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Pilloni G, Charvet LE, Bikson M, Palekar N, Kim MJ. Potential of Transcranial Direct Current Stimulation in Alzheimer's Disease: Optimizing Trials Toward Clinical Use. J Clin Neurol 2022; 18:391-400. [PMID: 35796264 PMCID: PMC9262447 DOI: 10.3988/jcn.2022.18.4.391] [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: 02/18/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a safe and well-tolerated noninvasive method for stimulating the brain that is rapidly developing into a treatment method for various neurological and psychiatric conditions. In particular, there is growing evidence of a therapeutic role for tDCS in ameliorating or delaying the cognitive decline in Alzheimer's disease (AD). We provide a brief overview of the current development and application status of tDCS as a nonpharmacological therapeutic method for AD and mild cognitive impairment (MCI), summarize the levels of evidence, and identify the improvements needed for clinical applications. We also suggest future directions for large-scale controlled clinical trials of tDCS in AD and MCI, and emphasize the necessity of identifying the mechanistic targets to facilitate clinical applications.
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Affiliation(s)
- Giuseppina Pilloni
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Leigh E Charvet
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, City University of New York, NY, USA
| | - Nikhil Palekar
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA
| | - Min-Jeong Kim
- Department of Psychiatry and Behavioral Health, Stony Brook University Renaissance School of Medicine, Stony Brook, NY, USA.
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Ghasemian-Shirvan E, Mosayebi-Samani M, Farnad L, Kuo MF, Meesen RL, Nitsche MA. Age-dependent non-linear neuroplastic effects of cathodal tDCS in the elderly population; a titration study. Brain Stimul 2022; 15:296-305. [DOI: 10.1016/j.brs.2022.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 12/27/2021] [Accepted: 01/16/2022] [Indexed: 11/16/2022] Open
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Ghasemian-Shirvan E, Farnad L, Mosayebi-Samani M, Verstraelen S, Meesen RL, Kuo MF, Nitsche MA. Age-related differences of motor cortex plasticity in adults: A transcranial direct current stimulation study. Brain Stimul 2020; 13:1588-1599. [DOI: 10.1016/j.brs.2020.09.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 08/21/2020] [Accepted: 09/09/2020] [Indexed: 12/14/2022] Open
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Gomes-Osman J, Indahlastari A, Fried PJ, Cabral DLF, Rice J, Nissim NR, Aksu S, McLaren ME, Woods AJ. Non-invasive Brain Stimulation: Probing Intracortical Circuits and Improving Cognition in the Aging Brain. Front Aging Neurosci 2018; 10:177. [PMID: 29950986 PMCID: PMC6008650 DOI: 10.3389/fnagi.2018.00177] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/22/2018] [Indexed: 12/14/2022] Open
Abstract
The impact of cognitive aging on brain function and structure is complex, and the relationship between aging-related structural changes and cognitive function are not fully understood. Physiological and pathological changes to the aging brain are highly variable, making it difficult to estimate a cognitive trajectory with which to monitor the conversion to cognitive decline. Beyond the information on the structural and functional consequences of cognitive aging gained from brain imaging and neuropsychological studies, non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) can enable stimulation of the human brain in vivo, offering useful insights into the functional integrity of intracortical circuits using electrophysiology and neuromodulation. TMS measurements can be used to identify and monitor changes in cortical reactivity, the integrity of inhibitory and excitatory intracortical circuits, the mechanisms of long-term potentiation (LTP)/depression-like plasticity and central cholinergic function. Repetitive TMS and tDCS can be used to modulate neuronal excitability and enhance cortical function, and thus offer a potential means to slow or reverse cognitive decline. This review will summarize and critically appraise relevant literature regarding the use of TMS and tDCS to probe cortical areas affected by the aging brain, and as potential therapeutic tools to improve cognitive function in the aging population. Challenges arising from intra-individual differences, limited reproducibility, and methodological differences will be discussed.
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Affiliation(s)
- Joyce Gomes-Osman
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
- Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Aprinda Indahlastari
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Danylo L. F. Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jordyn Rice
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nicole R. Nissim
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Serkan Aksu
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Molly E. McLaren
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
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Bartrés-Faz D, Rossi S, Pascual-Leone A. Editorial: Non-invasive Brain Stimulation and Plasticity Changes in Aging. Front Aging Neurosci 2016; 8:96. [PMID: 27199742 PMCID: PMC4854885 DOI: 10.3389/fnagi.2016.00096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 04/18/2016] [Indexed: 11/23/2022] Open
Affiliation(s)
- David Bartrés-Faz
- Unitat de Psicologia Médica, Departament de Medicina, Facultat de Medicina i Ciéncies de la Salut, Universitat de BarcelonaBarcelona, Spain
- *Correspondence: David Bartrés-Faz
| | - Simone Rossi
- Unit of Neurology and Clinical Neurophysiology, Brain Investigation and Neuromodulation Lab. (Si-BIN Lab), Department of Neuroscience, University of SienaSiena, Italy
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation and Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical SchoolBoston, MA, USA
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Freitas C, Farzan F, Pascual-Leone A. Assessing brain plasticity across the lifespan with transcranial magnetic stimulation: why, how, and what is the ultimate goal? Front Neurosci 2013; 7:42. [PMID: 23565072 PMCID: PMC3613699 DOI: 10.3389/fnins.2013.00042] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 03/09/2013] [Indexed: 12/30/2022] Open
Abstract
Sustaining brain and cognitive function across the lifespan must be one of the main biomedical goals of the twenty-first century. We need to aim to prevent neuropsychiatric diseases and, thus, to identify and remediate brain and cognitive dysfunction before clinical symptoms manifest and disability develops. The brain undergoes a complex array of changes from developmental years into old age, putatively the underpinnings of changes in cognition and behavior throughout life. A functionally “normal” brain is a changing brain, a brain whose capacity and mechanisms of change are shifting appropriately from one time-point to another in a given individual's life. Therefore, assessing the mechanisms of brain plasticity across the lifespan is critical to gain insight into an individual's brain health. Indexing brain plasticity in humans is possible with transcranial magnetic stimulation (TMS), which, in combination with neuroimaging, provides a powerful tool for exploring local cortical and brain network plasticity. Here, we review investigations to date, summarize findings, and discuss some of the challenges that need to be solved to enhance the use of TMS measures of brain plasticity across all ages. Ultimately, TMS measures of plasticity can become the foundation for a brain health index (BHI) to enable objective correlates of an individual's brain health over time, assessment across diseases and disorders, and reliable evaluation of indicators of efficacy of future preventive and therapeutic interventions.
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Affiliation(s)
- Catarina Freitas
- Department of Neurology, Division of Cognitive Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA, USA
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