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Berger P, Bitsch F, Falkenberg I. Humor in Psychiatry: Lessons From Neuroscience, Psychopathology, and Treatment Research. Front Psychiatry 2021; 12:681903. [PMID: 34122193 PMCID: PMC8193079 DOI: 10.3389/fpsyt.2021.681903] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/06/2021] [Indexed: 11/13/2022] Open
Abstract
Humor is a ubiquitous human characteristic that is socially motivated at its core and has a broad range of significant positive effects on emotional well-being and interpersonal relationships. Simultaneously, however, impairments in humor abilities have often been described in close association with the occurrence and course of neuropsychiatric disorders, such as schizophrenia, social anxiety, or depression. In the past decade, research in the neuroimaging and psychiatric domain has substantially progressed to (i) characterize impaired humor as an element of psychopathology, and (ii) shed light on the neurobiological mechanisms underlying the role of humor in neuropsychiatric diseases. However, (iii) targeted interventions using concepts of positive psychology have revealed first evidence that a systematic training and/or a potential reactivation of humor-related skills can improve rehabilitative outcome in neuropsychiatric patient groups. Here, we sought to integrate evidence from neuroscience, as well as from psychopathology and treatment research to shed more light on the role of humor in psychiatry. Based on these considerations, we provide directions for future research and application in mental health services, focusing on the question of how our scientific understanding of humor can provide the basis for psychological interventions that foster positive attitudes and well-being.
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Affiliation(s)
- Philipp Berger
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Florian Bitsch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg, Germany
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52
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The role of the left dorsolateral prefrontal cortex in attentional bias. Neuropsychologia 2020; 148:107631. [DOI: 10.1016/j.neuropsychologia.2020.107631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 09/09/2020] [Accepted: 09/11/2020] [Indexed: 11/22/2022]
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53
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Nejati V, Salehinejad MA, Nitsche MA, Najian A, Javadi AH. Transcranial Direct Current Stimulation Improves Executive Dysfunctions in ADHD: Implications for Inhibitory Control, Interference Control, Working Memory, and Cognitive Flexibility. J Atten Disord 2020; 24:1928-1943. [PMID: 28938852 DOI: 10.1177/1087054717730611] [Citation(s) in RCA: 72] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objective: This study examined effects of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) and orbitofrontal cortex (OFC) on major executive functions (EFs), including response inhibition, executive control, working memory (WM), and cognitive flexibility/task switching in ADHD. Method: ADHD children received (a) left anodal/right cathodal DLPFC tDCS and (b) sham stimulation in Experiment 1 and (a) left anodal DLPFC/right cathodal OFC tDCS, (b) left cathodal DLPFC/right anodal OFC tDCS, and (c) sham stimulation in Experiment 2. The current intensity was 1 mA for 15 min with a 72-hr interval between sessions. Participants underwent Go/No-Go task, N-back test, Wisconsin Card Sorting Test (WCST), and Stroop task after each tDCS condition. Results: Anodal left DLPFC tDCS most clearly affected executive control functions (e.g., WM, interference inhibition), while cathodal left DLPFC tDCS improved inhibitory control. Cognitive flexibility/task switching benefited from combined DLPFC-OFC, but not DLPFC stimulation alone. Conclusion: Task-specific stimulation protocols can improve EFs in ADHD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Mohammad Ali Salehinejad
- Institute for Cognitive & Brain Sciences, Shahid Beheshti University, Tehran, Iran.,Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Asal Najian
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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54
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Saldanha JS, Zortea M, Torres ILDS, Fregni F, Caumo W. Age as a Mediator of tDCS Effects on Pain: An Integrative Systematic Review and Meta-Analysis. Front Hum Neurosci 2020; 14:568306. [PMID: 33192397 PMCID: PMC7654216 DOI: 10.3389/fnhum.2020.568306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/22/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction: The transcranial direct current stimulation (tDCS) is a neuromodulatory technique with the potential to decrease pain scores and to improve chronic pain treatment. Although age is an essential factor that might impact the tDCS effect, most studies are solely conducted in adults. Therefore, the age limitation presents a critical research gap in this field and can be shown by only a handful of studies that have included other age groups. To examine the evidence upon the tDCS effect on pain scores on children, adolescents, or elderly, and indirectly, to infer the age-dependent impact on tDCS effects, we conducted a systematic review and meta-analysis. Methods: A systematic review searching the following databases: PubMed, EMBASE, and Science Direct using the following search terms adapted according to MeSh or Entree: [(“Adolescent” OR “Children” OR “Elderly”) AND (“tDCS”) AND (“Pain” OR “Pain threshold”) AND (“dorsolateral prefrontal cortex” OR “Motor cortex)] up to April 20th, 2020. We retrieved 228 articles, 13 were included in the systematic review, and five studies with elderly subjects that had their outcomes assessed by pain score or pain threshold were included in the meta-analysis. Results: For the analysis of pain score, 96 individuals received active stimulation, and we found a favorable effect for active tDCS to reduce pain score compared to sham (P = 0.002). The standardized difference was −0.76 (CI 95% = −1.24 to −0.28). For the pain threshold, the analysis showed no significant difference between active and sham tDCS. We reviewed two studies with adolescents: one study using anodal tDCS over the prefrontal cortex reported a reduction in pain scores. However, the second study reported an increase in pain sensitivity for the dorsolateral prefrontal cortex (DLPFC) stimulation. Conclusion: Our findings suggest tDCS may reduce pain levels in the elderly group. Nevertheless, the small number of studies included in this review—and the considerable heterogeneity for clinical conditions and protocols of stimulation present—limits the support of tDCS use for pain treatment in elderly people. Larger studies on the tDCS effect on pain are needed to be conducted in elderly and adolescents, also evaluating different montages and electrical current intensity.
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Affiliation(s)
- Júlia Schirmer Saldanha
- Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Maxciel Zortea
- Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Iraci Lucena da Silva Torres
- Pharmacology of Pain and Neuromodulation: Pre-Clinical Investigations Research Group, Universidade Federal do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Wolnei Caumo
- Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Brazil.,Laboratory of Pain and Neuromodulation, Clinical Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil.,Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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55
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Zhu R, Luo Y, Wang Z, You X. Modality effects in verbal working memory updating: Transcranial direct current stimulation over human inferior frontal gyrus and posterior parietal cortex. Brain Cogn 2020; 145:105630. [PMID: 33091807 DOI: 10.1016/j.bandc.2020.105630] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022]
Abstract
Verbal working memory (VWM) involves visual and auditory verbal information. Neuroimaging studies have shown significant modality effects for VWM in the left posterior parietal cortex (PPC). The left inferior frontal gyrus (IFG) is more sensitive to auditory and phonological information. However, much less is known about the effects of transcranial direct current stimulation (tDCS) over the left PPC and IFG on different sensory modalities of VWM (auditory vs. visual). Therefore, the present study aimed to examine whether tDCS over the left PPC and IFG affects visual and auditory VWM updating performance using a single-blind design. Fifty-one healthy participants were randomly assigned to three tDCS groups (left PPC/left IFG/sham) and were asked to complete both the visual and auditory letter 3-back tasks. Results showed that stimulating the left PPC enhanced the response efficiency of visual, but not auditory, VWM compared with the sham condition. Anodal stimulation to the left IFG improved the response efficiency of both tasks. The present study revealed a modality effect of VWM in the left PPC, while the left IFG had a causal role in VWM updating of different sensory modalities.
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Affiliation(s)
- Rongjuan Zhu
- Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Yangmei Luo
- Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Ziyu Wang
- Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China
| | - Xuqun You
- Key Laboratory for Behavior and Cognitive Neuroscience of Shaanxi Province, School of Psychology, Shaanxi Normal University, Xi'an 710062, China.
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56
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Shaw M, Pilloni G, Charvet L. Delivering Transcranial Direct Current Stimulation Away From Clinic: Remotely Supervised tDCS. Mil Med 2020; 185:319-325. [PMID: 32074357 DOI: 10.1093/milmed/usz348] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION To demonstrate the broad utility of the remotely supervised transcranial direct current stimulation (RS-tDCS) protocol developed to deliver at-home rehabilitation for individuals with multiple sclerosis (MS). METHODS Stimulation delivered with the RS-tDCS protocol and paired with adaptive cognitive training was delivered to three different study groups of MS patients to determine the feasibility and tolerability of the protocol. The three studies each used consecutively increasing amounts of stimulation amperage (1.5, 2.0, and 2.5 mA, respectively) and session numbers (10, 20, and 40 sessions, respectively). RESULTS High feasibility and tolerability of the stimulation were observed for n = 99 participants across three tDCS pilot studies. CONCLUSIONS RS-tDCS is feasible and tolerable for MS participants. The RS-tDCS protocol can be used to reach those in locations without clinic access and be paired with training or rehabilitation in locations away from the clinic. This protocol could be used to deliver tDCS paired with training or rehabilitation activities remotely to service members and veterans.
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Affiliation(s)
- Michael Shaw
- New York University Langone Health, 222 E 41st Street New York, NY 10017
| | - Giuseppina Pilloni
- New York University Langone Health, 222 E 41st Street New York, NY 10017.,Department of Mechanical Chemical and Materials Engineering, University of Cagliari, Via Marengo 2, Cagliari, ITALY 09123
| | - Leigh Charvet
- New York University Langone Health, 222 E 41st Street New York, NY 10017
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57
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Puonti O, Van Leemput K, Saturnino GB, Siebner HR, Madsen KH, Thielscher A. Accurate and robust whole-head segmentation from magnetic resonance images for individualized head modeling. Neuroimage 2020; 219:117044. [PMID: 32534963 PMCID: PMC8048089 DOI: 10.1016/j.neuroimage.2020.117044] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 05/15/2020] [Accepted: 06/09/2020] [Indexed: 12/18/2022] Open
Abstract
Transcranial brain stimulation (TBS) has been established as a method for modulating and mapping the function of the human brain, and as a potential treatment tool in several brain disorders. Typically, the stimulation is applied using a one-size-fits-all approach with predetermined locations for the electrodes, in electric stimulation (TES), or the coil, in magnetic stimulation (TMS), which disregards anatomical variability between individuals. However, the induced electric field distribution in the head largely depends on anatomical features implying the need for individually tailored stimulation protocols for focal dosing. This requires detailed models of the individual head anatomy, combined with electric field simulations, to find an optimal stimulation protocol for a given cortical target. Considering the anatomical and functional complexity of different brain disorders and pathologies, it is crucial to account for the anatomical variability in order to translate TBS from a research tool into a viable option for treatment. In this article we present a new method, called CHARM, for automated segmentation of fifteen different head tissues from magnetic resonance (MR) scans. The new method compares favorably to two freely available software tools on a five-tissue segmentation task, while obtaining reasonable segmentation accuracy over all fifteen tissues. The method automatically adapts to variability in the input scans and can thus be directly applied to clinical or research scans acquired with different scanners, sequences or settings. We show that an increase in automated segmentation accuracy results in a lower relative error in electric field simulations when compared to anatomical head models constructed from reference segmentations. However, also the improved segmentations and, by implication, the electric field simulations are affected by systematic artifacts in the input MR scans. As long as the artifacts are unaccounted for, this can lead to local simulation differences up to 30% of the peak field strength on reference simulations. Finally, we exemplarily demonstrate the effect of including all fifteen tissue classes in the field simulations against the standard approach of using only five tissue classes and show that for specific stimulation configurations the local differences can reach 10% of the peak field strength.
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Affiliation(s)
- Oula Puonti
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Koen Van Leemput
- Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, USA
| | - Guilherme B Saturnino
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kristoffer H Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Department of Applied Mathematics and Computer Science, Technical University of Denmark, Denmark
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Department of Health Technology, Technical University of Denmark, Kgs. Lyngby, Denmark.
