Frequency‐dependent and montage‐based differences in phosphene perception thresholds via transcranial alternating current stimulation

Stimulus effects of extremely low-frequency electric field exposure on calcium oscillations in a human cortical spheroid

High-intensity, low-frequency (1 Hz to 100 kHz) electric and magnetic fields (EF and MF) cause electrical excitation of the nervous system via an induced EF (iEF) in living tissue. However, the biological properties and thresholds of stimulus effects on synchronized activity in a three-dimensional (3D) neuronal network remain uncertain. In this study, we evaluated changes in neuronal network activity during extremely low-frequency EF (ELF-EF) exposure by measuring intracellular calcium ([Ca2+]i) oscillations, which reflect neuronal network activity. For ELF-EF exposure experiments, we used a human cortical spheroid (hCS), a 3D-cultured neuronal network generated from human induced pluripotent stem cell (hiPSC)-derived cortical neurons. A 50 Hz sinusoidal ELF-EF exposure modulated [Ca2+]i oscillations with dependencies on exposure intensity and duration. Based on the experimental setup and results, the iEF distribution inside the hCS was estimated using high-resolution numerical dosimetry. The numerical estimation revealed threshold values ranging between 255-510 V/m (peak) and 131-261 V/m (average). This indicates that thresholds of neuronal excitation in the hCS were equivalent to those of a thin nerve fiber.

Exploring the Therapeutic Effects and Mechanisms of Transcranial Alternating Current Stimulation on Improving Walking Ability in Stroke Patients via Modulating Cerebellar Gamma Frequency Band-a Narrative Review

The cerebellum plays an important role in maintaining balance, posture control, muscle tone, and lower limb coordination in healthy individuals and stroke patients. At the same time, the relationship between cerebellum and motor learning has been widely concerned in recent years. Due to the relatively intact structure preservation and high plasticity after supratentorial stroke, non-invasive neuromodulation targeting the cerebellum is increasingly used to treat abnormal gait in stroke patients. The gamma frequency of transcranial alternating current stimulation (tACS) is commonly used to improve motor learning. It is an essential endogenous EEG oscillation in the gamma range during the swing phase, and rhythmic movement changes in the gait cycle. However, the effect of cerebellar tACS in the gamma frequency band on balance and walking after stroke remains unknown and requires further investigation.

Thresholds and mechanisms of human magnetophosphene perception induced by low frequency sinusoidal magnetic fields

BACKGROUND

Virtually everyone is exposed to power-frequency MF (50/60 Hz), inducing in our body electric fields and currents, potentially modulating brain function. MF-induced electric fields within the central nervous system can generate flickering visual perceptions (magnetophosphenes), which form the basis of international MF exposure guidelines and recommendations protecting workers and the general public. However, magnetophosphene perception thresholds were estimated 40 years ago in a small, unreplicated study with significant uncertainties and leaving open the question of the involved interaction site.

METHODS

We used a stimulation modality termed transcranial alternating magnetic stimulation (tAMS), delivering in situ sinusoidal electric fields comparable to transcranial alternating current stimulation (tACS). Magnetophosphene perception was quantified in 81 volunteers exposed to MF (eye or occipital exposure) between 0 and 50 mT at frequencies of 20, 50, 60 and 100 Hz.

RESULTS

Reliable magnetophosphene perception was induced with tAMS without any scalp sensation, a major advantage as compared to tACS. Frequency-dependent thresholds were quantified using binary logistic regressions hence allowing to establish condition dependent probabilities of perception. Results support an interaction between induced current density and retinal rod cells.

CONCLUSION

Beyond fundamental and immediate implications for international safety guidelines, and for identifying the interaction site underlying phosphene perception (ubiquitous in tACS experiments), our results support exploring the potential of tAMS for the differential diagnosis of retinal disorders and neuromodulation therapy.

