51
|
Jeong H, Song IU, Chung YA, Kim D, Na S, Lee SH. Changes of regional cerebral blood flow after repeated transcranial direct current stimulation in healthy participants: a pilot study. Acta Radiol 2023; 64:2590-2593. [PMID: 37545172 DOI: 10.1177/02841851231185350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/08/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) can potentially enhance brain function and cognition in healthy individuals as well as in patients with cognitive impairment. However, neural correlates of repeated tDCS remain relatively unexplored in a healthy population. PURPOSE To assess the effects of repeated tDCS on regional cerebral blood flow (rCBF) in healthy volunteers in a pilot investigation. MATERIAL AND METHODS Five healthy adults received bifrontal tDCS to the dorsolateral prefrontal cortex (F3-F4 montage, 1 mA intensity, 30 minutes/session, five sessions/week) over four weeks. All participants underwent brain single-photon emission computed tomography (SPECT) scans at baseline and one week after the last tDCS session. Changes in rCBF were examined using Statistical Parametric Mapping. RESULTS Resting rCBF was significantly improved in the right superior frontal gyrus at the follow-up (P < 0.001). Adverse events were not reported and the stimulation was well-tolerated. CONCLUSION Repeated tDCS may be effective for enhancing brain function in healthy participants. Larger sham-controlled studies should be performed to confirm our preliminary findings.
Collapse
Affiliation(s)
- Hyeonseok Jeong
- Department of Radiology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Neurology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In-Uk Song
- Department of Neurology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yong-An Chung
- Department of Nuclear Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Doyu Kim
- Department of Nuclear Medicine, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seunghee Na
- Department of Neurology, Incheon St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sang Hoon Lee
- Department of Radiology, Yeouido St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
52
|
Gao J, Li L. Enhancement of neural regeneration as a therapeutic strategy for Alzheimer's disease (Review). Exp Ther Med 2023; 26:444. [PMID: 37614437 PMCID: PMC10443056 DOI: 10.3892/etm.2023.12143] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 07/18/2023] [Indexed: 08/25/2023] Open
Abstract
Alzheimer's disease (AD), the most common cause of dementia worldwide, has gradually become a global health concern for society and individuals with the process of global ageing. Although extensive research has been carried out on AD, the etiology and pathological mechanism of the disease are still unclear, and there is no specific drug to cure or delay AD progression. The exploration of enhancing nerve regeneration in AD has gradually attracted increasing attention. In the current review, the existing therapeutic strategies were summarized to induce nerve regeneration which can increase the number of neurons, and improve the survival of neurons, the plasticity of synapses and synaptic activity. The strategies include increasing neurotrophic expression (such as brain-derived neurotrophic factor and nerve growth factor), inhibiting acetylcholinesterase (such as donepezil, tacrine, rivastigmine and galanthamine), elevating histone deacetylase levels (such as RGFP-966, Tasquinimod, CM-414 and 44B), stimulating the brain by physiotherapy (such as near-infrared light, repetitive transcranial magnetic stimulation, and transcranial direct current stimulation) and transplanting exogenous neural stem cells. However, further evaluations need to be performed to determine the optimal treatment. The present study reviews recent interventions for enhancing adult neurogenesis and attempts to elucidate their mechanisms of action, which may provide a theoretical basis for inducing nerve regeneration to fight against AD.
Collapse
Affiliation(s)
- Junyan Gao
- Department of Physiology and Pharmacology, Health Science Centre, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| | - Liping Li
- Department of Physiology and Pharmacology, Health Science Centre, Ningbo University, Ningbo, Zhejiang 315211, P.R. China
| |
Collapse
|
53
|
Aberra AS, Wang R, Grill WM, Peterchev AV. Multi-scale model of axonal and dendritic polarization by transcranial direct current stimulation in realistic head geometry. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.23.554447. [PMID: 37767087 PMCID: PMC10522328 DOI: 10.1101/2023.08.23.554447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/29/2023]
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation modality that can alter cortical excitability. However, it remains unclear how the subcellular elements of different neuron types are polarized by specific electric field (E-field) distributions. Objective To quantify neuronal polarization generated by tDCS in a multi-scale computational model. Methods We embedded layer-specific, morphologically-realistic cortical neuron models in a finite element model of the E-field in a human head and simulated steady-state polarization generated by conventional primary-motor-cortex-supraorbital (M1-SO) and 4×1 high-definition (HD) tDCS. We quantified somatic, axonal, and dendritic polarization of excitatory pyramidal cells in layers 2/3, 5, and 6, as well as inhibitory interneurons in layers 1 and 4 of the hand knob. Results Axonal and dendritic terminals were polarized more than the soma in all neurons, with peak axonal and dendritic polarization of 0.92 mV and 0.21 mV, respectively, compared to peak somatic polarization of 0.07 mV for 1.8 mA M1-SO stimulation. Both montages generated regions of depolarization and hyperpolarization beneath the M1 anode; M1-SO produced slightly stronger, more diffuse polarization peaking in the central sulcus, while 4×1 HD produced higher peak polarization in the gyral crown. Simulating polarization by uniform local E-field approximated the spatial distribution of tDCS polarization but produced large errors in some regions. Conclusions Polarization of pre- and postsynaptic compartments of excitatory and inhibitory cortical neurons may play a significant role in tDCS neuromodulation. These effects cannot be predicted from the E-field distribution alone but rather require calculation of the neuronal response.
Collapse
|
54
|
Legutke BR, Gobbi LTB, Orcioli-Silva D, Santos PCRD, Moraca GAG, Vitório R, Beretta VS. Transcranial direct current stimulation suggests not improving postural control during adapted tandem position in people with Parkinson's disease: A pilot study. Behav Brain Res 2023; 452:114581. [PMID: 37453515 DOI: 10.1016/j.bbr.2023.114581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 07/07/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Balance impairments in people with Parkinson's disease (PD) demonstrated mainly in challenging postural tasks, such as increased body oscillation may be attributed to the deficits in the brain structures functionality involved in postural control (e.g., motor cortex, midbrain, and brainstem). Although promising results, the effect of transcranial direct current stimulation (tDCS) on postural control in people with PD is unclear, especially in objective measures such as the center of pressure (CoP) parameters. Thus, we analyzed the effects of a single session of tDCS on the CoP parameters during the adapted tandem position in people with PD. METHODS Nineteen people with PD participated in this crossover, randomized, and double-blind study. Anodal tDCS was applied over the primary motor cortex in two conditions of stimulation (2 mA/active and sham) on two different days for 20 min immediately before the postural control evaluation. Participants remained standing in an adapted tandem position for the postural control assessment for 30 s (three trials). CoP parameters were acquired by a force plate. RESULTS No significant differences were demonstrated between stimulation conditions (p-value range = 0.15-0.89). CONCLUSIONS Our results suggested that a single session of tDCS with 2 mA does not improve the postural control of people with PD during adapted tandem.
Collapse
Affiliation(s)
- Beatriz Regina Legutke
- São Paulo State University (Unesp), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil
| | - Lilian Teresa Bucken Gobbi
- São Paulo State University (Unesp), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University - UNESP, Brazil
| | - Diego Orcioli-Silva
- São Paulo State University (Unesp), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; University of Campinas (UNICAMP), School of Applied Sciences (FCA), Laboratory of Applied Sport Physiology (LAFAE), Limeira, Brazil
| | - Paulo Cezar Rocha Dos Santos
- Department of Computer Science and Applied Mathematics, Weizmann Institute of Science, Israel; The Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Israel
| | - Gabriel Antonio Gazziero Moraca
- São Paulo State University (Unesp), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University - UNESP, Brazil
| | - Rodrigo Vitório
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Victor Spiandor Beretta
- São Paulo State University (Unesp), Institute of Biosciences, Posture and Gait Studies Laboratory (LEPLO), Rio Claro, Brazil; Graduate Program in Movement Sciences, São Paulo State University - UNESP, Brazil; São Paulo State University (Unesp), School of Technology and Sciences, Presidente Prudente, São Paulo, Brazil.
| |
Collapse
|
55
|
Vergallito A, Varoli E, Pisoni A, Mattavelli G, Del Mauro L, Feroldi S, Vallar G, Romero Lauro LJ. State-dependent effectiveness of cathodal transcranial direct current stimulation on cortical excitability. Neuroimage 2023; 277:120242. [PMID: 37348625 DOI: 10.1016/j.neuroimage.2023.120242] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 06/24/2023] Open
Abstract
The extensive use of transcranial direct current stimulation (tDCS) in experimental and clinical settings does not correspond to an in-depth understanding of its underlying neurophysiological mechanisms. In previous studies, we employed an integrated system of Transcranial Magnetic Stimulation and Electroencephalography (TMS-EEG) to track the effect of tDCS on cortical excitability. At rest, anodal tDCS (a-tDCS) over the right Posterior Parietal Cortex (rPPC) elicits a widespread increase in cortical excitability. In contrast, cathodal tDCS (c-tDCS) fails to modulate cortical excitability, being indistinguishable from sham stimulation. Here we investigated whether an endogenous task-induced activation during stimulation might change this pattern, improving c-tDCS effectiveness in modulating cortical excitability. In Experiment 1, we tested whether performance in a Visuospatial Working Memory Task (VWMT) and a modified Posner Cueing Task (mPCT), involving rPPC, could be modulated by c-tDCS. Thirty-eight participants were involved in a two-session experiment receiving either c-tDCS or sham during tasks execution. In Experiment 2, we recruited sixteen novel participants who performed the same paradigm but underwent TMS-EEG recordings pre- and 10 min post- sham stimulation and c-tDCS. Behavioral results showed that c-tDCS significantly modulated mPCT performance compared to sham. At a neurophysiological level, c-tDCS significantly reduced cortical excitability in a frontoparietal network likely involved in task execution. Taken together, our results provide evidence of the state dependence of c-tDCS in modulating cortical excitability effectively. The conceptual and applicative implications are discussed.
Collapse
Affiliation(s)
- Alessandra Vergallito
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy.
| | - Erica Varoli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alberto Pisoni
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, 27100, Italy
| | - Lilia Del Mauro
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Sarah Feroldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy; MiBTec - Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Leonor J Romero Lauro
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy
| |
Collapse
|
56
|
Klees-Themens G, Théoret H. The effects of transcranial direct current stimulation on corticospinal excitability: A systematic review of nonsignificant findings. Eur J Neurosci 2023; 58:3074-3097. [PMID: 37407275 DOI: 10.1111/ejn.16073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate brain activity through the application of low-intensity electrical currents. Based on its reported effects on corticospinal excitability (CSE), tDCS has been used to study cognition in healthy individuals and reduce symptoms in a variety of clinical conditions. Despite its increasing popularity as a research and clinical tool, high interindividual variability has been reported in the response to protocols using transcranial magnetic stimulation (TMS) to assess tDCS-induced changes in CSE leading to several nonsignificant findings. In this systematic review, studies that reported no significant modulation of CSE following tDCS were identified from PubMed and Embase (Ovid) databases. Forty-three articles were identified where demographic, TMS and tDCS parameters were extracted. Overall, stimulation parameters, CSE measurements and participant characteristics were similar to those described in studies reporting positive results and were likewise heterogeneous between studies. Small sample sizes and inadequate blinding were notable features of the reviewed studies. This systematic review suggests that studies reporting nonsignificant findings do not markedly differ from those reporting significant modulation of CSE.
Collapse
Affiliation(s)
| | - Hugo Théoret
- Department of Psychology, Université de Montréal, Montreal, Québec, Canada
| |
Collapse
|
57
|
Bonnì S, Borghi I, Maiella M, Casula EP, Koch G, Caltagirone C, Gainotti G. Transcranial Direct Current Stimulation Effects on the Neural Substrate of Conceptual Representations. Brain Sci 2023; 13:1037. [PMID: 37508969 PMCID: PMC10376965 DOI: 10.3390/brainsci13071037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
The aim of this study was to shed light on the neural substrate of conceptual representations starting from the construct of higher-order convergence zones and trying to evaluate the unitary or non-unitary nature of this construct. We used the 'Thematic and Taxonomic Semantic (TTS) task' to investigate (a) the neural substrate of stimuli belonging to biological and artifact categories, (b) the format of stimuli presentation, i.e., verbal or pictorial, and (c) the relation between stimuli, i.e., categorial or contextual. We administered anodal transcranial direct current stimulation (tDCS) to different brain structures during the execution of the TTS task. Twenty healthy participants were enrolled and divided into two groups, one investigating the role of the anterior temporal lobes (ATL) and the other the temporo-parietal junctions (TPJ). Each participant underwent three sessions of stimulation to facilitate a control condition and to investigate the role of both hemispheres. Results showed that ATL stimulation influenced all conceptual representations in relation to the format of presentation (i.e., left-verbal and right-pictorial). Moreover, ATL stimulation modulated living categories and taxonomic relations specifically, whereas TPJ stimulation did not influence semantic task performances.
