself. We hypothesized that targeting the mPFC during exposure therapy would reduce intergroup anxiety and social anxiety. METHODS Participants (N = 31) with the public speaking subtype of social anxiety received active (anodal) or sham transcranial direct current stimulation (tDCS) targeting the mPFC during exposure therapy. Exposure therapy consisted of giving speeches to audiences in virtual reality. To target intergroup anxiety, half of the public speaking exposure trials were conducted with out-group audiences, defined in this study as audiences of a different ethnicity. RESULTS Contrary to hypotheses, tDCS did not facilitate symptom reduction. Some evidence even suggested that tDCS temporarily increased in-group favoritism, although these effects dissipated at 1-month follow-up. In addition, collapsing across all participants, we found reductions across time for public speaking anxiety and intergroup anxiety. CONCLUSIONS The data provide evidence that standard exposure therapy techniques for social anxiety can be adapted to target intergroup anxiety. Transcranial direct current stimulation targeting the mPFC may boost safety signaling, but only in contexts previously conditioned to signal safety, such as an in-group context.
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Melo L, Beaupain MC, Ghanavati E, Kuo MF, Nitsche MA. Neurochemical mechanisms underlying serotonergic modulation of neuroplasticity in humans. Brain Stimul 2024; 17:421-430. [PMID: 38574852 DOI: 10.1016/j.brs.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 03/31/2024] [Accepted: 04/01/2024] [Indexed: 04/06/2024] Open
Abstract
BACKGROUND Studies in animals and humans have shown that cortical neuroplasticity can be modulated by increasing serotonin levels by administering selective serotonin reuptake inhibitors (SSRI). However, little is known about the mechanistic background, especially the contribution of intracortical inhibition and facilitation, which depend on gamma-aminobutyric acid (GABA) and glutamate. OBJECTIVE We aimed to explore the relevance of drivers of plasticity (glutamate- and GABA-dependent processes) for the effects of serotonin enhancement on tDCS-induced plasticity in healthy humans. METHODS A crossover, partially double-blinded, randomized, and sham-controlled study was conducted in 21 healthy right-handed individuals. In each of the 7 sessions, plasticity was induced via transcranial direct current stimulation (tDCS). Anodal, cathodal, and sham tDCS were applied to the left motor cortex under SSRI (20 mg/40 mg citalopram) or placebo. Short-interval cortical inhibition (SICI) and intracortical facilitation (ICF) were monitored by paired-pulse transcranial magnetic stimulation for 5-6 h after intervention. RESULTS Under placebo, anodal tDCS-induced LTP-like plasticity decreased SICI and increased ICF. In contrast, cathodal tDCS-elicited LTD-like plasticity induced the opposite effect. Under 20 mg and 40 mg citalopram, anodal tDCS did not affect SICI largely, while ICF was enhanced and prolonged. For cathodal tDCS, citalopram converted the increase of SICI and decrease of ICF into antagonistic effects, and this effect was dosage-dependent since it lasted longer under 40 mg when compared to 20 mg. CONCLUSION We speculate that the main effects of acute serotonergic enhancement on tDCS-induced plasticity, the increase and prolongation of LTP-like plasticity effects, involves mainly the glutamatergic system.
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Affiliation(s)
- Lorena Melo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - Marie C Beaupain
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany; Department of Psychology, Ruhr-University Bochum, Germany
| | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany; Department of Psychology, Ruhr-University Bochum, Germany
| | - Min-Fang Kuo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Germany; German Center for Mental Health (DZPG), Partner Site - Bochum/Marburg, Germany
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35
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Jung J, Salazar Fajardo JC, Kim S, Kim B, Oh S, Yoon B. Effect of tDCS Combined With Physical Training on Physical Performance in a Healthy Population. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024; 95:149-156. [PMID: 37036388 DOI: 10.1080/02701367.2023.2166894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 12/21/2022] [Indexed: 06/19/2023]
Abstract
Purpose: The effectiveness of transcranial direct current stimulation (tDCS) combined with physical training has shown inconsistent results through research. Hence, a study utilizing a long-term tDCS application over the primary motor cortex and a large sample size is required to determine whether tDCS combined with physical training can increase physical performance (muscular strength, endurance, and explosive strength) in healthy adults. Material and methods: Fifty-six healthy adults were randomly distributed into two groups: active (active tDCS+ physical training) and sham (sham tDCS + physical training) and received the intervention three times per week for six weeks. Muscle strength was assessed using maximal isometric muscle strength (MIMS) by a digital dynamometer. Muscular endurance and lower limb explosive strength were assessed by using muscle fitness testing (MFT), and the Sargent jump test. Results: The active and sham groups exhibited significant improvement in all measured parameters in intragroup analyses. However, intergroup analyses revealed no significant difference between the groups. Conclusion: Our findings suggest that only physical training improved MIMS in the upper and lower extremities, MFT endurance scores, and lower limb explosive power. Thus, tDCS failed to demonstrate its effectiveness in a healthy population according to the protocol used in this study.