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58
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Haeckert J, Lasser C, Pross B, Hasan A, Strube W. Comparative study of motor cortical excitability changes following anodal tDCS or high-frequency tRNS in relation to stimulation duration. Physiol Rep 2020; 8:e14595. [PMID: 32996722 PMCID: PMC7525483 DOI: 10.14814/phy2.14595] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND In this study, we investigate the capacity of two different non-invasive brain stimulation (NIBS) techniques (anodal transcranial direct current stimulation (anodal tDCS) and high-frequency transcranial random noise stimulation (hf-tRNS)) regarding the relationship between stimulation duration and their efficacy in inducing long-lasting changes in motor cortical excitability. METHODS Fifteen healthy subjects attended six experimental sessions (90 experiments in total) and underwent both anodal tDCS of 7, 13, and 20 min duration, as well as high-frequency 1mA-tRNS of 7, 13, and 20 min stimulation duration. Sessions were performed in a randomized order and subjects were blinded to the applied methods. RESULTS For anodal tDCS, no significant stable increases of motor cortical excitability were observed for either stimulation duration. In contrast, for hf -tRNS a stimulation duration of 7 min resulted in a significant increase of motor cortical excitability lasting from 20 to 60 min poststimulation. While an intermediate duration of 13 min hf-tRNS failed to induce lasting changes in motor cortical excitability, a longer stimulation duration of 20 min hf-tRNS led only to significant increases at 50 min poststimulation which did not outlast until 60 min poststimulation. CONCLUSION Hf-tRNS for a duration of 7 min induced robust increases of motor cortical excitability, suggesting an indirect proportional relationship between stimulation duration and efficacy. While hf-tRNS appeared superior to anodal tDCS in this study, further systematic and randomized experiments are necessary to evaluate the generalizability of our observations and to address current intensity as a further modifiable contributor to the variability of transcranial brain stimulation.
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Affiliation(s)
- Jan Haeckert
- Department of Psychiatry and PsychotherapyUniversity Hospital MunichMünchenGermany
| | - Christoph Lasser
- Department of Psychiatry and PsychotherapyUniversity Hospital MunichMünchenGermany
| | - Benjamin Pross
- Department of Psychiatry and PsychotherapyUniversity Hospital MunichMünchenGermany
| | - Alkomiet Hasan
- Department of Psychiatry and PsychotherapyUniversity Hospital MunichMünchenGermany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus AugsburgUniversity of AugsburgAugsburgGermany
| | - Wolfgang Strube
- Department of Psychiatry and PsychotherapyUniversity Hospital MunichMünchenGermany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Bezirkskrankenhaus AugsburgUniversity of AugsburgAugsburgGermany
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McIntire LK, McKinley RA, Goodyear C, McIntire JP. The Effects of Anodal Transcranial Direct Current Stimulation on Sleep Time and Efficiency. Front Hum Neurosci 2020; 14:357. [PMID: 33192380 PMCID: PMC7481387 DOI: 10.3389/fnhum.2020.00357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/06/2020] [Indexed: 11/13/2022] Open
Abstract
A single session of anodal transcranial direct current stimulation (tDCS) has been shown to increase arousal in healthy participants for up to 24 h post-stimulation. However, little is known about the effects of tDCS on subsequent sleep in this population. Based on previous clinical studies, we hypothesized that anodal stimulation to the left dorsolateral prefrontal cortex (lDLPFC) would produce higher arousal with decreased sleep time and stimulation to the primary motor cortex (M1) would have the converse effect. Thirty-six active duty military were randomized into one of three groups (n = 12/group); active anodal tDCS over the lDLPFC, active anodal tDCS over left M1, or sham tDCS. Participants answered questionnaires 3 times a day and wore a wrist activity monitor (WAM) to measure sleep time and efficiency for 3 weeks. On weeks 2 and 3 (order counterbalance), participants received stimulation at 1800 h before 26 h of sustained wakefulness testing (sleep deprived) and at 1800 h without sleep deprivation (non-sleep deprived). There were no significant effects for the non-sleep deprived portion of testing. For the sleep deprived portion of testing, there were main effects of group and night on sleep time. The DLPFC group slept less than the other groups on the second and third night following stimulation. There is no negative effect on mood or sleep quality from a single dose of tDCS when participants have normal sleep patterns (i.e., non-sleep deprived portion of testing). The results suggest that stimulation may result in faster recovery from fatigue caused by acute periods of sleep deprivation, as their recovery sleep periods were less.
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Affiliation(s)
- Lindsey K McIntire
- Infoscitex, Inc., Wright-Patterson Air Force Base, Dayton, OH, United States
| | - R Andy McKinley
- Air Force Research Laboratory/Applied Neuroscience Branch, Wright-Patterson Air Force Base, Dayton, OH, United States
| | - Chuck Goodyear
- Infoscitex, Inc., Wright-Patterson Air Force Base, Dayton, OH, United States
| | - John P McIntire
- Air Force Research Laboratory/Security and Intelligence Branch, Wright-Patterson Air Force Base, Dayton, OH, United States
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60
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Transcranial direct current stimulation for post-stroke dysphagia: a systematic review and meta-analysis of randomized controlled trials. J Neurol 2020; 268:293-304. [PMID: 32797300 DOI: 10.1007/s00415-020-10142-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/03/2020] [Accepted: 08/05/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has been investigated as a tool for dysphagia recovery after stroke in several single-center randomized controlled trials (RCT). OBJECTIVE The aim of this investigation was to quantitatively evaluate the effect of tDCS on dysphagia recovery after a stroke utilizing a systematic review and meta-analysis. METHODS Major databases were searched through October 2019 using a pre-defined set of criteria. Any RCT investigating the efficacy of tDCS in post-stroke dysphagia using a standardized dysphagia scale as outcome measure was included. Studies were assessed for risk of bias and quality using the Physiotherapy Evidence Database (PEDro) scale. Effect sizes were calculated from extracted data and entered into a random effects analysis to obtain pooled estimates of the effect. RESULTS Seven RCTs with a total sample size of 217 patients fulfilled the criteria and were included in the analysis. The overall results revealed a small but statistically significant pooled effect size (0.31; CI 0.03, 0.59; p = 0.03). The subgroup which explored the stimulation intensity yielded a moderately significant effect size for the low-intensity stimulation group (g = 0.44; CI = 0.08, 0.81 vs. g = 0.15, CI - 0.30, 0.61). For the other subgroup analyses, neither comparisons of affected vs. unaffected hemisphere or acute vs. chronic stroke phase revealed a significant result. CONCLUSION This meta-analysis demonstrates a modest but significant beneficial effect of tDCS on improving post-stroke dysphagia. Whether benefits from this intervention are more pronounced in certain patient subgroups and with specific stimulation protocols requires further investigation.
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61
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Codella R, Alongi R, Filipas L, Luzi L. Ergogenic Effects of Bihemispheric Transcranial Direct Current Stimulation on Fitness: a Randomized Cross-over Trial. Int J Sports Med 2020; 42:66-73. [PMID: 32781476 DOI: 10.1055/a-1198-8525] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Several types of routines and methods have been experimented to gain neuromuscular advantages, in terms of exercise performance, in athletes and fitness enthusiasts. The aim of the present study was to evaluate the impact of biemispheric transcranial direct current stimulation on physical fitness indicators of healthy, physically active, men. In a randomized, single-blinded, crossover fashion, seventeen subjects (age: 30.9 ± 6.5 years, BMI: 24.8±3.1 kg/m2) underwent either stimulation or sham, prior to: vertical jump, sit & reach, and endurance running tests. Mixed repeated measures anova revealed a large main effect of stimulation for any of the three physical fitness measures. Stimulation determined increases of lower limb power (+ 5%), sit & reach amplitude (+ 9%) and endurance running capacity (+ 12%) with respect to sham condition (0.16<ηp2 < 0.41; p<0.05). Ratings-of-perceived-exertion, recorded at the end of each test session, did not change across all performances. However, in the stimulated-endurance protocol, an average lower rate-of-perceived-exertion at iso-time was inferred. A portable transcranial direct current stimulation headset could be a valuable ergogenic resource for individuals seeking to improve physical fitness in daily life or in athletic training.
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Affiliation(s)
- Roberto Codella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Rosario Alongi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Luca Filipas
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
| | - Livio Luzi
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy.,Department of Endocrinology, Nutrition and Metabolic Diseases, IRCCS MultiMedica, Milan, Italy
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62
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Park S, Choi WJ, Kim S, Kim B, Son SJ, Roh D, Kim WJ, Park JY. Effects of transcranial direct current stimulation using miniaturized devices vs sertraline for depression in Korea: A 6 week, multicenter, randomized, double blind, active-controlled study. J Psychiatr Res 2020; 127:42-47. [PMID: 32464489 DOI: 10.1016/j.jpsychires.2020.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 04/14/2020] [Accepted: 04/30/2020] [Indexed: 11/29/2022]
Abstract
We compared the efficacy and safety of transcranial direct current stimulation (tDCS) vs. Sertraline in the treatment of Major Depressive Disorder (MDD) in South Korean participants. This was a multi-center, double blind, active controlled study with non-inferiority testing. Patients were randomly assigned to receive tDCS (n = 45) or Sertraline (n = 47). tDCS was administered in 30-min, 2 mA prefrontal stimulation sessions for 10 consecutive weekdays, followed by 2 treatments at 4 and 6 weeks. Sertraline was administered at a dose of 50 mg per day for 6 weeks. The primary outcome measure was a change in the Montgomery-Asberg Depression Rating Scale (MADRS) score at six weeks. Mean MADRS scores decreased by 14.58 ± 8.51 points in the tDCS group and 12.32 ± 8.56 points in the Sertraline group. There was no significant main effect of group (p = 0.5877) or time by group interaction across weeks 0, 3, and 6 (p = 0.1539). Noninferiority of tDCS compared with Sertraline was not demonstrated. The mean difference between the Sertraline and tDCS group was -2.258 (95% confidence interval [CI], -5.795 to 1.27811), and the lower boundary of the CI was lower than the prespecified noninferiority margin of -3.56. There were no significant group differences in the rate of adverse events. In the present study, the noninferiority of tDCS to Sertraline for the treatment of depression was not found in this Korean population.
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Affiliation(s)
- Sunyoung Park
- Department of Psychiatry, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of Korea
| | - Won-Jung Choi
- Gangnam Yonsei Psychiatry Clinic, Seoul, South Korea; Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sejoo Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Republic of Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Daeyoung Roh
- Mind-neuromodulation Laboratory and Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Woo Jung Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi, South Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Gyeonggi, South Korea
| | - Jin Young Park
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Gyeonggi, South Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Gyeonggi, South Korea.
