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Evans NH, Suri C, Field-Fote EC. Walking and Balance Outcomes Are Improved Following Brief Intensive Locomotor Skill Training but Are Not Augmented by Transcranial Direct Current Stimulation in Persons With Chronic Spinal Cord Injury. Front Hum Neurosci 2022; 16:849297. [PMID: 35634208 PMCID: PMC9130633 DOI: 10.3389/fnhum.2022.849297] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022] Open
Abstract
Motor training to improve walking and balance function is a common aspect of rehabilitation following motor-incomplete spinal cord injury (MISCI). Evidence suggests that moderate- to high-intensity exercise facilitates neuroplastic mechanisms that support motor skill acquisition and learning. Furthermore, enhancing corticospinal drive via transcranial direct current stimulation (tDCS) may augment the effects of motor training. In this pilot study, we investigated whether a brief moderate-intensity locomotor-related motor skill training (MST) circuit, with and without tDCS, improved walking and balance outcomes in persons with MISCI. In addition, we examined potential differences between within-day (online) and between-day (offline) effects of MST. Twenty-six adults with chronic MISCI, who had some walking ability, were enrolled in a 5-day double-blind, randomized study with a 3-day intervention period. Participants were assigned to an intensive locomotor MST circuit and concurrent application of either sham tDCS (MST+tDCSsham) or active tDCS (MST+tDCS). The primary outcome was overground walking speed measured during the 10-meter walk test. Secondary outcomes included spatiotemporal gait characteristics (cadence and stride length), peak trailing limb angle (TLA), intralimb coordination (ACC), the Berg Balance Scale (BBS), and the Falls Efficacy Scale-International (FES-I) questionnaire. Analyses revealed a significant effect of the MST circuit, with improvements in walking speed, cadence, bilateral stride length, stronger limb TLA, weaker limb ACC, BBS, and FES-I observed in both the MST+tDCSsham and MST+tDCS groups. No differences in outcomes were observed between groups. Between-day change accounted for a greater percentage of the overall change in walking outcomes. In persons with MISCI, brief intensive MST involving a circuit of ballistic, cyclic locomotor-related skill activities improved walking outcomes, and selected strength and balance outcomes; however, concurrent application of tDCS did not further enhance the effects of MST.
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Affiliation(s)
- Nicholas H. Evans
- Shepherd Center, Crawford Research Institute, Atlanta, GA, United States
- Department of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, United States
| | - Cazmon Suri
- Shepherd Center, Crawford Research Institute, Atlanta, GA, United States
| | - Edelle C. Field-Fote
- Shepherd Center, Crawford Research Institute, Atlanta, GA, United States
- Department of Applied Physiology, Georgia Institute of Technology, Atlanta, GA, United States
- Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, United States
- *Correspondence: Edelle C. Field-Fote,
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102
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Au J, Smith-Peirce RN, Carbone E, Moon A, Evans M, Jonides J, Jaeggi SM. Effects of Multisession Prefrontal Transcranial Direct Current Stimulation on Long-term Memory and Working Memory in Older Adults. J Cogn Neurosci 2022; 34:1015-1037. [PMID: 35195728 PMCID: PMC9836784 DOI: 10.1162/jocn_a_01839] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a noninvasive form of electrical brain stimulation popularly used to augment the effects of working memory (WM) training. Although success has been mixed, some studies report enhancements in WM performance persisting days, weeks, or even months that are actually more reminiscent of consolidation effects typically observed in the long-term memory (LTM) domain, rather than WM improvements per se. Although tDCS has been often reported to enhance both WM and LTM, these effects have never been directly compared within the same study. However, given their considerable neural and behavioral overlap, this is a timely comparison to make. This study reports results from a multisession intervention in older adults comparing active and sham tDCS over the left dorsolateral pFC during training on both an n-back WM task and a word learning LTM task. We found strong and robust effects on LTM, but mixed effects on WM that only emerged for those with lower baseline ability. Importantly, mediation analyses showed an indirect effect of tDCS on WM that was mediated by improvements in consolidation. We conclude that tDCS over the left dorsolateral pFC can be used as an effective intervention to foster long-term learning and memory consolidation in aging, which can manifest in performance improvements across multiple memory domains.
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Affiliation(s)
- Jacky Au
- School of Education, University of California, Irvine, Irvine CA, 92697, USA
| | | | - Elena Carbone
- Department of General Psychology, University of Padova, Padova, 35131, Italy
| | - Austin Moon
- Department of Psychology, University of California, Riverside, Riverside CA, 92521, USA
| | - Michelle Evans
- Department of Psychology, University of Michigan, Ann Arbor MI, 48109, USA
| | - John Jonides
- Department of Psychology, University of Michigan, Ann Arbor MI, 48109, USA
| | - Susanne M. Jaeggi
- School of Education, University of California, Irvine, Irvine CA, 92697, USA
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103
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Antal A, Luber B, Brem AK, Bikson M, Brunoni AR, Cohen Kadosh R, Dubljević V, Fecteau S, Ferreri F, Flöel A, Hallett M, Hamilton RH, Herrmann CS, Lavidor M, Loo C, Lustenberger C, Machado S, Miniussi C, Moliadze V, Nitsche MA, Rossi S, Rossini PM, Santarnecchi E, Seeck M, Thut G, Turi Z, Ugawa Y, Venkatasubramanian G, Wenderoth N, Wexler A, Ziemann U, Paulus W. Non-invasive brain stimulation and neuroenhancement. Clin Neurophysiol Pract 2022; 7:146-165. [PMID: 35734582 PMCID: PMC9207555 DOI: 10.1016/j.cnp.2022.05.002] [Citation(s) in RCA: 49] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/19/2022] [Accepted: 05/18/2022] [Indexed: 12/15/2022] Open
Abstract
The available data frame with a wide parameter space of tES does not allow an overarching protocol recommendation. Established engineering risk-management procedures with regard to manufacturing should be followed. Consensus among experts is that tES for neuroenhancement is safe as long as tested protocols are followed.
Attempts to enhance human memory and learning ability have a long tradition in science. This topic has recently gained substantial attention because of the increasing percentage of older individuals worldwide and the predicted rise of age-associated cognitive decline in brain functions. Transcranial brain stimulation methods, such as transcranial magnetic (TMS) and transcranial electric (tES) stimulation, have been extensively used in an effort to improve cognitive functions in humans. Here we summarize the available data on low-intensity tES for this purpose, in comparison to repetitive TMS and some pharmacological agents, such as caffeine and nicotine. There is no single area in the brain stimulation field in which only positive outcomes have been reported. For self-directed tES devices, how to restrict variability with regard to efficacy is an essential aspect of device design and function. As with any technique, reproducible outcomes depend on the equipment and how well this is matched to the experience and skill of the operator. For self-administered non-invasive brain stimulation, this requires device designs that rigorously incorporate human operator factors. The wide parameter space of non-invasive brain stimulation, including dose (e.g., duration, intensity (current density), number of repetitions), inclusion/exclusion (e.g., subject’s age), and homeostatic effects, administration of tasks before and during stimulation, and, most importantly, placebo or nocebo effects, have to be taken into account. The outcomes of stimulation are expected to depend on these parameters and should be strictly controlled. The consensus among experts is that low-intensity tES is safe as long as tested and accepted protocols (including, for example, dose, inclusion/exclusion) are followed and devices are used which follow established engineering risk-management procedures. Devices and protocols that allow stimulation outside these parameters cannot claim to be “safe” where they are applying stimulation beyond that examined in published studies that also investigated potential side effects. Brain stimulation devices marketed for consumer use are distinct from medical devices because they do not make medical claims and are therefore not necessarily subject to the same level of regulation as medical devices (i.e., by government agencies tasked with regulating medical devices). Manufacturers must follow ethical and best practices in marketing tES stimulators, including not misleading users by referencing effects from human trials using devices and protocols not similar to theirs.
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Affiliation(s)
- Andrea Antal
- Department of Neurology, University Medical Center, Göttingen, Germany
- Corresponding author at: Department of Neurology, University Medical Center, Göttingen, Robert Koch Str. 40, 37075 Göttingen, Germany.
| | - Bruce Luber
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Marom Bikson
- Biomedical Engineering at the City College of New York (CCNY) of the City University of New York (CUNY), NY, USA
| | - Andre R. Brunoni
- Departamento de Clínica Médica e de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Veljko Dubljević
- Science, Technology and Society Program, College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, CERVO Brain Research Centre, Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Florinda Ferreri
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475 Greifswald, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roy H. Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Michal Lavidor
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Israel
| | - Collen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales; The George Institute; Sydney, Australia
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Carlo Miniussi
- Center for Mind/Brain Sciences – CIMeC and Centre for Medical Sciences - CISMed, University of Trento, Rovereto, Italy
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU, Dortmund, Germany
- Dept. Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Paolo M. Rossini
- Department of Neuroscience and Neurorehabilitation, Brain Connectivity Lab, IRCCS-San Raffaele-Pisana, Rome, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Margitta Seeck
- Department of Clinical Neurosciences, Hôpitaux Universitaires de Genève, Switzerland
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, School of Psychology and Neuroscience, EEG & Epolepsy Unit, University of Glasgow, United Kingdom
| | - Zsolt Turi
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Walter Paulus
- Department of of Neurology, Ludwig Maximilians University Munich, Germany
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104
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Jaberzadeh S, Zoghi M. Transcranial Direct Current Stimulation Enhances Exercise Performance: A Mini Review of the Underlying Mechanisms. FRONTIERS IN NEUROERGONOMICS 2022; 3:841911. [PMID: 38235480 PMCID: PMC10790841 DOI: 10.3389/fnrgo.2022.841911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/18/2022] [Indexed: 01/19/2024]
Abstract
Exercise performance (EP) is affected by a combination of factors including physical, physiological, and psychological factors. This includes factors such as peripheral, central, and mental fatigue, external peripheral factors such as pain and temperature, and psychological factors such as motivation and self-confidence. During the last century, numerous studies from different fields of research were carried out to improve EP by modifying these factors. During the last two decades, the focus of research has been mainly moved toward the brain as a dynamic ever-changing organ and the ways changes in this organ may lead to improvements in physical performance. Development of centrally-acting performance modifiers such as level of motivation or sleep deprivation and the emergence of novel non-invasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are the key motives behind this move. This article includes three sections. Section Introduction provides an overview of the mechanisms behind the reduction of EP. The main focus of the Effects of tDCS on EP section is to provide a brief description of the effects of tDCS on maximal and submaximal types of exercise and finally, the section Mechanisms Behind the Effects of tDCS on EP provides description of the mechanisms behind the effects of tDCS on EP.
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Affiliation(s)
- Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, School of Health, Federation University Australia, Churchill, VIC, Australia
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105
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Inter-Individual Variability in tDCS Effects: A Narrative Review on the Contribution of Stable, Variable, and Contextual Factors. Brain Sci 2022; 12:brainsci12050522. [PMID: 35624908 PMCID: PMC9139102 DOI: 10.3390/brainsci12050522] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Due to its safety, portability, and cheapness, transcranial direct current stimulation (tDCS) use largely increased in research and clinical settings. Despite tDCS’s wide application, previous works pointed out inconsistent and low replicable results, sometimes leading to extreme conclusions about tDCS’s ineffectiveness in modulating behavioral performance across cognitive domains. Traditionally, this variability has been linked to significant differences in the stimulation protocols across studies, including stimulation parameters, target regions, and electrodes montage. Here, we reviewed and discussed evidence of heterogeneity emerging at the intra-study level, namely inter-individual differences that may influence the response to tDCS within each study. This source of variability has been largely neglected by literature, being results mainly analyzed at the group level. Previous research, however, highlighted that only a half—or less—of studies’ participants could be classified as responders, being affected by tDCS in the expected direction. Stable and variable inter-individual differences, such as morphological and genetic features vs. hormonal/exogenous substance consumption, partially account for this heterogeneity. Moreover, variability comes from experiments’ contextual elements, such as participants’ engagement/baseline capacity and individual task difficulty. We concluded that increasing knowledge on inter-dividual differences rather than undermining tDCS effectiveness could enhance protocols’ efficiency and reproducibility.