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36
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Baetens K, Van Hoornweder S, Berger TA, Wischnewski M. ACES: Automated Correlation of Electric field strength and Stimulation effects for non-invasive brain stimulation. Brain Stimul 2024; 17:473-475. [PMID: 38621644 DOI: 10.1016/j.brs.2024.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Revised: 03/16/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024] Open
Affiliation(s)
- Kris Baetens
- Brain, Body and Cognition, Vrije Universiteit Brussel, Belgium.
| | - Sybren Van Hoornweder
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Belgium
| | - Taylor A Berger
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN, USA
| | - Miles Wischnewski
- University of Minnesota, Department of Biomedical Engineering, Minneapolis, MN, USA; Department of Experimental Psychology, University of Groningen, the Netherlands
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37
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Laakso I, Tani K, Gomez-Tames J, Hirata A, Tanaka S. Small effects of electric field on motor cortical excitability following anodal tDCS. iScience 2024; 27:108967. [PMID: 38352229 PMCID: PMC10863330 DOI: 10.1016/j.isci.2024.108967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/05/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
The dose-response characteristics of transcranial direct current stimulation (tDCS) remain uncertain but may be related to variability in brain electric fields due to individual anatomical factors. Here, we investigated whether the electric fields influence the responses to motor cortical tDCS. In a randomized cross-over design, 21 participants underwent 10 min of anodal tDCS with 0.5, 1.0, 1.5, or 2.0 mA or sham. Compared to sham, all active conditions increased the size of motor evoked potentials (MEP) normalized to the pre-tDCS baseline, irrespective of anterior or posterior magnetic test stimuli. The electric field calculated in the motor cortex of each participant had a nonlinear effect on the normalized MEP size, but its effects were small compared to those of other participant-specific factors. The findings support the efficacy of anodal tDCS in enhancing the MEP size but do not demonstrate any benefits of personalized electric field modeling in explaining tDCS response variability.
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Affiliation(s)
- Ilkka Laakso
- Department of Electrical Engineering and Automation, Aalto University, 02150 Espoo, Finland
| | - Keisuke Tani
- Faculty of Psychology, Otemon Gakuin University, Ibaraki, Osaka 567-8502, Japan
| | - Jose Gomez-Tames
- Department of Medical Engineering, Graduate School of Engineering, Chiba University, Chiba 263-8522, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Nagoya 466-8555, Japan
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Nagoya 466-8555, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka 431-3125, Japan
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38
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Farshad M, Artemenko C, Cipora K, Svaldi J, Schroeder PA. Regional specificity of cathodal transcranial direct current stimulation effects on spatial-numerical associations: Comparison of four stimulation sites. J Neurosci Res 2024; 102:e25304. [PMID: 38361404 DOI: 10.1002/jnr.25304] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 02/17/2024]
Abstract
Neuromodulation with transcranial direct current stimulation (tDCS) is an increasingly popular research tool to experimentally manipulate cortical areas and probe their causal involvements in behavior, but its replicability and regional specificity are not clear. This registered report investigated cathodal tDCS effects on spatial-numerical associations (i.e., the SNARC effect), the numerical distance effect (NDE), and inhibitory control (i.e., stop-signal reaction time; SSRT). Healthy adults (N = 160) were randomly assigned to one of five groups to receive sham tDCS or 1 mA cathodal tDCS to one of four stimulation sites (left/right prefrontal cortex [PFC], left/right posterior parietal cortex) with extracephalic return. We replicated that cathodal tDCS over the left PFC reduced the SNARC effect compared to sham tDCS and to tDCS over the left parietal cortex. However, neither NDE nor SSRT were modulated in the main analyses. Post hoc contrasts and exploratory analyses showed that cathodal tDCS over the right PFC had a time-dependent effect by delayed practice-related improvements in SSRT. Math anxiety moderated changes in the NDE in the groups receiving tDCS to the right parietal cortex. With few exceptions, the replicability and regional specificity of tDCS effects on behavior were weak and partially moderated by individual differences. Future research needs to characterize the parameter settings for effective neuromodulation.