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Salehinejad MA, Nejati V, Mosayebi-Samani M, Mohammadi A, Wischnewski M, Kuo MF, Avenanti A, Vicario CM, Nitsche MA. Transcranial Direct Current Stimulation in ADHD: A Systematic Review of Efficacy, Safety, and Protocol-induced Electrical Field Modeling Results. Neurosci Bull 2020; 36:1191-1212. [PMID: 32418073 DOI: 10.1007/s12264-020-00501-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 02/04/2020] [Indexed: 12/18/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a promising method for altering cortical excitability with clinical implications. It has been increasingly used in neurodevelopmental disorders, especially attention-deficit hyperactivity disorder (ADHD), but its efficacy (based on effect size calculations), safety, and stimulation parameters have not been systematically examined. In this systematic review, we aimed to (1) explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients, (2) evaluate the safety of tDCS application, especially in children with ADHD, (3) model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols, and (4) discuss and propose advanced tDCS parameters. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach, a literature search identified 14 empirical experiments investigating tDCS effects in ADHD. Partial improving effects of tDCS on cognitive deficits (response inhibition, working memory, attention, and cognitive flexibility) or clinical symptoms (e.g., impulsivity and inattention) are reported in 10 studies. No serious adverse effects are reported in 747 sessions of tDCS. The left and right dorsolateral prefrontal cortex are the regions most often targeted, and anodal tDCS the protocol most often applied. An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes. In ADHD children, however, the electrical field induced by 1 mA, which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children, was sufficient to result in significant behavioral change. Overall, tDCS seems to be a promising method for improving ADHD deficits. However, the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes. Cortical regions involved in ADHD pathophysiology, stimulation parameters (e.g. intensity, duration, polarity, and electrode size), and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD. Developmental aspects of tDCS in childhood ADHD should be considered as well.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139, Dortmund, Germany. .,International Graduate School of Neuroscience, Ruhr-University Bochum, 44801, Bochum, Germany. .,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, 1983963113, Iran.
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, 1983963113, Iran.
| | - Mohsen Mosayebi-Samani
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139, Dortmund, Germany.,Institute of Biomedical Engineering and Informatics, Ilmenau University of Technology, 98693, Ilmenau, Germany
| | - Ali Mohammadi
- Department of Psychology, Shahid Beheshti University, Tehran, 1983963113, Iran
| | - Miles Wischnewski
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, 6525 HR, Nijmegen, The Netherlands
| | - Min-Fang Kuo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139, Dortmund, Germany
| | - Alessio Avenanti
- Centro studi e ricerche in Neuroscienze Cognitive, Dipartimento di Psicologia, Alma Mater Studiorm, Università di Bologna, 47521, Cesena, Italy.,Centro de Investigación en Neuropsicología y Neurociencias Cognitivas, Universidad Católica del Maule, 3605, Talca, Chile
| | - Carmelo M Vicario
- Dipartimento di Scienze Cognitive, Psicologiche, Pedagogiche e degli studi culturali, Università di Messina, 98121, Messina, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, 44139, Dortmund, Germany. .,Department of Neurology, University Medical Hospital Bergmannsheil, 44789, Bochum, Germany.
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64
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Transcranial electrical stimulation motor threshold can estimate individualized tDCS dosage from reverse-calculation electric-field modeling. Brain Stimul 2020; 13:961-969. [PMID: 32330607 PMCID: PMC7906246 DOI: 10.1016/j.brs.2020.04.007] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Revised: 04/08/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Unique amongst brain stimulation tools, transcranial direct current stimulation (tDCS) currently lacks an easy or widely implemented method for individualizing dosage. Objective: We developed a method of reverse-calculating electric-field (E-field) models based on Magnetic Resonance Imaging (MRI) scans that can estimate individualized tDCS dose. We also evaluated an MRI-free method of individualizing tDCS dose by measuring transcranial magnetic stimulation (TMS) motor threshold (MT) and single pulse, suprathreshold transcranial electrical stimulation (TES) MT and regressing it against E-field modeling. Key assumptions of reverse-calculation E-field modeling, including the size of region of interest (ROI) analysis and the linearity of multiple E-field models were also tested. Methods: In 29 healthy adults, we acquired TMS MT, TES MT, and anatomical T1-weighted MPRAGE MRI scans with a fiducial marking the motor hotspot. We then computed a “reverse-calculated tDCS dose” of tDCS applied at the scalp needed to cause a 1.00 V/m E-field at the cortex. Finally, we examined whether the predicted E-field values correlated with each participant’s measured TMS MT or TES MT. Results: We were able to determine a reverse-calculated tDCS dose for each participant using a 5 × 5 x 5 voxel grid region of interest (ROI) approach (average = 6.03 mA, SD = 1.44 mA, range = 3.75–9.74 mA). The Transcranial Electrical Stimulation MT, but not the Transcranial Magnetic Stimulation MT, significantly correlated with the ROI-based reverse-calculated tDCS dose determined by E-field modeling (R2 = 0.45, p < 0.001). Conclusions: Reverse-calculation E-field modeling, alone or regressed against TES MT, shows promise as a method to individualize tDCS dose. The large range of the reverse-calculated tDCS doses between subjects underscores the likely need to individualize tDCS dose. Future research should further examine the use of TES MT to individually dose tDCS as an MRI-free method of dosing tDCS.
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Shou Z, Li Z, Wang X, Chen M, Bai Y, Di H. Non-invasive brain intervention techniques used in patients with disorders of consciousness. Int J Neurosci 2020; 131:390-404. [PMID: 32238043 DOI: 10.1080/00207454.2020.1744598] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Aim of the study: With the development of emergency medicine and intensive care technology, the number of people who survive with disorders of consciousness (DOC) has dramatically increased. The diagnosis and treatment of such patients have attracted much attention from the medical community. From the latest evidence-based guidelines, non-invasive brain intervention (NIBI) techniques may be valuable and promising in the diagnosis and conscious rehabilitation of DOC patients.Methods: This work reviews the studies on NIBI techniques for the assessment and intervention of DOC patients.Results: A large number of studies have explored the application of NIBI techniques in DOC patients. The NIBI techniques include transcranial magnetic stimulation, transcranial electric stimulation, music stimulation, near-infrared laser stimulation, focused shock wave therapy, low-intensity focused ultrasound pulsation and transcutaneous auricular vagus nerve stimulation.Conclusions: NIBI techniques present numerous advantages such as being painless, safe and inexpensive; having adjustable parameters and targets; and having broad development prospects in treating DOC patients.
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Affiliation(s)
- Zeyu Shou
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Zhilong Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Xueying Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Miaoyang Chen
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Yang Bai
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.,Key Laboratory of Aging and Cancer Biology of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
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DeCosta-Fortune TM, Ramshur JT, Li CX, de Jongh Curry A, Pellicer-Morata V, Wang L, Waters RS. Repetitive microstimulation in rat primary somatosensory cortex (SI) strengthens the connection between homotopic sites in the opposite SI and leads to expression of previously ineffective input from the ipsilateral forelimb. Brain Res 2020; 1732:146694. [PMID: 32017899 PMCID: PMC7237062 DOI: 10.1016/j.brainres.2020.146694] [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: 01/24/2018] [Revised: 01/06/2020] [Accepted: 01/29/2020] [Indexed: 10/25/2022]
Abstract
The primary somatosensory cortex (SI) receives input from the contralateral forelimb and projects to homotopic sites in the opposite SI. Since homotopic sites in SI are linked by a callosal pathway, we proposed that repetitive intracortical microstimulation (ICMSr) of neurons in layer V of SI forelimb cortex would increase spike firing in the opposite SI cortex thereby strengthening the callosal pathway sufficiently to allow normally ineffective stimuli from the ipsilateral forelimb to excite cells in the ipsilateral SI. The forelimb representation in SI in one hemisphere was mapped using mechanical and electrical stimulation of the contralateral forelimb, a homotopic site was similarly identified in the opposite SI, the presence of ipsilateral peripheral input was tested in both homotopic sites, and ICMS was used to establish an interhemispheric connection between the two homotopic recording sites. The major findings are: (1) each homotopic forelimb site in SI initially received short latency input only from the contralateral forelimb; (2) homotopic sites in layer V in each SI were interconnected by a callosal pathway; (3) ICMSr delivered to layer V of the homotopic SI in one hemisphere generally increased evoked response spike firing in layer V in the opposite homotopic site; (4) increased spike firing was often followed by the expression of a longer latency normally ineffective input from the ipsilateral forelimb; (5) these longer latency ipsilateral responses are consistent with a delay time sufficient to account for travel across the callosal pathway; (6) increased spike firing and the resulting ipsilateral peripheral input were also corroborated using in-vivo intracellular recording; and (7) inactivation of the stimulating site in SI by lidocaine injection or local surface cooling abolished the ipsilateral response, suggesting that the ipsilateral response was very likely relayed across the callosal pathway. These results suggest that repetitive microstimulation can do more than expand receptive fields in the territory adjacent to the stimulating electrode but in addition can also alter receptive fields in homotopic sites in the opposite SI to bring about the expression of previously ineffective input from the ipsilateral forelimb.
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Affiliation(s)
- Tina M DeCosta-Fortune
- Department of Biomedical Engineering, University of Memphis, Herff College of Engineering, 3815 Central Avenue, Memphis, TN 38152, USA
| | - John T Ramshur
- Department of Biomedical Engineering, University of Memphis, Herff College of Engineering, 3815 Central Avenue, Memphis, TN 38152, USA
| | - Cheng X Li
- Department of Biomedical Engineering, University of Memphis, Herff College of Engineering, 3815 Central Avenue, Memphis, TN 38152, USA; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, College of Medicine, 855 Monroe Avenue, Memphis, TN 38163, USA
| | - Amy de Jongh Curry
- Department of Biomedical Engineering, University of Memphis, Herff College of Engineering, 3815 Central Avenue, Memphis, TN 38152, USA
| | - Violeta Pellicer-Morata
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, College of Medicine, 855 Monroe Avenue, Memphis, TN 38163, USA
| | - Lie Wang
- Department of Neurology, University of Tennessee Health Science Center, College of Medicine, 855 Monroe Avenue, Memphis, TN 38163, USA
| | - Robert S Waters
- Department of Biomedical Engineering, University of Memphis, Herff College of Engineering, 3815 Central Avenue, Memphis, TN 38152, USA; Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, College of Medicine, 855 Monroe Avenue, Memphis, TN 38163, USA.
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67
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Bacomics: a comprehensive cross area originating in the studies of various brain-apparatus conversations. Cogn Neurodyn 2020; 14:425-442. [PMID: 32655708 DOI: 10.1007/s11571-020-09577-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 02/17/2020] [Accepted: 03/05/2020] [Indexed: 12/20/2022] Open
Abstract
The brain is the most important organ of the human body, and the conversations between the brain and an apparatus can not only reveal a normally functioning or a dysfunctional brain but also can modulate the brain. Here, the apparatus may be a nonbiological instrument, such as a computer, and the consequent brain-computer interface is now a very popular research area with various applications. The apparatus may also be a biological organ or system, such as the gut and muscle, and their efficient conversations with the brain are vital for a healthy life. Are there any common bases that bind these different scenarios? Here, we propose a new comprehensive cross area: Bacomics, which comes from brain-apparatus conversations (BAC) + omics. We take Bacomics to cover at least three situations: (1) The brain is normal, but the conversation channel is disabled, as in amyotrophic lateral sclerosis. The task is to reconstruct or open up new channels to reactivate the brain function. (2) The brain is in disorder, such as in Parkinson's disease, and the work is to utilize existing or open up new channels to intervene, repair and modulate the brain by medications or stimulation. (3) Both the brain and channels are in order, and the goal is to enhance coordinated development between the brain and apparatus. In this paper, we elaborate the connotation of BAC into three aspects according to the information flow: the issue of output to the outside (BAC-1), the issue of input to the brain (BAC-2) and the issue of unity of brain and apparatus (BAC-3). More importantly, there are no less than five principles that may be taken as the cornerstones of Bacomics, such as feedforward and feedback control, brain plasticity, harmony, the unity of opposites and systems principles. Clearly, Bacomics integrates these seemingly disparate domains, but more importantly, opens a much wider door for the research and development of the brain, and the principles further provide the general framework in which to realize or optimize these various conversations.