Modulation of Visually Induced Self-motion Illusions by α Transcranial Electric Stimulation over the Superior Parietal Cortex

The growing popularity of virtual reality systems has led to a renewed interest in understanding the neurophysiological correlates of the illusion of self-motion (vection), a phenomenon that can be both intentionally induced or avoided in such systems, depending on the application. Recent research has highlighted the modulation of α power oscillations over the superior parietal cortex during vection, suggesting the occurrence of inhibitory mechanisms in the sensorimotor and vestibular functional networks to resolve the inherent visuo-vestibular conflict. The present study aims to further explore this relationship and investigate whether neuromodulating these waves could causally affect the quality of vection. In a crossover design, 22 healthy volunteers received high amplitude and focused α-tACS (transcranial alternating current stimulation) over the superior parietal cortex while experiencing visually induced vection triggered by optokinetic stimulation. The tACS was tuned to each participant's individual α peak frequency, with θ-tACS and sham stimulation serving as controls. Overall, participants experienced better quality vection during α-tACS compared with control θ-tACS and sham stimulations, as quantified by the intensity of vection. The observed neuromodulation supports a causal relationship between parietal α oscillations and visually induced self-motion illusions, with their entrainment triggering overinhibition of the conflict within the sensorimotor and vestibular functional networks. These results confirm the potential of noninvasive brain stimulation for modulating visuo-vestibular conflicts, which could help to enhance the sense of presence in virtual reality environments.

Amplitude modulating frequency overrides carrier frequency in tACS-induced phosphene percept

The amplitude modulated (AM) neural oscillation is an essential feature of neural dynamics to coordinate distant brain areas. The AM transcranial alternating current stimulation (tACS) has recently been adopted to examine various cognitive functions, but its neural mechanism remains unclear. The current study utilized the phosphene phenomenon to investigate whether, in an AM-tACS, the AM frequency could modulate or even override the carrier frequency in phosphene percept. We measured the phosphene threshold and the perceived flash rate/pattern from 12 human subjects (four females, aged from 20-44 years old) under tACS that paired carrier waves (10, 14, 18, 22 Hz) with different envelope conditions (0, 2, 4 Hz) over the mid-occipital and left facial areas. We also examined the phosphene source by adopting a high-density stimulation montage. Our results revealed that (1) phosphene threshold was higher for AM-tACS than sinusoidal tACS and demonstrated different carrier frequency functions in two stimulation montages. (2) AM-tACS slowed down the phosphene flashing and abolished the relation between the carrier frequency and flash percept in sinusoidal tACS. This effect was independent of the intensity change of the stimulation. (3) Left facial stimulation elicited phosphene in the upper-left visual field, while occipital stimulation elicited equally distributed phosphene. (4) The near-eye electrodermal activity (EDA) measured under the threshold-level occipital tACS was greater than the lowest power sufficient to elicit retinal phosphene. Our results show that AM frequency may override the carrier frequency and determine the perceived flashing frequency of AM-tACS-induced phosphene.

Phosphene Attributes Depend on Frequency and Intensity of Retinal tACS

Phosphene is the experience of light without natural visual stimulation. It can be induced by electrical stimulation of the retina, optic nerve or cortex. Induction of phosphenes can be potentially used in assistive devices for the blind. Analysis of phosphene might be beneficial for practical reasons such as adjustment of transcranial alternating current stimulation (tACS) frequency and intensity to eliminate phosphene perception (e.g., tACS studies using verum tACS group and sham group) or, on the contrary, to maximize perception of phosphenes in order to be more able to study their dynamics. In this study, subjective reports of 50 healthy subjects exposed to different intensities of retinal tACS at 4 different frequencies (6, 10, 20 and 40 Hz) were analyzed. The effectiveness of different tACS frequencies in inducing phosphenes was at least 92 %. Subject reported 41 different phosphene types; the most common were light flashes and light circles. Changing the intensity of stimulation often induced a change in phosphene attributes. Up to nine phosphene attributes changed when the tACS intensity was changed. Significant positive correlation was observed between number of a different phosphene types and tACS frequency. Based on these findings, it can be concluded that tACS is effective in eliciting phosphenes whose type and attributes change depending on the frequency and intensity of tACS. The presented results open new questions for future research.