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Affiliation(s)
- Maryam Farshad
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
| | - Christina Artemenko
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
- LEAD Research Network, University of Tuebingen, Tuebingen, Germany
| | - Krzysztof Cipora
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
- LEAD Research Network, University of Tuebingen, Tuebingen, Germany
- Centre for Mathematical Cognition, Loughborough University, Loughborough, UK
| | - Jennifer Svaldi
- Department of Psychology, University of Tuebingen, Tuebingen, Germany
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Pezzetta R, Gambarota F, Tarantino V, Devita M, Cattaneo Z, Arcara G, Mapelli D, Masina F. A meta-analysis of non-invasive brain stimulation (NIBS) effects on cerebellar-associated cognitive processes. Neurosci Biobehav Rev 2024; 157:105509. [PMID: 38101590 DOI: 10.1016/j.neubiorev.2023.105509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
Non-invasive brain stimulation (NIBS) techniques, including transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES), have provided valuable insights into the role of the cerebellum in cognitive processes. However, replicating findings from studies involving cerebellar stimulation poses challenges. This meta-analysis investigates the impact of NIBS on cognitive processes associated with the cerebellum. We conducted a systematic search and analyzed 66 studies and 91 experiments involving healthy adults who underwent either TMS or transcranial direct current stimulation (tDCS) targeting the cerebellum. The results indicate that anodal tDCS applied to the medial cerebellum enhances cognitive performance. In contrast, high-frequency TMS disrupts cognitive performance when targeting the lateral cerebellar hemispheres or when employed in online protocols. Similarly, low-frequency TMS and continuous theta burst stimulation (cTBS) diminish performance in offline protocols. Moreover, high-frequency TMS impairs accuracy. By identifying consistent effects and moderators of modulation, this meta-analysis contributes to improving the replicability of studies using NIBS on the cerebellum and provides guidance for future research aimed at developing effective NIBS interventions targeting the cerebellum.
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Affiliation(s)
| | - Filippo Gambarota
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Vincenza Tarantino
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy
| | - Maria Devita
- Department of General Psychology, University of Padova, Padova, Italy; Geriatrics Unit, Department of Medicine, University of Padova, Padova, Italy.
| | - Zaira Cattaneo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Daniela Mapelli
- Department of General Psychology, University of Padova, Padova, Italy
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Hussain M, Davis NJ, Benn Y. A single tDCS session can enhance numerical competence. Neuropsychologia 2024; 193:108760. [PMID: 38103681 DOI: 10.1016/j.neuropsychologia.2023.108760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 12/05/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
While numerical skills are increasingly important in modern life, few interventions have been developed to support those with numeracy skills difficulties. Previous studies have demonstrated that applying transcranial Direct Current Stimulation (tDCS) can improve numerical skills. However, tDCS interventions designed to induce lasting changes typically involve reapplying brain-stimulation over several days. Repeated tDCS application can increase the risks associated with the procedure, as well as restricts the transferability of the method to a wider population, particularly those who may experience mobility issues, such as stroke survivors with acalculia. The current study investigated whether a single session of tDCS (anodal to right parietal lobe and cathodal to left parietal lobe), followed by four self-practice sessions without tDCS, could result in enhancement of numerical skills. Nineteen healthy adults (n = 10 tDCS, n = 9 sham control) implicitly learnt the magnitude association of nine arbitrary symbols, previously used by Cohen Kadosh et al. (2010). Numerical proficiency was assessed using number-to-space task, while automaticity was assessed with numerical Stroop. Results revealed that single-session tDCS had a significant effect on participants' accuracy on the number-to-space tasks, but not on the numerical Stroop task's congruity effect, implying automaticity may require longer practice. We conclude that a single session of tDCS should be considered as an avenue for interventions.