Collapse
Affiliation(s)
- Sonia Bonnì
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Ilaria Borghi
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Section of Human Physiology, University of Ferrara, 44121 Ferrara, Italy
| | - Michele Maiella
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Elias Paolo Casula
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giacomo Koch
- Non-Invasive Brain Stimulation Unit, Department of Behavioral and Clinical Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Section of Human Physiology, University of Ferrara, 44121 Ferrara, Italy
| | - Carlo Caltagirone
- Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy
- Department of Clinical and Behavioral Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
| | - Guido Gainotti
- Department of Clinical and Behavioral Neurology, Fondazione Santa Lucia IRCCS, 00179 Rome, Italy
- Institute of Neurology, Catholic University of the Sacred Heart, 00168 Rome, Italy
| |
Collapse
|
58
|
Tian D, Izumi SI. Different effects of I-wave periodicity repetitive TMS on motor cortex interhemispheric interaction. Front Neurosci 2023; 17:1079432. [PMID: 37457007 PMCID: PMC10349661 DOI: 10.3389/fnins.2023.1079432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background Activity of the neural circuits in the human motor cortex can be probed using transcranial magnetic stimulation (TMS). Changing TMS-induced current direction recruits different cortical neural circuits. I-wave periodicity repetitive TMS (iTMS) substantially modulates motor cortex excitability through neural plasticity, yet its effect on interhemispheric interaction remains unclear. Objective To explore the modulation of interhemispheric interaction by iTMS applied in different current directions. Materials and Methods Twenty right-handed healthy young volunteers (aged 27.5 ± 5.0 years) participated in this study with three visits. On each visit, iTMS in posterior-anterior/anterior-posterior direction (PA-/AP-iTMS) or sham-iTMS was applied to the right hemisphere, with corticospinal excitability and intracortical facilitation of the non-stimulated left hemisphere evaluated at four timepoints. Ipsilateral silent period was also measured at each timepoint probing interhemispheric inhibition (IHI). Results PA- and AP-iTMS potentiated cortical excitability concurrently in the stimulated right hemisphere. Corticospinal excitability of the non-stimulated left hemisphere increased 10 min after both PA- and AP-iTMS intervention, with a decrease in short-interval intracortical facilitation (SICF) observed in AP-iTMS only. Immediately after the intervention, PA-iTMS tilted the IHI balance toward inhibiting the non-stimulated hemisphere, while AP-iTMS shifted the balance toward the opposite direction. Conclusions Our findings provide systematic evidence on the plastic modulation of interhemispheric interaction by PA- and AP-iTMS. We show that iTMS induces an interhemispheric facilitatory effect, and that PA- and AP-iTMS differs in modulating interhemispheric inhibition.
Collapse
Affiliation(s)
- Dongting Tian
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai, Japan
- Graduate School of Biomedical Engineering, Tohoku University, Sendai, Japan
| |
Collapse
|
59
|
He J, Wang R, Li J, Jiang X, Zhou C, Liu J. Effect of transcranial direct current stimulation over the left dorsolateral prefrontal cortex on the aggressive behavior in methamphetamine addicts. J Psychiatr Res 2023; 164:364-371. [PMID: 37406500 DOI: 10.1016/j.jpsychires.2023.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
Aggressive behavior of drug addicts threatens human security and social stability, and Methamphetamine (MA) addicts show especially aggressive behavior. Researches showed that the decreased activity of dorsolateral prefrontal cortex (DLPFC) is closely related to violence and aggression, and continuous transcranial direct current stimulation (tDCS) on DLPFC can increase the activity of this position. So, the purpose of this study was to investigate the effect of tDCS on DLPFC for the aggressive behavior of MA addicts. Ninety MA addicts were recruited and randomly divided into anodal tDCS group, cathode tDCS group and sham tDCS group (current intensity was set as 2 mA, 2 mA and 0 mA, respectively). The tDCS intervention was conducted twice a day for five consecutive days. Taylor Aggression Paradigm (TAP) was used to measure the proactive aggressiveness and reactive aggressiveness of MA addicts at different time points (Pretest, Day 1, and Day 5). At the same time, we also recruited 30 healthy adult males as healthy controls, and measured their aggressiveness through TAP for comparative analysis. The results showed that the aggressiveness of MA addicts was significantly higher than that of healthy controls. The aggressiveness of MA addicts was effectively reduced by the anode intervention of tDCS on the left DLPFC, especially when they were subjected to high-intensity provocation, the 2-way interaction between time and tDCS group was statistically significant (F4,164 = 2.939, P = 0.022, ηp2 = 0.067). This study can provide a reference for how to correct the aggressive behavior of MA addicts.
Collapse
Affiliation(s)
- Jingzhen He
- College of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Rufang Wang
- College of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
| | - Jiaoyang Li
- College of Management, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaoyu Jiang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
| | | | - Jun Liu
- Drug Rehabilitation Administration of Sichuan Province, Chengdu, China
| |
Collapse
|
60
|
Antonenko D, Fromm AE, Thams F, Grittner U, Meinzer M, Flöel A. Microstructural and functional plasticity following repeated brain stimulation during cognitive training in older adults. Nat Commun 2023; 14:3184. [PMID: 37268628 DOI: 10.1038/s41467-023-38910-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
The combination of repeated behavioral training with transcranial direct current stimulation (tDCS) holds promise to exert beneficial effects on brain function beyond the trained task. However, little is known about the underlying mechanisms. We performed a monocenter, single-blind randomized, placebo-controlled trial comparing cognitive training to concurrent anodal tDCS (target intervention) with cognitive training to concurrent sham tDCS (control intervention), registered at ClinicalTrial.gov (Identifier NCT03838211). The primary outcome (performance in trained task) and secondary behavioral outcomes (performance on transfer tasks) were reported elsewhere. Here, underlying mechanisms were addressed by pre-specified analyses of multimodal magnetic resonance imaging before and after a three-week executive function training with prefrontal anodal tDCS in 48 older adults. Results demonstrate that training combined with active tDCS modulated prefrontal white matter microstructure which predicted individual transfer task performance gain. Training-plus-tDCS also resulted in microstructural grey matter alterations at the stimulation site, and increased prefrontal functional connectivity. We provide insight into the mechanisms underlying neuromodulatory interventions, suggesting tDCS-induced changes in fiber organization and myelin formation, glia-related and synaptic processes in the target region, and synchronization within targeted functional networks. These findings advance the mechanistic understanding of neural tDCS effects, thereby contributing to more targeted neural network modulation in future experimental and translation tDCS applications.
Collapse
Affiliation(s)
- Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany.
| | | | - Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Marcus Meinzer
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
| |
Collapse
|
61
|
Chatterjee SA, Seidler RD, Skinner JW, Lysne PE, Sumonthee C, Wu SS, Cohen RA, Rose DK, Woods AJ, Clark DJ. Effects of Prefrontal Transcranial Direct Current Stimulation on Retention of Performance Gains on an Obstacle Negotiation Task in Older Adults. Neuromodulation 2023; 26:829-839. [PMID: 35410769 PMCID: PMC9547038 DOI: 10.1016/j.neurom.2022.02.231] [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: 11/14/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Complex walking in older adults can be improved with task practice and might be further enhanced by pairing transcranial direct current stimulation (tDCS) to the dorsolateral prefrontal cortex. We tested the hypothesis that a single session of practice of a complex obstacle negotiation task paired with active tDCS in older adults would produce greater within-session improvements in walking performance and retention of gains, compared to sham tDCS and no tDCS conditions. MATERIALS AND METHODS A total of 50 older adults (mean age = 74.46 years ± 6.49) with self-reported walking difficulty were randomized to receive either active tDCS (active-tDCS group) or sham tDCS (sham-tDCS group) bilaterally to the dorsolateral prefrontal cortex or no tDCS (no-tDCS group). Each group performed ten practice trials of an obstacle negotiation task at their fastest safe speed. Retention of gains in walking performance was assessed with three trials conducted one week later. Within-session effects of practice and between-session retention effects on obstacle negotiation speed were examined. RESULTS At the practice session, all three groups exhibited significant within-session gains in walking speed (p ≤ 0.005). However, the gains were significantly greater in the sham-tDCS group than in the active-tDCS and no-tDCS groups (p ≤ 0.03) and were comparable between the active-tDCS and no-tDCS groups (p = 0.89). At one-week follow-up, the active-tDCS group exhibited significant between-session retention of gains and continued "offline" improvement in walking speed (p = 0.005). The active-tDCS group showed significantly greater retention of gains than the no-tDCS (p = 0.02) but not the sham-tDCS group (p = 0.24). CONCLUSIONS Pairing prefrontal active tDCS with a single session of obstacle negotiation practice may enhance one-week retention of gains in walking performance compared to no tDCS. However, the evidence is insufficient to suggest a benefit of active tDCS over sham tDCS for enhancing the gains in walking performance. Additional studies with a multisession intervention design and larger sample size are needed to further investigate these findings. CLINICAL TRIAL REGISTRATION The Clinicaltrials.gov registration number for the study is NCT03122236.
Collapse
Affiliation(s)
- Sudeshna A Chatterjee
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA.
| | - Rachael D Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, USA
| | - Jared W Skinner
- Geriatric Research, Education, and Clinical Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| | - Paige E Lysne
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA
| | - Chanoan Sumonthee
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Samuel S Wu
- Department of Biostatistics, University of Florida, Gainesville, FL, USA
| | - Ronald A Cohen
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Dorian K Rose
- Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA; Department of Physical Therapy, University of Florida, Gainesville, FL, USA; Brooks Rehabilitation, Jacksonville, FL, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - David J Clark
- Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, USA; Brain Rehabilitation Research Center, Malcom Randall VA Medical Center, Gainesville, FL, USA
| |
Collapse
|
62
|
Mannarelli D, Pauletti C, Petritis A, Maffucci A, Currà A, Trompetto C, Marinelli L, Fattapposta F. The role of cerebellum in timing processing: a contingent negative variation study. Neurosci Lett 2023:137301. [PMID: 37244448 DOI: 10.1016/j.neulet.2023.137301] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/20/2023] [Accepted: 05/12/2023] [Indexed: 05/29/2023]
Abstract
Time management is an important aspect of human behaviour and cognition. Several brain regions are thought to be involved in motor timing and time estimation tasks. However, subcortical regions such as the basal nuclei and cerebellum seem to play a role in timing control. The aim of this study was to investigate the role of the cerebellum in temporal processing. For this purpose, we transitorily inhibited cerebellar activity by means of cathodal transcranial direct current stimulation (tDCS) and studied the effects of this inhibition on contingent negative variation (CNV) parameters elicited during a S1-S2 motor task in healthy subjects. Sixteen healthy subjects underwent a S1-S2 motor task prior to and after cathodal and sham cerebellar tDCS in separate sessions. The CNV task consisted of a duration discrimination task in which subjects had to determine whether the duration of a probe interval trial was shorter (800 ms), longer (1600 ms), or equal to the target interval of 1200 ms. A reduction in total CNV amplitude emerged only after cathodal tDCS for short and target interval trials, while no differences were detected for the long interval trial. Errors were significantly higher after cathodal tDCS than at baseline evaluation of short and target intervals. No reaction time differences were found for any time interval after the cathodal and sham sessions. These results point to a role of the cerebellum in time perception. In particular, the cerebellum seems to regulate temporal interval discrimination for second and sub-second ranges.
Collapse
Affiliation(s)
- Daniela Mannarelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Caterina Pauletti
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Alessia Petritis
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Andrea Maffucci
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, A. Fiorini Hospital, Terracina, LT, Sapienza University of Rome, Polo Pontino, Latina, Italy.
| | - Carlo Trompetto
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Department of Neurosciences, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Lucio Marinelli
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy; Department of Neurosciences, IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - Francesco Fattapposta
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, Italy.
| |
Collapse
|
63
|
Ghosh S, Nagarajan L. Tolerability and Effectiveness of Cathodal Transcranial Direct Current Stimulation in Children with Refractory Epilepsy: A Case Series. Brain Sci 2023; 13:brainsci13050760. [PMID: 37239232 DOI: 10.3390/brainsci13050760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 04/29/2023] [Indexed: 05/28/2023] Open
Abstract
There are limited treatment options for drug-resistant epilepsy (DRE) in children. We performed a pilot study to investigate the tolerability and effectiveness of cathodal transcranial direct current stimulation (tDCS) in DRE. Twelve children with DRE of varied etiology underwent three to four daily sessions of cathodal tDCS. The seizure frequency at 2 weeks before and after tDCS was obtained from seizure diaries; clinic reviews at 3 and 6 months assessed any longer-term benefits or adverse effects. The spike wave index (SWI) was analyzed in the EEGs done immediately before and after tDCS on the first and last day of tDCS. One child remained seizure free for a year after tDCS. One child had reduced frequency of ICU admissions for status epilepticus for 2 weeks, likely due to reduced severity of seizures. In four children, an improvement in alertness and mood was reported for 2-4 weeks after tDCS. There was no benefit following tDCS in the other children. There were no unexpected or serious adverse effects in any child. Benefit was seen in two children, and the reasons for the lack of benefit in the other children need further study. It is likely that tDCS stimulus parameters will need to be tailored for different epilepsy syndromes and etiologies.