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106
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Sanches C, Amzallag F, Dubois B, Lévy R, Truong DQ, Bikson M, Teichmann M, Valero-Cabré A. Evaluation of the effect of transcranial direct current stimulation on language impairments in the behavioural variant of frontotemporal dementia. Brain Commun 2022; 4:fcac050. [PMID: 35356034 PMCID: PMC8963324 DOI: 10.1093/braincomms/fcac050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 12/05/2021] [Accepted: 03/24/2022] [Indexed: 11/30/2022] Open
Abstract
The behavioural variant of frontotemporal dementia is a neurodegenerative disease characterized by bilateral atrophy of the prefrontal cortex, gradual deterioration of behavioural and executive capacities, a breakdown of language initiation and impaired search mechanisms in the lexicon. To date, only a few studies have analysed the modulation of language deficits in the behavioural variant of frontotemporal dementia patients with transcranial direct current stimulation, yet with inconsistent results. Our goal was to assess the impact on language performance of a single session of transcranial direct current stimulation on patients with the behavioural variant of frontotemporal dementia. Using a sham-controlled double-blind crossover design in a cohort of behavioural frontotemporal dementia patients (n = 12), we explored the impact on language performance of a single transcranial direct current stimulation session delivering anodal or cathodal transcranial direct current stimulation, over the left and right dorsolateral prefrontal cortex, compared with sham stimulation. A Letter fluency and a Picture naming task were performed prior and following transcranial direct current stimulation, to assess modulatory effects on language. Behavioural frontotemporal dementia patients were impaired in all evaluation tasks at baseline compared with healthy controls. Computational finite element method (FEM) models of cortical field distribution corroborated expected impacts of left-anodal and right-cathodal transcranial direct current stimulation over the dorsolateral prefrontal cortex and showed lower radial field strength in case of atrophy. However, none of the two tasks showed statistically significant evidence of language improvement caused by active transcranial direct current stimulation compared with sham. Our findings do not argue in favour of pre-therapeutic effects and suggest that stimulation strategies evaluating the modulatory role of transcranial direct current stimulation in the behavioural variant of frontotemporal dementia must carefully weigh the influence of symptom severity and cortical atrophy affecting prefrontal regions to ensure clinical success.
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Affiliation(s)
- Clara Sanches
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
| | - Fanny Amzallag
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
| | - Bruno Dubois
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Richard Lévy
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Dennis Q. Truong
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of City University of New York, New York, NY, USA
| | - Marom Bikson
- Neural Engineering Laboratory, Department of Biomedical Engineering, The City College of City University of New York, New York, NY, USA
| | - Marc Teichmann
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Department of Neurology, National Reference Center for « PPA and rare dementias », Pitié Salpêtrière Hospital, AP-HP, Paris, France
| | - Antoni Valero-Cabré
- Groupe de Dynamiques Cérébrales, Plasticité et Rééducation, FRONTLAB team, Institut du Cerveau et de la Moelle Epinière, CNRS UMR 7225, INSERM 1127, Sorbonne Université, Paris, France
- Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University School of Medicine, Boston, MA, USA
- Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
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107
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Mathematical Model Insights into EEG Origin under Transcranial Direct Current Stimulation (tDCS) in the Context of Psychosis. J Clin Med 2022; 11:jcm11071845. [PMID: 35407453 PMCID: PMC8999473 DOI: 10.3390/jcm11071845] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/12/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023] Open
Abstract
Schizophrenia is a psychotic disease that develops progressively over years with a transition from prodromal to psychotic state associated with a disruption in brain activity. Transcranial Direct Current Stimulation (tDCS), known to alleviate pharmaco-resistant symptoms in patients suffering from schizophrenia, promises to prevent such a psychotic transition. To understand better how tDCS affects brain activity, we propose a neural cortico-thalamo-cortical (CTC) circuit model involving the Ascending Reticular Arousal System (ARAS) that permits to describe major impact features of tDCS, such as excitability for short-duration stimulation and electroencephalography (EEG) power modulation for long-duration stimulation. To this end, the mathematical model relates stimulus duration and Long-Term Plasticity (LTP) effect, in addition to describing the temporal LTP decay after stimulus offset. This new relation promises to optimize future stimulation protocols. Moreover, we reproduce successfully EEG-power modulation under tDCS in a ketamine-induced psychosis model and confirm the N-methyl-d-aspartate (NMDA) receptor hypofunction hypothesis in the etiopathophysiology of schizophrenia. The model description points to an important role of the ARAS and the δ-rhythm synchronicity in CTC circuit in early-stage psychosis.
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108
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Li X, Lin X, Yao J, Chen S, Hu Y, Liu J, Jin R. Effects of High-Definition Transcranial Direct Current Stimulation Over the Primary Motor Cortex on Cold Pain Sensitivity Among Healthy Adults. Front Mol Neurosci 2022; 15:853509. [PMID: 35370540 PMCID: PMC8971908 DOI: 10.3389/fnmol.2022.853509] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
Some clinical studies have shown promising effects of transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) on pain relief. Nevertheless, a few studies reported no significant analgesic effects of tDCS, likely due to the complexity of clinical pain conditions. Human experimental pain models that utilize indices of pain in response to well-controlled noxious stimuli can avoid many confounds that are present in the clinical data. This study aimed to investigate the effects of high-definition tDCS (HD-tDCS) stimulation over M1 on sensitivity to experimental pain and assess whether these effects could be influenced by the pain-related cognitions and emotions. A randomized, double-blinded, crossover, and sham-controlled design was adopted. A total of 28 healthy participants received anodal, cathodal, or sham HD-tDCS over M1 (1 mA for 20 min) in different sessions, in which montage has the advantage of producing more focal stimulation. Using a cold pressor test, several indices reflecting the sensitivity to cold pain were measured immediately after HD-tDCS stimulation, such as cold pain threshold and tolerance and cold pain intensity and unpleasantness ratings. Results showed that only anodal HD-tDCS significantly increased cold pain threshold when compared with sham stimulation. Neither anodal nor cathodal HD-tDCS showed significant analgesic effects on cold pain tolerance, pain intensity, and unpleasantness ratings. Correlation analysis revealed that individuals that a had lower level of attentional bias to negative information benefited more from attenuating pain intensity rating induced by anodal HD-tDCS. Therefore, single-session anodal HD-tDCS modulates the sensory-discriminative aspect of pain perception as indexed by the increased pain threshold. In addition, the modulating effects of HD-tDCS on attenuating pain intensity to suprathreshold pain could be influenced by the participant’s negative attentional bias, which deserves to be taken into consideration in the clinical applications.
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Affiliation(s)
- Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Xinxin Lin
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Junjie Yao
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Shengxiong Chen
- Medical Rehabilitation Center, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Yu Hu
- Medical Rehabilitation Center, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Jiang Liu
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, China
| | - Richu Jin
- Department of Computer Science and Engineering, Southern University of Science and Technology, Shenzhen, China
- *Correspondence: Richu Jin,
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109
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Morin M, St-Gelais R, Ketounou KÉ, d'Assomption RML, Ezzaidi H, Fernandes KBP, da Silva RA, Ngomo S. tDCS Task-Oriented Approach Improves Function in Individuals With Fibromyalgia Pain. A Pilot Study. FRONTIERS IN PAIN RESEARCH 2022; 2:692250. [PMID: 35295530 PMCID: PMC8915725 DOI: 10.3389/fpain.2021.692250] [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: 04/08/2021] [Accepted: 10/28/2021] [Indexed: 11/13/2022] Open
Abstract
Fibromyalgia (FM) is a complex pain syndrome accompanied by physical disability and loss of daily life activities. Evidences suggest that modulation of the primary motor cortex (M1) by transcranial direct current stimulation (tDCS) improves functional physical capacity in chronic pain conditions. However, the gain on physical function in people living with FM receiving tDCS is still unclear. This study aimed to evaluate whether the tDCS task-oriented approach improves function and reduces pain in a single cohort of 10 FM. A total of 10 women with FM (60.4 ± 15.37 years old) were enrolled in an intervention including anodal tDCS delivered on M1 (2 mA from a constant stimulator for 20 min); simultaneously they performed a functional task. The anode was placed on the contralateral hemisphere of the dominant hand. Outcome assessments were done before the stimulation, immediately after stimulation and 30 min after the end of tDCS. The same protocol was applied in subsequent sessions. A total of five consecutive days of tDCS were completed. The main outcomes were the number of repetitions achieved and time in active practice to evaluate functional physical task performance such as intensity of the pain (visual analog scale) and level of fatigue (Borg scale). After 5 days of tDCS, the number of repetitions achieved significantly increased by 49% (p = 0.012). No change was observed in active practice time. No increase in pain was observed despite the mobility of the painful parts of the body. These results are encouraging since an increase in pain due to the mobilization of painful body parts could have been observed at the end of the 5th day of the experiment. These results support the use of tDCS in task-based rehabilitation.
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Affiliation(s)
- Marika Morin
- Laboratoire de recherche Lab BioNR, Physical Therapy Program, Health Sciences Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Raphaël St-Gelais
- École de Réadaptation, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Kossi Épiphane Ketounou
- Laboratoire de recherche Lab BioNR, Physical Therapy Program, Health Sciences Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Régis M-L d'Assomption
- Laboratoire de recherche Lab BioNR, Physical Therapy Program, Health Sciences Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Hassan Ezzaidi
- Department of Applied Sciences, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | | | - Rubens A da Silva
- Laboratoire de recherche Lab BioNR, Physical Therapy Program, Health Sciences Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
| | - Suzy Ngomo
- Laboratoire de recherche Lab BioNR, Physical Therapy Program, Health Sciences Department, Université du Québec à Chicoutimi, Chicoutimi, QC, Canada
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Herrmann O, Ficek B, Webster KT, Frangakis C, Spira AP, Tsapkini K. Sleep as a predictor of tDCS and language therapy outcomes. Sleep 2022; 45:zsab275. [PMID: 34875098 PMCID: PMC8919198 DOI: 10.1093/sleep/zsab275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/01/2021] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES To determine whether sleep at baseline (before therapy) predicted improvements in language following either language therapy alone or coupled with transcranial direct current stimulation (tDCS) in individuals with primary progressive aphasia (PPA). METHODS Twenty-three participants with PPA (mean age 68.13 ± 6.21) received written naming/spelling therapy coupled with either anodal tDCS over the left inferior frontal gyrus (IFG) or sham condition in a crossover, sham-controlled, double-blind design (ClinicalTrials.gov identifier: NCT02606422). The outcome measure was percent of letters spelled correctly for trained and untrained words retrieved in a naming/spelling task. Given its particular importance as a sleep parameter in older adults, we calculated sleep efficiency (total sleep time/time in bed x100) based on subjective responses on the Pittsburgh Sleep Quality Index (PSQI). We grouped individuals based on a median split: high versus low sleep efficiency. RESULTS Participants with high sleep efficiency benefited more from written naming/spelling therapy than participants with low sleep efficiency in learning therapy materials (trained words). There was no effect of sleep efficiency in generalization of therapy materials to untrained words. Among participants with high sleep efficiency, those who received tDCS benefitted more from therapy than those who received sham condition. There was no additional benefit from tDCS in participants with low sleep efficiency. CONCLUSION Sleep efficiency modified the effects of language therapy and tDCS on language in participants with PPA. These results suggest sleep is a determinant of neuromodulation effects.Clinical Trial: tDCS Intervention in Primary Progressive Aphasia https://clinicaltrials.gov/ct2/show/NCT02606422.
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Affiliation(s)
- Olivia Herrmann
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kimberly T Webster
- Department of Otolaryngology, Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Constantine Frangakis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Cognitive Science, The Johns Hopkins University, Baltimore, MD, USA
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111
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Muffel T, Shih PC, Kalloch B, Nikulin V, Villringer A, Sehm B. Differential effects of anodal and dual tDCS on sensorimotor functions in chronic hemiparetic stroke patients. Brain Stimul 2022; 15:509-522. [DOI: 10.1016/j.brs.2022.02.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/14/2022] [Accepted: 02/21/2022] [Indexed: 11/24/2022] Open
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112
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Ekhtiari H, Ghobadi-Azbari P, Thielscher A, Antal A, Li LM, Shereen AD, Cabral-Calderin Y, Keeser D, Bergmann TO, Jamil A, Violante IR, Almeida J, Meinzer M, Siebner HR, Woods AJ, Stagg CJ, Abend R, Antonenko D, Auer T, Bächinger M, Baeken C, Barron HC, Chase HW, Crinion J, Datta A, Davis MH, Ebrahimi M, Esmaeilpour Z, Falcone B, Fiori V, Ghodratitoostani I, Gilam G, Grabner RH, Greenspan JD, Groen G, Hartwigsen G, Hauser TU, Herrmann CS, Juan CH, Krekelberg B, Lefebvre S, Liew SL, Madsen KH, Mahdavifar-Khayati R, Malmir N, Marangolo P, Martin AK, Meeker TJ, Ardabili HM, Moisa M, Momi D, Mulyana B, Opitz A, Orlov N, Ragert P, Ruff CC, Ruffini G, Ruttorf M, Sangchooli A, Schellhorn K, Schlaug G, Sehm B, Soleimani G, Tavakoli H, Thompson B, Timmann D, Tsuchiyagaito A, Ulrich M, Vosskuhl J, Weinrich CA, Zare-Bidoky M, Zhang X, Zoefel B, Nitsche MA, Bikson M. A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement. Nat Protoc 2022; 17:596-617. [PMID: 35121855 PMCID: PMC7612687 DOI: 10.1038/s41596-021-00664-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Low-intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation, applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional MRI (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both brain function and tES effects. Methodological aspects of tES-fMRI studies underpin the results, and reporting them in appropriate detail is required for reproducibility and interpretability. Despite the growing number of published reports, there are no consensus-based checklists for disclosing methodological details of concurrent tES-fMRI studies. The objective of this work was to develop a consensus-based checklist of reporting standards for concurrent tES-fMRI studies to support methodological rigor, transparency and reproducibility (ContES checklist). A two-phase Delphi consensus process was conducted by a steering committee (SC) of 13 members and 49 expert panelists through the International Network of the tES-fMRI Consortium. The process began with a circulation of a preliminary checklist of essential items and additional recommendations, developed by the SC on the basis of a systematic review of 57 concurrent tES-fMRI studies. Contributors were then invited to suggest revisions or additions to the initial checklist. After the revision phase, contributors rated the importance of the 17 essential items and 42 additional recommendations in the final checklist. The state of methodological transparency within the 57 reviewed concurrent tES-fMRI studies was then assessed by using the checklist. Experts refined the checklist through the revision and rating phases, leading to a checklist with three categories of essential items and additional recommendations: (i) technological factors, (ii) safety and noise tests and (iii) methodological factors. The level of reporting of checklist items varied among the 57 concurrent tES-fMRI papers, ranging from 24% to 76%. On average, 53% of checklist items were reported in a given article. In conclusion, use of the ContES checklist is expected to enhance the methodological reporting quality of future concurrent tES-fMRI studies and increase methodological transparency and reproducibility.