Vestibular Extremely Low-Frequency Magnetic and Electric Stimulation Effects on Human Subjective Visual Vertical Perception

Electric fields from both extremely low‐frequency magnetic fields (ELF‐MF) and alternating current (AC) stimulations impact human neurophysiology. As the retinal photoreceptors, vestibular hair cells are graded potential cells and are sensitive to electric fields. Electrophosphene and magnetophosphene literature suggests different impacts of AC and ELF‐MF on the vestibular hair cells. Furthermore, while AC modulates the vestibular system more globally, lateral ELF‐MF stimulations could be more utricular specific. Therefore, to further address the impact of ELF‐MF‐induced electric fields on the human vestibular system and the potential differences with AC stimulations, we investigated the effects of both stimulation modalities on the perception of verticality using a subjective visual vertical (SVV) paradigm. For similar levels of SVV precision, the ELF‐MF condition required more time to adjust SVV, and SVV variability was higher with ELF‐MF than with AC vestibular‐specific stimulations. Yet, the differences between AC and ELF‐MF stimulations were small. Overall, this study highlights small differences between AC and ELF‐MF vestibular stimulations, underlines a potential utricular contribution, and has implications for international exposure guidelines and standards. © 2022 Bioelectromagnetics Society.

Effect of ambient lighting on frequency dependence in transcranial electrical stimulation-induced phosphenes

Inconsistencies have been found in the relationship between ambient lighting conditions and frequency-dependence in transcranial electric stimulation (tES) induced phosphenes. Using a within-subjects design across lighting condition (dark, mesopic [dim], photopic [bright]) and tES stimulation frequency (10, 13, 16, 18, 20 Hz), this study determined phosphene detection thresholds in 24 subjects receiving tES using an FPz-Cz montage. Minima phosphene thresholds were found at 16 Hz in mesopic, 10 Hz in dark and 20 Hz in photopic lighting conditions, with these thresholds being substantially lower for mesopic than both dark (60% reduction) and photopic (56% reduction), conditions. Further, whereas the phosphene threshold-stimulation frequency relation increased with frequency in the dark and decreased with frequency in the photopic conditions, in the mesopic condition it followed the dark condition relation from 10 to 16 Hz, and photopic condition relation from 16 to 20 Hz. The results clearly demonstrate that ambient lighting is an important factor in the detection of tES-induced phosphenes, and that mesopic conditions are most suitable for obtaining overall phosphene thresholds.

Optimizing the Montage for Cerebellar Transcranial Alternating Current Stimulation (tACS): a Combined Computational and Experimental Study

OBJECTIVE

The application of cerebellar transcranial alternating current stimulation (tACS) is limited by the absence of commonly agreed montages and also the presence of unpleasant side effects. We aimed to find the most effective cerebellar tACS montage with minimum side effects (skin sensations and phosphenes).

APPROACH

We first simulated cerebellar tACS with five montages (return electrode on forehead, buccinator, jaw, and neck positions, additionally focal montage with high-definition ring electrodes) to compare induced cerebellar current, then stimulated healthy participants and evaluated side effects for different montages and varying stimulation frequencies.

MAIN RESULTS

The simulation revealed a descending order of current density in the cerebellum from forehead to buccinator, jaw, neck and ring montage respectively. Montages inducing higher current intensity in the eyeballs during the simulation resulted in stronger and broader phosphenes during tACS sessions. Strong co-stimulation of the brainstem was observed for the neck. Skin sensations did not differ between montages or frequencies. We propose the jaw montage as an optimal choice for maximizing cerebellar stimulation while minimizing unwanted side effects.

SIGNIFICANCE

These findings contribute to adopting a standard cerebellar tACS protocol. The combination of computational modelling and experimental data offers improved experimental control, safety, effectiveness, and reproducibility to all brain stimulation practices.

Modern concepts of bionic vision

Loss of vision is a pressing medical and social problem leading to profound disability, loss of ability to work, serious alterations in the psycho-emotional state, and a decline of the quality of life. When conservative or surgical treatment can not help restore vision, the use of visual prosthesis - bionic eye - can be an effective solution. This review covers the main modern approaches to the development of visual prosthetic systems. Analysis of publications revealed that there are several main approaches to visual prosthesis differing primarily by the anatomical structure targeted for stimulation in order to activate visual sensations. The most significant among them are retinal prostheses, optic nerve stimulation, and cortical visual prostheses. Currently, retinal prostheses such as ARGUS II demonstrate the most successful results, since the stimulation of the surviving neural structures of the retina is a relatively easy task, but their field of application is limited to diseases associated with pathological changes in photoreceptors. The development of cortical visual prostheses is more difficult, but in the future they may allow using more stimulation channels to obtain a more detailed visual perception. In addition, cortical visual prostheses are universal, as they do not require preservation of any structures of the visual organ, only the primary visual cortex.