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Affiliation(s)
- Maryam Hussain
- School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom; Department of Psychology, Manchester Metropolitan University, Manchester, M15 6GX, United Kingdom
| | - Nick J Davis
- Department of Psychology, Manchester Metropolitan University, Manchester, M15 6GX, United Kingdom
| | - Yael Benn
- Department of Psychology, Manchester Metropolitan University, Manchester, M15 6GX, United Kingdom.
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Klírová M, Adamová A, Biačková N, Laskov O, Renková V, Stuchlíková Z, Odnohová K, Novák T. Transcranial direct current stimulation (tDCS) in the treatment of neuropsychiatric symptoms of long COVID. Sci Rep 2024; 14:2193. [PMID: 38272997 PMCID: PMC10810850 DOI: 10.1038/s41598-024-52763-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/23/2024] [Indexed: 01/27/2024] Open
Abstract
The study aimed to assess the efficacy of transcranial direct current stimulation (tDCS) in the treatment of neuropsychiatric (NP) symptoms of the post-acute sequelae of SARS-CoV-2 infection (PASC), known as the long COVID. A double-blind, randomized, sham-controlled study compared the efficacy and safety of prefrontal cortex active tDCS to sham-tDCS in treating NP-PASC. Patients diagnosed with NP-PASC, with a Fatigue Impact Scale (FIS) score ≥ 40, were eligible for the study. Twenty tDCS sessions were administered within four weeks, with continuous, end-of-treatment, and follow-up measurements. The primary outcome was a change in the FIS at the end-of-treatment, analyzed in the intention-to-treat population. Data from 33 patients assigned to active (n = 16) or sham-tDCS (n = 17) were analyzed. After the treatment, a decrease in the FIS score was more pronounced in the sham than in the active group, yet the intergroup difference was insignificant (11.7 [95% CI -11.1 to 34.5], p = 0.6). Furthermore, no significant intergroup differences were observed regarding anxiety, depression, quality of life, and cognitive performance. The small cohort sample, differences in baseline FIS scores between groups (non-stratified randomization), or chosen stimulation parameters may have influenced our findings. However, it might also be possible that the expected mechanism of action of tDCS is insufficient to treat these conditions.
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Affiliation(s)
- Monika Klírová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Andrea Adamová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nina Biačková
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olga Laskov
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Renková
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | | | - Karolína Odnohová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Tomáš Novák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Šimko P, Pupíková M, Gajdoš M, Klobušiaková P, Vávra V, Šimo A, Rektorová I. Exploring the impact of intensified multiple session tDCS over the left DLPFC on brain function in MCI: a randomized control trial. Sci Rep 2024; 14:1512. [PMID: 38233437 PMCID: PMC10794210 DOI: 10.1038/s41598-024-51690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024] Open
Abstract
Transcranial direct current stimulation combined with cognitive training (tDCS-cog) represents a promising approach to combat cognitive decline among healthy older adults and patients with mild cognitive impairment (MCI). In this 5-day-long double-blinded randomized trial, we investigated the impact of intensified tDCS-cog protocol involving two trains of stimulation per day on working memory (WM) enhancement in 35 amnestic and multidomain amnestic MCI patients. Specifically, we focused to improve WM tasks relying on top-down attentional control and hypothesized that intensified tDCS would enhance performance of visual object matching task (VOMT) immediately after the stimulation regimen and at a 1-month follow-up. Secondarily, we explored whether the stimulation would augment online visual working memory training. Using fMRI, we aimed to elucidate the neural mechanisms underlying the intervention effects by analyzing BOLD activations during VOMT. Our main finding revealed no superior after-effects of tDCS-cog over the sham on VOMT among individuals with MCI as indicated by insignificant immediate and long-lasting after-effects. Additionally, the tDCS-cog did not enhance online training as predicted. The fMRI analysis revealed brain activity alterations in right insula that may be linked to tDCS-cog intervention. In the study we discuss the insignificant behavioral results in the context of the current evidence in tDCS parameter space and opening the discussion of possible interference between trained cognitive tasks.