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Affiliation(s)
| | - Peyman Ghobadi-Azbari
- Department of Biomedical Engineering, Shahed University, Tehran, Iran
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Andrea Antal
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Lucia M Li
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
- UK DRI Centre for Care Research and Technology, Imperial College London, London, UK
| | - A Duke Shereen
- Advanced Science Research Center, The Graduate Center, City University of New York, New York, NY, USA
| | - Yuranny Cabral-Calderin
- Research Group Neural and Environmental Rhythms, Max Planck Institute for Empirical Aesthetics, Frankfurt, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Munich, Germany
- Department of Radiology, University Hospital LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital LMU Munich, Munich, Germany
| | - Til Ole Bergmann
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Asif Jamil
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jorge Almeida
- Proaction Lab, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Marcus Meinzer
- Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Queensland, Australia
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, UK
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Daria Antonenko
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tibor Auer
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Marc Bächinger
- Neural Control of Movement Lab, Department of Health Sciences and Technology, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel, University Hospital Brussels, Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Helen C Barron
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, UK
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jenny Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Abhishek Datta
- Research and Development, Soterix Medical, New York, USA
- The City College of the City University of New York, New York, USA
| | - Matthew H Davis
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Esmaeilpour
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA
| | - Brian Falcone
- Northrop Grumman Company, Mission Systems, Falls Church, VA, USA
| | - Valentina Fiori
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science (ICMC), University of Sao Paulo, Sao Paulo, Brazil
| | - Gadi Gilam
- Systems Neuroscience and Pain Laboratory, Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
- The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roland H Grabner
- Educational Neuroscience, Institute of Psychology, University of Graz, Graz, Austria
| | - Joel D Greenspan
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Georg Groen
- Department of Psychiatry, University of Ulm, Ulm, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tobias U Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Christoph S Herrmann
- Experimental Psychology Lab, Cluster of Excellence "Hearing4all", European Medical School, University of Oldenburg, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, University of Oldenburg, Oldenburg, Germany
- Research Centre Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Cognitive Intelligence and Precision Healthcare Research Center, National Central University, Taoyuan, Taiwan
| | - Bart Krekelberg
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, USA
| | - Stephanie Lefebvre
- Translational Research Centre, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sook-Lei Liew
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- USC Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kristoffer H Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, K, Lyngby, Denmark
| | | | - Nastaran Malmir
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Paola Marangolo
- Department of Humanities Studies, University Federico II, Naples, Italy
- Aphasia Research Lab, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Andrew K Martin
- Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Queensland, Australia
- Department of Psychology, University of Kent, Canterbury, UK
| | - Timothy J Meeker
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marius Moisa
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Davide Momi
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Beni Mulyana
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Natasza Orlov
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Psychology, Jagiellonian University, Cracow, Poland
| | - Patrick Ragert
- Institute for General Kinesiology and Exercise Science, University of Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christian C Ruff
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Giulio Ruffini
- Neuroelectrics Corporation, Cambridge, Cambridge, MA, USA
- Neuroelectrics Corporation, Barcelona, Barcelona, Spain
| | - Michaela Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arshiya Sangchooli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gottfried Schlaug
- Neuroimaging-Neuromodulation and Stroke Recovery Laboratories, Department of Neurology, Baystate-University of Massachusetts Medical School, and Department of Biomedical Engineering, Institute of Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Ghazaleh Soleimani
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Hosna Tavakoli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Cognitive Neuroscience, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, Hong Kong
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | | | - Martin Ulrich
- Department of Psychiatry, University of Ulm, Ulm, Germany
| | - Johannes Vosskuhl
- Experimental Psychology Lab, Cluster of Excellence "Hearing4all", European Medical School, University of Oldenburg, Oldenburg, Germany
| | - Christiane A Weinrich
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
- Department of Cognitive Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities & Social Science, University of Science & Technology of China, Hefei, China
| | - Benedikt Zoefel
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Centre de Recherche Cerveau et Cognition (CerCo), CNRS, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA
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Greeley B, Barnhoorn JS, Verwey WB, Seidler RD. Anodal Transcranial Direct Current Stimulation Over Prefrontal Cortex Slows Sequence Learning in Older Adults. Front Hum Neurosci 2022; 16:814204. [PMID: 35280208 PMCID: PMC8907426 DOI: 10.3389/fnhum.2022.814204] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Aging is associated with declines in sensorimotor function. Several studies have demonstrated that transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, can be combined with training to mitigate age-related cognitive and motor declines. However, in some cases, the application of tDCS disrupts performance and learning. Here, we applied anodal tDCS either over the left prefrontal cortex (PFC), right PFC, supplementary motor complex (SMC), the left M1, or in a sham condition while older adults (n = 63) practiced a Discrete Sequence Production (DSP), an explicit motor sequence, task across 3 days. We hypothesized that stimulation to either the right or left PFC would enhance motor learning for older adults, based on the extensive literature showing increased prefrontal cortical activity during motor task performance in older adults. Contrary to our predictions, stimulation to the right and left PFC resulted in slowed motor learning, as evidenced by a slower reduction rate of reduction of reaction time and the number of sequence chunks across trials relative to sham in session one and session two, respectively. These findings suggest an integral role of the right PFC early in sequence learning and a role of the left PFC in chunking in older adults, and contribute to mounting evidence of the difficultly of using tDCS in an aging population.
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Affiliation(s)
- Brian Greeley
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Jonathan S. Barnhoorn
- Department of Learning, Data-Analytics and Technology, University of Twente, Enschede, Netherlands
| | - Willem B. Verwey
- Department of Learning, Data-Analytics and Technology, University of Twente, Enschede, Netherlands
| | - Rachael D. Seidler
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
- *Correspondence: Rachael D. Seidler,
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Review of tDCS Configurations for Stimulation of the Lower-Limb Area of Motor Cortex and Cerebellum. Brain Sci 2022; 12:brainsci12020248. [PMID: 35204011 PMCID: PMC8870282 DOI: 10.3390/brainsci12020248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/28/2022] [Accepted: 02/01/2022] [Indexed: 11/17/2022] Open
Abstract
This article presents an exhaustive analysis of the works present in the literature pertaining to transcranial direct current stimulation(tDCS) applications. The aim of this work is to analyze the specific characteristics of lower-limb stimulation, identifying the strengths and weaknesses of these works and framing them with the current knowledge of tDCS. The ultimate goal of this work is to propose areas of improvement to create more effective stimulation therapies with less variability.
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115
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Long-term prophylactic efficacy of transcranial direct current stimulation in chronic migraine. A randomised, patient-assessor blinded, sham-controlled trial. Brain Stimul 2022; 15:441-453. [DOI: 10.1016/j.brs.2022.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 01/31/2022] [Accepted: 02/20/2022] [Indexed: 12/14/2022] Open
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116
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Ten Sessions of 30 Min tDCS over 5 Days to Achieve Remission in Depression: A Randomized Pilot Study. J Clin Med 2022; 11:jcm11030782. [PMID: 35160235 PMCID: PMC8836436 DOI: 10.3390/jcm11030782] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
Although transcranial Direct Current stimulation (tDCS) shows promise in the treatment of major depressive episodes, the optimal parameters and population to target remain unclear. We investigated the clinical interest of a 10 session tDCS regimen in patients with mild to severe treatment-resistant depression, in a pilot double-blind, randomized sham-controlled trial. tDCS was delivered over 5 consecutive days (two 30 min sessions per day separated by at least 2 h, 2 mA). The anode and cathode were placed over the left and the right dorsolateral prefrontal cortex, respectively. One month after tDCS, we observed significantly fewer patients who achieved remission (MADRS10 < 10) in the sham group (0 out of 18 patients) than in the active group (5 out of 21 patients; p = 0.05). However, no significant difference was observed between the groups regarding the mean scores of severity changes throughout the study period. Bifrontal add-on tDCS delivered twice per day over 5 days, in combination with antidepressant medication, can be a safe and suitable approach to achieve remission in patients with mild to severe treatment-resistant major depressive disorder. However, in regards to the pilot nature and limitations of the present study, further studies are needed before any frank conclusions can be made regarding the use of tDCS with the proposed parameters in clinical settings.
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de Oliveira PCA, de Araújo TAB, Machado DGDS, Rodrigues AC, Bikson M, Andrade SM, Okano AH, Simplicio H, Pegado R, Morya E. Transcranial Direct Current Stimulation on Parkinson's Disease: Systematic Review and Meta-Analysis. Front Neurol 2022; 12:794784. [PMID: 35082749 PMCID: PMC8785799 DOI: 10.3389/fneur.2021.794784] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 11/30/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Clinical impact of transcranial direct current stimulation (tDCS) alone for Parkinson's disease (PD) is still a challenge. Thus, there is a need to synthesize available results, analyze methodologically and statistically, and provide evidence to guide tDCS in PD. Objective: Investigate isolated tDCS effect in different brain areas and number of stimulated targets on PD motor symptoms. Methods: A systematic review was carried out up to February 2021, in databases: Cochrane Library, EMBASE, PubMed/MEDLINE, Scopus, and Web of science. Full text articles evaluating effect of active tDCS (anodic or cathodic) vs. sham or control on motor symptoms of PD were included. Results: Ten studies (n = 236) were included in meta-analysis and 25 studies (n = 405) in qualitative synthesis. The most frequently stimulated targets were dorsolateral prefrontal cortex and primary motor cortex. No significant effect was found among single targets on motor outcomes: Unified Parkinson's Disease Rating Scale (UPDRS) III – motor aspects (MD = −0.98%, 95% CI = −10.03 to 8.07, p = 0.83, I2 = 0%), UPDRS IV – dyskinesias (MD = −0.89%, CI 95% = −3.82 to 2.03, p = 0.55, I2 = 0%) and motor fluctuations (MD = −0.67%, CI 95% = −2.45 to 1.11, p = 0.46, I2 = 0%), timed up and go – gait (MD = 0.14%, CI 95% = −0.72 to 0.99, p = 0.75, I2 = 0%), Berg Balance Scale – balance (MD = 0.73%, CI 95% = −1.01 to 2.47, p = 0.41, I2 = 0%). There was no significant effect of single vs. multiple targets in: UPDRS III – motor aspects (MD = 2.05%, CI 95% = −1.96 to 6.06, p = 0.32, I2 = 0%) and gait (SMD = −0.05%, 95% CI = −0.28 to 0.17, p = 0.64, I2 = 0%). Simple univariate meta-regression analysis between treatment dosage and effect size revealed that number of sessions (estimate = −1.7, SE = 1.51, z-score = −1.18, p = 0.2, IC = −4.75 to 1.17) and cumulative time (estimate = −0.07, SE = 0.07, z-score = −0.99, p = 0.31, IC = −0.21 to 0.07) had no significant association. Conclusion: There was no significant tDCS alone short-term effect on motor function, balance, gait, dyskinesias or motor fluctuations in Parkinson's disease, regardless of brain area or targets stimulated.
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Affiliation(s)
- Paloma Cristina Alves de Oliveira
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | - Thiago Anderson Brito de Araújo
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | | | - Abner Cardoso Rodrigues
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | | | - Alexandre Hideki Okano
- Center for Mathematics, Computing and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
| | - Hougelle Simplicio
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil.,Rehabilitation Center, Anita Garibaldi Center for Education and Health, Santos Dumont Institute, Macaíba, Brazil.,Department of Biomedical Sciences, State University of Rio Grande do Norte, Mossoró, Brazil.,Neuron-Care Unit in Neurosurgery, Hospital Rio Grande, Natal, Brazil
| | - Rodrigo Pegado
- Program in Rehabilitation Science, Program in Health Science, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Edgard Morya
- Program in Neuroengineering, Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Brazil
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118
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Stuchlíková Z, Klírová M. A Literature Mini-Review of Transcranial Direct Current Stimulation in Schizophrenia. Front Psychiatry 2022; 13:874128. [PMID: 35530026 PMCID: PMC9069055 DOI: 10.3389/fpsyt.2022.874128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/14/2022] [Indexed: 11/25/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive neurostimulation method that utilizes the effect of low-current on brain tissue. In recent years, the effect of transcranial direct current stimulation has been investigated as a therapeutic modality in various neuropsychiatric indications, one of them being schizophrenia. This article aims to provide an overview of the potential application and effect of tDCS in treating patients with schizophrenia. A literature search was performed using the PubMed, Web of Science, and Google Scholar databases for relevant research published from any date until December 2021. Eligible studies included those that used randomized controlled parallel-group design and focused on the use of transcranial direct current stimulation for the treatment of positive, negative, or cognitive symptoms of schizophrenia. Studies were divided into groups based on the focus of research and an overview is provided in separate sections and tables in the article. The original database search yielded 705 results out of which 27 randomized controlled trials met the eligibility criteria and were selected and used for the purpose of this article. In a review of the selected trials, transcranial direct current stimulation is a safe and well-tolerated method that appears to have the potential as an effective modality for the treatment of positive and negative schizophrenic symptoms and offers promising results in influencing cognition. However, ongoing research is needed to confirm these conclusions and to further specify distinct application parameters.