Magneto- and electrophosphene thresholds in the retina: a dosimetry modeling study

Objective:Sensations of flickering light produced by time-varying magnetic fields or electric currents are called magneto- or electrophosphenes. Phosphene thresholds have been used in international guidelines and standards as an estimate of the thresholds of exposure that produce effects in the central nervous system. However, the estimated threshold values have a large range of uncertainty.Approach:Phosphene thresholds were approximated by simulating five phosphene threshold experiments. Retinal electric fields and currents induced by electric and magnetic stimulation were calculated using the finite element method and 14 anatomically realistic computational models of human heads.Main results:The radial component of retinal current density was determined to be in the range of 6.0~--~20.6~mA/m$^2$. This study produces more accurate estimates for threshold current density in the retina using detailed anatomical models and the estimates had a reduced range of uncertainty compared to earlier studies.Significance:The results are useful for studying the mechanisms of retinal phosphenes and for the development of exposure limits for the central nervous system.

Amplitude modulated transcranial alternating current stimulation (AM-TACS) efficacy evaluation via phosphene induction

Amplitude modulated transcranial alternating current stimulation (AM-tACS) is a novel method of electrostimulation which enables the recording of electrophysiological signals during stimulation, thanks to an easier removable stimulation artefact compared to classical electrostimulation methods. To gauge the neuromodulatory potential of AM-tACS, we tested its capacity to induce phosphenes as an indicator of stimulation efficacy. AM-tACS was applied via a two-electrode setup, attached on FpZ and below the right eye. AM-tACS waveforms comprised of different carrier (50 Hz, 200 Hz, 1000 Hz) and modulation frequencies (8 Hz, 16 Hz, 28 Hz) were administered with at maximum 2 mA peak-to-peak stimulation strength. TACS conditions in the same frequencies were used as a benchmark for phosphene induction. AM-tACS conditions using a 50 Hz carrier frequency were able to induce phosphenes, but with no difference in phosphene thresholds between modulation frequencies. AM-tACS using a 200 Hz or 1000 Hz carrier frequency did not induce phosphenes. TACS conditions induced phosphenes in line with previous studies. Stimulation effects of AM-tACS conditions were independent of amplitude modulation and instead relied solely on the carrier frequency. A possible explanation may be that AM-tACS needs higher stimulation intensities for its amplitude modulation to have a neuromodulatory effect.

Evaluating Current Density Modeling of Non-Invasive Eye and Brain Electrical Stimulation Using Phosphene Thresholds

Because current flow cannot be measured directly in the intact retina or brain, current density distribution models were developed to estimate it during magnetic or electrical stimulation. A paradigm is now needed to evaluate if current flow modeling can be related to physiologically meaningful signs of true current distribution in the human brain. We used phosphene threshold measurements (PTs) as surrogate markers of current-flow to determine if PTs, evoked by transcranial alternating current stimulation (tACS), can be matched with current density estimates generated by head model-based computer simulations. Healthy, male subjects (n=15) were subjected to three-staged PT measurements comparing six unilateral and one bilateral stimulation electrode montages according to the 10/20 system: Fp2-Suborbital right (So), Fp2-right shoulder (rS), Fp2-Cz, Fp2- O2, So-rS, Cz-F8 and F7-F8. The stimulation frequency was set at 16 Hz. Subjects were asked to report the appearance and localization of phosphenes in their visual field for every montage. Current density models were built using multi-modal imaging data of a standard brain, meshed with isotropic conductivities of different tissues of the head using the SimBio and SCIRun software packages. We observed that lower PTs were associated with higher simulated current levels in the unilateral montages of the model head, and shorter electrode distances to the eye had lower PTs. The lowest mean PT and the lowest variability were found in the F7-F8 montage (95±33 μA). Our results confirm the hypothesis that phosphenes are primarily of retinal origin, and they provide the first in vivo evidence that computer models of current flow using head models are a valid tool to estimate real current flow in the human eye and brain.