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68
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Van Noppen P, van Dun K, Depestele S, Verstraelen S, Meesen R, Manto M. Transcranial direct current stimulation and attention skills in burnout patients: a randomized blinded sham-controlled pilot study. F1000Res 2020; 9:116. [PMID: 33363715 PMCID: PMC7737710 DOI: 10.12688/f1000research.21831.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2020] [Indexed: 11/30/2022] Open
Abstract
Background: Burnout is characterized by deficiencies in attention and several components of the working memory. It has been shown that cognitive behavioral therapy can have a positive effect on burnout and depressive symptoms, however, the lingering effects of impaired attention and executive functions are the most frustrating. We hypothesized that anodal transcranial direct current stimulation (atDCS) over the left dorsolateral prefrontal cortex (DLPFC) can improve the executive control of attention and possibly several other components of working memory in patients with burnout. Methods: This was a randomized double-blind sham-controlled pilot study with two groups. Patients with burnout received three weeks of daily sessions (15 sessions in total) of atDCS or sham stimulation in addition to three weekly sessions of standard behavioral therapy. The primary outcome measure was attention and the central executive of the working memory. Secondary, the effect of atDCS was measured on other components of working memory, on burnout and depression scores, and on quality of life (QoL). Results: We enrolled and randomly assigned 16 patients to a sham or real stimulation group, 15 (7 sham, 8 real) were included in the analysis. atDCS had a significant impact on attention. Post-hoc comparisons also revealed a trend towards more improvement after real tDCS for inhibition and shifting, updating and control, and encoding. Both groups improved on burnout and depression scores. Conclusion: These data provide preliminary evidence for the value of atDCS over the left DLPFC in rehabilitating attention deficits, and possibly also central executive and encoding deficits, in burnout. However, the current study has some limitations, including the sample size and heterogeneous patient population. More elaborate studies are needed to elucidate the specific impact of atDCS over the left DLPFC on burnout. Trial registration: ISRCTN.com ( ISRCTN94275121) 17/11/19.
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Affiliation(s)
| | - Kim van Dun
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), UHasselt, Diepenbeek, Limburg, 2590, Belgium
- Clinical and Experimental Neurolinguistics (CLIN), Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - Siel Depestele
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), UHasselt, Diepenbeek, Limburg, 2590, Belgium
| | - Stefanie Verstraelen
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), UHasselt, Diepenbeek, Limburg, 2590, Belgium
| | - Raf Meesen
- Neuroplasticity and Movement Control Research Group, Rehabilitation Research Institute (REVAL), UHasselt, Diepenbeek, Limburg, 2590, Belgium
| | - Mario Manto
- Service de Neurologie, CHU-Charleroi, Charleroi, Henegouwen, 6041, Belgium
- Service de Neurosciences, Université de Mons, Mons, Henegouwen, 7000, Belgium
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69
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Jiang N, Wei J, Li G, Wei B, Zhu FF, Hu Y. Effect of dry-electrode-based transcranial direct current stimulation on chronic low back pain and low back muscle activities: A double-blind sham-controlled study. Restor Neurol Neurosci 2020; 38:41-54. [DOI: 10.3233/rnn-190922] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Naifu Jiang
- CAS Key Laboratory of Human-Machine Intelligence-Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- The Shenzhen Engineering Laboratory of Neural Rehabilitation Technology, Shenzhen, China
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Jinsong Wei
- Department of Orthopaedics, Spinal Division, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Guangsheng Li
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
- Department of Orthopaedics, Spinal Division, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Bo Wei
- Department of Orthopaedics, Spinal Division, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Frank F. Zhu
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yong Hu
- Department of Orthopaedics and Traumatology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Chhabra H, Bose A, Shivakumar V, Agarwal SM, Sreeraj VS, Shenoy S, Hazari N, Dinakaran D, Parlikar R, Koparde V, Ramesh V, Biswal J, Murugaraja V, Gowda SM, Chand PK, Sivakumar PT, Kalmady SV, Narayanaswamy JC, Murthy P, Girimaji SC, Venkatasubramanian G. Tolerance of transcranial direct current stimulation in psychiatric disorders: An analysis of 2000+ sessions. Psychiatry Res 2020; 284:112744. [PMID: 31955053 DOI: 10.1016/j.psychres.2020.112744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/05/2019] [Accepted: 01/01/2020] [Indexed: 12/29/2022]
Abstract
Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.
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Affiliation(s)
- Harleen Chhabra
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Anushree Bose
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Venkataram Shivakumar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sri Mahavir Agarwal
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vanteemar S Sreeraj
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sonia Shenoy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Nandita Hazari
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Damodharan Dinakaran
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Rujuta Parlikar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vinayak Koparde
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vinutha Ramesh
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Jitendriya Biswal
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Venkatachalam Murugaraja
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Shayanth Manche Gowda
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Prabhat K Chand
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Palanimuthu T Sivakumar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sunil V Kalmady
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Janardhanan C Narayanaswamy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Pratima Murthy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Satish C Girimaji
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Ganesan Venkatasubramanian
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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Constans C, Ahnine H, Santin M, Lehericy S, Tanter M, Pouget P, Aubry JF. Non-invasive ultrasonic modulation of visual evoked response by GABA delivery through the blood brain barrier. J Control Release 2020; 318:223-231. [DOI: 10.1016/j.jconrel.2019.12.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 10/25/2019] [Accepted: 12/05/2019] [Indexed: 11/25/2022]
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Jamil A, Batsikadze G, Kuo HI, Meesen RLJ, Dechent P, Paulus W, Nitsche MA. Current intensity- and polarity-specific online and aftereffects of transcranial direct current stimulation: An fMRI study. Hum Brain Mapp 2019; 41:1644-1666. [PMID: 31860160 PMCID: PMC7267945 DOI: 10.1002/hbm.24901] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/11/2019] [Accepted: 12/04/2019] [Indexed: 01/03/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) induces polarity‐ and dose‐dependent neuroplastic aftereffects on cortical excitability and cortical activity, as demonstrated by transcranial magnetic stimulation (TMS) and functional imaging (fMRI) studies. However, lacking systematic comparative studies between stimulation‐induced changes in cortical excitability obtained from TMS, and cortical neurovascular activity obtained from fMRI, prevent the extrapolation of respective physiological and mechanistic bases. We investigated polarity‐ and intensity‐dependent effects of tDCS on cerebral blood flow (CBF) using resting‐state arterial spin labeling (ASL‐MRI), and compared the respective changes to TMS‐induced cortical excitability (amplitudes of motor evoked potentials, MEP) in separate sessions within the same subjects (n = 29). Fifteen minutes of sham, 0.5, 1.0, 1.5, and 2.0‐mA anodal or cathodal tDCS was applied over the left primary motor cortex (M1) in a randomized repeated‐measure design. Time‐course changes were measured before, during and intermittently up to 120‐min after stimulation. ROI analyses indicated linear intensity‐ and polarity‐dependent tDCS after‐effects: all anodal‐M1 intensities increased CBF under the M1 electrode, with 2.0‐mA increasing CBF the greatest (15.3%) compared to sham, while all cathodal‐M1 intensities decreased left M1 CBF from baseline, with 2.0‐mA decreasing the greatest (−9.3%) from sham after 120‐min. The spatial distribution of perfusion changes correlated with the predicted electric field, as simulated with finite element modeling. Moreover, tDCS‐induced excitability changes correlated more strongly with perfusion changes in the left sensorimotor region compared to the targeted hand‐knob region. Our findings reveal lasting tDCS‐induced alterations in cerebral perfusion, which are dose‐dependent with tDCS parameters, but only partially account for excitability changes.
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Affiliation(s)
- Asif Jamil
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,REVAL Research Institute, University of Hasselt, Hasselt, Belgium
| | - Giorgi Batsikadze
- Department of Neurology, Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | - Hsiao-I Kuo
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Raf L J Meesen
- REVAL Research Institute, University of Hasselt, Hasselt, Belgium
| | - Peter Dechent
- Department of Cognitive Neurology, University Medical Center, University of Göttingen, Göttingen, Germany
| | - Walter Paulus
- Department of Clinical Neurophysiology, University Medical Center, University of Göttingen, Göttingen, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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73
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Komori T, Makinodan M, Kishimoto T. Social status and modern-type depression: A review. Brain Behav 2019; 9:e01464. [PMID: 31743626 PMCID: PMC6908884 DOI: 10.1002/brb3.1464] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/06/2019] [Accepted: 10/13/2019] [Indexed: 01/14/2023] Open
Abstract
BACKGROUNDS Social hierarchy is one of the most influential social structures employed by social species. While dominants in such hierarchies can preferentially access rich resources, subordinates are forced into lower social statuses and lifestyles with inferior resources. Previous studies have indicated that the social rank regulates social behaviors and emotion in a variety of species, whereby individual organisms live within the framework of their ranks. However, in human societies, people, particularly young men, who cannot accept their own social status may show social withdrawal behaviors such as hikikomori to avoid confronting their circumstances. METHODS This article reviews the neural mechanisms underlying social status identified in animal studies with rodents and primates, and assesses how social rank affects animal's social behaviors and emotion which may be relevant to modern type depression. RESULTS Several brain regions such as medial prefrontal cortex are implicated in the formation of animal's social status, which leads to the differences in vulnerability and resilience to social stress. CONCLUSION On the basis of these findings, we propose that physical interventions such as voluntary exercise, diet, transcranial direct current stimulation, and psychotherapy, rather than psychotropic drugs, may be useful therapeutic approaches for modern type depression, which is a typical example of social status conflict and a phenotype of adjustment disorder to the traditional hierarchical social order.
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Affiliation(s)
- Takashi Komori
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Manabu Makinodan
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
| | - Toshifumi Kishimoto
- Department of Psychiatry, Nara Medical University School of Medicine, Kashihara, Japan
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74
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Different Therapeutic Effects of Transcranial Direct Current Stimulation on Upper and Lower Limb Recovery of Stroke Patients with Motor Dysfunction: A Meta-Analysis. Neural Plast 2019; 2019:1372138. [PMID: 31827495 PMCID: PMC6881758 DOI: 10.1155/2019/1372138] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/09/2019] [Indexed: 12/21/2022] Open
Abstract
Objective To explore the effects of transcranial direct current stimulation (tDCS) on the motor recovery of stroke patients and the effect differences between the upper limb and lower limb. Methods Randomized control trials published until January 2019 were searched from PubMed, Embase, ScienceDirect, and Cochrane Library databases. The standardized mean difference (SMD) with 95% confidence interval (CI) was estimated separately for upper and lower limb motor outcomes to understand the mean effect size. Results Twenty-nine studies with 664 subjects were included in this meta-analysis. The overall analyses of tDCS demonstrated significant effect size both for the upper limb (SMD = 0.26, P = 0.002) and the lower limb (SMD = 0.47, P = 0.002). Compared with acute and subacute stroke patients, chronic stroke patients obtained significant effects after tDCS (SMD = 0.25, P = 0.03) in upper limb function. Furthermore, both anode and cathode stimulations produced significant effect size for stroke patients after ≤10 sessions of tDCS (anode: SMD = 0.40, P = 0.001; cathode: SMD = 0.79, P < 0.0001) with >0.029 mA/cm2 of density (anode: SMD = 0.46, P = 0.002; cathode: SMD = 0.79, P < 0.0001). But for lower limb function, more prominent effects were found in subacute stroke patients (SMD = 0.56, P = 0.001) with bilateral tDCS (SMD = 0.59, p = 0.009). Conclusion tDCS is effective for the recovery of stroke patients with motor dysfunction. In addition, upper limb and lower limb functions obtain distinct effects from different therapeutic parameters of tDCS at different stages, respectively.