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Affiliation(s)
- Zuzana Stuchlíková
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia.,Hospital České Budĕjovice, a.s., České Budĕjovice, Czechia
| | - Monika Klírová
- National Institute of Mental Health, Klecany, Czechia.,Third Faculty of Medicine, Charles University, Prague, Czechia
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119
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Zhang M, He T, Wang Q. Effects of Non-invasive Brain Stimulation on Multiple System Atrophy: A Systematic Review. Front Neurosci 2021; 15:771090. [PMID: 34966257 PMCID: PMC8710715 DOI: 10.3389/fnins.2021.771090] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022] Open
Abstract
Background/Objective: Multiple system atrophy (MSA) refers to a progressive neurodegenerative disease characterized by autonomic dysfunction, parkinsonism, cerebellar ataxia, as well as cognitive deficits. Non-invasive brain stimulation (NIBS) has recently served as a therapeutic technique for MSA by personalized stimulation. The primary aim of this systematic review is to assess the effects of NIBS on two subtypes of MSA: parkinsonian-type MSA (MSA-P) and cerebellar-type MSA (MSA-C). Methods: A literature search for English articles was conducted from PubMed, Embase, Web of Science, Cochrane Library, CENTRAL, CINAHL, and PsycINFO up to August 2021. Original articles investigating the therapeutics application of NIBS in MSA were screened and analyzed by two independent reviewers. Moreover, a customized form was adopted to extract data, and the quality of articles was assessed based on the PEDro scale for clinical articles. Results: On the whole, nine articles were included, i.e., five for repetitive transcranial magnetic stimulation (rTMS), two for transcranial direct current stimulation (tDCS), one for paired associative stimulation, with 123 patients recruited. The mentioned articles comprised three randomized controlled trials, two controlled trials, two non-controlled trials, and two case reports which assessed NIBS effects on motor function, cognitive function, and brain modulatory effects. The majority of articles demonstrated significant motor symptoms improvement and increased cerebellar activation in the short term after active rTMS. Furthermore, short-term and long-term effects on improvement of motor performance were significant for tDCS. As opposed to the mentioned, no significant change of motor cortical excitability was reported after paired associative stimulation. Conclusion: NIBS can serve as a useful neurorehabilitation strategy to improve motor and cognitive function in MSA-P and MSA-C patients. However, further high-quality articles are required to examine the underlying mechanisms and standardized protocol of rTMS as well as its long-term effect. Furthermore, the effects of other NIBS subtypes on MSA still need further investigation.
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Affiliation(s)
- Mengjie Zhang
- Department of Occupational Therapy, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Department of Rehabilitation Sciences, School of Medicine, Tongji University, Shanghai, China
| | - Ting He
- Department of Occupational Therapy, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Department of Rehabilitation Sciences, School of Medicine, Tongji University, Shanghai, China
| | - Quan Wang
- Department of Occupational Therapy, Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai, China.,Department of Rehabilitation Sciences, School of Medicine, Tongji University, Shanghai, China
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120
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Diana L, Scotti G, Aiello EN, Pilastro P, Eberhard-Moscicka AK, Müri RM, Bolognini N. Conventional and HD-tDCS May (or May Not) Modulate Overt Attentional Orienting: An Integrated Spatio-Temporal Approach and Methodological Reflections. Brain Sci 2021; 12:brainsci12010071. [PMID: 35053814 PMCID: PMC8773815 DOI: 10.3390/brainsci12010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) has been employed to modulate visuo-spatial attentional asymmetries, however, further investigation is needed to characterize tDCS-associated variability in more ecological settings. In the present research, we tested the effects of offline, anodal conventional tDCS (Experiment 1) and HD-tDCS (Experiment 2) delivered over the posterior parietal cortex (PPC) and Frontal Eye Field (FEF) of the right hemisphere in healthy participants. Attentional asymmetries were measured by means of an eye tracking-based, ecological paradigm, that is, a Free Visual Exploration task of naturalistic pictures. Data were analyzed from a spatiotemporal perspective. In Experiment 1, a pre-post linear mixed model (LMM) indicated a leftward attentional shift after PPC tDCS; this effect was not confirmed when the individual baseline performance was considered. In Experiment 2, FEF HD-tDCS was shown to induce a significant leftward shift of gaze position, which emerged after 6 s of picture exploration and lasted for 200 ms. The present results do not allow us to conclude on a clear efficacy of offline conventional tDCS and HD-tDCS in modulating overt visuospatial attention in an ecological setting. Nonetheless, our findings highlight a complex relationship among stimulated area, focality of stimulation, spatiotemporal aspects of deployment of attention, and the role of individual baseline performance in shaping the effects of tDCS.
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Affiliation(s)
- Lorenzo Diana
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Correspondence:
| | - Giulia Scotti
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Edoardo N. Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Patrick Pilastro
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Aleksandra K. Eberhard-Moscicka
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - René M. Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, 20126 Milan, Italy;
- Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, 20122 Milan, Italy
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121
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Direct Current Stimulation in Cell Culture Systems and Brain Slices-New Approaches for Mechanistic Evaluation of Neuronal Plasticity and Neuromodulation: State of the Art. Cells 2021; 10:cells10123583. [PMID: 34944091 PMCID: PMC8700319 DOI: 10.3390/cells10123583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 11/09/2021] [Accepted: 12/16/2021] [Indexed: 12/21/2022] Open
Abstract
Non-invasive direct current stimulation (DCS) of the human brain induces neuronal plasticity and alters plasticity-related cognition and behavior. Numerous basic animal research studies focusing on molecular and cellular targets of DCS have been published. In vivo, ex vivo, and in vitro models enhanced knowledge about mechanistic foundations of DCS effects. Our review identified 451 papers using a PRISMA-based search strategy. Only a minority of these papers used cell culture or brain slice experiments with DCS paradigms comparable to those applied in humans. Most of the studies were performed in brain slices (9 papers), whereas cell culture experiments (2 papers) were only rarely conducted. These ex vivo and in vitro approaches underline the importance of cell and electric field orientation, cell morphology, cell location within populations, stimulation duration (acute, prolonged, chronic), and molecular changes, such as Ca2+-dependent intracellular signaling pathways, for the effects of DC stimulation. The reviewed studies help to clarify and confirm basic mechanisms of this intervention. However, the potential of in vitro studies has not been fully exploited and a more systematic combination of rodent models, ex vivo, and cellular approaches might provide a better insight into the neurophysiological changes caused by tDCS.
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122
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da Silva Machado CB, da Silva LM, Gonçalves AF, Andrade PRD, Mendes CKTT, de Assis TJCF, Godeiro Júnior CDO, Andrade SM. Multisite non-invasive brain stimulation in Parkinson's disease: A scoping review. NeuroRehabilitation 2021; 49:515-531. [PMID: 34776426 PMCID: PMC8764602 DOI: 10.3233/nre-210190] [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] [Indexed: 12/03/2022]
Abstract
BACKGROUND: Parkinson’s disease (PD) is a progressive neurodegenerative disorder, characterized by cardinal motor symptoms in addition to cognitive impairment. New insights concerning multisite non-invasive brain stimulation effects have been gained, which can now be used to develop innovative treatment approaches. OBJECTIVE: Map the researchs involving multisite non-invasive brain stimulation in PD, synthesize the available evidence and discuss future directions. METHODS: The databases PubMed, PsycINFO, CINAHL, LILACS and The Cochrane Library were searched from inception until April 2020, without restrictions on the date of publication or the language in which it was published. The reviewers worked in pairs and sequentially evaluated the titles, abstracts and then the full text of all publications identified as potentially relevant. RESULTS: Twelve articles met the inclusion criteria. The target brain regions included mainly the combination of a motor and a frontal area, such as stimulation of the primary motor córtex associated with the dorsolateral prefrontal cortex. Most of the trials showed that this modality was only more effective for the motor component, or for the cognitive and/or non-motor, separately. CONCLUSIONS: Despite the results being encouraging for the use of the multisite aproach, the indication for PD management should be carried out with caution and deserves scientific deepening.
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Affiliation(s)
| | | | | | | | | | | | - Clécio de Oliveira Godeiro Júnior
- Division of Neurology, CHU of Grenoble, Grenoble Alpes University, La Tronche, Grenoble, France.,Division of Neurology, Hospital Universitario Onofre Lopes, Federal University of Rio Grande do Norte, Natal, Brazil
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123
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Gonsalvez I, Spagnolo P, Dworetzky B, Baslet G. Neurostimulation for the treatment of functional neurological disorder: A systematic review. Epilepsy Behav Rep 2021; 16:100501. [PMID: 34950864 PMCID: PMC8671519 DOI: 10.1016/j.ebr.2021.100501] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/28/2021] [Accepted: 11/04/2021] [Indexed: 01/02/2023] Open
Abstract
Functional Neurological Disorder (FND), also known as conversion disorder, is characterized by neurological symptoms that are incompatible with any known structural disorder and best explained by a biopsychosocial model. Evidence-based treatments for FND are limited, with cognitive behavioral therapy (CBT) and physiotherapy being the most effective interventions [1]. In recent years, functional neuroimaging studies have provided robust evidence of alterations in activity and connectivity in multiple brain networks in FND. This body of evidence suggests that neurocircuitry-based interventions, such as non-invasive brain stimulation techniques (NIBS), may also represent an effective therapeutic option for patients with FND. In this systematic review, we outline the current state of knowledge of NIBS in FND, and discuss limitations and future directions that may help establish the efficacy of NIBS as a therapeutic option for FND.
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Affiliation(s)
- Irene Gonsalvez
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Primavera Spagnolo
- Mary Horrigan Connors Center for Women's Health & Gender Biology, Department of Psychiatry, Brigham and Women Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Barbara Dworetzky
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Gaston Baslet
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
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124
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Sharma M, Farahani F, Bikson M, Parra LC. Weak DCS causes a relatively strong cumulative boost of synaptic plasticity with spaced learning. Brain Stimul 2021; 15:57-62. [PMID: 34749007 PMCID: PMC8816825 DOI: 10.1016/j.brs.2021.10.552] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Electric fields generated during direct current stimulation (DCS) are known to modulate activity-dependent synaptic plasticity in-vitro. This provides a mechanistic explanation for the lasting behavioral effects observed with transcranial direct current stimulation (tDCS) in human learning experiments. However, previous in-vitro synaptic plasticity experiments show relatively small effects despite using strong fields compared to what is expected with conventional tDCS in humans (20 V/m vs. 1 V/m). There is therefore a need to improve the effectiveness of tDCS at realistic field intensities. Here we leverage the observation that effects of learning are known to accumulate over multiple bouts of learning, known as spaced learning. Hypothesis: We propose that effects of DCS on synaptic long-term potentiation (LTP) accumulate over time in a spaced learning paradigm, thus revealing effects at more realistic field intensities. Methods: We leverage a standard model for spaced learning by inducing LTP with repeated bouts of theta burst stimulation (TBS) in hippocampal slice preparations. We studied the cumulative effects of DCS paired with TBS at various intensities applied during the induction of LTP in the CA1 region of rat hippocampal slices. Results: As predicted, DCS applied during repeated bouts of theta burst stimulation (TBS) resulted in an increase of LTP. This spaced learning effect is saturated quickly with strong TBS protocols and stronger fields. In contrast, weaker TBS and the weakest electric fields of 2.5 V/m resulted in the strongest relative efficacies (12% boost in LTP per 1 V/m applied). Conclusions: Weak DCS causes a relatively strong cumulative effect of spaced learning on synaptic plasticity. Staturarion may have masked stronger effects sizes in previous in-vitro studies. Relative effect sizes of DCS are now closer in line with human tDCS experiments.
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Affiliation(s)
- Mahima Sharma
- Department of Biomedical Engineering, The City College of New York, CUNY, 160 Convent Avenue, New York, NY, USA.
| | - Forouzan Farahani
- Department of Biomedical Engineering, The City College of New York, CUNY, 160 Convent Avenue, New York, NY, USA.
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, CUNY, 160 Convent Avenue, New York, NY, USA.
| | - Lucas C Parra
- Department of Biomedical Engineering, The City College of New York, CUNY, 160 Convent Avenue, New York, NY, USA.