Collapse
Affiliation(s)
- Soumya Ghosh
- Children's Neuroscience Service, Department of Neurology, Perth Children's Hospital, Nedlands, WA 6009, Australia
- Perron Institute for Neurological and Translational Science, University of Western Australia, Nedlands, WA 6009, Australia
| | - Lakshmi Nagarajan
- Children's Neuroscience Service, Department of Neurology, Perth Children's Hospital, Nedlands, WA 6009, Australia
- School of Medicine, University of Western Australia, Nedlands, WA 6009, Australia
| |
Collapse
|
64
|
Hausman HK, Alexander GE, Cohen R, Marsiske M, DeKosky ST, Hishaw GA, O'Shea A, Kraft JN, Dai Y, Wu S, Woods AJ. Primary outcome from the augmenting cognitive training in older adults study (ACT): A tDCS and cognitive training randomized clinical trial. Brain Stimul 2023; 16:904-917. [PMID: 37245842 PMCID: PMC10436327 DOI: 10.1016/j.brs.2023.05.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 05/08/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND There is a need for effective interventions to stave off cognitive decline in older adults. Cognitive training has variably produced gains in untrained tasks and daily functioning. Combining cognitive training with transcranial direct current stimulation (tDCS) may augment cognitive training effects; however, this approach has yet to be tested on a large-scale. OBJECTIVE This paper will present the primary findings of the Augmenting Cognitive Training in Older Adults (ACT) clinical trial. We hypothesize that receiving active stimulation with cognitive training will result in greater improvements on an untrained fluid cognition composite compared to sham following intervention. METHODS 379 older adults were randomized, and 334 were included in intent-to-treat analyses for a 12-week multidomain cognitive training and tDCS intervention. Active or sham tDCS was administered at F3/F4 during cognitive training daily for two weeks then weekly for 10 weeks. To assess the tDCS effect, we fitted regression models for changes in NIH Toolbox Fluid Cognition Composite scores immediately following intervention and one year from baseline controlling for covariates and baseline scores. RESULTS Across the entire sample, there were improvements in NIH Toolbox Fluid Cognition Composite scores immediately post-intervention and one year following baseline; however, there were no significant tDCS group effects at either timepoint. CONCLUSIONS The ACT study models rigorous, safe administration of a combined tDCS and cognitive training intervention in a large sample of older adults. Despite potential evidence of near-transfer effects, we failed to demonstrate an additive benefit of active stimulation. Future analyses will continue to assess the intervention's efficacy by examining additional measures of cognition, functioning, mood, and neural markers.
Collapse
Affiliation(s)
- Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA; Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Yunfeng Dai
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
65
|
Aloi D, Jalali R, Calzolari S, Lafanechere M, Miall RC, Fernández-Espejo D. Multi-session tDCS paired with passive mobilisation of the thumb modulates thalamo-cortical coupling during command following in the healthy brain. Neuroimage 2023; 274:120145. [PMID: 37121374 DOI: 10.1016/j.neuroimage.2023.120145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 04/05/2023] [Accepted: 04/27/2023] [Indexed: 05/02/2023] Open
Abstract
Therapeutic options to restore responsiveness in patients with prolonged disorder of consciousness (PDOC) are limited. We have recently shown that a single session of tDCS over M1 delivered at rest can reduce thalamic self-inhibition during motor command following. Here, we build upon this by exploring whether pairing tDCS with a concurrent passive mobilisation protocol can further influence thalamo-M1 dynamics and whether these changes are enhanced after multiple stimulation sessions. Specifically, we used Dynamic Causal Modelling (DCM) of functional magnetic resonance imaging (fMRI) data from 22 healthy participants to assess changes on effective connectivity within the motor network during active thumb movements after 1 or 5 sessions of tDCS paired with passive mobilisations of the thumb. We found that a single anodal tDCS session (paired with passive mobilisation of the thumb) decreased self-inhibition in M1, with five sessions further enhancing this effect. In addition, anodal tDCS increased thalamo-M1 excitation as compared to cathodal stimulation, with the effects maintained after 5 sessions. Together, our results suggest that pairing anodal tDCS with passive mobilisation across multiple sessions may facilitate thalamo-cortical dynamics that are relevant for behavioural responsiveness in PDOC. More broadly, they offer a mechanistic window into the neural underpinnings of the cumulative effects of multi-session tDCS.
Collapse
Affiliation(s)
- Davide Aloi
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Roya Jalali
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Sara Calzolari
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham
| | | | - Davinia Fernández-Espejo
- School of Psychology, University of Birmingham; Centre for Human Brain Health, University of Birmingham.
| |
Collapse
|
66
|
Benussi A, Batsikadze G, França C, Cury RG, Maas RPPWM. The Therapeutic Potential of Non-Invasive and Invasive Cerebellar Stimulation Techniques in Hereditary Ataxias. Cells 2023; 12:cells12081193. [PMID: 37190102 DOI: 10.3390/cells12081193] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/17/2023] Open
Abstract
The degenerative ataxias comprise a heterogeneous group of inherited and acquired disorders that are characterized by a progressive cerebellar syndrome, frequently in combination with one or more extracerebellar signs. Specific disease-modifying interventions are currently not available for many of these rare conditions, which underscores the necessity of finding effective symptomatic therapies. During the past five to ten years, an increasing number of randomized controlled trials have been conducted examining the potential of different non-invasive brain stimulation techniques to induce symptomatic improvement. In addition, a few smaller studies have explored deep brain stimulation (DBS) of the dentate nucleus as an invasive means to directly modulate cerebellar output, thereby aiming to alleviate ataxia severity. In this paper, we comprehensively review the clinical and neurophysiological effects of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and dentate nucleus DBS in patients with hereditary ataxias, as well as the presumed underlying mechanisms at the cellular and network level and perspectives for future research.
Collapse
Affiliation(s)
- Alberto Benussi
- Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, 25121 Brescia, Italy
| | - Giorgi Batsikadze
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, 45147 Essen, Germany
| | - Carina França
- Movement Disorders Center, Department of Neurology, University of São Paulo, São Paulo 05508-010, Brazil
| | - Rubens G Cury
- Movement Disorders Center, Department of Neurology, University of São Paulo, São Paulo 05508-010, Brazil
| | - Roderick P P W M Maas
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| |
Collapse
|
67
|
Calzolari S, Jalali R, Fernández-Espejo D. Characterising stationary and dynamic effective connectivity changes in the motor network during and after tDCS. Neuroimage 2023; 269:119915. [PMID: 36736717 DOI: 10.1016/j.neuroimage.2023.119915] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/04/2023] Open
Abstract
The exact mechanisms behind the effects of transcranial direct current stimulation (tDCS) at a network level are still poorly understood, with most studies to date focusing on local (cortical) effects and changes in motor-evoked potentials or BOLD signal. Here, we explored stationary and dynamic effective connectivity across the motor network at rest in two experiments where we applied tDCS over the primary motor cortex (M1-tDCS) or the cerebellum (cb-tDCS) respectively. Two cohorts of healthy volunteers (n = 21 and n = 22) received anodal, cathodal, and sham tDCS sessions (counterbalanced) during 20 min of resting-state functional magnetic resonance imaging (fMRI). We used spectral Dynamic Causal Modelling (DCM) and hierarchical Parametrical Empirical Bayes (PEB) to analyze data after (compared to a pre-tDCS baseline) and during stimulation. We also implemented a novel dynamic (sliding windows) DCM/PEB approach to model the nature of network reorganisation across time. In both experiments we found widespread effects of tDCS that extended beyond the targeted area and modulated effective connectivity between cortex, thalamus, and cerebellum. These changes were characterised by unique nonlinear temporal fingerprints across connections and polarities. Our results support growing research challenging the classic notion of anodal and cathodal tDCS as excitatory and inhibitory respectively, as well as the idea of a cumulative effect of tDCS over time. Instead, they described a rich set of changes with specific spatial and temporal patterns. Our work provides a starting point for advancing our understanding of network-level tDCS effects and may guide future work to optimise its cognitive and clinical applications.
Collapse
Affiliation(s)
- Sara Calzolari
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham B15 2TT, UK
| | - Roya Jalali
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham B15 2TT, UK; University Hospitals Birmingham NHS Foundation Trust, UK
| | - Davinia Fernández-Espejo
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham B15 2TT, UK; School of Psychology, University of Birmingham, Birmingham B15 2TT, UK.
| |
Collapse
|
68
|
Goble M, Caddick V, Patel R, Modi H, Darzi A, Orihuela-Espina F, Leff DR. Optical neuroimaging and neurostimulation in surgical training and assessment: A state-of-the-art review. FRONTIERS IN NEUROERGONOMICS 2023; 4:1142182. [PMID: 38234498 PMCID: PMC10790870 DOI: 10.3389/fnrgo.2023.1142182] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/03/2023] [Indexed: 01/19/2024]
Abstract
Introduction Functional near-infrared spectroscopy (fNIRS) is a non-invasive optical neuroimaging technique used to assess surgeons' brain function. The aim of this narrative review is to outline the effect of expertise, stress, surgical technology, and neurostimulation on surgeons' neural activation patterns, and highlight key progress areas required in surgical neuroergonomics to modulate training and performance. Methods A literature search of PubMed and Embase was conducted to identify neuroimaging studies using fNIRS and neurostimulation in surgeons performing simulated tasks. Results Novice surgeons exhibit greater haemodynamic responses across the pre-frontal cortex than experts during simple surgical tasks, whilst expert surgical performance is characterized by relative prefrontal attenuation and upregulation of activation foci across other regions such as the supplementary motor area. The association between PFC activation and mental workload follows an inverted-U shaped curve, activation increasing then attenuating past a critical inflection point at which demands outstrip cognitive capacity Neuroimages are sensitive to the impact of laparoscopic and robotic tools on cognitive workload, helping inform the development of training programs which target neural learning curves. FNIRS differs in comparison to current tools to assess proficiency by depicting a cognitive state during surgery, enabling the development of cognitive benchmarks of expertise. Finally, neurostimulation using transcranial direct-current-stimulation may accelerate skill acquisition and enhance technical performance. Conclusion FNIRS can inform the development of surgical training programs which modulate stress responses, cognitive learning curves, and motor skill performance. Improved data processing with machine learning offers the possibility of live feedback regarding surgeons' cognitive states during operative procedures.
Collapse
Affiliation(s)
- Mary Goble
- Department of Surgery and Cancer, Imperial College London, London, United Kingdom
| | | | | | | | | | | | | |
Collapse
|
69
|
Han LT, Cohen MS, He LK, Green LM, Knowlton BJ, Castel AD, Rissman J. Establishing a causal role for left ventrolateral prefrontal cortex in value-directed memory encoding with high-definition transcranial direct current stimulation. Neuropsychologia 2023; 181:108489. [PMID: 36669696 DOI: 10.1016/j.neuropsychologia.2023.108489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/23/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
One critical approach for promoting the efficiency of memory is to adopt selective encoding strategies to prioritize more valuable information. Past neuroimaging studies have shown that value-directed modulation of verbal memory depends heavily on the engagement of left-lateralized semantic processing regions, particularly in the ventrolateral prefrontal cortex (VLPFC). In the present study, we used high-definition transcranial direct current stimulation (HD-tDCS) to seek evidence for a causal role of left VLPFC in supporting the memory advantage for high-value items. Three groups of healthy young adult participants were presented with lists of words to remember, with each word accompanied by an arbitrarily assigned point value. During the first session, all participants received sham stimulation as they encoded five lists of 30 words each. Two of these lists were immediately tested with free recall, with feedback given to allow participants to develop metacognitive insight and strategies to maximize their point total. The second session had the exact same structure as the first, but the groups differed in whether they received continued sham stimulation (N = 22) or anodal stimulation of the left VLPFC (N = 21) or right VLPFC (N = 20). Those lists not tested with immediate recall were tested with recognition judgments after a one-day delay. Since no brain stimulation was applied during this Day 2 test, any performance differences can be attributed to the effects of stimulation on Day 1 encoding processes. Anodal stimulation of left VLPFC significantly boosted participants' memory encoding selectivity. In comparison, no such effect was seen in participants who received right VLPFC or sham stimulation. Estimates of recollection- and familiarity-based responding revealed that left VLPFC stimulation specifically amplified the effects of item value on recollection. These results demonstrate a causal role for left VLPFC in the implementation of selective value-directed encoding strategies, putatively by boosting deep semantic processing of high-value words. Our findings also provide further evidence on the hemispheric lateralization of value-directed verbal memory encoding.