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Affiliation(s)
- P Šimko
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - M Pupíková
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
| | - M Gajdoš
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Brno, Czech Republic
| | - P Klobušiaková
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic
- Surgeon General Office of the, Slovak Armed Forces, Ružomberok, Slovak Republic
| | - V Vávra
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - A Šimo
- Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - I Rektorová
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Kamenice 5, 625 00, Brno, Czech Republic.
- First Department of Neurology, Faculty of Medicine and St. Anne's University Hospital, Brno, Czech Republic.
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Chen Y, Lyu D, Wang F, Huang Q, Yang W, Zhang M, Wei Z, Shi S, Kong S, Chen S, He S, Yang V, Fang Y, Douiri A, Hong W. Adjunctive duration-doubled transcranial direct current stimulation for the treatment of depressive patients with suicidal ideation: study protocol for a double-blind, randomized, sham-controlled trial. Trials 2024; 25:15. [PMID: 38167178 PMCID: PMC10759703 DOI: 10.1186/s13063-023-07858-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The problem of suicide has become increasingly common in individuals with major depressive disorder (MDD). Transcranial direct current stimulation (tDCS) is an effective treatment for MDD with 2 milliamperes (mA) for at least 30 min per day for 2 weeks. This study aims to investigate the efficacy of daily duration-doubled tDCS as an adjunctive intervention for rapidly reducing suicidal ideation and improving depression in MDD patients. METHODS In this double-blind, randomized, sham-controlled study, 76 MDD patients with suicidal ideation are randomly assigned to either active (n=38) or sham (n=38) tDCS group. The anode and cathode are placed over the scalp areas corresponding to left and right dorsolateral prefrontal cortex (DLPFC), respectively, and each stimulation lasts for 60 min. The primary outcome is defined as change of Beck Scale for Suicide Ideation (BSI) after 5 and 10 sessions. The change of other clinical assessments, blood biomarkers related to suicidal ideation and depressive sumptoms are defined as secondary outcomes. Blood biomarkers related to suicidal ideation are collected at baseline and after 10 sessions. DISCUSSION This study suggests the adjunctive duration-doubled tDCS might be a novel method to rapidly reduce suicidal ideation and improve depressive symptom. The variation of biomarkers could be potential predictive models of suicide risk. TRIAL REGISTRATION The trial protocol is registered with ClinicalTrials.gov under protocol registration number NCT05555927. Registered on September 25, 2022.
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Affiliation(s)
- Yiming Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongbin Lyu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fan Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qinte Huang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | | | - Mengke Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheyi Wei
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuxiang Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuqi Kong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shentse Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shuang He
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Vivien Yang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yiru Fang
- Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China
- CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, China
- Hunan Second People's Hospital (Hunan Brain Hospital), Hunan, China
| | - Abdel Douiri
- King's College London, School of Life Course & Population Sciences, London, UK.
- National Institute for Health Research Biomedical Research Centre (BRC), Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK.
| | - Wu Hong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai, China.
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Chan YH, Chang HM, Lu ML, Goh KK. Targeting cravings in substance addiction with transcranial direct current stimulation: insights from a meta-analysis of sham-controlled trials. Psychiatry Res 2024; 331:115621. [PMID: 38043411 DOI: 10.1016/j.psychres.2023.115621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/06/2023] [Accepted: 11/19/2023] [Indexed: 12/05/2023]
Abstract
Addiction is a substantial health concern; craving-the core symptom of addiction-is strongly associated with relapse. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that reduces cravings by altering cortical excitability and connectivity in brain regions. This systematic review and meta-analysis was conducted (following the PRISMA guidelines) to evaluate the efficacy of tDCS in reducing cravings for substances. Our analysis included 43 randomized, sham-controlled trials involving 1,095 and 913 participants receiving tDCS and sham stimulation, respectively. We analyzed the changes in craving scores and found that tDCS led to a moderate reduction in cravings compared with the sham effects. This effect was particularly pronounced when bilateral stimulation was used, the anodal electrode was placed on the right dorsolateral prefrontal cortex, current intensities ranged from 1.5 to 2 mA, stimulation sessions lasted 20 minutes, and the electrodes size was ≥35 cm². Notably, tDCS effectively reduced cravings for opioids, methamphetamine, cocaine, and tobacco but not for alcohol or cannabis. Our findings indicate tDCS as a promising, noninvasive, and low-risk intervention for reducing cravings for opioids, methamphetamine, cocaine, and tobacco. Additional studies are warranted to refine stimulation parameters and evaluate the long-term efficacy of tDCS in managing substance cravings.