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75
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Kapadia N, Zivanovic V, Moineau B, Downar J, Zariffa J, Popovic MR. Functional electrical stimulation of the facial muscles to improve symptoms in individuals with major depressive disorder: pilot feasibility study. Biomed Eng Online 2019; 18:109. [PMID: 31727068 PMCID: PMC6857333 DOI: 10.1186/s12938-019-0730-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 11/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background Currently, the mainstay of treatment in patients diagnosed with major depressive disorder (MDD) requiring medical attention is second generation anti-depressants. However, about 40% of patients treated with second-generation anti-depressants do not respond to initial treatment and approximately 70% do not achieve remission during the first-step treatment. There are a few non-pharmacological options available, but none have shown consistently positive results. There is a need for an intervention that is relatively easy to administer, produces consistently positive results and is associated with minimal side effects. In the current study, we assessed the feasibility of using transcutaneous Functional Electrical Stimulation Therapy (FEST) of the facial muscles, as a tool for improving depressive symptoms in individuals with MDD. Results Ten (10) individuals with moderate to severe MDD received three FEST sessions/week for a minimum of 10 to a maximum of 40 sessions. All study participants completed the required 10 therapy sessions, and 5 of the 10 participants completed additional 30 (totalling 40) FEST sessions. There were no adverse events or concerns regarding compliance to therapy. We found statistically significant improvements on Hamilton Rating Scale for Depression (HDS) and Inventory of Depressive Symptomatology (IDS) measures. However, no significant improvements were found on Positive and Negative Affect Scale and 10-point Visual Analogue Scale scales. Participants reported improvements in sleeping patterns, and this correlated with statistically significant improvements on sleep parameters of HDS and IDS measures. Conclusion This study indicates that facial FEST is an acceptable, practical, and safe treatment in individuals with MDD. We provide preliminary evidence to show improvements in depressive symptoms following a minimum of 10 FEST sessions.
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Affiliation(s)
- Naaz Kapadia
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada. .,Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.
| | - Vera Zivanovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada
| | - Bastien Moineau
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Myant Inc., Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
| | - Jonathan Downar
- Department of Psychiatry, University of Toronto, Toronto, Canada.,MRI Guided rTMS Clinic, Toronto Western Hospital, University Health Network, Toronto, Canada
| | - Jose Zariffa
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.,Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, Canada
| | - Milos R Popovic
- Rehabilitation Engineering Laboratory, Lyndhurst Centre, KITE, Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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76
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Wong HL, Chan WC, Wong YL, Wong SN, Yung HY, Wong SMC, Cheng PWC. High-definition transcranial direct current stimulation-An open-label pilot intervention in alleviating depressive symptoms and cognitive deficits in late-life depression. CNS Neurosci Ther 2019; 25:1244-1253. [PMID: 31657152 PMCID: PMC6834921 DOI: 10.1111/cns.13253] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 12/31/2022] Open
Abstract
The efficacy of high-definition transcranial direct current stimulation (HD-tDCS) in late-life depression (LLD) remains unknown due to limited research on its therapeutic effects on the hallmarks of LLD-the depressive and cognitive symptoms. The present open-label pilot study aimed to examine the effectiveness of HD-tDCS as an augmentation therapy with antidepressants in improving the depressive and cognitive symptoms for LLD. Significant improvements were hypothesized in the depressive, cognitive, and daily functioning outcomes over time. A total of 15 subjects with LLD (13 females, mean age = 73.27 ± 6.25) received five consecutive daily sessions of 20-minute active HD-tDCS interventions weekly for 2 weeks, with a 2 mA anodal stimulation over F3 and cathodal stimulation over FC1, AF3, F7, and FC5. Depressive symptoms and cognitive and daily functioning were assessed across five assessment timepoints. The results revealed that the HD-tDCS was effective in reducing the depressive severity and the remission rates, with a sustained effect at both the 1-month and 3-month follow-up. Pre-post improvements were seen in the overall cognitive functioning and in verbal fluency, but not in executive functioning. Our pilot study provides a preliminary result of HD-tDCS in LLD, which was a safe and effective treatment in alleviating depressive symptoms, with mild cognitive improvements observed. Further larger scale randomized controlled trials are needed to confirm this result.
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Affiliation(s)
- Hau-Lam Wong
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Yiu-Lung Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Sze-Nga Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Hui-Yan Yung
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
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77
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Mishima T, Nagai T, Yahagi K, Akther S, Oe Y, Monai H, Kohsaka S, Hirase H. Transcranial Direct Current Stimulation (tDCS) Induces Adrenergic Receptor-Dependent Microglial Morphological Changes in Mice. eNeuro 2019; 6:ENEURO.0204-19.2019. [PMID: 31444225 PMCID: PMC6751370 DOI: 10.1523/eneuro.0204-19.2019] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/05/2019] [Accepted: 08/19/2019] [Indexed: 12/23/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been reported for its beneficial effects on memory formation and various brain disorders. While the electrophysiological readout of tDCS effects is subtle, astrocytes have been demonstrated to elicit Ca2+ elevations during tDCS in a rodent model. This study aimed to elucidate the effects of tDCS on another major glial cell type, microglia, by histology and in vivo imaging. tDCS performed in awake conditions induced a significant change in the pixel intensity distribution of Iba-1 immunohistochemistry, and microglial somata were enlarged when examined 3 h after tDCS. These effects were blocked by adrenergic receptor antagonists or in IP3R2 (inositol trisphosphate receptor type 2)-deficient mice, which lack large cytosolic Ca2+ elevations in astrocytes. No obvious changes were observed in isoflurane-anesthetized mice. Furthermore, in vivo two-photon imaging of microglia showed a reduction of motility that was blocked by a β2-adrenergic receptor antagonist. Our observations add support for the influence of noradrenaline in tDCS and suggest possible interactions between microglia and astrocytes to express functional changes associated with tDCS.
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Affiliation(s)
- Tsuneko Mishima
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
| | - Terumi Nagai
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
| | - Kazuko Yahagi
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
| | - Sonam Akther
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
- Brain and Body System Science Institute, Saitama University, Saitama 338-8570, Japan
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Yuki Oe
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
| | - Hiromu Monai
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
- Faculty of Core Research Natural Science Division, Ochanomizu University, Tokyo 112-8610, Japan
| | - Shinichi Kohsaka
- National Institute of Neuroscience, National Center of Neurology and Psychiatry, Kodaira 187-0031, Japan
| | - Hajime Hirase
- Laboratory for Neuron-Glia Circuitry, RIKEN Center for Brain Science, Wako 351-0198, Japan
- Brain and Body System Science Institute, Saitama University, Saitama 338-8570, Japan
- Center for Translational Neuromedicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
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78
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Accessibility of cortical regions to focal TES: Dependence on spatial position, safety, and practical constraints. Neuroimage 2019; 203:116183. [PMID: 31525498 DOI: 10.1016/j.neuroimage.2019.116183] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 08/14/2019] [Accepted: 09/10/2019] [Indexed: 11/22/2022] Open
Abstract
Transcranial electric stimulation (TES) can modulate intrinsic neural activity in the brain by injecting weak currents through electrodes attached to the scalp. TES has been widely used as a neuroscience tool to investigate how behavioural and physiological variables of brain function are modulated by electric stimulation of specific brain regions. For an unambiguous interpretation of TES experiments, it is important that the electric fields can be steered towards one or several brain regions-of-interest. However, the conductive proprieties of the human head impose inherent physical limitations on how focal the electric fields in the brain produced by multi-electrode TES can be. As a rule of thumb, it is not feasible to selectively target deep brain areas with TES, although focusing the field in some specific deeper locations might be possible due to favourable conductive properties in the surrounding tissue. In the present study, we first propose a computationally efficient method for the automatic determination of electrode placements and stimulation intensities to optimally affect a given target position. We provide a robust implementation of the optimization procedure that is able to adhere to safety constraints, while explicitly controlling both the number of active electrodes and the angular deviation of the field in the target area relative to the desired field direction. Leveraging the high computational efficiency of our method, we systematically assess the achievable focality of multi-electrode TES for all cortex positions, thereby investigating the dependence on the chosen constraints. Our results provide comprehensive insight into the limitations regarding the achievable TES dose and focality that are imposed by the biophysical constraints and the safety considerations of TES.
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79
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Lu H, Gallinaro JV, Rotter S. Network remodeling induced by transcranial brain stimulation: A computational model of tDCS-triggered cell assembly formation. Netw Neurosci 2019; 3:924-943. [PMID: 31637332 PMCID: PMC6777963 DOI: 10.1162/netn_a_00097] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 05/14/2019] [Indexed: 11/22/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a variant of noninvasive neuromodulation, which promises treatment for brain diseases like major depressive disorder. In experiments, long-lasting aftereffects were observed, suggesting that persistent plastic changes are induced. The mechanism underlying the emergence of lasting aftereffects, however, remains elusive. Here we propose a model, which assumes that tDCS triggers a homeostatic response of the network involving growth and decay of synapses. The cortical tissue exposed to tDCS is conceived as a recurrent network of excitatory and inhibitory neurons, with synapses subject to homeostatically regulated structural plasticity. We systematically tested various aspects of stimulation, including electrode size and montage, as well as stimulation intensity and duration. Our results suggest that transcranial stimulation perturbs the homeostatic equilibrium and leads to a pronounced growth response of the network. The stimulated population eventually eliminates excitatory synapses with the unstimulated population, and new synapses among stimulated neurons are grown to form a cell assembly. Strong focal stimulation tends to enhance the connectivity within new cell assemblies, and repetitive stimulation with well-chosen duty cycles can increase the impact of stimulation even further. One long-term goal of our work is to help in optimizing the use of tDCS in clinical applications. Noninvasive brain stimulation techniques like tDCS have the potential to directly interfere with neural activity, but may also trigger activity-dependent plasticity. We propose a model to study the mechanism of tDCS and persistent aftereffects that may be induced as a consequence of homeostatic structural plasticity. Based on the idea that tDCS perturbs the ongoing activity of neurons, our model predicts that the stimulation also triggers a rearrangement of synapses among stimulated and unstimulated neurons, eventually leading to network remodeling and cell assembly formation. Focal and strong stimulation leads to stronger cell assemblies, and so does repetitive stimulation with optimized stimulation protocols. This is the first original work studying possible long-lasting aftereffects of transcranial stimulation at the mesoscopic neuronal network level using a computational model.
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Affiliation(s)
- Han Lu
- Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Júlia V Gallinaro
- Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Stefan Rotter
- Bernstein Center Freiburg and Faculty of Biology, University of Freiburg, Freiburg, Germany
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80
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Gold J, Ciorciari J. A Transcranial Stimulation Intervention to Support Flow State Induction. Front Hum Neurosci 2019; 13:274. [PMID: 31440152 PMCID: PMC6694760 DOI: 10.3389/fnhum.2019.00274] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 07/23/2019] [Indexed: 12/18/2022] Open
Abstract
Background: Flow states are considered a positive, subjective experience during an optimal balance between skills and task demands. Previously, experimentally induced flow experiences have relied solely on adaptive tasks. Objective: To investigate whether cathodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) area and anodal tDCS over the right parietal cortex area during video game play will promote an increased experience of flow states. Methods: Two studies had participants play Tetris or first-person shooter (FPS) video games while receiving either real tDCS or sham stimulation. Tetris recruited 21 untrained players who infrequently played video games while the 11 FPS participants played FPS frequently. Flow experience was assessed before and after stimulation. Results: Compared to sham stimulation, real stimulation increased flow experience for both untrained Tetris and trained FPS players. Improved performance effects were only seen with untrained groups. Conclusion: Cathodal and anodal tDCS over the left DLPFC and right parietal areas, respectively may encourage flow experiences in complex real-life motor tasks that occur during sports, games, and everyday life.