Collapse
Affiliation(s)
- Linfeng Tony Han
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA; Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Department of Psychology, Tsinghua University, Beijing, 100084, China
| | - Michael S Cohen
- Department of Psychology, University of Chicago, Chicago, IL, 60637, USA
| | - Liqin Ken He
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Laura M Green
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Barbara J Knowlton
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Alan D Castel
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jesse Rissman
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, 90095, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA.
| |
Collapse
|
70
|
Nemanich ST, Lench DH, Sutter EN, Kowalski JL, Francis SM, Meekins GD, Krach LE, Feyma T, Gillick BT. Safety and feasibility of transcranial direct current stimulation stratified by corticospinal organization in children with hemiparesis. Eur J Paediatr Neurol 2023; 43:27-35. [PMID: 36878110 PMCID: PMC10117060 DOI: 10.1016/j.ejpn.2023.01.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/13/2023] [Accepted: 01/25/2023] [Indexed: 03/04/2023]
Abstract
Children with hemiparesis (CWH) due to stroke early in life face lifelong impairments in motor function. Transcranial direct current stimulation (tDCS) may be a safe and feasible adjuvant therapy to augment rehabilitation. Given the variability in outcomes following tDCS, tailored protocols of tDCS are required. We evaluated the safety, feasibility, and preliminary effects of a single session of targeted anodal tDCS based on individual corticospinal tract organization on corticospinal excitability. Fourteen CWH (age = 13.8 ± 3.63) were stratified into two corticospinal organization subgroups based on transcranial magnetic stimulation (TMS)-confirmed motor evoked potentials (MEP): ipsilesional MEP presence (MEPIL+) or absence (MEPIL-). Subgroups were randomized to real anodal or sham tDCS (1.5 mA, 20 min) applied to the ipsilesional (MEPIL + group) or contralesional (MEPIL- group) hemisphere combined with hand training. Safety was assessed with questionnaires and motor function evaluation, and corticospinal excitability was assessed at baseline and every 15 min for 1 h after tDCS. No serious adverse events occurred and anticipated minor side effects were reported and were self-limiting. Six of 14 participants had consistent ipsilesional MEPs (MEPIL + group). Paretic hand MEP amplitude increased in 5/8 participants who received real anodal tDCS to either the ipsilesional or contralesional hemisphere (+80% change). Application of tDCS based on individual corticospinal organization was safe and feasible with expected effects on excitability, indicating the potential for tailored tDCS protocols for CWH. Additional research involving expanded experimental designs is needed to confirm these effects and to determine if this approach can be translated into a clinically relevant intervention.
Collapse
Affiliation(s)
- Samuel T Nemanich
- Department of Occupational Therapy, Marquette University, 1700 West Wells St., Room 140, Milwaukee, WI, 53201, USA.
| | - Daniel H Lench
- Department of Neurology, Medical University of South Carolina, 208B Rutledge Avenue, Charleston, SC, 29425, USA
| | - Ellen N Sutter
- Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware St SE, MMC 388, Minneapolis, MN, 55455, USA
| | - Jesse L Kowalski
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, 79/96 13th Street, Charlestown, MA, United States
| | - Sunday M Francis
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, 2312 S. 6th St.Floor 2, Suite F-275, Minneapolis, MN, 55454, USA
| | - Gregg D Meekins
- Department of Neurology, University of Minnesota, 420 Delaware St SE, MMC 295, Minneapolis, MN, 55455, USA
| | - Linda E Krach
- Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware St SE, MMC 388, Minneapolis, MN, 55455, USA; Rehabilitation Medicine, Gillette Children's Specialty Healthcare, 200 University Ave E, St Paul, MN, 55101, USA
| | - Tim Feyma
- Neurology, Gillette Children's Specialty Healthcare, 200 University Ave E, St Paul, MN, 55101, USA
| | - Bernadette T Gillick
- Department of Rehabilitation Medicine, University of Minnesota, 420 Delaware St SE, MMC 388, Minneapolis, MN, 55455, USA; Department of Pediatrics, University of Wisconsin-Madison, 1500 Highland Avenue, Madison, WI, 53705, USA
| |
Collapse
|
71
|
Abul Hasan M, Shahid H, Ahmed Qazi S, Ejaz O, Danish Mujib M, Vuckovic A. Underpinning the neurological source of executive function following cross hemispheric tDCS stimulation. Int J Psychophysiol 2023; 185:1-10. [PMID: 36634750 DOI: 10.1016/j.ijpsycho.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a promising technique for enhancement of executive functions in healthy as well as neurologically disturbed patients. However, the evidence regarding the neuropsychological and behavioral change with neurophysiological shifts as well as the mechanism of tDCS action as evidenced by activation of neuronal sources important for executive functions have remained unaddressed. The study thereby endeavors to (1) determine the neuropsychological, behavioral, and neurophysiological change induced with five sessions of bilateral tDCS stimulation and (2) identify putative neuronal sources related to the executive functions responsible for neuropsychological and behavioral change. For this single blinded study, a total of 40 healthy participants, randomly allocated to active (n = 19) or sham (n = 21) groups completed five sessions of 2 mA tDCS stimulation administered over Dorso-Lateral Prefrontal Cortex (DLPFC) (F3 as anode, F4 as cathode). Repeated measure analysis was performed on neuropsychological (Everyday Memory Questionnaire and Mindful Attention Awareness Scale), and behavioral assessment (n-Back and Stroop tests) to investigate within and between group differences. Pre and post neurophysiological (Electroencephalogram) results showed that bilateral tDCS stimulation activates cortical regions responsible for executive functions including updation (working memory) and inhibition (interference control or attention). Multiple sessions of bilateral tDCS stimulation results in a significant increase in theta, alpha, and beta-band activity in the DLPFC, cingulate and parietal cortex. This study provides evidence that tDCS can be used for performance enhancement of executive functions in able-bodied people.
Collapse
Affiliation(s)
- Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan; Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan
| | - Hira Shahid
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan; Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom.
| | - Saad Ahmed Qazi
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan; Department of Electrical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Osama Ejaz
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan
| | - Muhammad Danish Mujib
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Aleksandra Vuckovic
- Biomedical Engineering Division, University of Glasgow, Glasgow, United Kingdom
| |
Collapse
|
72
|
Jung B, Yang C, Lee SH. Electroceutical and Bioelectric Therapy: Its Advantages and Limitations. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:19-31. [PMID: 36700309 PMCID: PMC9889897 DOI: 10.9758/cpn.2023.21.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 01/27/2023]
Abstract
Given the long history, the field of electroceutical and bioelectric therapy has grown impressively, recognized as the main modality of mental health treatments along with psychotherapy and pharmacotherapy. Electroceutical and bioelectric therapy comprises electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS), transcranial electrical stimulation (tES), and other brain stimulation techniques. Much empirical research has been published regarding the application guidelines, mechanism of action, and efficacy of respective brain stimulation techniques, but no comparative study that delineates the advantages and limitations of each therapy exists for a comprehensive understanding of each technique. This review provides a comparison of existing electroceutical and bioelectric techniques, primarily focusing on the therapeutic advantages and limitations of each therapy in the current electroceutical and bioelectric field.
Collapse
Affiliation(s)
- Bori Jung
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea,Department of Psychology, Sogang University, Seoul, Korea
| | - Chaeyeon Yang
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea,Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea,Address for correspondence: Seung-Hwan Lee Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-gu, Goyang 10380, Korea, E-mail: , ORCID: https://orcid.org/0000-0003-0305-3709
| |
Collapse
|
73
|
Hsu SP, Lu CF, Lin BF, Tang CW, Kuo IJ, Tsai YA, Guo CY, Lee PL, Shyu KK, Niddam DM, Lee IH. Effects of bihemispheric transcranial direct current stimulation on motor recovery in subacute stroke patients: a double-blind, randomized sham-controlled trial. J Neuroeng Rehabil 2023; 20:27. [PMID: 36849990 PMCID: PMC9969953 DOI: 10.1186/s12984-023-01153-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 02/17/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND Bihemispheric transcranial direct current stimulation (tDCS) of the primary motor cortex (M1) can simultaneously modulate bilateral corticospinal excitability and interhemispheric interaction. However, how tDCS affects subacute stroke recovery remains unclear. We investigated the effects of bihemispheric tDCS on motor recovery in subacute stroke patients. METHODS We enrolled subacute inpatients who had first-ever ischemic stroke at subcortical regions and moderate-to-severe baseline Fugl-Meyer Assessment of Upper Extremity (FMA-UE) score 2-56. Participants between 14 and 28 days after stroke were double-blind, randomly assigned (1:1) to receive real (n = 13) or sham (n = 14) bihemispheric tDCS (with ipsilesional M1 anode and contralesional M1 cathode, 20 min, 2 mA) during task practice twice daily for 20 sessions in two weeks. Residual integrity of the ipsilesional corticospinal tract was stratified between groups. The primary efficacy outcome was the change in FMA-UE score from baseline (responder as an increase ≥ 10). The secondary measures included changes in the Action Research Arm Test (ARAT), FMA-Lower Extremity (FMA-LE) and explorative resting-state MRI functional connectivity (FC) of target regions after intervention and three months post-stroke. RESULTS Twenty-seven participants completed the study without significant adverse effects. Nineteen patients (70%) had no recordable baseline motor-evoked potentials (MEP-negative) from the paretic forearm. Compared with the sham group, the real tDCS group showed enhanced improvement of FMA-UE after intervention (p < 0.01, effect size η2 = 0.211; responder rate: 77% vs. 36%, p = 0.031), which sustained three months post-stroke (p < 0.01), but not ARAT. Interestingly, in the MEP-negative subgroup analysis, the FMA-UE improvement remained but delayed. Additionally, the FMA-LE improvement after real tDCS was not significantly greater until three months post-stroke (p < 0.01). We found that the individual FMA-UE improvements after real tDCS were associated with bilateral intrahemispheric, rather than interhemispheric, FC strengths in the targeted cortices, while the improvements after sham tDCS were associated with predominantly ipsilesional FC changes after adjustment for age and sex (p < 0.01). CONCLUSIONS Bihemispheric tDCS during task-oriented training may facilitate motor recovery in subacute stroke patients, even with compromised corticospinal tract integrity. Further studies are warranted for tDCS efficacy and network-specific neuromodulation. TRIAL REGISTRATION This study is registered with ClinicalTrials.gov: (ID: NCT02731508).
Collapse
Affiliation(s)
- Shih-Pin Hsu
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan
| | - Chia-Feng Lu
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Bing-Fong Lin
- Department of Biomedical Imaging and Radiological Sciences, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Chih-Wei Tang
- Department of Neurology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - I-Ju Kuo
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Yun-An Tsai
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei City, Taiwan
| | - Chao-Yu Guo
- Institute of Public Health, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Po-Lei Lee
- Department of Electrical Engineering, National Central University, Taoyuan, Taiwan
| | - Kuo-Kai Shyu
- Department of Electrical Engineering, National Central University, Taoyuan, Taiwan
| | - David M Niddam
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei City, Taiwan.,Brain Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - I-Hui Lee
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei City, Taiwan. .,Division of Cerebrovascular Diseases, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City, 11217, Taiwan. .,Brain Research Center, National Yang Ming Chiao Tung University, Taipei City, Taiwan.
| |
Collapse
|
74
|
Mosayebi-Samani M, Agboada D, Mutanen TP, Haueisen J, Kuo MF, Nitsche MA. Transferability of cathodal tDCS effects from the primary motor to the prefrontal cortex: A multimodal TMS-EEG study. Brain Stimul 2023; 16:515-539. [PMID: 36828302 DOI: 10.1016/j.brs.2023.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/24/2023] [Accepted: 02/19/2023] [Indexed: 02/24/2023] Open
Abstract
Neurophysiological effects of transcranial direct current stimulation (tDCS) have been extensively studied over the primary motor cortex (M1). Much less is however known about its effects over non-motor areas, such as the prefrontal cortex (PFC), which is the neuronal foundation for many high-level cognitive functions and involved in neuropsychiatric disorders. In this study, we, therefore, explored the transferability of cathodal tDCS effects over M1 to the PFC. Eighteen healthy human participants (11 males and 8 females) were involved in eight randomized sessions per participant, in which four cathodal tDCS dosages, low, medium, and high, as well as sham stimulation, were applied over the left M1 and left PFC. After-effects of tDCS were evaluated via transcranial magnetic stimulation (TMS)-electroencephalography (EEG), and TMS-elicited motor evoked potentials (MEP), for the outcome parameters TMS-evoked potentials (TEP), TMS-evoked oscillations, and MEP amplitude alterations. TEPs were studied both at the regional and global scalp levels. The results indicate a regional dosage-dependent nonlinear neurophysiological effect of M1 tDCS, which is not one-to-one transferable to PFC tDCS. Low and high dosages of M1 tDCS reduced early positive TEP peaks (P30, P60), and MEP amplitudes, while an enhancement was observed for medium dosage M1 tDCS (P30). In contrast, prefrontal low, medium and high dosage tDCS uniformly reduced the early positive TEP peak amplitudes. Furthermore, for both cortical areas, regional tDCS-induced modulatory effects were not observed for late TEP peaks, nor TMS-evoked oscillations. However, at the global scalp level, widespread effects of tDCS were observed for both, TMS-evoked potentials and oscillations. This study provides the first direct physiological comparison of tDCS effects applied over different brain areas and therefore delivers crucial information for future tDCS applications.