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Affiliation(s)
- Yi-Hsun Chan
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hu-Ming Chang
- Department of Addiction Sciences, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Mong-Liang Lu
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Kah Kheng Goh
- Department of Psychiatry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan; The Innovative and Translational Research Center for Brain Consciousness, Taipei Medical University, Taipei, Taiwan.
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45
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Vöckel J, Spitznagel N, Markser A, Sigrist C, Koenig J. A paucity of evidence in youth: The curious case of transcranial direct current stimulation for depression. Asian J Psychiatr 2024; 91:103838. [PMID: 38000172 DOI: 10.1016/j.ajp.2023.103838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/10/2023] [Accepted: 11/17/2023] [Indexed: 11/26/2023]
Abstract
A significant proportion of youth with depression do not respond to available treatment. Transcranial direct current stimulation (tDCS) is a promising third-line treatment in depressed adults, but evidence in youth seems scarce. Following the PRISMA guidelines, we conducted a systematic literature review on tDCS treatment for depression in children and adolescents. No published studies were found on the use of tDCS in youth with depression. Given the null-findings, no conclusion can be drawn about the effectiveness of tDCS treatment for adolescent depression. The reasons for this paucity of evidence in light of existing regulatory frameworks and technical challenges are discussed.
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Affiliation(s)
- Jasper Vöckel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany.
| | - Nele Spitznagel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Anna Markser
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Christine Sigrist
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Julian Koenig
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
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Chen W, Jiang T, Huang H, Zeng J. Post-stroke fatigue: a review of development, prevalence, predisposing factors, measurements, and treatments. Front Neurol 2023; 14:1298915. [PMID: 38187145 PMCID: PMC10768193 DOI: 10.3389/fneur.2023.1298915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Background Post-stroke fatigue (PSF) is a ubiquitous and overwhelming symptom for most stroke survivors. However, there are no effective management strategies for PSF, which is partly due to our limited understanding. Objective In this paper, we review the development, prevalence, predisposing factors, measurements, and treatments of PSF. Results PSF is an independent symptom after stroke, with a prevalence ranging from 42 to 53%, which depends on the selection of measurement tools and stroke characteristics. It is affected by biological, physical, and psychological factors, among which inflammation may play a key role. Conclusion Numerous but non-specific evaluation measurement tools limit the management of PSF. In clinical practice, it may be beneficial to identify PSF by combining scales and objective indexes, such as walking tests and electromyographic examinations. There are no evidence-based interventions to improve PSF. However, increasing evidence suggests that transcranial direct-current stimulation and mindfulness-based interventions may become promising treatments. Further studies are urgently needed to better understand the etiology of PSF, thereby providing the basis for developing new measurement tools and targeted treatments.
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Affiliation(s)
| | - Tao Jiang
- Department of Neurology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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Popyvanova A, Pomelova E, Bredikhin D, Koriakina M, Shestakova A, Blagovechtchenski E. Transspinal Direct Current Electrical Stimulation Selectively Affects the Excitability of the Corticospinal System, Depending on the Intensity but Not Motor Skills. Life (Basel) 2023; 13:2353. [PMID: 38137954 PMCID: PMC10744344 DOI: 10.3390/life13122353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Transspinal direct current stimulation (tsDCS) is a non-invasive technique used to modulate spinal cord activity. However, the effects and mechanisms of this stimulation are currently not comprehensively known. This study aimed to estimate the effect of different intensities of tsDCS applied at the level of cervical enlargement of the spinal cord (C7-Th1 segments) on the excitability of the corticospinal system (CSS) and the correction of motor skills in healthy subjects. The effect of tsDCS was estimated by the motor-evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) in the primary motor cortex (M1). The study involved 54 healthy adults aged 22 ± 4 years. The application of 11 min anodal tsDCS at the level of the cervical spine C7-Th1 with a current intensity of 2.5 mA did not change the MEP amplitude of the upper limb muscles, in contrast to the data that we previously obtained with a current intensity of 1.5 mA. We also found no difference in the effect of 2.5 mA stimulation on motor skill correction in healthy subjects in the nine-hole peg test (9-HPT) and the serial reaction time task (SRT) as with 1.5 mA stimulation. Our data show that an increase in the intensity of stimulation does not lead to an increase in the effects but rather reduces the effects of stimulation. These results provide information about the optimally appropriate stimulation current intensities to induce CSS excitability and the ability of tsDCS to influence motor skills in healthy adults.