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125
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Mendes AJ, Pacheco-Barrios K, Lema A, Gonçalves ÓF, Fregni F, Leite J, Carvalho S. Modulation of the cognitive event-related potential P3 by transcranial direct current stimulation: Systematic review and meta-analysis. Neurosci Biobehav Rev 2021; 132:894-907. [PMID: 34742723 DOI: 10.1016/j.neubiorev.2021.11.002] [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: 04/15/2021] [Revised: 07/16/2021] [Accepted: 11/01/2021] [Indexed: 10/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been widely used to modulate cognition and behavior. However, only a few studies have been probing the brain mechanism underlying the effects of tDCS on cognitive processing, especially throughout electrophysiological markers, such as the P3. This meta-analysis assessed the effects of tDCS in P3 amplitude and latency during an oddball, n-back, and Go/No-Go tasks, as well as during emotional processing. A total of 36 studies were identified, but only 23 were included in the quantitative analysis. The results show that the parietal P3 amplitude increased during oddball and n-back tasks, mostly after anodal stimulation over the left dorsolateral prefrontal cortex (p = 0.018, SMD = 0.4) and right inferior frontal gyrus (p < 0.001, SMD = 0.669) respectively. These findings suggest the potential usefulness of the parietal P3 ERP as a marker of tDCS-induced effects during task performance. Nonetheless, this study had a low number of studies and the presence of considerable risk of bias, highlighting issues to be addressed in the future.
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Affiliation(s)
- Augusto J Mendes
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Alberto Lema
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
| | - Óscar F Gonçalves
- Proaction Laboratory - CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Jorge Leite
- INPP, Portucalense University, Porto, Portugal
| | - Sandra Carvalho
- Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal; Department of Education and Psychology, University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal.
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126
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No aftereffects of high current density 10 Hz and 20 Hz tACS on sensorimotor alpha and beta oscillations. Sci Rep 2021; 11:21416. [PMID: 34725379 PMCID: PMC8560917 DOI: 10.1038/s41598-021-00850-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 10/19/2021] [Indexed: 12/27/2022] Open
Abstract
Application of transcranial alternating current stimulation (tACS) is thought to modulate ongoing brain oscillations in a frequency-dependent manner. However, recent studies report various and sometimes inconsistent results regarding its capacity to induce changes in cortical activity beyond the stimulation period. Here, thirty healthy volunteers participated in a randomized, cross-over, sham-controlled, double-blind study using EEG to measure the offline effects of tACS on alpha and beta power. Sham and high current density tACS (1 mA; 10 Hz and 20 Hz; 0.32 mA/cm2) were applied for 20 min over bilateral sensorimotor areas and EEG was recorded at rest before and after stimulation for 20 min. Bilateral tACS was not associated with significant changes in local alpha and beta power frequencies at stimulation sites (C3 and C4 electrodes). Overall, the present results fail to provide evidence that bilateral tACS with high current density applied over sensorimotor regions at 10 and 20 Hz reliably modulates offline brain oscillation power at the stimulation site. These results may have implications for the design and implementation of future protocols aiming to induce sustained changes in brain activity, including in clinical populations.
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127
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Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O’Shea A, Indahlastari A, Albizu A, Nissim NR, Evangelista ND, Cohen R, Porges EC, Woods AJ. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci 2021; 13:761348. [PMID: 34744698 PMCID: PMC8568306 DOI: 10.3389/fnagi.2021.761348] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study examines the impact of transcranial direct current stimulation (tDCS) combined with cognitive training on neurotransmitter concentrations in the prefrontal cortex. Materials and Methods: Twenty-three older adults were randomized to either active-tDCS or sham-tDCS in combination with cognitive training for 2 weeks. Active-tDCS was delivered over F3 (cathode) and F4 (anode) electrode placements for 20 min at 2 mA intensity. For each training session, 40-min of computerized cognitive training were applied with active or sham stimulation delivered during the first 20-min. Glutamine/glutamate (Glx) and gamma-aminobutyric acid (GABA) concentrations via proton magnetic resonance spectroscopy were evaluated at baseline and at the end of 2-week intervention. Results: Glx concentrations increased from pre- to post-intervention (p = 0.010) in the active versus sham group after controlling for age, number of intervention days, MoCA scores, and baseline Glx concentration. No difference in GABA concentration was detected between active and sham groups (p = 0.650) after 2-week intervention. Conclusion: Results provide preliminary evidence suggesting that combining cognitive training and tDCS over the prefrontal cortex elicits sustained increase in excitatory neurotransmitter concentrations. Findings support the combination of tDCS and cognitive training as a potential method for altering neurotransmitter concentrations in the frontal cortices, which may have implications for neuroplasticity in the aging brain.
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Affiliation(s)
- Stacey Alvarez-Alvarado
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Emanuel M. Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole R. Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
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128
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Lazzaro G, Battisti A, Varuzza C, Celestini L, Pani P, Costanzo F, Vicari S, Kadosh RC, Menghini D. Boosting Numerical Cognition in Children and Adolescents with Mathematical Learning Disabilities by a Brain-Based Intervention: A Study Protocol for a Randomized, Sham-Controlled Clinical Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10969. [PMID: 34682715 PMCID: PMC8536003 DOI: 10.3390/ijerph182010969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 01/29/2023]
Abstract
Numbers are everywhere, and supporting difficulties in numerical cognition (e.g., mathematical learning disability (MLD)) in a timely, effective manner is critical for their daily use. To date, only low-efficacy cognitive-based interventions are available. The extensive data on the neurobiology of MLD have increased interest in brain-directed approaches. The overarching goal of this study protocol is to provide the scientific foundation for devising brain-based and evidence-based treatments in children and adolescents with MLD. In this double-blind, between-subject, sham-controlled, randomized clinical trial, transcranial random noise stimulation (tRNS) plus cognitive training will be delivered to participants. Arithmetic, neuropsychological, psychological, and electrophysiological measures will be collected at baseline (T0), at the end of the interventions (T1), one week (T2) and three months later (T3). We expect that tRNS plus cognitive training will significantly improve arithmetic measures at T1 and at each follow-up (T2, T3) compared with placebo and that such improvements will correlate robustly and positively with changes in the neuropsychological, psychological, and electrophysiological measures. We firmly believe that this clinical trial will produce reliable and positive results to accelerate the validation of brain-based treatments for MLD that have the potential to impact quality of life.
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Affiliation(s)
- Giulia Lazzaro
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
- Department of Human Science, LUMSA University, 00193 Rome, Italy
| | - Andrea Battisti
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
| | - Cristiana Varuzza
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
| | - Laura Celestini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
| | - Pierpaolo Pani
- Department of Physiology and Pharmacology, Sapienza University, 00185 Rome, Italy;
| | - Floriana Costanzo
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, 30AD04 Elizabeth Fry Building, University of Surrey, Guildford GU2 7XH, UK;
- Department of Experimental Psychology, University of Oxford, New Radcliffe House, Radcliffe Observatory Quarter, Oxford OX2 6GG, UK
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children’s Hospital, IRCCS, 00146 Rome, Italy; (G.L.); (A.B.); (C.V.); (L.C.); (F.C.); (S.V.)
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Herrojo Ruiz M, Maudrich T, Kalloch B, Sammler D, Kenville R, Villringer A, Sehm B, Nikulin VV. Modulation of neural activity in frontopolar cortex drives reward-based motor learning. Sci Rep 2021; 11:20303. [PMID: 34645848 PMCID: PMC8514446 DOI: 10.1038/s41598-021-98571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 08/26/2021] [Indexed: 12/03/2022] Open
Abstract
The frontopolar cortex (FPC) contributes to tracking the reward of alternative choices during decision making, as well as their reliability. Whether this FPC function extends to reward gradients associated with continuous movements during motor learning remains unknown. We used anodal transcranial direct current stimulation (tDCS) over the right FPC to investigate its role in reward-based motor learning. Nineteen healthy human participants practiced novel sequences of finger movements on a digital piano with corresponding auditory feedback. Their aim was to use trialwise reward feedback to discover a hidden performance goal along a continuous dimension: timing. We additionally modulated the contralateral motor cortex (left M1) activity, and included a control sham stimulation. Right FPC-tDCS led to faster learning compared to lM1-tDCS and sham through regulation of motor variability. Bayesian computational modelling revealed that in all stimulation protocols, an increase in the trialwise expectation of reward was followed by greater exploitation, as shown previously. Yet, this association was weaker in lM1-tDCS suggesting a less efficient learning strategy. The effects of frontopolar stimulation were dissociated from those induced by lM1-tDCS and sham, as motor exploration was more sensitive to inferred changes in the reward tendency (volatility). The findings suggest that rFPC-tDCS increases the sensitivity of motor exploration to updates in reward volatility, accelerating reward-based motor learning.
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Affiliation(s)
- M Herrojo Ruiz
- Psychology Department, Goldsmiths University of London, London, UK. .,Center for Cognition and Decision Making, National Research University Higher School of Economics, Moscow, Russian Federation. .,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - T Maudrich
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - B Kalloch
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - D Sammler
- Research Group Neurocognition of Music and Language, Max Planck Institute for Empirical Aesthetics, Frankfurt am Main, Germany
| | - R Kenville
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - A Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - B Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Department of Neurology, University Hospital Halle (Saale), Halle, Germany
| | - V V Nikulin
- Center for Cognition and Decision Making, National Research University Higher School of Economics, Moscow, Russian Federation. .,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
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130
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Effect of transcranial direct current stimulation on in-vivo assessed neuro-metabolites through magnetic resonance spectroscopy: a systematic review. Acta Neuropsychiatr 2021; 33:242-253. [PMID: 33926587 DOI: 10.1017/neu.2021.14] [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] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous studies have examined the effect of transcranial direct current stimulation (tDCS) on the in-vivo concentrations of neuro-metabolites assessed through magnetic resonance spectroscopy (MRS) in neurological and psychiatry disorders. This review aims to systematically evaluate the data on the effect of tDCS on MRS findings and thereby attempt to understand the potential mechanism of tDCS on neuro-metabolites. METHODS The relevant literature was obtained through PubMed and cross-reference (search till June 2020). Thirty-four studies were reviewed, of which 22 reported results from healthy controls and 12 were from patients with neurological and psychiatric disorders. RESULTS The evidence converges to highlight that tDCS modulates the neuro-metabolite levels at the site of stimulation, which, in turn, translates into alterations in the behavioural outcome. It also shows that the baseline level of these neuro-metabolites can, to a certain extent, predict the outcome after tDCS. However, even though tDCS has shown promising effects in alleviating symptoms of various psychiatric disorders, there are limited studies that have reported the effect of tDCS on neuro-metabolite levels. CONCLUSIONS There is a compelling need for more systematic studies examining patients with psychiatric/neurological disorders with larger samples and harmonised tDCS protocols. More studies will potentially help us to understand the tDCS mechanism of action pertinent to neuro-metabolite levels modulation. Further, studies should be conducted in psychiatric patients to understand the neurological changes in this population and potentially unravel the neuro-metabolite × tDCS interaction effect that can be translated into individualised treatment.
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131
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Singh A, Erwin-Grabner T, Goya-Maldonado R, Antal A. Transcranial Magnetic and Direct Current Stimulation in the Treatment of Depression: Basic Mechanisms and Challenges of Two Commonly Used Brain Stimulation Methods in Interventional Psychiatry. Neuropsychobiology 2021; 79:397-407. [PMID: 31487716 DOI: 10.1159/000502149] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 07/16/2019] [Indexed: 12/12/2022]
Abstract
Noninvasive neuromodulation, including repetitive trans-cranial magnetic stimulation (rTMS) and direct current stimulation (tDCS), provides researchers and health care professionals with the ability to gain unique insights into brain functions and treat several neurological and psychiatric conditions. Undeniably, the number of published research and clinical papers on this topic is increasing exponentially. In parallel, several methodological and scientific caveats have emerged in the transcranial stimulation field; these include less robust and reliable effects as well as contradictory clinical findings. These inconsistencies are maybe due to the fact that research exploring the relationship between the methodological aspects and clinical efficacy of rTMS and tDCS is far from conclusive. Hence, additional work is needed to understand the mechanisms underlying the effects of magnetic stimulation and low-intensity transcranial electrical stimulation (TES) in order to optimize dosing, methodological designs, and safety aspects.
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Affiliation(s)
- Aditya Singh
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Tracy Erwin-Grabner
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Roberto Goya-Maldonado
- Laboratory of Systems Neuroscience and Imaging in Psychiatry (SNIP-Lab), Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Andrea Antal
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Göttingen, Germany, .,Institute for Medical Psychology, Medical Faculty, Otto-v.-Guericke University Magdeburg, Magdeburg, Germany,
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132
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Huo L, Zhu X, Zheng Z, Ma J, Ma Z, Gui W, Li J. Effects of Transcranial Direct Current Stimulation on Episodic Memory in Older Adults: A Meta-analysis. J Gerontol B Psychol Sci Soc Sci 2021; 76:692-702. [PMID: 31782505 DOI: 10.1093/geronb/gbz130] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES In the last two decades, the number of intervention studies using transcranial direct current stimulation (tDCS) has grown enormously. Though some studies have shown positive influences on episodic memory among older adults, disagreement exists in the literature. Therefore, the current meta-analysis aimed to provide a quantitative assessment of the efficacy of tDCS in modulating episodic memory functions in older adults. METHOD Eligible studies were sham-controlled trials examining the effects of anodal tDCS on episodic memory in older adults. Twenty-four articles comprising 566 participants aged over 60 qualified for inclusion. RESULTS Compared to the sham tDCS group, the active tDCS group showed significant memory improvements at both immediate poststimulation (Hedges' g = 0.625, p = .001) and long-term follow-up (Hedges' g = 0.404, p = .002). There were no differences in effect sizes between cognitively healthy and impaired older adults. Moderator analyses suggested that tDCS having a duration of 20 min or less, bilateral stimulation, or a larger stimulation area would produce greater benefits for episodic memory performance in older adults. DISCUSSION These findings suggest that tDCS holds great promise to ameliorate memory decline in older individuals. In the future, well-designed randomized controlled trials are expected to verify the optimal stimulation protocols and determine the factors impacting the long-term effects of tDCS in enhancing episodic memory.