Collapse
Affiliation(s)
- Mohsen Mosayebi-Samani
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, Ilmenau, Germany
| | - Desmond Agboada
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Institute of Psychology, Federal Armed Forces University Munich, Neubiberg, Germany
| | - Tuomas P Mutanen
- Department of Neuroscience & Biomedical Engineering, Aalto University, School of Science, 00076, Aalto, Espoo, Finland
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Technische Universität Ilmenau, Ilmenau, Germany
| | - Min-Fang Kuo
- 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; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Bielefeld, Germany.
| |
Collapse
|
75
|
Truong DQ, Guillen A, Nooristani M, Maheu M, Champoux F, Datta A. Impact of galvanic vestibular stimulation electrode current density on brain current flow patterns: Does electrode size matter? PLoS One 2023; 18:e0273883. [PMID: 36735686 PMCID: PMC9897567 DOI: 10.1371/journal.pone.0273883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/10/2023] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Galvanic vestibular stimulation (GVS) uses at least one electrode placed on the mastoid process with one or multiple placed over other head areas to stimulate the vestibular system. The exact electrode size used is not given much importance in the literature and has not been reported in several studies. In a previous study, we compared the clinical effects of using different electrode sizes (3 cm2 and 35 cm2) with placebo but with the same injected current, on postural control. We observed significant improvement using the smaller size electrode but not with the bigger size electrode. The goal of this study was to simulate the current flow patterns with the intent to shed light and potentially explain the experimental outcome. METHODS We used an ultra-high-resolution structural dataset and developed a model to simulate the application of different electrode sizes. We considered current flow in the brain and in the vestibular labyrinth. RESULTS Our simulation results verified the focality increase using smaller electrodes that we postulated as the main reason for our clinical effect. The use of smaller size electrodes in combination with the montage employed also result in higher induced electric field (E-field) in the brain. CONCLUSIONS Electrode size and related current density is a critical parameter to characterize any GVS administration as the choice impacts the induced E-field. It is evident that the higher induced E-field likely contributed to the clinical outcome reported in our prior study.
Collapse
Affiliation(s)
- Dennis Q. Truong
- Research and Development, Soterix Medical, Woodbridge, NJ, United States of America
- * E-mail:
| | - Alexander Guillen
- Research and Development, Soterix Medical, Woodbridge, NJ, United States of America
| | - Mujda Nooristani
- Faculty of Medicine, School of Speech-Language and Audiology, University of Montreal, Montreal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Maxime Maheu
- Faculty of Medicine, School of Speech-Language and Audiology, University of Montreal, Montreal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, Montréal, QC, Canada
| | - Francois Champoux
- Faculty of Medicine, School of Speech-Language and Audiology, University of Montreal, Montreal, QC, Canada
- Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Pavillon Laurier, CIUSSS du Centre-Sud-de-L’Île-de-Montréal, Montréal, QC, Canada
- Centre de Recherche de l’Institut Universitaire de Gériatrie de Montréal, Montréal, Québec, Canada
| | - Abhishek Datta
- Research and Development, Soterix Medical, Woodbridge, NJ, United States of America
- City College of New York, New York, NY, United States of America
| |
Collapse
|
76
|
Estudillo AJ, Lee YJ, Álvarez-Montesinos JA, García-Orza J. High-frequency transcranial random noise stimulation enhances unfamiliar face matching of high resolution and pixelated faces. Brain Cogn 2023; 165:105937. [PMID: 36462222 DOI: 10.1016/j.bandc.2022.105937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 11/22/2022] [Accepted: 11/23/2022] [Indexed: 12/05/2022]
Abstract
Face identification is useful for social interactions and its impairment can lead to severe social and mental problems. This ability is also remarkably important in applied settings, including eyewitness identification and ID verification. Several studies have demonstrated the potential of Transcranial Random Noise Stimulation (tRNS) to enhance different cognitive skills. However, research has produced inconclusive results about the effectiveness of tRNS to improve face identification. The present study aims to further explore the effect of tRNS on face identification using an unfamiliar face matching task. Observers firstly received either high-frequency bilateral tRNS or sham stimulation for 20 min. The stimulation targeted occipitotemporal areas, which have been previously involved in face processing. In a subsequent stage, observers were asked to perform an unfamiliar face matching task consisting of unaltered and pixelated face pictures. Compared to the sham stimulation group, the high-frequency tRNS group showed better unfamiliar face matching performance with both unaltered and pixelated faces. Our results show that a single high-frequency tRNS session might suffice to improve face identification abilities. These results have important consequences for the treatment of face recognition disorders, and potential applications in those scenarios whereby the identification of faces is primordial.
Collapse
Affiliation(s)
| | - Ye Ji Lee
- University of Nottingham Malaysia, Malaysia
| | | | | |
Collapse
|
77
|
Vimolratana O, Lackmy-Vallee A, Aneksan B, Hiengkaew V, Klomjai W. Non-linear dose response effect of cathodal transcranial direct current stimulation on muscle strength in young healthy adults: a randomized controlled study. BMC Sports Sci Med Rehabil 2023; 15:10. [PMID: 36717894 PMCID: PMC9887803 DOI: 10.1186/s13102-023-00621-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 01/25/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a technique that modulates brain excitability in humans. Increasing the stimulation intensity or duration within certain limits could enhance tDCS efficacy with a polarity-dependent effect; anodal stimulation increases cortical excitability, whereas cathodal stimulation decreases excitability. However, recent studies have reported a non-linear effect of cathodal tDCS on neuronal excitability in humans, and there is no conclusive result regarding the effect of cathodal tDCS on muscle performance. METHODS Our study aimed to investigate the immediate effects of different intensities (i.e., 1, 1.5, and 2 mA and sham tDCS) of cathodal tDCS on muscle strength in healthy participants. All participants [mean age 23.17 (3.90) years] were recruited and randomly allocated into four groups (1, 1.5, and 2 mA cathodal tDCS and sham tDCS). Muscle strength in bilateral upper and lower extremities was measured before and immediately after tDCS using a handheld dynamometer. RESULTS Our results showed that cathodal tDCS at 1 and 1.5 mA reduced muscle strength bilaterally in upper and lower extremity muscles, whereas stimulation at 2 mA tended to increase muscle strength on the dominant limb. CONCLUSION These findings support the non-linear effects of cathodal tDCS on muscle strength, which should be considered for the clinical use of tDCS in motor rehabilitation. TRIAL REGISTRATION NCT04672122, date of first registration 17/12/2020.
Collapse
Affiliation(s)
- Oranich Vimolratana
- grid.10223.320000 0004 1937 0490Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand ,grid.10223.320000 0004 1937 0490Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand
| | - Alexandra Lackmy-Vallee
- grid.462844.80000 0001 2308 1657Laboratoire d’Imagerie Biomédicale, LIB, CNRS, INSERM, Sorbonne Université, 75005 Paris, France
| | - Benchaporn Aneksan
- grid.10223.320000 0004 1937 0490Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand ,grid.10223.320000 0004 1937 0490Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand
| | - Vimonwan Hiengkaew
- grid.10223.320000 0004 1937 0490Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand
| | - Wanalee Klomjai
- grid.10223.320000 0004 1937 0490Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand ,grid.10223.320000 0004 1937 0490Faculty of Physical Therapy, Mahidol University, 999 Phutthamonthon 4 Road, Nakhon Pathom, 73170 Thailand
| |
Collapse
|
78
|
Filmer HL, Ballard T, Amarasekera KDR, Sewell DK, Dux PE. The causal role of the prefrontal and superior medial frontal cortices in the incidental manipulation of decision strategies. Neuropsychologia 2023; 179:108466. [PMID: 36567008 DOI: 10.1016/j.neuropsychologia.2022.108466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 11/07/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022]
Abstract
A key strategic decision one must make in virtually every task context concerns the speed accuracy trade-off (SAT). Experimentally, this ubiquitous phenomenon, whereby response speed and task accuracy are inversely related, is typically studied by explicitly instructing participants to adjust their strategy: by either focusing on speed, or on accuracy. Computational modelling has been applied to deconvolve the latent decision processes involved in the SAT, with considerable evidence suggesting that response caution (the amount of evidence needed for a decision to be reached) is a key variable in the setting of SAT strategy. Neuroimaging has implicated the prefrontal cortex, the pre-supplementary motor area (preSMA), and the striatum in the setting of response caution. In addition, brain stimulation has provided causal evidence for the involvement of the left prefrontal cortex and superior medial frontal cortex (SMFC, which includes the preSMA) in adjustments of response caution following explicit instructions, although stimulation of the two regions has dissociable effects. Here, in a double-blind and preregistered study we investigated the role of these two regions using an incidental manipulation of SAT strategy - via stimulus signal variability - which has previously been shown to influence decision confidence. We again found tDCS applied to both regions modulated response caution, and there was a dissociation: stimulating prefrontal cortex increased, and stimulating SMFC decreased, response caution. These findings provide further support for key, but dissociable, roles of these brain regions in decision strategies whether they are implemented explicitly or incidentally.
Collapse
Affiliation(s)
- Hannah L Filmer
- School of Psychology, The University of Queensland, St Lucia, Australia.
| | - Timothy Ballard
- School of Psychology, The University of Queensland, St Lucia, Australia
| | | | - David K Sewell
- School of Psychology, The University of Queensland, St Lucia, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, St Lucia, Australia
| |
Collapse
|
79
|
Tseng PT, Chen YW, Zeng BY, Zeng BS, Hung CM, Sun CK, Cheng YS, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Lin PY, Liang CS, Hsu CW, Chu CS, Suen MW, Li CT. The beneficial effect on cognition of noninvasive brain stimulation intervention in patients with dementia: a network meta-analysis of randomized controlled trials. Alzheimers Res Ther 2023; 15:20. [PMID: 36698219 PMCID: PMC9875424 DOI: 10.1186/s13195-023-01164-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 08/29/2022] [Indexed: 01/26/2023]
Abstract
BACKGROUND Dementia [i.e., Alzheimer disease (AD)], the most common neurodegenerative disease, causes profound negative impacts on executive function and quality of life. Available pharmacological treatments often fail to achieve satisfactory outcomes. Noninvasive brain stimulation (NIBS) techniques, which focally modify cortical function and enhance synaptic long-term potentiation, are potentially beneficial for the cognition in patients with AD. The aim of the current network meta-analysis (NMA) was to evaluate the efficacy and safety of different NIBS interventions in patients with AD through NMA. METHODS Only randomized controlled trials (RCTs) examining NIBS interventions in patients with AD had been included. All NMA procedures were performed under the frequentist model. The primary and secondary outcomes were changes in cognitive function and quality of life, respectively. RESULTS Nineteen RCTs (639 participants) were included. The mean treatment and follow-up durations were 5.7 and 10.5 weeks, respectively. The combination of cathodal tDCS of the left dorsolateral prefrontal cortex and anodal tDCS over the right supraorbital region (c-tDCS-F3 + a-tDCS-Fp2) was associated with a significant beneficial effect on cognition compared with sham controls (standardized mean difference=2.43, 95% confidence interval=0.61-4.26, n=12 and 11). It was also associated with the greatest beneficial effect on cognition among all the investigated NIBS approaches. All the methods were well tolerated with regard to the safety profile, as reflected in the rates of adverse events or local discomfort, as well as acceptability, as indicated by dropout rate. CONCLUSIONS The present findings provide evidence of the benefits of NIBS, especially tDCS, for beneficial effect on cognition in patients with AD. However, because of few studies included, this effect was not replicated yet in the other studies. Therefore, future larger-scale and longer follow-up duration RCTs should be warranted. TRIAL REGISTRATION PROSPERO CRD42020209516. The current study had been approved by the Institutional Review Board of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. B-109-29).
Collapse
Affiliation(s)
- Ping-Tao Tseng
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan ,grid.412036.20000 0004 0531 9758Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan ,grid.252470.60000 0000 9263 9645Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan ,grid.278247.c0000 0004 0604 5314Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan ,grid.412036.20000 0004 0531 9758Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung City, Taiwan
| | - Bing-Yan Zeng
- grid.411447.30000 0004 0637 1806Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Bing-Syuan Zeng
- grid.411447.30000 0004 0637 1806Department of Internal Medicine, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chao-Ming Hung
- grid.411447.30000 0004 0637 1806Division of General Surgery, Department of Surgery, E-Da Cancer Hospital, I-Shou University, Kaohsiung, Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
| | - Cheuk-Kwan Sun
- grid.411447.30000 0004 0637 1806Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan ,grid.411447.30000 0004 0637 1806I-Shou University School of Medicine for International Students, Kaohsiung, Taiwan
| | - Yu-Shian Cheng
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung, Taiwan
| | - Brendon Stubbs
- grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK ,grid.37640.360000 0000 9439 0839Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK ,grid.5115.00000 0001 2299 5510Faculty of Health, Social Care Medicine and Education, Anglia Ruskin University, Chelmsford, UK
| | - Andre F. Carvalho
- grid.414257.10000 0004 0540 0062Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, VIC Australia
| | - Andre R. Brunoni
- grid.11899.380000 0004 1937 0722Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da USP, São Paulo, Brazil ,grid.11899.380000 0004 1937 0722Departamento de Ciências Médicas, Faculdade de Medicina da USP, São Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai’s Home, Kaohsiung, Taiwan ,grid.411508.90000 0004 0572 9415Mind-Body Interface Laboratory (MBI-Lab), China Medical University and Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- grid.19188.390000 0004 0546 0241Institute of Epidemiology & Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- grid.452620.7Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- grid.260565.20000 0004 0634 0356Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan
| | - Pao-Yen Lin
- grid.145695.a0000 0004 1798 0922Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan ,grid.145695.a0000 0004 1798 0922Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- grid.260565.20000 0004 0634 0356Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan ,grid.260565.20000 0004 0634 0356Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Chih-Wei Hsu
- grid.145695.a0000 0004 1798 0922Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Che-Sheng Chu
- grid.415011.00000 0004 0572 9992Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan ,grid.415011.00000 0004 0572 9992Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Mein-Woei Suen
- grid.252470.60000 0000 9263 9645Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan ,grid.252470.60000 0000 9263 9645Gender Equality Education and Research Center, Asia University, Taichung, Taiwan ,grid.252470.60000 0000 9263 9645Department of Medical Research, Asia University Hospital, Asia University, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Cheng-Ta Li
- grid.278247.c0000 0004 0604 5314Division of Community & Rehabilitation Psychiatry, Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science, National Yang Ming Chiao Tung University, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Functional Neuroimaging and Brain Stimulation Lab, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Road, Beitou District, Taipei City, 11267 Taiwan
| |
Collapse
|
80
|
The interaction between metaplastic neuromodulation and fatigue in multiple sclerosis. J Neurol Sci 2023; 444:120521. [PMID: 36528976 DOI: 10.1016/j.jns.2022.120521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Neuromuscular fatigue contributes to decrements in quality of life in Multiple Sclerosis (MS), yet available treatments demonstrate limited efficacy. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique which presents promise in managing fatigue, possibly related to its capacity to modulate corticospinal excitability. There is evidence for capitalising on metaplasticity using tDCS for improving outcomes. However, this remains to be explored with fatigue in people with MS (pwMS). We investigated cathodal tDCS (ctDCS) priming on anodal tDCS (atDCS)-induced corticospinal excitability and fatigue modulation in pwMS. METHODS 15 pwMS and 15 healthy controls completed fatiguing exercise whilst receiving either ctDCS or sham (stDCS) primed atDCS to the motor cortex. We assessed change in contraction force and motor evoked potential (MEP) amplitude across time to represent changes in fatigue and corticospinal excitability. RESULTS AND CONCLUSION ctDCS primed atDCS induced MEP elevation in healthy participants but not in pwMS, possibly indicating impaired metaplasticity in pwMS. No tDCS-mediated change in the magnitude of fatigue was observed, implying that development of fatigue may not rely on changes in corticospinal excitability. SIGNIFICANCE These findings expand understanding of tDCS effects in pwMS, highlighting differences that may be relevant in the disease pathophysiology.