Synaptic Effect of Aδ-Fibers by Pulse-Train Electrical Stimulation

Electrical stimulation of specific small fibers (Aδ- and C-fibers) is used in basic studies on nociception and neuropathic pain and to diagnose neuropathies. For selective stimulation of small fibers, the optimal stimulation waveform parameters are an important aspect together with the study of electrode design. However, determining an optimal stimulation condition is challenging, as it requires the characterization of the response of the small fibers to electrical stimulation. The perception thresholds are generally characterized using single-pulse stimulation based on the strength-duration curve. However, this does not account for the temporal effects of the different waveforms used in practical applications. In this study, we designed an experiment to characterize the effects of multiple pulse stimulation and proposed a computational model that considers electrostimulation of fibers and synaptic effects in a multiscale model. The measurements of perception thresholds showed that the pulse dependency of the threshold was an exponential decay with a maximum reduction of 55%. In addition, the frequency dependence of the threshold showed a U-shaped response with a reduction of 25% at 30 Hz. Moreover, the computational model explained the synaptic effects, which were also confirmed by evoked potential recordings. This study further characterized the activation of small fibers and clarified the synaptic effects, demonstrating the importance of waveform selection.

Retinal and Cortical Contributions to Phosphenes During Transcranial Electrical Current Stimulation

It is generally believed that the phosphenes induced by transcranial electric current stimulation (tECS) are a product of retinal activation, even when electrode placement is directly over the primary visual cortex. However, the origins of these tECS-induced phosphenes have not yet been conclusively determined. In this study, phosphene detection thresholds using an FPz-Oz montage were compared with those from (i) an Oz-Cz montage to determine whether prefrontal regions, such as the retina, contribute to phosphenes and (ii) an FPz-Cz montage to determine whether the visual cortex in the occipital lobe contributes to phosphenes. Twenty-two participants received transcranial current stimulation with each of these montages (as well as a T3-T4 montage included for exploratory purposes) at 6, 10, 16, 20, 24, 28, and 32 Hz. To estimate differences in current density at the retina and occipital lobe across montages, modeling of current density at phosphene thresholds was measured across 20 head models. Consistent with the proposal that tECS-induced phosphenes are generated in the retina, increasing current density near the retina (FPz-Oz relative to Oz-Cz montage) reduced phosphene thresholds. However, increasing current density near the occipital cortex (FPz-Oz relative to FPz-Cz montage) also reduced phosphene thresholds while also requiring less current density at the retina according to the modeling estimates. This suggests that tECS of this occipital cortex also contributed to phosphene perception. © 2020 Bioelectromagnetics Society.

The response of the neuronal activity in the somatosensory cortex after high-intensity intermediate-frequency magnetic field exposure to the spinal cord in rats under anesthesia and waking states

Novel technologies using the intermediate-frequency magnetic field (IF-MF) in living environments are becoming popular with the advance in electricity utilization. However, the biological effects induced by the high-intensity and burst-type IF-MF exposure used in the wireless power transfer technologies for electric vehicles or medical devices, such as the magnetic stimulation techniques, are not well understood. Here, we developed an experimental platform using rats, that combined an 18 kHz, high-intensity (Max. 88 mT), Gaussian-shaped burst IF-MF exposure system with an in vivo extracellular recording system. In this paper, we aimed to report the qualitative differences in stimulus responses in the regions of the somatosensory cortex and peripheral nerve fibers that were induced by the IF-MF exposure to the rat spinal cord. We also report the modulation of the stimulus responses in the somatosensory cortex under anesthesia or waking states. Using this experimental platform, we succeeded in the detection of the motor evoked potentials or the neuronal activity in the somatosensory cortex that was induced by the IF-MF exposure to the spinal cord in rats. Compared to the state of anesthesia, the neuronal activities in the somatosensory cortex was enhanced during the waking state. On the other hand, these neuronal responses could not be confirmed by the IF-MF exposure-related coil sound only. Our experimental results indicated the basic knowledge of the biological responses and excitation mechanisms of the spinal cord stimulation by the IF-MF exposure.