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Affiliation(s)
- Lijuan Huo
- Center on Aging Psychology, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xinyi Zhu
- Center on Aging Psychology, 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
| | - Zhiwei Zheng
- Center on Aging Psychology, 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
| | - Jialing Ma
- School of Psychology, University of Aberdeen, UK
| | - Zhuoya Ma
- Center on Aging Psychology, 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
| | - Wenjun Gui
- Center on Aging Psychology, 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
| | - Juan Li
- Center on Aging Psychology, 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
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133
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Vo L, Ilich N, Fujiyama H, Drummond PD. Anodal Transcranial Direct Current Stimulation Reduces Secondary Hyperalgesia Induced by low Frequency Electrical Stimulation in Healthy Volunteers. THE JOURNAL OF PAIN 2021; 23:305-317. [PMID: 34500109 DOI: 10.1016/j.jpain.2021.08.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 08/05/2021] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
The aim of the study was to determine whether transcranial direct current stimulation (tDCS) reduced pain and signs of central sensitization induced by low frequency electrical stimulation in healthy volunteers. Thirty-nine participants received tDCS stimulation under 4 different conditions: anodal tDCS of the primary motor cortex (M1), anodal tDCS of the dorsolateral prefrontal cortex (DLPFC), anodal tDCS over M1 and DLPFC concurrently, and sham tDCS. Participants were blind to the tDCS condition. The order of the conditions was randomized among participants. Pain ratings to pinpricks, the current level that evoked moderate pain, and pain induced by low frequency electrical stimulation were assessed in the forearm by an experimenter who was blind to the tDCS conditions. Anodal tDCS at M1 increased the current level that evoked moderate pain compared to sham and other conditions. Anodal tDCS of DLPFC completely abolished secondary hyperalgesia. Unexpectedly, however, concurrent anodal tDCS over M1 and DLPFC did not reduce pain or hyperalgesia more than M1 alone or DLPFC alone. Overall, these findings suggest that anodal tDCS over M1 suppresses pain, and that anodal tDCS over DLPFC modulates secondary hyperalgesia (a sign of central sensitization) in healthy participants. PERSPECTIVE: Anodal transcranial current stimulation (atDCS) at the left motor cortex and the dorsolateral prefrontal cortex increased the electrically-evoked pain threshold and reduced secondary hyperalgesia in healthy participants. Replication of this study in chronic pain populations may open more avenues for chronic pain treatment.
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Affiliation(s)
- Lechi Vo
- College of Science, Health, Engineering and Education, Discipline of Psychology Murdoch University, Perth, Australia.
| | - Nicole Ilich
- College of Science, Health, Engineering and Education, Discipline of Psychology Murdoch University, Perth, Australia
| | - Hakuei Fujiyama
- College of Science, Health, Engineering and Education, Discipline of Psychology Murdoch University, Perth, Australia
| | - Peter D Drummond
- College of Science, Health, Engineering and Education, Discipline of Psychology Murdoch University, Perth, Australia
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Behrangrad S, Zoghi M, Kidgell D, Jaberzadeh S. The Effect of a Single Session of Non-Invasive Brain Stimulation on Balance in Healthy Individuals: A Systematic Review and Best Evidence Synthesis. Brain Connect 2021; 11:695-716. [PMID: 33798002 DOI: 10.1089/brain.2020.0872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To evaluate the effects of a single session of non-invasive brain stimulation (NIBS) on postural balance. Introduction: The NIBS has been used widely in improving balance. However, the effect of a single session of NIBS on balance in healthy individuals has not been systemically reviewed. Methods: A systematic literature review and best evidence synthesis were conducted, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, to determine the effects of different NIBS techniques on balance function in healthy individuals. The methodological quality of included articles was assessed by the risk of bias, and the Downs and Black tool. Data were analyzed by using the best evidence synthesis. Thirty-five articles were included that used the following NIBS techniques: anodal transcranial direct current stimulation (a-tDCS), cathodal transcranial direct current stimulation (c-tDCS), continuous theta burst stimulation (cTBS), and repetitive transcranial magnetic stimulation (rTMS) on primary motor cortex (M1), supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPFC), and cerebellum on balance. Results: Strong evidence showed that a-tDCS of M1, SMA improve balance in healthy participants, and the a-tDCS of DLPFC induces improvement only in dual task balance indices. Also, the findings indicate that cerebellar a-tDCS might significantly improve balance, if at least 10 min cerebellar a-tDCS with an intensity of ≥1 mA, over or maximum 1.5 cm below the inion, is used. Strong evidence showed that c-tDCS, cTBS, and rTMS are not effective on the balance. Conclusion: According to the results, the a-tDCS may be a useful technique to improve balance in healthy adults.
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Affiliation(s)
- Shabnam Behrangrad
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Dawson Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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135
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Savoury R, Kibele A, Behm DG. Methodological Issues with Transcranial Direct Current Stimulation for Enhancing Muscle Strength and Endurance: A Narrative Review. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00222-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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136
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Yao J, Li X, Zhang W, Lin X, Lyu X, Lou W, Peng W. Analgesia induced by anodal tDCS and high-frequency tRNS over the motor cortex: Immediate and sustained effects on pain perception. Brain Stimul 2021; 14:1174-1183. [PMID: 34371209 DOI: 10.1016/j.brs.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Many studies have shown effects of anodal transcranial direct current stimulation (a-tDCS) and high-frequency transcranial random noise stimulation (tRNS) on elevating cortical excitability. Moreover, tRNS with a direct current (DC)-offset is more likely to lead to increases in cortical excitability than solely tRNS. While a-tDCS over primary motor cortex (M1) has been shown to attenuate pain perception, tRNS + DC-offset may prove as an effective means for pain relief. OBJECTIVE This study aimed to examine effects of a-tDCS and high-frequency tRNS + DC-offset over M1 on pain expectation and perception, and assess whether these effects could be influenced by the certainty of pain expectation. METHODS Using a double-blinded and sham-controlled design, 150 healthy participants were recruited to receive a single-session a-tDCS, high-frequency tRNS + DC-offset, or sham stimulation over M1. The expectation and perception of electrical stimulation in certain and uncertain contexts were assessed at baseline, immediately after, and 30 min after stimulation. RESULTS Compared with sham stimulation, a-tDCS induced immediate analgesic effects that were greater when the stimulation outcome was expected with uncertainty; tRNS induced immediate and sustained analgesic effects that were mediated by decreasing pain expectation. Nevertheless, we found no strong evidence for tRNS being more effective for attenuating pain than a-tDCS. CONCLUSIONS The analgesic effects of a-tDCS and tRNS showed different temporal courses, which could be related to the more sustained effectiveness of high-frequency tRNS + DC-offset in elevating cortical excitability. Moreover, expectations of pain intensity should be taken into consideration to maximize the benefits of neuromodulation.
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Affiliation(s)
- Junjie Yao
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Wenyun Zhang
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xinxin Lin
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaohan Lyu
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Wutao Lou
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China.
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137
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Rasmussen ID, Boayue NM, Mittner M, Bystad M, Grnli OK, Vangberg TR, Csifcsák G, Aslaksen PM. High-Definition Transcranial Direct Current Stimulation Improves Delayed Memory in Alzheimer's Disease Patients: A Pilot Study Using Computational Modeling to Optimize Electrode Position. J Alzheimers Dis 2021; 83:753-769. [PMID: 34366347 DOI: 10.3233/jad-210378] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND The optimal stimulation parameters when using transcranial direct current stimulation (tDCS) to improve memory performance in patients with Alzheimer's disease (AD) are lacking. In healthy individuals, inter-individual differences in brain anatomy significantly influence current distribution during tDCS, an effect that might be aggravated by variations in cortical atrophy in AD patients. OBJECTIVE To measure the effect of individualized HD-tDCS in AD patients. METHODS Nineteen AD patients were randomly assigned to receive active or sham high-definition tDCS (HD-tDCS). Computational modeling of the HD-tDCS-induced electric field in each patient's brain was analyzed based on magnetic resonance imaging (MRI) scans. The chosen montage provided the highest net anodal electric field in the left dorsolateral prefrontal cortex (DLPFC). An accelerated HD-tDCS design was conducted (2 mA for 3×20 min) on two separate days. Pre- and post-intervention cognitive tests and T1 and T2-weighted MRI and diffusion tensor imaging data at baseline were analyzed. RESULTS Different montages were optimal for individual patients. The active HD-tDCS group improved significantly in delayed memory and MMSE performance compared to the sham group. Five participants in the active group had higher scores on delayed memory post HD-tDCS, four remained stable and one declined. The active HD-tDCS group had a significant positive correlation between fractional anisotropy in the anterior thalamic radiation and delayed memory score. CONCLUSION HD-tDCS significantly improved delayed memory in AD. Our study can be regarded as a proof-of-concept attempt to increase tDCS efficacy. The present findings should be confirmed in larger samples.
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Affiliation(s)
- Ingrid Daae Rasmussen
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway.,Department of Geropsychiatry, University Hospital of North Norway, Norway
| | - Nya Mehnwolo Boayue
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Matthias Mittner
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Martin Bystad
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway.,Department of Geropsychiatry, University Hospital of North Norway, Norway
| | - Ole K Grnli
- Department of Geropsychiatry, University Hospital of North Norway, Norway
| | - Torgil Riise Vangberg
- Department of Clinical Medicine, University hospital of North Norway, Norway.,PET Center, University hospital of North Norway, Tromsø, Norway
| | - Gábor Csifcsák
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway
| | - Per M Aslaksen
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, UiT The Artic University of Norway, Tromsø, Norway.,Department of Child and Adolescent Psychiatry, University Hospital of North Norway, Tromsø, Norway
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Maatoug R, Bihan K, Duriez P, Podevin P, Silveira-Reis-Brito L, Benyamina A, Valero-Cabré A, Millet B. Non-invasive and invasive brain stimulation in alcohol use disorders: A critical review of selected human evidence and methodological considerations to guide future research. Compr Psychiatry 2021; 109:152257. [PMID: 34246194 DOI: 10.1016/j.comppsych.2021.152257] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Alcohol use disorder (AUD) ranks among the leading causes of decrements in disability-adjusted life-years. Long-term exposure to alcohol leads to an imbalance of activity between frontal cortical systems and the striatum, thereby enhancing impulsive behaviours and weakening inhibitory control. Alternative therapeutic approaches such as non-invasive and invasive brain stimulation have gained some momentum in the field of addictology by capitalizing on their ability to target specific anatomical structures and correct abnormalities in dysfunctional brain circuits. MATERIALS AND METHODS The current review, covers original peer-reviewed published research on the use of brain stimulation methods for the rehabilitation of AUD. A broad and systematic search was carried out on four electronic databases: NCBI PubMed, Web of Science, Handbooks and the Cochrane Library. Any original article in English or French language, without restrictions of patient age or gender, article type and publication outlet, were included in the final pool of selected studies. RESULTS The outcomes of this systematic review suggest that the dorsolateral prefrontral cortex (DLPFC) is a promising target for treating AUD with high frequency repetitive transcranial magnetic stimulation. Such effect would reduce feelings of craving by enhancing cognitive control and modulating striatal function. Existing literature also supports the notion that changes of DLPFC activity driven by transcranial direct current stimulation, could decrease alcohol craving and consumption. However, to date, no major differences have been found between the efficacy of these two non-invasive brain-stimulation approaches, which require further confirmation. In contrast, beneficial stronger evidence supports an impact of deep brain stimulation reducing craving and improving quality of life in AUD, effects that would be mediated by an impact on the nucleus accumbens, a central structure of the brain's reward circuitry. Overall, neurostimulation shows promise contributing to the treatment of AUD. Nonetheless, progress has been limited by a number of factors such as the low number of controlled randomized trials, small sample sizes, variety of stimulation parameters precluding comparability and incomplete or questionable sham-conditions. Additionally, a lack of data concerning clinical impact on the severity of AUD or craving and the short follow up periods precluding and accurate estimation of effect duration after discontinuing the treatment, has also limited the clinical relevance of final outcomes. CONCLUSION Brain stimulation remains a promising approach to contribute to AUD therapy, co-adjuvant of more conventional procedures. However, a stronger therapeutic rational based on solid physio-pathological evidence and accurate estimates of efficacy, are still required to achieve further therapeutic success and expand clinical use.