Collapse
|
81
|
Arora Y, Dutta A. Perspective: Disentangling the effects of tES on neurovascular unit. Front Neurol 2023; 13:1038700. [PMID: 36698881 PMCID: PMC9868757 DOI: 10.3389/fneur.2022.1038700] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 11/28/2022] [Indexed: 01/11/2023] Open
Abstract
Transcranial electrical stimulation (tES) can modulate the neurovascular unit, including the perivascular space morphology, but the mechanisms are unclear. In this perspective article, we used an open-source "rsHRF toolbox" and an open-source functional magnetic resonance imaging (fMRI) transcranial direct current stimulation (tDCS) data set to show the effects of tDCS on the temporal profile of the haemodynamic response function (HRF). We investigated the effects of tDCS in the gray matter and at three regions of interest in the gray matter, namely, the anodal electrode (FC5), cathodal electrode (FP2), and an independent site remote from the electrodes (PZ). A "canonical HRF" with time and dispersion derivatives and a finite impulse response (FIR) model with three parameters captured the effects of anodal tDCS on the temporal profile of the HRF. The FIR model showed tDCS onset effects on the temporal profile of HRF for verum and sham tDCS conditions that were different from the no tDCS condition, which questions the validity of the sham tDCS (placebo). Here, we postulated that the effects of tDCS onset on the temporal profile of HRF are subserved by the effects on neurovascular coupling. We provide our perspective based on previous work on tES effects on the neurovascular unit, including mechanistic grey-box modeling of the effects of tES on the vasculature that can facilitate model predictive control (MPC). Future studies need to investigate grey-box modeling of online effects of tES on the neurovascular unit, including perivascular space, neurometabolic coupling, and neurovascular coupling, that can facilitate MPC of the tES dose-response to address the momentary ("state") and phenotypic ("trait") factors.
Collapse
Affiliation(s)
- Yashika Arora
- Neuroimaging and Neurospectroscopy (NINS) Laboratory, National Brain Research Centre, Gurugram, India
| | - Anirban Dutta
- School of Engineering, University of Lincoln, Lincoln, United Kingdom
| |
Collapse
|
82
|
Isik M, Eskikurt G, Erdogan ET. Neuromodulation of the left auditory cortex with transcranial direct current stimulation (tDCS) has no effect on the categorical perception of speech sounds. Neuropsychologia 2023; 178:108442. [PMID: 36481255 DOI: 10.1016/j.neuropsychologia.2022.108442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/23/2022] [Accepted: 12/03/2022] [Indexed: 12/11/2022]
Abstract
Temporal cue analysis in auditory stimulus is essential in the perception of speech sounds. The effect of transcranial direct current stimulation (tDCS) on auditory temporal processing remains unclear. In this study, we examined whether tDCS applied over the left auditory cortex (AC) has a polarity-specific behavioral effect on the categorical perception of speech sounds whose temporal features are modulated. Sixteen healthy volunteers in each group were received anodal, cathodal, or sham tDCS. A phonetic categorization task including auditory stimuli with varying voice onset time was performed before and during tDCS, and responses were analyzed. No statistically significant difference was observed between groups (anode, cathode, sham) and within the groups (pre-tDCS, during tDCS) in comparisons of the slope parameter of the identification function obtained from the phonetic categorization task data. Our results show that a single-session application of tDCS over the left AC does not significantly affect the categorical perception of speech sounds.
Collapse
Affiliation(s)
- Mevlude Isik
- Neurological Sciences Research and Application Center (İSÜCAN), Istinye University, Istanbul, Turkey.
| | - Gokcer Eskikurt
- Department of Physiology, Istinye University, Faculty of Medicine, Istanbul, Turkey.
| | - Ezgi Tuna Erdogan
- Department of Physiology, Koç University, Faculty of Medicine, Istanbul, Turkey.
| |
Collapse
|
83
|
Wang Y, Wang J, Zhang QF, Xiao KW, Wang L, Yu QP, Xie Q, Poo MM, Wen Y. Neural Mechanism Underlying Task-Specific Enhancement of Motor Learning by Concurrent Transcranial Direct Current Stimulation. Neurosci Bull 2023; 39:69-82. [PMID: 35908004 PMCID: PMC9849633 DOI: 10.1007/s12264-022-00901-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 04/10/2022] [Indexed: 01/22/2023] Open
Abstract
The optimal protocol for neuromodulation by transcranial direct current stimulation (tDCS) remains unclear. Using the rotarod paradigm, we found that mouse motor learning was enhanced by anodal tDCS (3.2 mA/cm2) during but not before or after the performance of a task. Dual-task experiments showed that motor learning enhancement was specific to the task accompanied by anodal tDCS. Studies using a mouse model of stroke induced by middle cerebral artery occlusion showed that concurrent anodal tDCS restored motor learning capability in a task-specific manner. Transcranial in vivo Ca2+ imaging further showed that anodal tDCS elevated and cathodal tDCS suppressed neuronal activity in the primary motor cortex (M1). Anodal tDCS specifically promoted the activity of task-related M1 neurons during task performance, suggesting that elevated Hebbian synaptic potentiation in task-activated circuits accounts for the motor learning enhancement. Thus, application of tDCS concurrent with the targeted behavioral dysfunction could be an effective approach to treating brain disorders.
Collapse
Affiliation(s)
- Ying Wang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China
- Shanghai Center for Brain Science and Brain-Inspired Intelligence Technology, Lingang Laboratory, Shanghai, 201210, China
| | - Jixian Wang
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Qing-Fang Zhang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Ke-Wei Xiao
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Liang Wang
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Qing-Ping Yu
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Qing Xie
- Department of Rehabilitation Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Mu-Ming Poo
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
- University of Chinese Academy of Sciences, Beijing, 100049, China.
- School of Life Science and Technology, ShanghaiTech University, Shanghai, 201210, China.
- Shanghai Center for Brain Science and Brain-Inspired Intelligence Technology, Lingang Laboratory, Shanghai, 201210, China.
| | - Yunqing Wen
- Institute of Neuroscience, State Key Laboratory of Neuroscience, Key Laboratory of Primate Neurobiology, Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, 200031, China.
| |
Collapse
|
84
|
Schwell G, Kozol Z, Tarshansky D, Einat M, Frenkel-Toledo S. The effect of action observation combined with high-definition transcranial direct current stimulation on motor performance in healthy adults: A randomized controlled trial. Front Hum Neurosci 2023; 17:1126510. [PMID: 36936614 PMCID: PMC10014919 DOI: 10.3389/fnhum.2023.1126510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
Action observation (AO) can improve motor performance in humans, probably via the human mirror neuron system. In addition, there is some evidence that transcranial direct current stimulation (tDCS) can improve motor performance. However, it is yet to be determined whether AO combined with tDCS has an enhanced effect on motor performance. We investigated the effect of AO combined with high-definition tDCS (HD-tDCS) targeting the inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), the main aggregates of the human mirror neuron system, on motor performance in healthy adults and compared the immediate vs. 24-h retention test effects (anodal electrodes were placed over these regions of interest). Sixty participants were randomly divided into three groups that received one of the following single-session interventions: (1) observation of a video clip that presented reaching movement sequences toward five lighted units + active HD-tDCS stimulation (AO + active HD-tDCS group); (2) observation of a video clip that presented the same reaching movement sequences + sham HD-tDCS stimulation (AO + sham HD-tDCS group); and (3) observation of a video clip that presented neutral movie while receiving sham stimulation (NM + sham HD-tDCS group). Subjects' reaching performance was tested before and immediately after each intervention and following 24 h. Subjects performed reaching movements toward units that were activated in the same order as the observed sequence during pretest, posttest, and retest. Occasionally, the sequence order was changed by beginning the sequence unexpectedly with a different activated unit. Outcome measures included mean Reaching Time and difference between the Reaching Time of the unexpected and expected reaching movements (Delta). In the posttest and retest, Reaching Time and Delta improved in the AO + sham HD-tDCS group compared to the NM + HD-sham tDCS group. In addition, at posttest, Delta improved in the AO + active HD-tDCS group compared to the NM + sham HD-tDCS group. It appears that combining a montage of active HD-tDCS, which targets the IPL and IFG, with AO interferes with the positive effects of AO alone on the performance of reaching movement sequences.
Collapse
Affiliation(s)
- Gidon Schwell
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Zvi Kozol
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - David Tarshansky
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Moshe Einat
- Department of Electrical and Electronic Engineering, Ariel University, Ariel, Israel
| | - Silvi Frenkel-Toledo
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Neurological Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
- *Correspondence: Silvi Frenkel-Toledo,
| |
Collapse
|
85
|
Shah-Basak P, Boukrina O, Li XR, Jebahi F, Kielar A. Targeted neurorehabilitation strategies in post-stroke aphasia. Restor Neurol Neurosci 2023; 41:129-191. [PMID: 37980575 PMCID: PMC10741339 DOI: 10.3233/rnn-231344] [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] [Indexed: 11/21/2023]
Abstract
BACKGROUND Aphasia is a debilitating language impairment, affecting millions of people worldwide. About 40% of stroke survivors develop chronic aphasia, resulting in life-long disability. OBJECTIVE This review examines extrinsic and intrinsic neuromodulation techniques, aimed at enhancing the effects of speech and language therapies in stroke survivors with aphasia. METHODS We discuss the available evidence supporting the use of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation, and functional MRI (fMRI) real-time neurofeedback in aphasia rehabilitation. RESULTS This review systematically evaluates studies focusing on efficacy and implementation of specialized methods for post-treatment outcome optimization and transfer to functional skills. It considers stimulation target determination and various targeting approaches. The translation of neuromodulation interventions to clinical practice is explored, emphasizing generalization and functional communication. The review also covers real-time fMRI neurofeedback, discussing current evidence for efficacy and essential implementation parameters. Finally, we address future directions for neuromodulation research in aphasia. CONCLUSIONS This comprehensive review aims to serve as a resource for a broad audience of researchers and clinicians interested in incorporating neuromodulation for advancing aphasia care.
Collapse
Affiliation(s)
| | - Olga Boukrina
- Kessler Foundation, Center for Stroke Rehabilitation Research, West Orange, NJ, USA
| | - Xin Ran Li
- School of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Fatima Jebahi
- Department of Speech, Languageand Hearing Sciences, University of Arizona, Tucson, AZ, USA
| | - Aneta Kielar
- Department of Speech, Languageand Hearing Sciences, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
86
|
Transcranial direct current stimulation influences repetitive bimanual force control and interlimb force coordination. Exp Brain Res 2023; 241:313-323. [PMID: 36512062 DOI: 10.1007/s00221-022-06526-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/06/2022] [Indexed: 12/15/2022]
Abstract
This study aimed to investigate the potential effect of bilateral transcranial direct current stimulation (tDCS) on repetitive bimanual force control and force coordination in healthy young adults. In this sham-controlled crossover study, 18 right-handed young adults were enrolled. Repetitive bimanual handgrip force control trials were performed by the participants at 40% of maximum voluntary contraction until task failure. We randomly provided bilateral active and sham tDCS to the primary motor cortex (M1) of each participant before conducting the repetitive bimanual force control task. We quantified the number of successful trials to assess the ability to maintain bimanual force control across multiple trials. Moreover, we estimated bimanual force control and force coordination by quantifying force accuracy, variability, regularity, and correlation coefficient in maximal and adjusted successful trials. Force asymmetry was calculated to examine potential changes in motor dependency on each hand during the task. Bilateral tDCS significantly increased the number of successful trials compared with sham tDCS. The adjusted successful trial revealed that participants who received bilateral tDCS maintained better bimanual force control and coordination, as indicated by decreased force variability and regularity as well as more negative correlation coefficient values in comparison with sham condition. Moreover, participants who received bilateral tDCS produced more force from the dominant hand than from the nondominant hand in both maximal and adjusted successful trials. These findings suggest that bilateral tDCS on M1 successfully maintains bimanual force control with better force coordination by modulating motor dependency.