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Affiliation(s)
| | | | | | | | | | - Evgeny Blagovechtchenski
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, 101000 Moscow, Russia; (A.P.); (E.P.); (D.B.); (M.K.); (A.S.)
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48
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Löffler BS, Stecher HI, Meiser A, Fudickar S, Hein A, Herrmann CS. Attempting to counteract vigilance decrement in older adults with brain stimulation. FRONTIERS IN NEUROERGONOMICS 2023; 4:1201702. [PMID: 38234473 PMCID: PMC10790873 DOI: 10.3389/fnrgo.2023.1201702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 11/23/2023] [Indexed: 01/19/2024]
Abstract
Introduction Against the background of demographic change and the need for enhancement techniques for an aging society, we set out to repeat a study that utilized 40-Hz transcranial alternating current stimulation (tACS) to counteract the slowdown of reaction times in a vigilance experiment but with participants aged 65 years and older. On an oscillatory level, vigilance decrement is linked to rising occipital alpha power, which has been shown to be downregulated using gamma-tACS. Method We applied tACS on the visual cortex and compared reaction times, error rates, and alpha power of a group stimulated with 40 Hz to a sham and a 5-Hz-stimulated control group. All groups executed two 30-min-long blocks of a visual task and were stimulated according to group in the second block. We hypothesized that the expected increase in reaction times and alpha power would be reduced in the 40-Hz group compared to the control groups in the second block (INTERVENTION). Results Statistical analysis with linear mixed models showed that reaction times increased significantly over time in the first block (BASELINE) with approximately 3 ms/min for the SHAM and 2 ms/min for the 5-Hz and 40-Hz groups, with no difference between the groups. The increase was less pronounced in the INTERVENTION block (1 ms/min for SHAM and 5-Hz groups, 3 ms/min for the 40-Hz group). Differences among groups in the INTERVENTION block were not significant if the 5-Hz or the 40-Hz group was used as the base group for the linear mixed model. Statistical analysis with a generalized linear mixed model showed that alpha power was significantly higher after the experiment (1.37 μV2) compared to before (1 μV2). No influence of stimulation (40 Hz, 5 Hz, or sham) could be detected. Discussion Although the literature has shown that tACS offers potential for older adults, our results indicate that findings from general studies cannot simply be transferred to an old-aged group. We suggest adjusting stimulation parameters to the neurophysiological features expected in this group. Next to heterogeneity and cognitive fitness, the influence of motivation and medication should be considered.