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Affiliation(s)
- R Maatoug
- Sorbonne Université, AP-HP, Service de psychiatrie adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, F-75013 Paris, France.
| | - K Bihan
- Regional pharmacovigilance center, department of pharmacology, Pitié-Salpêtrière hospital, 47/83, boulevard de l'Hôpital, 75013 Paris, France
| | - P Duriez
- Institute of Psychiatry and Neurosciences of Paris, Unité Mixte de Recherche en Santé (UMRS) 1266 Institut National de la Santé et de la Recherche Médicale (INSERM), University Paris Descartes, Paris, France; Clinique des Maladies Mentales et de l'Encéphale, Groupement Hospitalier Universitaire (GHU) Paris Psychiatry and Neuroscience, Sainte-Anne Hospital, Paris, France
| | - P Podevin
- Sorbonne Université, AP-HP, Service de psychiatrie adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, F-75013 Paris, France
| | - L Silveira-Reis-Brito
- Sorbonne Université, AP-HP, Service de psychiatrie adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, F-75013 Paris, France; Rede mater dei de saúde, Brazil
| | - A Benyamina
- Dispositif Territorial de Recherche et de Formation (DTRF) Paris Sud, 94275 Le Kremlin-Bicêtre, France; Département de psychiatrie et d'addictologie, Hôpital Paul Brousse, Hôpitaux Universitaires Paris Sud, Assistance Publique-Hôpitaux de Paris, 94800 Villejuif, France
| | - A Valero-Cabré
- Institut du Cerveau et de la Moelle Epinière (ICM), CNRS UMR 7225, INSERM U 1127 and Sorbonne Université, Paris, France; Laboratory for Cerebral Dynamics Plasticity and Rehabilitation, Boston University, School of Medicine, Boston, MA, USA; Cognitive Neuroscience and Information Technology Research Program, Open University of Catalonia (UOC), Barcelona, Spain
| | - B Millet
- Sorbonne Université, AP-HP, Service de psychiatrie adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, F-75013 Paris, France
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Wittkopf PG, Larsen DB, Graven-Nielsen T. Protocols for inducing homeostatic plasticity reflected in the corticospinal excitability in healthy human participants: A systematic review and meta-analysis. Eur J Neurosci 2021; 54:5444-5461. [PMID: 34251703 DOI: 10.1111/ejn.15389] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
Homeostatic plasticity complements synaptic plasticity by stabilising neural activity within a physiological range. In humans, homeostatic plasticity is investigated using two blocks of non-invasive brain stimulation (NIBS) with an interval without stimulation between blocks. The aim of this systematic review and meta-analysis was to investigate the effect of homeostatic plasticity induction protocols on motor evoked potentials (MEP) in healthy participants. Four databases were searched (Medline, Scopus, Embase and Cochrane library). Studies describing the application of two blocks of NIBS of the primary motor cortex with an interval of no stimulation between blocks reporting changes in corticospinal excitability by MEP amplitude were included. Thirty-seven reports with 55 experiments (700 participants) were included. Study quality was considered poor overall, with heterogeneity in study size, sample and designs. Two blocks of excitatory stimulation at the primary motor cortex produced a homeostatic response (decreased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. Two blocks of inhibitory stimulation at the primary motor cortex using interval duration of 10 min or less produced a homeostatic response (increased MEP) between 0 and 30 min post-protocols, when compared with a single stimulation block. There were no differences in MEPs when compared with baseline MEPs. In conclusion, homeostatic plasticity induction using two blocks of NIBS with an interval of 10 min or less without stimulation between blocks produces a homeostatic response up to 30 min post-protocol. Improvements in participant selection, sample sizes and protocols of NIBS techniques are needed.
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Affiliation(s)
- Priscilla G Wittkopf
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Dennis B Larsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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140
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An Overview of Noninvasive Brain Stimulation: Basic Principles and Clinical Applications. Can J Neurol Sci 2021; 49:479-492. [PMID: 34238393 DOI: 10.1017/cjn.2021.158] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The brain has the innate ability to undergo neuronal plasticity, which refers to changes in its structure and functions in response to continued changes in the environment. Although these concepts are well established in animal slice preparation models, their application to a large number of human subjects could only be achieved using noninvasive brain stimulation (NIBS) techniques. In this review, we discuss the mechanisms of plasticity induction using NIBS techniques including transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), transcranial alternating current stimulation (tACS), random noise stimulation (RNS), transcranial ultrasound stimulation (TUS), vagus nerve stimulation (VNS), and galvanic vestibular stimulation (GVS). We briefly introduce these techniques, explain the stimulation parameters and potential clinical implications. Although their mechanisms are different, all these NIBS techniques can be used to induce plasticity at the systems level, to examine the neurophysiology of brain circuits and have potential therapeutic use in psychiatric and neurological disorders. TMS is the most established technique for the treatment of brain disorders, and repetitive TMS is an approved treatment for medication-resistant depression. Although the data on the clinical utility of the other modes of stimulation are more limited, the electrical stimulation techniques (tDCS, tACS, RNS, VNS, GVS) have the advantage of lower cost, portability, applicability at home, and can readily be combined with training or rehabilitation. Further research is needed to expand the clinical utility of NIBS and test the combination of different modes of NIBS to optimize neuromodulation induced clinical benefits.
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141
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Rangarajan SK, Suhas S, Reddy MSS, Sreeraj VS, Sivakumar PT, Venkatasubramanian G. Domiciliary tDCS in Geriatric Psychiatric Disorders: Opportunities and Challenges. Indian J Psychol Med 2021; 43:351-356. [PMID: 34385730 PMCID: PMC8327869 DOI: 10.1177/02537176211003666] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Subhashini K Rangarajan
- Dept. of Clinical Neurosciences, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Satish Suhas
- Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mukku Shiva Shanker Reddy
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Vanteemar S Sreeraj
- WISER Neuromodulation Programme, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Palanimuthu Thangaraju Sivakumar
- Geriatric Clinic and Services, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Ganesan Venkatasubramanian
- WISER Neuromodulation Programme, Dept. of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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142
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García-González S, Lugo-Marín J, Setien-Ramos I, Gisbert-Gustemps L, Arteaga-Henríquez G, Díez-Villoria E, Ramos-Quiroga JA. Transcranial direct current stimulation in Autism Spectrum Disorder: A systematic review and meta-analysis. Eur Neuropsychopharmacol 2021; 48:89-109. [PMID: 33773886 DOI: 10.1016/j.euroneuro.2021.02.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 02/11/2021] [Accepted: 02/24/2021] [Indexed: 02/06/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has gained relevance in recent years as an alternative treatment for neuropsychiatric conditions. The aim of this study is to conduct a systematic review of the use of tDCS in Autism Spectrum Disorder (ASD). Both electronic and manual searches were conducted to identify studies published in peer-reviewed scientific journals addressing the use of tDCS in ASD population. A total of 16 studies fulfilled the criteria to be included in the review. Studies were conducted both in child and adult population. Anodal stimulation on the left dorsolateral prefrontal cortex was the most commonly chosen methodology. Outcomes addressed ASD symptoms and neuropsychological functions. Meta-analytic synthesis identified improvements in social, health, and behavioral problem domains of the Autism Treatment Evaluation Checklist. Limitations included high heterogeneity in the methodology and low-efficacy study designs (pre-post and single-case studies). Recent controlled trials shed promising results for the use of tDCS in ASD. A standardized stimulation protocol and a consensus in the measures used in the evaluation of the efficacy are imperative.
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Affiliation(s)
- Sara García-González
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Jorge Lugo-Marín
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Imanol Setien-Ramos
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Laura Gisbert-Gustemps
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gara Arteaga-Henríquez
- Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain
| | - Emiliano Díez-Villoria
- Centro de Atención Integral al Autismo-InFoAutismo, INICO-Instituto Universitario de Integración en la Comunidad, University of Salamanca, Salamanca, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Group of Psychiatry, Mental Health and Addictions, Vall d'Hebron Research Institute (VHIR), Barcelona, Catalonia, Spain; Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Psychiatric Genetics Unit, Vall d'Hebron Research Institute, Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain.
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143
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Shorafa Y, Halawa I, Hewitt M, Nitsche MA, Antal A, Paulus W. Isometric agonist and antagonist muscle activation interacts differently with 140-Hz transcranial alternating current stimulation aftereffects at different intensities. J Neurophysiol 2021; 126:340-348. [PMID: 34191638 DOI: 10.1152/jn.00065.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
During transcranial electric stimulation, increasing intracellular Ca2+ levels beyond those needed for inducing long term potentiation (LTP) may collapse aftereffects. State-dependent plastic aftereffects are reduced when applied during muscle activation as compared with rest. Cortical surround inhibition by antagonistic muscle activation inhibits the center-innervated agonist. The objective of this study is to determine the interaction of state dependency of transcranial alternating current stimulation (tACS) aftereffects at rest and under activation of agonist and antagonist muscles during stimulation with different intensities. In 13 healthy participants, we measured motor-evoked potential (MEP) amplitudes before and after applying tACS at 140 Hz over the motor cortex in nine single-blinded sessions using sham, 1 mA, and 2 mA stimulation intensities during rest and activation of agonist and antagonist muscles. During rest, only 1 mA tACS produced a significant MEP increase, whereas the 2 mA stimulation produced no significant MEP size shift. During agonist activation 1 mA did not induce MEP changes; after 2 mA, first a decrease and later an increase of MEPs were observed. Antagonist activation under sham tACS led to an inhibition, which was restored to baseline by 1 and 2 mA tACS. Increasing stimulation intensity beyond 1 mA does not increase excitability, compatible with too strong intracellular Ca2+ increase. Antagonist innervation leads to MEP inhibition, supporting the concept of surround inhibition, which can be overcome by tACS at both intensities. During agonist innervation, a tACS dose-dependent relationship exists. Our results integrate concepts of "leaky membranes" under activation, surround inhibition, intracellular Ca2+ increase, and their role in the aftereffects of tACS.NEW & NOTEWORTHY Stimulation intensity and activation of center versus surround muscles affect cortical excitability alterations generated by 140-Hz tACS. At rest, excitatory aftereffects were induced by tACS with 1 mA, but not 2 mA stimulation intensity. With agonistic muscle activation, excitability first decreases, and then increases with 2 mA. For antagonist activation, the MEP amplitude reduction observed in the sham condition is counteracted upon by 1 and 2 mA tACS. This reflects the relation of LTP-like aftereffects to Ca2+ concentration alterations.
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Affiliation(s)
- Y Shorafa
- Department of Clinical Neurophysiology, University Medical Centre Göttingen, Göttingen, Germany
| | - I Halawa
- Department of Clinical Neurophysiology, University Medical Centre Göttingen, Göttingen, Germany.,Medical Research Division, National Research Center, Cairo, Egypt
| | - M Hewitt
- Department of Clinical Neurophysiology, University Medical Centre Göttingen, Göttingen, Germany
| | - M A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Hospital Bergmannsheil, Bochum, Germany
| | - A Antal
- Department of Clinical Neurophysiology, University Medical Centre Göttingen, Göttingen, Germany
| | - W Paulus
- Department of Clinical Neurophysiology, University Medical Centre Göttingen, Göttingen, Germany
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144
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Pol F, Salehinejad MA, Baharlouei H, Nitsche MA. The effects of transcranial direct current stimulation on gait in patients with Parkinson's disease: a systematic review. Transl Neurodegener 2021; 10:22. [PMID: 34183062 PMCID: PMC8240267 DOI: 10.1186/s40035-021-00245-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 12/01/2022] Open
Abstract
Background Gait problems are an important symptom in Parkinson’s disease (PD), a progressive neurodegenerative disease. Transcranial direct current stimulation (tDCS) is a neuromodulatory intervention that can modulate cortical excitability of the gait-related regions. Despite an increasing number of gait-related tDCS studies in PD, the efficacy of this technique for improving gait has not been systematically investigated yet. Here, we aimed to systematically explore the effects of tDCS on gait in PD, based on available experimental studies. Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, PubMed, Web of Science, Scopus, and PEDro databases were searched for randomized clinical trials assessing the effect of tDCS on gait in patients with PD. Results Eighteen studies were included in this systematic review. Overall, tDCS targeting the motor cortex and supplementary motor area bilaterally seems to be promising for gait rehabilitation in PD. Studies of tDCS targeting the dorosolateral prefrontal cortex or cerebellum showed more heterogeneous results. More studies are needed to systematically compare the efficacy of different tDCS protocols, including protocols applying tDCS alone and/or in combination with conventional gait rehabilitation treatment in PD. Conclusions tDCS is a promising intervention approach to improving gait in PD. Anodal tDCS over the motor areas has shown a positive effect on gait, but stimulation of other areas is less promising. However, the heterogeneities of methods and results have made it difficult to draw firm conclusions. Therefore, systematic explorations of tDCS protocols are required to optimize the efficacy.