Collapse
|
87
|
Tu Y, Zhang L, Kong J. Placebo and nocebo effects: from observation to harnessing and clinical application. Transl Psychiatry 2022; 12:524. [PMID: 36564374 PMCID: PMC9789123 DOI: 10.1038/s41398-022-02293-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/25/2022] Open
Abstract
Placebo and nocebo effects are salubrious benefits and negative outcomes attributable to non-specific symbolic components. Leveraging advanced experimental and analytical approaches, recent studies have elucidated complicated neural mechanisms that may serve as a solid basis for harnessing the powerful self-healing and self-harming capacities and applying these findings to improve medical practice and minimize the unintended exacerbation of symptoms in medical practice. We review advances in employing psychosocial, pharmacological, and neuromodulation approaches to modulate/harness placebo and nocebo effects. While these approaches show promising potential, translating these research findings into clinical settings still requires careful methodological, technical, and ethical considerations.
Collapse
Affiliation(s)
- Yiheng Tu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China. .,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Libo Zhang
- grid.9227.e0000000119573309CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China ,grid.410726.60000 0004 1797 8419Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Jian Kong
- grid.32224.350000 0004 0386 9924Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA USA
| |
Collapse
|
88
|
Shen QR, Hu MT, Feng W, Li KP, Wang W. Narrative Review of Noninvasive Brain Stimulation in Stroke Rehabilitation. Med Sci Monit 2022; 28:e938298. [PMID: 36457205 PMCID: PMC9724451 DOI: 10.12659/msm.938298] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 11/03/2022] [Indexed: 09/02/2023] Open
Abstract
Stroke is a disease with a high incidence and disability rate, resulting in changes in neural network and corticoid-subcortical excitability and various functional disabilities. The aim of the present study was to discuss the current status of research and limitations and potential direction in the application of noninvasive brain stimulation (NIBS) on post-stroke patients. This literature review focused on clinical studies and reviews. Literature retrieval was conducted in PubMed, Cochrane, Scopus, and CNKI, using the following keywords: Repeated transcranial magnetic stimulation, Transcranial direct current stimulation, Transcranial alternating current stimulation, Transcranial alternating current stimulation, Transcranial focused ultrasound, Noninvasive vagus nerve stimulation, Stroke, and Rehabilitation. We selected 200 relevant publications from 1985 to 2022. An overview of recent research on the use of NIBS on post-stroke patients, including its mechanism, therapeutic parameters, effects, and safety, is presented. It was found that NIBS has positive therapeutic effects on dysfunctions of motor, sensory, cognitive, speech, swallowing, and depression after stroke, but standardized stimulus programs are still lacking. The literature suggests that rTMS and tDCS are more beneficial to post-stroke patients, while tFUS and tVNS are currently less studied for post-stroke rehabilitation, but are also potential interventions.
Collapse
Affiliation(s)
- Qian-ru Shen
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Meng-ting Hu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Wei Feng
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Kun-Peng Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, PR China
| | - Wu Wang
- Department of Rehabilitation Therapy, The Second Rehabilitation Hospital of Shanghai, Shanghai, PR China
| |
Collapse
|
89
|
Sun W, Song J, Dong X, Kang X, He B, Zhao W, Li Z, Feng Z, Chen X. Bibliometric and visual analysis of transcranial direct current stimulation in the web of science database from 2000 to 2022 via CiteSpace. Front Hum Neurosci 2022; 16:1049572. [PMID: 36530203 PMCID: PMC9751488 DOI: 10.3389/fnhum.2022.1049572] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/31/2022] [Indexed: 12/03/2022] Open
Abstract
Objective This study aimed to evaluate the current research hotspots and development tendency of Transcranial Direct Current Stimulation (tDCS) in the field of neurobiology from a bibliometric perspective by providing visualized information to scientists and clinicians. Materials and methods Publications related to tDCS published between 2000 and 2022 were retrieved from the Web of Science Core Collection (WOSCC) on May 5, 2022. Bibliometric features including the number of publications and citations, citation frequency, H-index, journal impact factors, and journal citation reports were summarized using Microsoft Office Excel. Co-authorship, citation, co-citation, and co-occurrence analyses among countries, institutions, authors, co-authors, journals, publications, references, and keywords were analyzed and visualized using CiteSpace (version 6.1.R3). Results A total of 4,756 publications on tDCS fulfilled the criteria we designed and then were extracted from the WOSCC. The United States (1,190 publications, 25.02%) and Harvard University (185 publications, 3.89%) were the leading contributors among all the countries and institutions, respectively. NITSCHE MA and FREGNI F, two key researchers, have made great achievements in tDCS. Brain Stimulation (306 publications) had the highest number of publications relevant to tDCS and the highest number of citations (4,042 times). In terms of potential hotspots, we observed through reference co-citation analysis timeline viewer related to tDCS that "depression"#0, "Sensorimotor network"#10, "working memory"#11, and "Transcranial magnetic stimulation"#9 might be the future research hotspots, while keywords with the strong burst and still ongoing were "intensity" (2018-2022), "impairment" (2020-2022), "efficacy" (2020-2022), and "guideline" (2020-2022). Conclusion This was the first-ever study of peer-reviewed publications relative to tDCS using several scientometric and visual analytic methods to quantitatively and qualitatively reveal the current research status and trends in the field of tDCS. Through the bibliometric method, we gained an in-depth understanding of the current research status and development trend on tDCS. Our research and analysis results might provide some practical sources for academic scholars and clinicians.
Collapse
Affiliation(s)
- Weiming Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China,Weiming Sun,
| | - JingJing Song
- Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xiangli Dong
- Jiangxi Medical College, Nanchang University, Nanchang, China,Department of Psychosomatic Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xizhen Kang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Binjun He
- School of Life Science, Nanchang University, Nanchang, China
| | - Wentao Zhao
- The Third Clinical Department, China Medical University, Shenyang, China
| | - Zhaoting Li
- School of Life Science, Nanchang University, Nanchang, China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China
| | - Xiuping Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China,Jiangxi Medical College, Nanchang University, Nanchang, China,*Correspondence: Xiuping Chen,
| |
Collapse
|
90
|
Cardon E, Jacquemin L, Vermeersch H, Joossen I, Moyaert J, Mertens G, Vanderveken OM, Lammers MJW, Van de Heyning P, Van Rompaey V, Gilles A. Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial. Brain 2022; 145:4222-4231. [PMID: 36450310 PMCID: PMC9762937 DOI: 10.1093/brain/awac263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 12/03/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a potential intervention for subjective tinnitus, but supporting evidence remains limited. We aimed to investigate the effect of anodal high-definition tDCS of the left temporal area and right dorsolateral prefrontal cortex on tinnitus severity. This double-blind randomized controlled trial included 77 patients (age range 18-79, 43 male) with chronic subjective tinnitus as their primary complaint. Thirty-eight subjects received six consecutive sessions of dual-site sequential high-definition-tDCS with electrodes positioned over the left temporal area and right dorsolateral prefrontal cortex. Both areas were stimulated for 15 min per session, with total stimulation time amounting to 30 min. Thirty-nine subjects received sham stimulation. The primary outcome measure was the change in tinnitus severity, as evaluated by the Tinnitus Functional Index, from baseline to a follow-up visit at 8 ± 2 weeks after treatment completion. Secondary outcomes included changes in perceived tinnitus loudness, as measured with a visual analogue scale and a tinnitus matching procedure, as well as scores on the Hospital Anxiety and Depression Scale, and the Hyperacusis Questionnaire. No differences in Tinnitus Functional Index change scores were identified between the active treatment and sham control groups (linear regression: P = 0.86). The Tinnitus Functional Index scores decreased significantly over time in both groups (P = 0.0012), indicating the presence of a considerable placebo effect. These change scores were significantly influenced by sex (linear regression: P = 0.037) and baseline symptoms of anxiety (linear regression: P = 0.049) in both groups. In general, Tinnitus Functional Index scores decreased more profoundly in males and in subjects with a higher degree of anxiety at baseline. None of the included secondary measures differed significantly between experimental arms. Our results suggest that dual-site sequential high-definition-tDCS of the left temporal area and right dorsolateral prefrontal cortex does not alleviate tinnitus severity. Interestingly, in our study population, fluctuations in tinnitus severity were influenced by gender and concurrent mental condition. It is therefore important to take these factors into account when conducting or planning randomized controlled trials in tinnitus populations.
Collapse
Affiliation(s)
- Emilie Cardon
- Correspondence to: Emilie Cardon Department of Translational Neuroscience, Faculty of Medicine and Health Science University of Antwerp, Campus Drie Eiken, Antwerp, Belgium E-mail:
| | - Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Hanne Vermeersch
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Iris Joossen
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Julie Moyaert
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Olivier M Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
| |
Collapse
|
91
|
Hodkinson DJ, Jackson SR, Jung J. Task-dependent plasticity in distributed neural circuits after transcranial direct current stimulation of the human motor cortex: A proof-of-concept study. FRONTIERS IN PAIN RESEARCH 2022; 3:1005634. [PMID: 36506269 PMCID: PMC9732378 DOI: 10.3389/fpain.2022.1005634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
The ability of non-invasive brain stimulation to induce neuroplasticity and cause long-lasting functional changes is of considerable interest for the reversal of chronic pain and disability. Stimulation of the primary motor cortex (M1) has provided some of the most encouraging after-effects for therapeutic purposes, but little is known about its underlying mechanisms. In this study we combined transcranial Direct Current Stimulation (tDCS) and fMRI to measure changes in task-specific activity and interregional functional connectivity between M1 and the whole brain. Using a randomized counterbalanced sham-controlled design, we applied anodal and cathodal tDCS stimulation over the left M1. In agreement with previous studies, we demonstrate that tDCS applied to the target region induces task-specific facilitation of local brain activity after anodal tDCS, with the stimulation effects having a negative relationship to the resting motor threshold. Beyond the local effects, tDCS also induced changes in multiple downstream regions distinct from the motor system that may be important for therapeutic efficacy, including the operculo-insular and cingulate cortex. These results offer opportunities to improve outcomes of tDCS for the individual patient based on the degree of presumed neuroplasticity. Further research is still warranted to address the optimal stimulation targets and parameters for those with disease-specific symptoms of chronic pain.
Collapse
Affiliation(s)
- Duncan J. Hodkinson
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Queens Medical Center, Nottingham, United Kingdom
- Versus Arthritis Pain Centre, University of Nottingham, Nottingham, United Kingdom
| | - Stephen R. Jackson
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Queens Medical Center, Nottingham, United Kingdom
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - JeYoung Jung
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
92
|
Ehrhardt SE, Ballard T, Wards Y, Mattingley JB, Dux PE, Filmer HL. tDCS augments decision-making efficiency in an intensity dependent manner: A training study. Neuropsychologia 2022; 176:108397. [DOI: 10.1016/j.neuropsychologia.2022.108397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
|
93
|
Efficacy and safety of simultaneous rTMS-tDCS over bilateral angular gyrus on neuropsychiatric symptoms in patients with moderate Alzheimer's disease: A prospective, randomized, sham-controlled pilot study. Brain Stimul 2022; 15:1530-1537. [PMID: 36460293 DOI: 10.1016/j.brs.2022.11.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 11/14/2022] [Accepted: 11/27/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Treating neuropsychiatric symptoms (NPS) in Alzheimer's disease (AD) remains highly challenging. Noninvasive brain stimulation using repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) is of considerable interest in this context. OBJECTIVE To investigate the efficacy and safety of a novel technique involving simultaneous application of rTMS and tDCS (rTMS-tDCS) over bilateral angular gyrus (AG, P5/P6 electrode site) for AD-related NPS. METHODS Eighty-four AD patients were randomized to receive rTMS-tDCS, single-rTMS, single-tDCS, or sham stimulation for 4 weeks, with evaluation at week-4 (W4, immediately after treatment) and week-12 (W12, follow-up period) after initial examination. Primary outcome comprising Neuropsychiatric Inventory (NPI) score and secondary outcomes comprising mini-mental state examination (MMSE), AD assessment scale-cognitive subscale (ADAS-cog), and Pittsburgh sleep quality index (PSQI) scores were collected and analyzed by a two-factor (time and treatment), mixed-design ANOVA. RESULTS rTMS-tDCS produced greater improvement in NPI scores than single-tDCS and sham at W4 and W12 (both P < 0.017) and trended better than single-rTMS (W4: P = 0.058, W12: P = 0.034). rTMS-tDCS improved MMSE scores compared with single-tDCS at W4 (P = 0.011) and sham at W4 and W12 (both P < 0.017). rTMS-tDCS also significantly improved PSQI compared with single-rTMS and sham (both P < 0.017). Interestingly, rTMS-tDCS-induced NPI/PSQI improvement was significantly associated with MMSE/ADAS-cog improvement. tDCS- and/or rTMS-related adverse events appeared slightly and briefly. CONCLUSIONS rTMS-tDCS application to bilateral AG can effectively improve AD-related NPS, cognitive function, and sleep quality with considerable safety.