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Affiliation(s)
- Joshua Gold
- Centre for Mental Health, Swinburne Neuroimaging (SNI), Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Joseph Ciorciari
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
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81
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Al-Shargie F, Tariq U, Mir H, Alawar H, Babiloni F, Al-Nashash H. Vigilance Decrement and Enhancement Techniques: A Review. Brain Sci 2019; 9:E178. [PMID: 31357524 PMCID: PMC6721323 DOI: 10.3390/brainsci9080178] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 01/05/2023] Open
Abstract
This paper presents the first comprehensive review on vigilance enhancement using both conventional and unconventional means, and further discusses the resulting contradictory findings. It highlights the key differences observed between the research findings and argues that variations of the experimental protocol could be a significant contributing factor towards such contradictory results. Furthermore, the paper reveals the effectiveness of unconventional means of enhancement in significant reduction of vigilance decrement compared to conventional means. Meanwhile, a discussion on the challenges of enhancement techniques is presented, with several suggested recommendations and alternative strategies to maintain an adequate level of vigilance for the task at hand. Additionally, this review provides evidence in support of the use of unconventional means of enhancement on vigilance studies, regardless of their practical challenges.
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Affiliation(s)
- Fares Al-Shargie
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates.
| | - Usman Tariq
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Hasan Mir
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Hamad Alawar
- Dubai Police Headquarters, Dubai 1493, United Arab Emirates
| | - Fabio Babiloni
- Dept. Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy
- College of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Hasan Al-Nashash
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
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82
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Tsapa D, Ahmadlou M, Heimel JA. Long-term enhancement of visual responses by repeated transcranial electrical stimulation of the mouse visual cortex. Brain Stimul 2019; 12:1421-1428. [PMID: 31331791 DOI: 10.1016/j.brs.2019.07.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 07/15/2019] [Accepted: 07/16/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Transcranial electrical stimulation (tES) is a popular method to modulate brain activity by sending a weak electric current through the head. Despite its popularity, long-term effects are poorly understood. OBJECTIVE We wanted to test if anodal tES immediately changes cerebral responses to visual stimuli, and if repeated sessions of tES produce plasticity in these responses. METHODS We applied repeated anodal tES, like transcranial direct current stimulation (tDCS), but pulsed (8 s on, 10 s off), to the visual cortex of mice while visually presenting gratings. We measured the responses to these visual stimuli in the visual cortex using the genetically encoded calcium indicator GCaMP3. RESULTS We found an increase in the visual response when concurrently applying tES on the bone without skin (epicranially). This increase was only transient when tES was applied through the skin (transcutaneous). There was no immediate after-effect of tES. However, repeated transcutaneous tES for four sessions at two-day intervals increased the visual response in the visual cortex. This increase was not specific to the grating stimulus coupled to tES and also occurred for an orthogonal grating presented in the same sessions but without concurrent tES. No increase was found in mice that received no tES. CONCLUSION Our study provides evidence that tES induces long-term changes in the mouse brain. Results in mice do not directly translate to humans, because of differences in stimulation protocols and the way current translates to electric field strength in vastly different heads.
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Affiliation(s)
- Despoina Tsapa
- Cortical Structure & Function Group, Netherlands Institute for Neuroscience, Institute of the Royal Academy for Arts and Sciences, Amsterdam, the Netherlands
| | - Mehran Ahmadlou
- Cortical Structure & Function Group, Netherlands Institute for Neuroscience, Institute of the Royal Academy for Arts and Sciences, Amsterdam, the Netherlands
| | - J Alexander Heimel
- Cortical Structure & Function Group, Netherlands Institute for Neuroscience, Institute of the Royal Academy for Arts and Sciences, Amsterdam, the Netherlands.
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83
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Valiengo L, Gordon PC, de Carvalho JB, Rios RM, Koebe S, Serpa MH, van de Bilt M, Lacerda A, Elkis H, Gattaz WF, Brunoni AR. Schizophrenia TreAtment with electRic Transcranial Stimulation (STARTS): design, rationale and objectives of a randomized, double-blinded, sham-controlled trial. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2019; 41:104-111. [PMID: 31241683 DOI: 10.1590/2237-6089-2018-0047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 09/29/2018] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Schizophrenia is a severe mental disorder. While some antipsychotic medications have demonstrated efficacy in treating positive symptoms, there is no widely recognized treatment for negative symptoms, which can cause significant distress and impairment for patients with schizophrenia. Here we describe the rationale and design of the STARTS study (Schizophrenia TreAtment with electRic Transcranial Stimulation), a clinical trial aimed to test the efficacy of a non-pharmacological treatment known as transcranial direct current stimulation (tDCS) for treating the negative symptoms of schizophrenia. METHODS The STARTS study is designed as a randomized, sham-controlled, double-blinded trial evaluating tDCS for the treatment of the negative symptoms of schizophrenia. One-hundred patients will be enrolled and submitted to 10 tDCS sessions over the left dorsolateral prefrontal cortex (anodal stimulation) and left temporoparietal junction (cathodal stimulation) over 5 consecutive days. Participants will be assessed using clinical and neuropsychological tests before and after the intervention. The primary outcome is change in the Positive and Negative Syndrome Scale (PANSS) negative subscale score over time and across groups. Biological markers, including blood neurotrophins and interleukins, genetic polymorphisms, and motor cortical excitability, will also be assessed. RESULTS The clinical results will provide insights about tDCS as a treatment for the negative symptoms of schizophrenia, and the biomarker investigation will contribute towards an improved understanding of the tDCS mechanisms of action. CONCLUSION Our results could introduce a novel therapeutic technique for the negative symptoms of schizophrenia. Clinical trial registration: ClinicalTrials.gov, NCT02535676 .
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Affiliation(s)
- Leandro Valiengo
- Laboratório de Neurociências (LIM27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Pedro Caldana Gordon
- Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Juliana Barbosa de Carvalho
- Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Rosa Maria Rios
- Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Stephanie Koebe
- Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Mauricio Henrique Serpa
- Laboratório de Neurociências (LIM27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.,Laboratório de Neuroimagem (LIM-21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Martinus van de Bilt
- Laboratório de Neurociências (LIM27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - Acioly Lacerda
- Centro de Pesquisa e Ensaios Clínicos Sinapse-Bairral, Instituto Bairral de Psiquiatria, Itapira, SP, Brazil.,Laboratório Interdisciplinar de Neurociências Clínicas (LiNC), Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Helio Elkis
- Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Wagner Farid Gattaz
- Laboratório de Neurociências (LIM27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil
| | - André Russowsky Brunoni
- Laboratório de Neurociências (LIM27), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil.,Serviço Interdisciplinar de Neuromodulação (SIN), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil.,Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.,Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil.,Department and Institute of Psychiatry, LMU Munich, Munich, Germany
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84
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Nelson JM, Phillips CA, McKinley RA, McIntire LK, Goodyear C, Monforton L. The effects of transcranial direct current stimulation (tDCS) on multitasking performance and oculometrics. MILITARY PSYCHOLOGY 2019. [DOI: 10.1080/08995605.2019.1598217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
| | - Chandler A. Phillips
- Department of Industrial and Biomedical Engineering, Wright State University, Dayton, Ohio
| | - R. Andy McKinley
- Applied Neuroscience Branch, Wright-Patterson Air Force Base, Ohio
| | | | | | - Lanie Monforton
- Department of Industrial and Biomedical Engineering, Wright State University, Dayton, Ohio
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85
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Wiegand A, Sommer A, Nieratschker V, Plewnia C. Improvement of cognitive control and stabilization of affect by prefrontal transcranial direct current stimulation (tDCS). Sci Rep 2019; 9:6797. [PMID: 31043662 PMCID: PMC6494905 DOI: 10.1038/s41598-019-43234-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 04/09/2019] [Indexed: 12/23/2022] Open
Abstract
Cognitive control of information processing is an essential prerequisite of human behavior. Particularly, focusing attention in the face of failure poses a common challenge. Previous work has demonstrated that transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (dlPFC) can improve cognitive control in a challenging and repeatedly frustrating task. In a randomized, sham-controlled, crossover design 22 healthy, male participants performed an adaptive 2-back version of the Paced Auditory Serial Addition Task (PASAT), parallel to anodal or sham tDCS over the left dlPFC and the return electrode on the right upper arm. Before and after the 2-back PASAT, the affective state was assessed by means of the Positive and Negative Affective Schedule (PANAS). We observed an interaction between stimulation condition and task performance driven by an increase in performance with anodal tDCS and no improvement with sham stimulation. In addition, after the 2-back PASAT we found a higher positive and a trend towards lower negative affect with anodal as compared to sham tDCS. Our data support and extend previous results showing improved processing speed under anodal stimulation associated with a reduced task-induced negative affect indicating an improvement of cognitive control. Further studies will investigate long-term effects and clinical applicability.
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Affiliation(s)
- Ariane Wiegand
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Anja Sommer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany.
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86
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Zhang W, Lang S, Zheng Y, Qin X, Chen H, You Y, Ou H. The Effects of Transcranial Direct Current Stimulation Versus Electroacupuncture on Working Memory in Healthy Subjects. J Altern Complement Med 2019; 25:637-642. [PMID: 31033335 DOI: 10.1089/acm.2018.0532] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objective: Working memory (WM) can influence human thought processes through interactions with perception, long-term memory, and behavior. In recent years, transcranial direct current stimulation (tDCS) and electric acupuncture have been used to improve the performance of WM. Therefore, due to the n-back task as a continuous performance task that is commonly used to measure WM, the aim of this study is to investigate the differences in short-term efficacy between tDCS and electroacupuncture on WM under n-back task paradigm in healthy subjects. Methods: Forty-four college students (age: 23.70 ± 1.52 years; education: 16.93 ± 2.24 years) were recruited as experimental subjects and randomly divided into two groups by a random double-blind two-stage crossover experiment design. Group A received a tDCS intervention followed by at least 1 week of washout period and then the electroacupuncture intervention. Group B had the opposite sequence of interventions. The WM test under the n-back task paradigm was conducted before and after each intervention, and the changes in the accuracy (number of correct responses) and correct response time (RT) before and after the interventions were detected. The data were statistically analyzed using SPSS 24.0 to compare the short-term efficacy of tDCS and electroacupuncture on WM under different tasks. Results: In the 0-back task and 1-back tasks, there was no significant difference in the accuracy or RT before and after the interventions between tDCS and electroacupuncture stimulation. In the 2-back task, there was no significant difference in the accuracy before and after interventions between tDCS and electroacupuncture stimulation. However, there was a significant difference in RT (p < 0.05), which was lower after tDCS than after electroacupuncture in the 2-back task. Conclusion: The results show that tDCS with anodal stimulation on the left dorsolateral prefrontal cortex could increase the RT of the 2-back task performance in comparison with electroacupuncture stimulation of the Baihui (GV20) and Shenting (DU24) acupoints. The present results indicate that tDCS may have greater impact on WM in healthy subjects than electroacupuncture stimulation.
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Affiliation(s)
- Wenjing Zhang
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shijuan Lang
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuxin Zheng
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xi Qin
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hongxin Chen
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yaoyao You
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haining Ou
- 1 Department of Rehabilitation, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.,2 Experiment Education Model Center of Rehabilitation Medicine, Guangzhou Medical University, Guangzhou, China.,3 Department of Rehabilitation, Guangdong Province Hospital of Chinese Medicine, Guangzhou, China
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87
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Brookshire G, Casasanto D. Approach motivation in human cerebral cortex. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0141. [PMID: 29915009 DOI: 10.1098/rstb.2017.0141] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/12/2022] Open
Abstract
Different regions of the human cerebral cortex are specialized for different emotions, but the principles underlying this specialization have remained unknown. According to the sword and shield hypothesis, hemispheric specialization for affective motivation, a basic dimension of human emotion, varies across individuals according to the way they use their hands to perform approach- and avoidance-related actions. In a test of this hypothesis, here we measured approach motivation before and after five sessions of transcranial direct current stimulation to increase excitation in the left or right dorsolateral prefrontal cortex, in healthy adults whose handedness ranged from strongly left-handed to strongly right-handed. The strength and direction of participants' handedness predicted whether electrical stimulation to frontal cortex caused an increase or decrease in their experience of approach-related emotions. The organization of approach motivation in the human cerebral cortex varies across individuals as predicted by the organization of the individuals' motor systems. These results show that the large-scale cortical organization of abstract concepts corresponds with the way people use their hands to interact with the world. Affective motivation may re-use neural circuits that evolved for performing approach- and avoidance-related motor actions.This article is part of the theme issue 'Varieties of abstract concepts: development, use and representation in the brain'.