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Affiliation(s)
- Fateme Pol
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Hamzeh Baharlouei
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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145
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Lahogue C, Pinault D. Frontoparietal anodal tDCS reduces ketamine-induced oscillopathies. Transl Neurosci 2021; 12:282-296. [PMID: 34239718 PMCID: PMC8240415 DOI: 10.1515/tnsci-2020-0157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 05/05/2021] [Accepted: 05/14/2021] [Indexed: 12/26/2022] Open
Abstract
During the prodromal phase of schizophrenia with its complex and insidious clinical picture, electroencephalographic recordings detect widespread oscillation disturbances (or oscillopathies) during the wake-sleep cycle. Neural oscillations are electrobiomarkers of the connectivity state within systems. A single-systemic administration of ketamine, a non-competitive NMDA glutamate receptor antagonist, transiently reproduces the oscillopathies with a clinical picture reminiscent of the psychosis prodrome. This acute pharmacological model may help the research and development of innovative treatments against psychotic transition. Transcranial electrical stimulation is recognized as an appropriate non-invasive therapeutic modality since it can increase cognitive performance and modulate neural oscillations with little or no side effects. Therefore, our objective was to set up, in the sedated adult rat, a stimulation method that is able to normalize ketamine-induced increase in gamma-frequency (30-80 Hz) oscillations and decrease in sigma-frequency (10-17 Hz) oscillations. Unilateral and bipolar frontoparietal (FP), transcranial anodal stimulation by direct current (<+1 mA) was applied in ketamine-treated rats. A concomitant bilateral electroencephalographic recording of the parietal cortex measured the stimulation effects on its spontaneously occurring oscillations. A 5 min FP anodal tDCS immediately and quickly reduced, significantly with an intensity-effect relationship, the ketamine-induced gamma hyperactivity, and sigma hypoactivity at least in the bilateral parietal cortex. A duration effect was also recorded. The tDCS also tended to diminish the ketamine-induced delta hypoactivity. These preliminary neurophysiological findings are promising for developing a therapeutic proof-of-concept against neuropsychiatric disorders.
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Affiliation(s)
- Caroline Lahogue
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche en Biomédecine de Strasbourg (CRBS), Faculté de médecine, Strasbourg, France
| | - Didier Pinault
- Université de Strasbourg, Strasbourg, France
- INSERM U1114, Neuropsychologie Cognitive et Physiopathologie de la Schizophrénie, Strasbourg, France
- Fédération de Médecine Translationnelle de Strasbourg (FMTS), Centre de Recherche en Biomédecine de Strasbourg (CRBS), Faculté de médecine, Strasbourg, France
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146
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Lerner O, Friedman J, Frenkel-Toledo S. The effect of high-definition transcranial direct current stimulation intensity on motor performance in healthy adults: a randomized controlled trial. J Neuroeng Rehabil 2021; 18:103. [PMID: 34174914 PMCID: PMC8236155 DOI: 10.1186/s12984-021-00899-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 06/14/2021] [Indexed: 11/22/2022] Open
Abstract
Background The results of transcranial direct current stimulation (tDCS) studies that seek to improve motor performance for people with neurological disorders, by targeting the primary motor cortex, have been inconsistent. One possible reason, among others, for this inconsistency, is that very little is known about the optimal protocols for enhancing motor performance in healthy individuals. The best way to optimize stimulation protocols for enhancing tDCS effects on motor performance by means of current intensity modulation has not yet been determined. We aimed to determine the effect of current intensity on motor performance using–for the first time–a montage optimized for maximal focal stimulation via anodal high-definition tDCS (HD-tDCS) on the right primary motor cortex in healthy subjects. Methods Sixty participants randomly received 20-min HD-tDCS at 1.5, 2 mA, or sham stimulation. Participants’ reaching performance with the left hand on a tablet was tested before, during, and immediately following stimulation, and retested after 24 h. Results In the current montage of HD-tDCS, movement time did not differ between groups in each timepoint. However, only after HD-tDCS at 1.5 mA did movement time improve at posttest as compared to pretest. This reduction in movement time from pretest to posttest was significantly greater compared to HD-tDCS 2 mA. Following HD-tDCS at 1.5 mA and sham HD-tDCS, but not 2 mA, movement time improved at retest compared to pretest, and at posttest and retest compared to the movement time during stimulation. In HD-tDCS at 2 mA, the negligible reduction in movement time from the course of stimulation to posttest was significantly lower compared to sham HD-tDCS. Across all groups, reaction time improved in retest compared to pretest and to the reaction time during stimulation, and did not differ between groups in each timepoint. Conclusions It appears that 2 mA in this particular experimental setup inhibited the learning effects. These results suggest that excitatory effects induced by anodal stimulation do not hold for every stimulation intensity, information that should be taken into consideration when translating tDCS use from the realm of research into more optimal neurorehabilitation. Trial registration: Clinical Trials Gov, NCT04577768. Registered 6 October 2019 -Retrospectively registered, https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S000A9B3&selectaction=Edit&uid=U0005AKF&ts=8&cx=buucf0. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-021-00899-z.
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Affiliation(s)
- Ohad Lerner
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Jason Friedman
- Department of Physical Therapy, Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Silvi Frenkel-Toledo
- Department of Physical Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel. .,Department of Neurological Rehabilitation, Loewenstein Hospital, Raanana, Israel.
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147
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Jafari E, Alizadehgoradel J, Pourmohseni Koluri F, Nikoozadehkordmirza E, Refahi M, Taherifard M, Nejati V, Hallajian AH, Ghanavati E, Vicario CM, Nitsche MA, Salehinejad MA. Intensified electrical stimulation targeting lateral and medial prefrontal cortices for the treatment of social anxiety disorder: A randomized, double-blind, parallel-group, dose-comparison study. Brain Stimul 2021; 14:974-986. [PMID: 34167918 DOI: 10.1016/j.brs.2021.06.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Social Anxiety Disorder (SAD) is the most common anxiety disorder while remains largely untreated. Disturbed amygdala-frontal network functions are central to the pathophysiology of SAD, marked by hypoactivity of the lateral prefrontal cortex (PFC), and hypersensitivity of the medial PFC and the amygdala. The objective of this study was to determine whether modulation of the dorsolateral and medial PFC activity with a novel intensified stimulation protocol reduces SAD core symptoms, improves treatment-related variables, and reduces attention bias to threatening stimuli. METHODS In this randomized, sham-controlled, double-blind trial, we assessed the efficacy of an intensified stimulation protocol (20 min, twice-daily sessions with 20 min intervals, 5 consecutive days) in two intensities (1 vs 2 mA) compared to sham stimulations. 45 patients with SAD were randomized in three tDCS arms (1-mA, 2-mA, sham). SAD symptoms, treatment-related variables (worries, depressive state, emotion regulation, quality of life), and attention bias to threatening stimuli (dot-probe paradigm) were assessed before and right after the intervention. SAD symptoms were also assessed at 2-month follow-up. RESULTS Both 1-mA and 2-mA protocols significantly reduced fear/avoidance symptoms, worries and improved, emotion regulation and quality of life after the intervention compared to the sham group. Improving effect of the 2-mA protocol on avoidance symptoms, worries and depressive state was significantly larger than the 1-mA group. Only the 2-mA protocol reduced attention bias to threat-related stimuli, the avoidance symptom at follow-up, and depressive states, as compared to the sham group. CONCLUSIONS Modulation of lateral-medial PFC activity with intensified stimulation can improve cognitive control, motivation and emotion networks in SAD and might thereby result in therapeutic effects. These effects can be larger with 2-mA vs 1-mA intensities, though a linear relationship between intensity and efficacy should not be concluded. Our results need replication in larger trials.
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Affiliation(s)
- Eisa Jafari
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Jaber Alizadehgoradel
- Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran.
| | | | | | - Meysam Refahi
- Department of Psychology, Payame Noor University, Tehran, Iran
| | - Mina Taherifard
- Department of Psychology, Mohaghegh-Ardabili University, Ardabil, Iran
| | - Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | | | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Carmelo M Vicario
- Department of Cognitive Science, University of Messina, Messina, Italy
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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148
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Li X, Yao J, Zhang W, Chen S, Peng W. Effects of transcranial direct current stimulation on experimental pain perception: A systematic review and meta-analysis. Clin Neurophysiol 2021; 132:2163-2175. [PMID: 34284252 DOI: 10.1016/j.clinph.2021.05.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 04/01/2021] [Accepted: 05/16/2021] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Many studies have examined the effectiveness of transcranial direct current stimulation (tDCS) on human pain perception in both healthy populations and pain patients. Nevertheless, studies have yielded conflicting results, likely due to differences in stimulation parameters, experimental paradigms, and outcome measures. Human experimental pain models that utilize indices of pain in response to well-controlled noxious stimuli can avoid many confounds present in clinical data. This study aimed to assess the robustness of tDCS effects on experimental pain perception among healthy populations. METHODS We conducted three meta-analyses that analyzed tDCS effects on ratings of perceived pain intensity to suprathreshold noxious stimuli, pain threshold and tolerance. RESULTS The meta-analyses showed a statically significant tDCS effect on attenuating pain-intensity ratings to suprathreshold noxious stimuli. In contrast, tDCS effects on pain threshold and pain tolerance were statistically non-significant. Moderator analysis further suggested that stimulation parameters (active electrode size and current density) and experimental pain modality moderated the effectiveness of tDCS in attenuating pain-intensity ratings. CONCLUSION The effectiveness of tDCS on attenuating experimental pain perception depends on both stimulation parameters of tDCS and the modality of experimental pain. SIGNIFICANCE This study provides some theoretical basis for the application of tDCS in pain management.
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Affiliation(s)
- Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Junjie Yao
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Wenyun Zhang
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Shengxiong Chen
- Medical Rehabilitation Center, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, China; Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China.
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149
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The effects of transcranial direct current stimulation on upper-limb function post-stroke: A meta-analysis of multiple-session studies. Clin Neurophysiol 2021; 132:1897-1918. [PMID: 34157634 DOI: 10.1016/j.clinph.2021.05.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/21/2021] [Accepted: 05/10/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To systematically review how patient characteristics and/or transcranial direct current stimulation (tDCS) parameters influence tDCS effectiveness in respect to upper limb function post-stroke. METHODS Three electronic databases were searched for sham-controlled randomised trials using the Fugl-Meyer Assessment for upper extremity as outcome measure. A meta-analysis and nine subgroup-analyses were performed to identify which tDCS parameters yielded the greatest impact on upper limb function recovery in stroke patients. RESULTS Eighteen high-quality studies (507 patients) were included. tDCS applied in a chronic stage yields greater results than tDCS applied in a (sub)acute stage. Additionally, patients with low baseline upper limb impairments seem to benefit more from tDCS than those with high baseline impairments. Regarding tDCS configuration, all stimulation types led to a significant improvement, but only tDCS applied during therapy, and not before therapy, yielded significant results. A positive dose-response relationship was identified for current/charge density and stimulation duration, but not for number of sessions. CONCLUSION Our results demonstrate that tDCS improves upper limb function post-stroke. However, its effectiveness depends on numerous factors. Especially chronic stroke patients improved, which is promising as they are typically least amenable to recovery. SIGNIFICANCE The current work highlights the importance of several patient-related and protocol-related factors regarding tDCS effectiveness.
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150
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Melo L, Mosayebi-Samani M, Ghanavati E, Nitsche MA, Kuo MF. Dosage-Dependent Impact of Acute Serotonin Enhancement on Transcranial Direct Current Stimulation Effects. Int J Neuropsychopharmacol 2021; 24:787-797. [PMID: 34106250 PMCID: PMC8538892 DOI: 10.1093/ijnp/pyab035] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/27/2021] [Accepted: 06/07/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The serotonergic system has an important impact on basic physiological and higher brain functions. Acute and chronic enhancement of serotonin levels via selective serotonin reuptake inhibitor administration impacts neuroplasticity in humans, as shown by its effects on cortical excitability alterations induced by non-invasive brain stimulation, including transcranial direct current stimulation (tDCS). Nevertheless, the interaction between serotonin activation and neuroplasticity is not fully understood, particularly considering dose-dependent effects. Our goal was to explore dosage-dependent effects of acute serotonin enhancement on stimulation-induced plasticity in healthy individuals. METHODS Twelve healthy adults participated in 7 sessions conducted in a crossover, partially double-blinded, randomized, and sham-controlled study design. Anodal and cathodal tDCS was applied to the motor cortex under selective serotonin reuptake inhibitor (20 mg/40 mg citalopram) or placebo medication. Motor cortex excitability was monitored by single-pulse transcranial magnetic stimulation. RESULTS Under placebo medication, anodal tDCS enhanced, and cathodal tDCS reduced, excitability for approximately 60-120 minutes after the intervention. Citalopram enhanced and prolonged the facilitation induced by anodal tDCS regardless of the dosage while turning cathodal tDCS-induced excitability diminution into facilitation. For the latter, prolonged effects were observed when 40 mg was administrated. CONCLUSIONS Acute serotonin enhancement modulates tDCS after-effects and has largely similar modulatory effects on motor cortex neuroplasticity regardless of the specific dosage. A minor dosage-dependent effect was observed only for cathodal tDCS. The present findings support the concept of boosting the neuroplastic effects of anodal tDCS by serotonergic enhancement, a potential clinical approach for the treatment of neurological and psychiatric disorders.
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Affiliation(s)
- Lorena Melo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany,International Graduate School of Neuroscience (IGSN), Ruhr-University Bochum, Germany
| | - Mohsen Mosayebi-Samani
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - Elham Ghanavati
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Min-Fang Kuo
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Dortmund, Germany,Correspondence: Min-Fang Kuo, MD, PhD, Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors (IfADo), Ardeystraße 67, 44139 Dortmund, Germany ()
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