Collapse
|
94
|
Maudrich T, Ragert P, Perrey S, Kenville R. Single-session anodal transcranial direct current stimulation to enhance sport-specific performance in athletes: A systematic review and meta-analysis. Brain Stimul 2022; 15:1517-1529. [PMID: 36442774 DOI: 10.1016/j.brs.2022.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/13/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has emerged as a promising and feasible method to improve motor performance in healthy and clinical populations. However, the potential of tDCS to enhance sport-specific motor performance in athletes remains elusive. OBJECTIVE We aimed at analyzing the acute effects of a single anodal tDCS session on sport-specific motor performance changes in athletes compared to sham. METHODS A systematic review and meta-analysis was conducted in the electronic databases PubMed, Web of Science, and SPORTDiscus. The meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, two subgroup analyses were conducted (1) depending on the stimulated brain areas (primary motor cortex (M1), temporal cortex (TC), prefrontal cortex (PFC), cerebellum (CB)), and (2) studies clustered in subgroups according to different sports performance domains (endurance, strength, visuomotor skill). RESULTS A total number of 19 studies enrolling a sample size of 258 athletes were deemed eligible for inclusion. Across all included studies, a significant moderate standardized mean difference (SMD) favoring anodal tDCS to enhance sport-specific motor performance could be observed. Subgroup analysis depending on cortical target areas of tDCS indicated a significant moderate SMD in favor of anodal tDCS compared to sham for M1 stimulation. CONCLUSION A single anodal tDCS session can lead to performance enhancement in athletes in sport-specific motor tasks. Although no definitive conclusions can be drawn regarding the modes of action as a function of performance domain or stimulation site, these results imply intriguing possibilities concerning sports performance enhancement through anodal M1 stimulation.
Collapse
Affiliation(s)
- Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Patrick Ragert
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Stéphane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Rouven Kenville
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| |
Collapse
|
95
|
Cancel LM, Silas D, Bikson M, Tarbell JM. Direct current stimulation modulates gene expression in isolated astrocytes with implications for glia-mediated plasticity. Sci Rep 2022; 12:17964. [PMID: 36289296 PMCID: PMC9606293 DOI: 10.1038/s41598-022-22394-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/13/2022] [Indexed: 01/24/2023] Open
Abstract
While the applications of transcranial direct current stimulation (tDCS) across brain disease and cognition are diverse, they rely on changes in brain function outlasting stimulation. The cellular mechanisms of DCS leading to brain plasticity have been studied, but the role of astrocytes remains unaddressed. We previously predicted that during tDCS current is concentrated across the blood brain-barrier. This will amplify exposure of endothelial cells (ECs) that form blood vessels and of astrocytes that wrap around them. The objective of this study was to investigate the effect of tDCS on the gene expression by astrocytes or ECs. DCS (0.1 or 1 mA, 10 min) was applied to monolayers of mouse brain ECs or human astrocytes. Gene expression of a set of neuroactive genes were measured using RT-qPCR. Expression was assessed immediately or 1 h after DCS. Because we previously showed that DCS can produce electroosmotic flow and fluid shear stress known to influence EC and astrocyte function, we compared three interventions: pressure-driven flow across the monolayer alone, pressure-driven flow plus DCS, and DCS alone with flow blocked. We show that DCS can directly modulate gene expression in astrocytes (notably FOS and BDNF), independent of but synergistic with pressure-driven flow gene expression. In ECs, pressure-driven flow activates genes expression with no evidence of further contribution from DCS. In ECs, DCS alone produced mixed effects including an upregulation of FGF9 and downregulation of NTF3. We propose a new adjunct mechanism for tDCS based on glial meditated plasticity.
Collapse
Affiliation(s)
- Limary M Cancel
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, Room 404C, 160 Convent Ave, New York, NY, 10031, USA
| | - Dharia Silas
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, Room 404C, 160 Convent Ave, New York, NY, 10031, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, Room 404C, 160 Convent Ave, New York, NY, 10031, USA
| | - John M Tarbell
- Department of Biomedical Engineering, The City College of New York, Steinman Hall, Room 404C, 160 Convent Ave, New York, NY, 10031, USA.
| |
Collapse
|
96
|
Coulborn S, Fernández-Espejo D. Prefrontal tDCS is unable to modulate mind wandering propensity or underlying functional or effective brain connectivity. Sci Rep 2022; 12:18021. [PMID: 36289366 PMCID: PMC9606118 DOI: 10.1038/s41598-022-22893-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/20/2022] [Indexed: 01/24/2023] Open
Abstract
There is conflicting evidence over the ability to modulate mind-wandering propensity with anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (prefrontal tDCS). Here, 20 participants received 20-min of active and sham prefrontal tDCS while in the MRI scanner, in two separate sessions (counterbalanced). In each session, they completed two runs of a sustained attention to response task (before and during tDCS), which included probes recording subjective responses of mind-wandering. We assessed the effects of tDCS on behavioural responses as well as functional and effective dynamics, via dynamic functional network connectivity (dFNC) and dynamic causal modelling analyses over regions of the default mode, salience and executive control networks. Behavioural results provided substantial evidence in support of no effect of tDCS on task performance nor mind-wandering propensity. Similarly, we found no effect of tDCS on frequency (how often) or dwell time (time spent) of underlying brain states nor effective connectivity. Overall, our results suggest that prefrontal tDCS is unable to modulate mind-wandering propensity or influence underlying brain function. This expands previous behavioural replication failures in suggesting that prefrontal tDCS may not lead to even subtle (i.e., under a behavioural threshold) changes in brain activity during self-generated cognition.
Collapse
Affiliation(s)
- Sean Coulborn
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Birmingham, UK ,grid.6572.60000 0004 1936 7486Centre for Human Brain Health, University of Birmingham, Birmingham, UK ,grid.47840.3f0000 0001 2181 7878University of California, Berkeley, USA
| | - Davinia Fernández-Espejo
- grid.6572.60000 0004 1936 7486School of Psychology, University of Birmingham, Birmingham, UK ,grid.6572.60000 0004 1936 7486Centre for Human Brain Health, University of Birmingham, Birmingham, UK
| |
Collapse
|
97
|
Satorres E, Meléndez JC, Pitarque A, Real E, Abella M, Escudero J. Enhancing Immediate Memory, Potential Learning, and Working Memory with Transcranial Direct Current Stimulation in Healthy Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12716. [PMID: 36232016 PMCID: PMC9564946 DOI: 10.3390/ijerph191912716] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has emerged as a prevention method or minimizer of the normal cognitive deterioration that occurs during the aging process. tDCS can be used to enhance cognitive functions such as immediate memory, learning, or working memory in healthy subjects. The objective of this study was to analyze the effect of two 20-min sessions of anodal transcranial direct stimulation on immediate memory, learning potential, and working memory in healthy older adults. METHODS A randomized, single-blind, repeated-measures, sham-controlled design was used. The sample is made up of 31 healthy older adults, of whom 16 were in the stimulation group and 15 were in the sham group. The anode was placed on position F7, coinciding with the left dorsolateral prefrontal cortex region, and the cathode was placed on Fp2, the right supraorbital area (rSO). RESULTS When comparing the results of the treatment group and the sham group, differences were observed in working memory and learning potential; however, no differences in immediate memory were found. CONCLUSION The results showed that tDCS is a non-invasive and safe tool to enhance cognitive processes in healthy older adults interested in maintaining some cognitive function.
Collapse
Affiliation(s)
- Encarnación Satorres
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Juan C. Meléndez
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Alfonso Pitarque
- Department of Methodology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Elena Real
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Mireia Abella
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, Av. Blasco Ibañez 21, 46010 Valencia, Spain
| | - Joaquin Escudero
- Hospital General of Valencia, Av. Tres Cruces, 2, 46014 Valencia, Spain
| |
Collapse
|
98
|
Van Hoornweder S, A Caulfield K, Nitsche M, Thielscher A, L J Meesen R. Addressing transcranial electrical stimulation variability through prospective individualized dosing of electric field strength in 300 participants across two samples: the 2-SPED approach. J Neural Eng 2022; 19:056045. [PMID: 36240729 PMCID: PMC9855635 DOI: 10.1088/1741-2552/ac9a78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/14/2022] [Indexed: 01/25/2023]
Abstract
Objective. Transcranial electrical stimulation (tES) is a promising method for modulating brain activity and excitability with variable results to date. To minimize electric (E-)field strength variability, we introduce the 2-sample prospective E-field dosing (2-SPED) approach, which uses E-field strengths induced by tES in a first population to individualize stimulation intensity in a second population.Approach. We performed E-field modeling of three common tES montages in 300 healthy younger adults. First, permutation analyses identified the sample size required to obtain a stable group average E-field in the primary motor cortex (M1), with stability being defined as the number of participants where all group-average E-field strengths ± standard deviation did not leave the population's 5-95 percentile range. Second, this stable group average was used to individualize tES intensity in a second independent population (n = 100). The impact of individualized versus fixed intensity tES on E-field strength variability was analyzed.Main results. In the first population, stable group average E-field strengths (V/m) in M1 were achieved at 74-85 participants, depending on the tES montage. Individualizing the stimulation intensity (mA) in the second population resulted in uniform M1 E-field strength (all p < 0.001) and significantly diminished peak cortical E-field strength variability (all p < 0.01), across all montages.Significance. 2-SPED is a feasible way to prospectively induce more uniform E-field strengths in a region of interest. Future studies might apply 2-SPED to investigate whether decreased E-field strength variability also results in decreased physiological and behavioral variability in response to tES.
Collapse
Affiliation(s)
- Sybren Van Hoornweder
- REVAL—Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium,Author to whom any correspondence should be addressed
| | - Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States of America
| | - Michael Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany,
Department of Neurology, University Medical Hospital Bergmannsheil, Bürkle de la Camp-Platz, Bochum, Germany
| | - Axel Thielscher
- Section for Magnetic Resonance, Department of Health Technology, Technical University of Denmark, Kgs Lyngby, Denmark,
Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Copenhagen, Denmark
| | - Raf L J Meesen
- REVAL—Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium,
Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences KU Leuven, Leuven, Belgium
| |
Collapse
|
99
|
Li Y, Li HP, Wu MX, Wang QY, Zeng X. Effects of transcranial direct current stimulation for post-stroke depression: A systematic review and meta-analysis. Clin Neurophysiol 2022; 142:1-10. [DOI: 10.1016/j.clinph.2022.07.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 04/05/2022] [Accepted: 07/09/2022] [Indexed: 12/24/2022]
|
100
|
Yang D, Ma R, Yang N, Sun K, Han J, Duan Y, Liu A, Zhao X, Li T, Liu J, Liu W, Chen F, Hu N, Xu C, Fan C, Wang Y. Repeated long sessions of transcranial direct current stimulation reduces seizure frequency in patients with refractory focal epilepsy: An open-label extension study. Epilepsy Behav 2022; 135:108876. [PMID: 36088785 DOI: 10.1016/j.yebeh.2022.108876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 05/17/2022] [Accepted: 08/04/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Although clinical trials have demonstrated that cathodal transcranial direct current stimulation (tDCS) is effective for seizure reduction, its long-term efficacy is unknown. This study aimed to determine the long-term effects of repeated cathodal long tDCS sessions on seizure suppression in patients with refractory epilepsy. METHODS Patients were recruited to participate in an extended phase of a previous randomized, double-blind, sham-controlled, three-arm, parallel, multicenter study on tDCS. The patients were divided into an active tDCS group (20 min of tDCS per day) and an intensified tDCS group (2 × 20 min of tDCS per day). Each tDCS session lasted 2 weeks and the patients underwent repeated sessions at intervals of 2 to 6 months. The cathode was placed over the epileptogenic focus with the current intensity set as 2 mA. Seizure frequency reduction from baseline was analyzed using the Wilcoxon signed-rank test for two related samples. A generalized estimating equation model was used to estimate group, time, and interaction effects. RESULTS Among the 19 patients who participated in the extended phase, 11 were in the active tDCS group and underwent 2-16 active tDCS sessions, and eight were in the intensified tDCS group and underwent 3-11 intensified tDCS sessions. Seizure reduction was significant from the first to the seventh follow-up, with a median seizure frequency reduction of 41.7%-83.3% (p < 0.05). Compared to the regular tDCS protocol, each intensified tDCS session substantially decreased seizure frequency by 0.3680 (p < 0.05). One patient experienced an increase of 8.5%-232.8% in the total number of seizures during three treatment sessions and follow-ups. CONCLUSION Repeated long cathodal tDCS sessions yielded significant and progressive long-term seizure reductions in patients with refractory focal epilepsy.
Collapse
Affiliation(s)
- Dongju Yang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Rui Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Nuo Yang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Ke Sun
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jiaqi Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Yiran Duan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China
| | - Aihua Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xuan Zhao
- Department of Pediatric, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ting Li
- Department of Pediatric, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jing Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wenjing Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Fang Chen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ningning Hu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Cuiping Xu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chunqiu Fan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Neuromodulation, Beijing, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
| |
Collapse
|