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Affiliation(s)
- Geoffrey Brookshire
- Department of Human Development, Cornell University, Ithaca, NY 14850, USA.,Department of Psychology, University of Chicago, Chicago, IL 60637, USA
| | - Daniel Casasanto
- Department of Human Development, Cornell University, Ithaca, NY 14850, USA .,Department of Psychology, Cornell University, Ithaca, NY 14850, USA.,Department of Psychology, University of Chicago, Chicago, IL 60637, USA.,Grossman Institute for Neuroscience, University of Chicago, Chicago, IL 60637, USA
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88
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Salehinejad MA, Wischnewski M, Nejati V, Vicario CM, Nitsche MA. Transcranial direct current stimulation in attention-deficit hyperactivity disorder: A meta-analysis of neuropsychological deficits. PLoS One 2019; 14:e0215095. [PMID: 30978259 PMCID: PMC6461252 DOI: 10.1371/journal.pone.0215095] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 03/26/2019] [Indexed: 02/02/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a promising method for altering cortical excitability with clinical implications in neuropsychiatric diseases. Its application in neurodevelopmental disorders especially attention-deficit hyperactivity disorder (ADHD), is in early stage and promising but its effectiveness has not been systematically examined yet. We conducted a meta-analysis on the effectiveness of tDCS on the most studied neuropsychological symptoms of ADHD, which is the first reported meta-analysis of tDCS studies on ADHD. Data from 10 randomized controlled studies (including 11 separate experiments) targeting inhibitory control, and/or working memory (WM) in ADHD were included. Results show that overall tDCS significantly improved inhibitory control. Sub-analyses further show that dorsolateral prefrontal cortex (dlPFC) (but not right inferior frontal gyrus) tDCS and anodal (but not cathodal) tDCS significantly improved inhibitory control with a small effect size. Anodal dlPFC-tDCS had the largest significant effect on inhibitory control with a small-to-medium effect size. Additionally, a significant improving effect of tDCS on inhibitory control accuracy (but not response time) and WM speed (but not accuracy) were found. Overall, this meta-analysis supports a beneficial effect of tDCS on inhibitory control and WM in ADHD with a small-to-medium effect size. TDCS seems to be a promising method for improving neuropsychological and cognitive deficits in ADHD. However, there might be a dissociation between neuropsychological deficits and clinical symptoms of ADHD and therefore, the significance of this meta-analysis for clinical purposes is limited. Future studies should systematically evaluate the role of inter-individual factors (i.e., ADHD subtype, types of the deficit) and stimulation parameters (i.e., site, polarity, intensity, duration, repetition rate) on tDCS efficacy in ADHD population and examine whether benefits are long-term.
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Affiliation(s)
- Mohammad Ali Salehinejad
- Ruhr-University Bochum, International Graduate School of Neuroscience, Bochum, Germany
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany
- * E-mail:
| | - Miles Wischnewski
- Donders Institute for Brain, Cognition, and Behaviour, Radboud University Nijmegen, The Netherlands
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
- Department of Psychology, University of Regensburg, Regensburg, Germany
| | - Carmelo M. Vicario
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany
- University of Messina, Department of Scienze Cognitive della Formazione e degli Studi Culturali, Messina, Italy
| | - Michael A. Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Department of Psychology and Neurosciences, Dortmund, Germany
- University Medical Hospital Bergmannsheil, Department of Neurology, Bochum, Germany
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89
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Li YT, Chen SC, Yang LY, Hsieh TH, Peng CW. Designing and Implementing a Novel Transcranial Electrostimulation System for Neuroplastic Applications: A Preliminary Study. IEEE Trans Neural Syst Rehabil Eng 2019; 27:805-813. [PMID: 30951469 DOI: 10.1109/tnsre.2019.2908674] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Recently, a specific repetitive transcranial magnetic stimulation (rTMS) waveform, namely, the theta burst stimulation (TBS) protocol, has been proposed for more efficiently inducing neuroplasticity for various clinic rehabilitation purposes. However, few studies have explored the feasibility of using the TBS combined with direct current (dc) waveform for brain neuromodulation; this waveform is transcranially delivered using electrical current power rather than magnetic power. This study implemented a prototype of a novel transcranial electrostimulation device that can flexibly output a waveform that combined dc and the TBS-like protocol and assessed the effects of the novel combinational waveform on neuroplasticity. An in vivo experiment was conducted first to validate the accuracy of the stimulator's current output at various impedance loads. Using this transcranial stimulator, a series of transcranial stimulation experiments was conducted on the brain cortex of rats, in which electrode-tissue impedance and motor evoked potentials (MEPs) were measured. These experiments were designed to assess the feasibility and efficacy of the new combinational waveforms for brain neuroplasticity. Our results indicated that the transcranial electrostimulation system exhibited satisfactory performance, as evidenced by the error percentage of less than 5% for current output. In the animal experiment, the dc combined with intermittent TBS-like protocol exerted a stronger neuroplastic effect than the conventional dc protocol. These results demonstrated that the combination of electrical dc and TBS-like protocols in our system can produce a new feasible therapeutic waveform for transcranially inducing a promising neuromodulatory effect on various diseases of the central nervous system.
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90
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Bell SB, DeWall N. Does transcranial direct current stimulation to the prefrontal cortex affect social behavior? A meta-analysis. Soc Cogn Affect Neurosci 2019; 13:899-906. [PMID: 30137565 PMCID: PMC6137315 DOI: 10.1093/scan/nsy069] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 08/08/2018] [Indexed: 11/13/2022] Open
Abstract
This meta-analysis (k = 48, N = 2196) examined the effect of transcranial direct current brain stimulation (tDCS) applied to the prefrontal cortex on a variety of social behaviors, including aggression, overeating, impulsivity, bias, honesty, and risk-taking. tDCS showed an overall significant effect on reducing undesirable behaviors, with an average effect size of d = −0.20. tDCS was most effective at reducing risk-taking behavior, bias, and overeating. tDCS did not affect aggression, impulsivity, or dishonesty. We examined moderators such as brain region of interest, online vs offline stimulation, within- vs between-subjects designs, dose, and duration, but none showed significant interactions. We also tested for potential publication bias using two different tools, which indicated signs of publication bias in the literature. After correcting for potential publication bias, the effect of tDCS was still significant, but the size was reduced (d = −0.10). These findings suggest the presence of tDCS studies with null findings outside of the published literature. Taken together, these results suggest that although tDCS can reduce undesirable behaviors, researchers should consider the types of behaviors they measure and use strategies to ensure sufficient power to detect a possible effect of tDCS on social behavior.
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Affiliation(s)
- Sarah Beth Bell
- Kastle Hall 125, Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - Nathan DeWall
- Kastle Hall 125, Department of Psychology, University of Kentucky, Lexington, KY, USA
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91
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Motter JN, Grinberg A, Lieberman DH, Iqnaibi WB, Sneed JR. Computerized cognitive training in young adults with depressive symptoms: Effects on mood, cognition, and everyday functioning. J Affect Disord 2019; 245:28-37. [PMID: 30366235 DOI: 10.1016/j.jad.2018.10.109] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/18/2018] [Accepted: 10/16/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Computerized cognitive training (CCT) has previously improved cognition and mood in people with depression. Existing research has not determined if the benefits following CCT are specific to the content of CCT or are a function of participation in an engaging activity. In this double-blind randomized controlled trial, we tested whether executive functioning and processing speed (EF/PS)-focused CCT could outperform verbal ability-focused CCT. METHODS 46 young adults with at least mild depressive symptoms (HDRS ≥ 10) were recruited from the community and randomized to either EF/PS CCT or verbal ability CCT. Participants trained on their mobile device 5 days per week for 8 weeks. Depressive severity, everyday functioning, and cognition were evaluating pre and post-training. RESULTS The EF/PS group had greater gains in executive functioning and processing speed than the verbal group. There were no differences between groups in mood or everyday functioning improvement, though the EF/PS obtained equivalent improvement with half the training time. Both groups saw significant improvements in self and clinician-rated depressive severity, everyday functioning, and cognition. LIMITATIONS There was no waitlist control condition and the sample consisted of individuals with mild depressive symptoms and not diagnosed major depressive disorder. CONCLUSIONS CCT is associated with improved mood, cognition, and everyday functioning, though the type of CCT content does not differentially impact depressive symptom change. EF/PS focused CCT has greater impact on processing speed and executive functioning and leads to equivalent mood/everyday functioning gains as verbal-focused CCT more efficiently. Common factors remain plausible drivers of CCT's therapeutic effects.
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Affiliation(s)
- Jeffrey N Motter
- The Graduate Center, City University of New York, United States; Queens College, City University of New York, United States.
| | - Alice Grinberg
- The Graduate Center, City University of New York, United States; Queens College, City University of New York, United States
| | | | | | - Joel R Sneed
- The Graduate Center, City University of New York, United States; Queens College, City University of New York, United States; Columbia University and the New York State Psychiatric Institute, United States
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92
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Combining attentional bias modification with dorsolateral prefrontal rTMS does not attenuate maladaptive attentional processing. Sci Rep 2019; 9:1168. [PMID: 30718539 PMCID: PMC6362221 DOI: 10.1038/s41598-018-37308-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 11/22/2018] [Indexed: 11/08/2022] Open
Abstract
High frequency repetitive Transcranial Magnetic Stimulation (rTMS) over the left dorsolateral prefrontal cortex (DLPFC) has been shown to reduce depressive symptoms and improve cognitive biases such as attentional bias. One promising technique that may complement rTMS treatment is attentional bias modification (ABM) training, given the similarity in modulating attentional bias and affecting neuronal activity. We tested whether the combination of rTMS treatment and ABM training in a single session would attenuate maladaptive attentional processing and improve mood in participants with subclinical depressive symptoms. To this end, 122 healthy participants were randomly assigned to one of four groups, receiving either a single rTMS treatment, a single ABM treatment, a combination of rTMS and ABM or a sham treatment. Of these 122 participants, 72 showed a heightened BDI-II score (between 9 and 25) and were included in our main analyses. In our subclinical (≥9 and ≤25 BDI-II) sample, a single combination treatment of rTMS and ABM training induced no significant changes in attentional bias, attentional control or mood, nor did rTMS alone affect attentional bias systematically. We discuss these null findings in light of the task specifics and relate them to the ongoing discussion on ABM training in depression.
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93
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Kelley NJ, Gallucci A, Riva P, Romero Lauro LJ, Schmeichel BJ. Stimulating Self-Regulation: A Review of Non-invasive Brain Stimulation Studies of Goal-Directed Behavior. Front Behav Neurosci 2019; 12:337. [PMID: 30713492 PMCID: PMC6345691 DOI: 10.3389/fnbeh.2018.00337] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022] Open
Abstract
Self-regulation enables individuals to guide their thoughts, feelings, and behaviors in a purposeful manner. Self-regulation is thus crucial for goal-directed behavior and contributes to many consequential outcomes in life including physical health, psychological well-being, ethical decision making, and strong interpersonal relationships. Neuroscientific research has revealed that the prefrontal cortex plays a central role in self-regulation, specifically by exerting top-down control over subcortical regions involved in reward (e.g., striatum) and emotion (e.g., amygdala). To orient readers, we first offer a methodological overview of tDCS and then review experiments using non-invasive brain stimulation techniques (especially transcranial direct current stimulation) to target prefrontal brain regions implicated in self-regulation. We focus on brain stimulation studies of self-regulatory behavior across three broad domains of response: persistence, delay behavior, and impulse control. We suggest that stimulating the prefrontal cortex promotes successful self-regulation by altering the balance in activity between the prefrontal cortex and subcortical regions involved in emotion and reward processing.