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Affiliation(s)
- Birte S. Löffler
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Heiko I. Stecher
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4all”, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Arnd Meiser
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4all”, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Sebastian Fudickar
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Andreas Hein
- Assistance Systems and Medical Device Technology, Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, European Medical School, Cluster of Excellence “Hearing4all”, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
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49
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De Koninck BP, Brazeau D, Guay S, Herrero Babiloni A, De Beaumont L. Transcranial Alternating Current Stimulation to Modulate Alpha Activity: A Systematic Review. Neuromodulation 2023; 26:1549-1584. [PMID: 36725385 DOI: 10.1016/j.neurom.2022.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/05/2022] [Accepted: 12/08/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Transcranial alternating current stimulation (tACS) has been one of numerous investigation methods used for their potential to modulate brain oscillations; however, such investigations have given contradictory results and a lack of standardization. OBJECTIVES In this systematic review, we aimed to assess the potential of tACS to modulate alpha spectral power. The secondary outcome was the identification of tACS methodologic key parameters, adverse effects, and sensations. MATERIALS AND METHODS Studies in healthy adults who were receiving active and sham tACS intervention or any differential condition were included. The main outcome assessed was the increase/decrease of alpha spectral power through either electroencephalography or magnetoencephalography. Secondary outcomes were methodologic parameters, sensation reporting, and adverse effects. Risks of bias and the study quality were assessed with the Cochrane assessment tool. RESULTS We obtained 1429 references, and 20 met the selection criteria. A statistically significant alpha-power increase was observed in nine studies using continuous tACS stimulation and two using intermittent tACS stimulation set at a frequency within the alpha range. A statistically significant alpha-power increase was observed in three more studies using a stimulation frequency outside the alpha range. Heterogeneity among stimulation parameters was recognized. Reported adverse effects were mild. The implementation of double blind was identified as challenging using tACS, in part owing to electrical artifacts generated by stimulation on the recorded signal. CONCLUSIONS Most assessed studies reported that tACS has the potential to modulate brain alpha power. The optimization of this noninvasive brain stimulation method is of interest mostly for its potential clinical applications with neurological conditions associated with perturbations in alpha brain activity. However, more research efforts are needed to standardize optimal parameters to achieve lasting modulation effects, develop methodologic alternatives to reduce experimental bias, and improve the quality of studies using tACS to modulate brain activity.
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Affiliation(s)
- Beatrice P De Koninck
- Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada.
| | - Daphnée Brazeau
- Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada
| | - Samuel Guay
- Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada
| | - Alberto Herrero Babiloni
- Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada; McGill University, Montreal, Quebec, Canada
| | - Louis De Beaumont
- Sports and Trauma Applied Research Lab, Montreal Sacred Heart Hospital, CIUSSS North-Montreal-Island, Montreal, Quebec, Canada; University of Montreal, Montréal, Quebec, Canada
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50
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Dissanayaka T, Nakandala P, Malwanage K, Hill AT, Ashthree DN, Lane MM, Travicia N, Gamage E, Marx W, Jaberzadeh S. The effects of anodal tDCS on pain reduction in people with knee osteoarthritis: A systematic review and meta-analysis. Neurophysiol Clin 2023; 53:102921. [PMID: 37984240 DOI: 10.1016/j.neucli.2023.102921] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To synthesise the literature on the efficacy of primary motor cortex anodal transcranial direct current stimulation (M1-a-tDCS), as a standalone or priming technique, for pain reduction in people with knee osteoarthritis (KOA). METHODS The systematic literature search was conducted in MEDLINE, CINAHL, Embase and CENTRAL according to PRISMA statement. RESULTS Fourteen studies involving 740 people with KOA were included. In the meta-analysis, six studies compared a-tDCS alone with sham stimulation, and five studies compared a-tDCS combined with other methods with sham stimulation. We found positive effect of a-tDCS alone on pain in KOA (standard mean difference (SMD) -0.52; 95% CI, -0.78 to -0.25; P=0.001; I2 = 69%). Further, a-tDCS with other treatments showed positive effect (SMD -1.23; 95% CI, -1.59 to -0.88; P<0.001; I2 = 48%) on pain in people with KOA. This evidence showed low certainty due to a high risk of bias and imprecision. DISCUSSION AND CONCLUSION A-tDCS could be considered as standalone and an adjunct treatment for pain reduction in people with KOA. Future randomised studies should address quality issues, including small sample size, to enhance the overall certainty of the findings. SIGNIFICANCE A-tDCS can be used as a standalone and adjunct treatment for KOA. STUDY REGISTRATION PROSPERO number CRD42021255114.
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Affiliation(s)
- Thusharika Dissanayaka
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia.
| | | | - Kavinda Malwanage
- Department of Physiotherapy, Faculty of Allied Health Sciences, University of Peradeniya, Sri Lanka
| | - Aron T Hill
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Melbourne, Australia; Department of Psychiatry, Central Clinical School, Monash University, Melbourne, Australia
| | - Deborah N Ashthree
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Melissa M Lane
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Nikolaj Travicia
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Elizabeth Gamage
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Wolfgang Marx
- Deakin University, IMPACT (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, School of Medicine, Barwon Health, Geelong, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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