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Affiliation(s)
- Nicholas J. Kelley
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Alessia Gallucci
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Paolo Riva
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | | | - Brandon J. Schmeichel
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
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94
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Learned Helplessness After Anterior Cruciate Ligament Reconstruction: An Altered Neurocognitive State? Sports Med 2019; 49:647-657. [DOI: 10.1007/s40279-019-01054-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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95
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PsychotherapyPlus: augmentation of cognitive behavioral therapy (CBT) with prefrontal transcranial direct current stimulation (tDCS) in major depressive disorder-study design and methodology of a multicenter double-blind randomized placebo-controlled trial. Eur Arch Psychiatry Clin Neurosci 2018; 268:797-808. [PMID: 29214483 DOI: 10.1007/s00406-017-0859-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 12/02/2017] [Indexed: 01/20/2023]
Abstract
Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders worldwide. About 20-30% of patients do not respond to the standard psychopharmacological and/or psychotherapeutic interventions. Mounting evidence from neuroimaging studies in MDD patients reveal altered activation patterns in lateral prefrontal brain areas. Successful cognitive behavioral therapy (CBT) is associated with a recovery of these neural alterations. Moreover, it has been demonstrated that transcranial direct current stimulation (tDCS) is capable of influencing prefrontal cortex activity and cognitive functions such as working memory and emotion regulation. Thus, a clinical trial investigating the effects of an antidepressant intervention combining CBT with tDCS seems promising. The present study investigates the antidepressant efficacy of a combined CBT-tDCS intervention as compared to CBT with sham-tDCS or CBT alone. A total of 192 patients (age range 20-65 years) with MDD (Hamilton Depression Rating Scale Score ≥ 15, 21-item version) will be recruited at four study sites across Germany (Berlin, Munich, Tuebingen, and Freiburg) and randomly assigned to one of the following three treatment arms: (1) CBT + active tDCS; (2) CBT + sham-tDCS; and (3) CBT alone. All participants will attend a 6-week psychotherapeutic intervention comprising 12 sessions of CBT each lasting 100 min in a closed group setting. tDCS will be applied simultaneously with CBT. Active tDCS includes stimulation with an intensity of 2 mA for 30 min with the anode placed over F3 and the cathode over F4 according to the EEG 10-20 system, if assigned. The primary outcome measure is the change in Montgomery-Åsberg Depression Rating Scale scores from baseline to 6, 18, and 30 weeks after the first session. Participants also undergo pre- and post-treatment neuropsychological testing and functional magnetic resonance imaging (fMRI) to assess changes in prefrontal functioning and connectivity. The study investigates whether CBT can be augmented by non-invasive brain stimulation techniques such as tDCS in the treatment of MDD. It is designed as a proof-of-principle trial for the combined tDCS-CBT treatment, but also allows the investigation of the neurobiological underpinnings of the interaction between both interventions in MDD. Trial registration ClinicalTrials.gov Identifier NCT02633449.
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96
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Wang Y, Zhou H, Li Y, Liu W. Impact of Electrode Number on the Performance of High-Definition Transcranial Direct Current Stimulation (HD-tDCS). ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:4182-4185. [PMID: 30441277 DOI: 10.1109/embc.2018.8513379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation for treating brain disorders by applying constant current through scalp towards the targeted cortex regions. Precisely activating or inhibiting a specific area without interfering other parts in the brain is a challenge of tDCS. Recently high-definition tDCS (HD-tDCS) with optimization technique attracts a lot of attention due to the improved focality. Unlike conventional tDCS which utilizes two large pads to deliver current to certain area, HD-tDCS employs tens of smaller electrodes. The purpose of this work is to study the effect of the electrode number on the performance of HD-tDCS. A realistic head model with four layers of tissue was constructed with different electrode montages. A systematic simulation study was conducted using targets in different regions with different functions to analyze the focusing capability, stimulation accuracy, and the intensity of constrained least square based optimized HD-tDCS. Results show that better performance in all three aspects can be achieved by increasing the electrode number.
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Dumel G, Bourassa ME, Charlebois-Plante C, Desjardins M, Doyon J, Saint-Amour D, De Beaumont L. Motor Learning Improvement Remains 3 Months After a Multisession Anodal tDCS Intervention in an Aging Population. Front Aging Neurosci 2018; 10:335. [PMID: 30405402 PMCID: PMC6207687 DOI: 10.3389/fnagi.2018.00335] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/04/2018] [Indexed: 01/04/2023] Open
Abstract
Healthy aging is associated with decline of motor function that can generate serious consequences on the quality of life and safety. Our studies aim to explore the 3-month effects of a 5-day multisession anodal transcranial direct current stimulation (a-tDCS) protocol applied over the primary motor cortex (M1) during motor sequence learning in elderly. The present sham-controlled aging study investigated whether tDCS-induced motor improvements previously observed 1 day after the intervention persist beyond 3 months. A total of 37 cognitively-intact aging participants performed five consecutive daily 20-min sessions of the serial-reaction time task (SRTT) concomitant with either anodal (n = 18) or sham (n = 19) tDCS over M1. All participants performed the Purdue Pegboard Test and transcranial magnetic stimulation (TMS) measures of cortical excitability were collected before, 1 day after and 3 months after the intervention. The last follow-up session also included the execution of the trained SRTT. The main findings are the demonstration of durable effects of a 5-day anodal tDCS intervention at the trained skill, while the active intervention did not differ from the sham intervention at both the untrained task and on measures of M1-disinhibition. Thus, the current article revealed for the first time the durability of functional effects of a-tDCS combined with motor training after only 5 days of intervention in an aging population. This finding provides evidence that the latter treatment alternative is effective in achieving our primary motor rehabilitation goal, that is to allow durable motor training effects in an aging population.
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Affiliation(s)
- Gaëlle Dumel
- Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Marie-Eve Bourassa
- Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | | | - Martine Desjardins
- Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Département de Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Julien Doyon
- Unité de Neuroimagerie Fonctionnelle, Centre de Recherche de l'Institut de Gériatrie de Montréal, Montréal, QC, Canada
| | - Dave Saint-Amour
- Département de Psychologie, Université du Québec à Montréal, Montréal, QC, Canada
| | - Louis De Beaumont
- Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada.,Département de Chirurgie, Université de Montréal, Montréal, QC, Canada
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98
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Lindenmayer JP, Kulsa MKC, Sultana T, Kaur A, Yang R, Ljuri I, Parker B, Khan A. Transcranial direct-current stimulation in ultra-treatment-resistant schizophrenia. Brain Stimul 2018; 12:54-61. [PMID: 30316742 DOI: 10.1016/j.brs.2018.10.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Transcranial direct-current stimulation (tDCS), a non-invasive neurostimulation treatment, has been reported in a number of sham-controlled studies to show significant improvements in treatment-resistant auditory hallucinations in schizophrenia patients, primarily in ambulatory and higher-functioning patients, but little is known of the effects of tDCS on hospitalized, low-functioning inpatients. OBJECTIVE/HYPOTHESIS The purpose of this study was to examine the efficacy and safety of tDCS for auditory hallucinations in hospitalized ultra-treatment-resistant schizophrenia (TRS) and to evaluate the effects of tDCS on cognitive functions. We hypothesized that treatment non-response reported in previous tDCS studies may have been due to the insufficient duration of direct-current stimulation. METHODS Inpatient participants with DSM-V schizophrenia, long-standing treatment-resistance, and auditory verbal hallucinations (AVH) participated in this 4-week sham-controlled, randomized trial. Assessments included the Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB) at baseline and endpoint (at the end of Week 4), and the Auditory Hallucinations Rating Scale (AHRS) administered at baseline, endpoint, and weekly throughout the study. Participants were randomized to receive active vs. sham tDCS treatments twice daily for 4 weeks. RESULTS Twenty-eight participants were enrolled (tDCS, n = 15; control, n = 13) and 21 participants completed all 4 weeks of the trial. Results showed a significant reduction for the auditory hallucination total score (p ≤ 0.05). We found a 21.9% decrease in AHRS Total Score for the tDCS group and a 12.6% decrease in AHRS Total Score for the control group. Significant reductions in frequency, number of voices over time, length of auditory hallucinations, and overall psychopathology were also observed for the tDCS group. When assessing cognitive functioning, only Working Memory showed improvement for the tDCS group. CONCLUSION Although there was only a small improvement noted in auditory hallucination scores for the tDCS group, this improvement was meaningful when compared to no standard treatment of the control group. While this makes the interpretation of clinical significance debatable, it does confirm that tDCS combined with pharmacological intervention can provide clinical gains over pharmacological intervention alone. Therefore, tDCS treatment appears to be effective not only for ambulatory, higher-functioning patients, but also for patients with ultra-treatment-resistant schizophrenia.
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Affiliation(s)
- J P Lindenmayer
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
| | - Mila Kirstie C Kulsa
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; Teachers College Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
| | - Tania Sultana
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Amandeep Kaur
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Ran Yang
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; Teachers College Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
| | - Isidora Ljuri
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Benedicto Parker
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Anzalee Khan
- Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; NeuroCog Trials, 3211 Shannon Road #300, Durham, NC, 27707, USA.
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99
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Weinberger AB, Cortes RA, Green AE, Giordano J. Neuroethical and Social Implications of Using Transcranial Electrical Stimulation to Augment Creative Cognition. CREATIVITY RESEARCH JOURNAL 2018. [DOI: 10.1080/10400419.2018.1488199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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100
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Welch ES, Weigand A, Hooker JE, Philip NS, Tyrka AR, Press DZ, Carpenter LL. Feasibility of Computerized Cognitive‐Behavioral Therapy Combined With Bifrontal Transcranial Direct Current Stimulation for Treatment of Major Depression. Neuromodulation 2018; 22:898-903. [DOI: 10.1111/ner.12807] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 05/20/2018] [Accepted: 06/04/2018] [Indexed: 12/22/2022]
Affiliation(s)
- Emma S. Welch
- Mood Disorders Research ProgramButler Hospital Providence RI USA
| | - Anne Weigand
- Department of Neurology, Berenson‐Allen Center for Noninvasive Brain StimulationHarvard Medical School and Beth Israel Deaconess Medical Center Boston MA USA
| | - Julia E. Hooker
- Department of Neurology, Berenson‐Allen Center for Noninvasive Brain StimulationHarvard Medical School and Beth Israel Deaconess Medical Center Boston MA USA
| | - Noah S. Philip
- Center for Neurorestoration and NeurotechnologyProvidence VA Medical CenterProvidenceRIUSA
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University Providence RI USA
| | - Audrey R. Tyrka
- Mood Disorders Research ProgramButler Hospital Providence RI USA
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University Providence RI USA
| | - Daniel Z. Press
- Department of Neurology, Berenson‐Allen Center for Noninvasive Brain StimulationHarvard Medical School and Beth Israel Deaconess Medical Center Boston MA USA
| | - Linda L. Carpenter
- Mood Disorders Research ProgramButler Hospital Providence RI USA
- Department of Psychiatry and Human BehaviorAlpert Medical School of Brown University Providence RI USA
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