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Choy O, Raine A. The neurobiology of antisocial personality disorder. Neuropharmacology 2024; 261:110150. [PMID: 39244014 DOI: 10.1016/j.neuropharm.2024.110150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 08/21/2024] [Accepted: 09/04/2024] [Indexed: 09/09/2024]
Abstract
Despite increasing recognition that there is a neurobiological basis of antisocial behavior in addition to its psychosocial foundation, much less is known about the specificity of the neurobiological findings to the psychiatric condition of antisocial personality disorder (APD). This article provides a review of research on genetic, brain imaging, neurocognitive, and psychophysiological factors in relation to assessments of APD. Findings show that there are significant genetic effects on APD, particularly related to the serotonergic system, as well as abnormalities in brain regions such as the frontal lobe. Associations between psychophysiological measures of autonomic nervous system functioning and APD are more mixed. Results indicating that APD has a significant genetic basis and is characterized by abnormalities in brain structure/function and neurocognitive impairments provide additional evidence that supports the conceptualization of APD as a neurodevelopmental disorder. Findings may also help inform treatment approaches that target neurobiological risks for APD symptoms. This article is part of the Special Issue on "Personality Disorders".
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Affiliation(s)
- Olivia Choy
- Department of Psychology, Nanyang Technological University, Singapore.
| | - Adrian Raine
- Departments of Criminology, Psychiatry, and Psychology, University of Pennsylvania, USA.
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Sun Y, Tang X, Li Y, Gao C, Shen Z, Guo X, Guo X, Wei Z, Jia Y, Zheng M, Zhang Y, Xing Y, Tian S. Evaluating the efficacy of transcranial direct current stimulation for refractory epilepsy: A meta-analysis of RCTs and non-RCTs. Epilepsy Res 2024; 208:107456. [PMID: 39426213 DOI: 10.1016/j.eplepsyres.2024.107456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 09/09/2024] [Accepted: 09/26/2024] [Indexed: 10/21/2024]
Abstract
An increasing number of research indicate that non-invasive neurostimulation techniques, like transcranial direct current stimulation (tDCS), can effectively control refractory epilepsy. While previous meta-analyses have primarily focused on randomized controlled trials (RCTs), this study expands the scope by including both RCTs and non-RCTs to provide a more comprehensive assessment of tDCS efficacy in treating refractory epilepsy. Through a systematic search of "PUBMED, Embase and Cochrane", we sought relevant studies related to the research topic. We utilized the Cochrane Collaboration tool to assess the risk of bias for the RCTs and the Methodological Index for Non-Randomized Studies (MINORS) tool to evaluate the quality of the non-RCTs included in this meta-analysis. In addition, a protocol for this meta-analysis was registered on PROSPERO (CRD42024496837 http://www.crd.york.ac.uk/ PROSPERO). A total of 14 studies, including 8 RCTs and 6 non-RCTs , involving 307 subjects with refractory epilepsy, were included in this meta-analysis. The combined analysis of RCTs and non-RCTs indicated that tDCS was effective in reducing seizure frequency (SF) in refractory epilepsy patients, with significant improvements observed both four weeks (MD = -4.54; p < 0.01; 95 % CI = -5.69 to -3.38) and eight weeks (MD = -3.49; p < 0.01; 95 % CI = -5.37 to -1.61) after stimulation. There were no statistically significant differences in Interictal Epileptiform Discharges (IEDs) shortly after stimulation (MD = -3.59; p = 0.42; 95 % CI = -12.33-5.16). However, a reduction was observed at four weeks (MD = -5.28; p < 0.01; 95 % CI = -6.88 to -3.68) and eight weeks post-stimulation (MD = -3.37; p < 0.01; 95 % CI = -5.35 to -1.40). The patient's adverse reactions were mild, and they could be relieved shortly after discontinuation of the stimulus. The quality of evidence across outcomes was assessed as moderate. The results indicate that tDCS demonstrates promising efficacy and safety in managing seizures in refractory epilepsy. While this meta-analysis provides valuable findings, additional large-scale randomized controlled trials are needed to further confirm the efficacy of tDCS for refractory epilepsy.
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Affiliation(s)
- Yuteng Sun
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Xian Tang
- Department of Rehabilitation Medicine, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Ye Li
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chao Gao
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
| | - Zhiyuan Shen
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China; Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Xiaosu Guo
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China; Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Xin Guo
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China; Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China
| | - Zibin Wei
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China
| | - Yicun Jia
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Mengyi Zheng
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yaxin Zhang
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Yuan Xing
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China; Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China.
| | - Shujuan Tian
- Department of Neurology, the First Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Neurology, Hebei Hospital, Xuanwu Hospital, Capital Medical University, Shijiazhuang, Hebei, China; Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang, Hebei, China.
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Huang X, Xu Z, Zhou L, Dong K, Liu Q, Li J, Lei D, Liu H, Chen X. The Impact of Bilateral Cerebellar Transcranial Direct Current Stimulation on Balance Control in Healthy Young Adults. CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01749-z. [PMID: 39379642 DOI: 10.1007/s12311-024-01749-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2024] [Indexed: 10/10/2024]
Abstract
Cerebellar transcranial direct current stimulation (tDCS) has been shown to influence movement functions, but little is known about the specific effects of stimulation polarity on balance control. This study investigated the impact of bilateral cerebellar tDCS on balance functions as a function of stimulation polarity. In this randomized, controlled trial, thirty-nine healthy young adults were assigned to one of three groups: right anodal/left cathodal cerebellar stimulation (AC group), right cathodal/left anodal cerebellar stimulation (CA group), and a control sham group. Each participant underwent a daily 30-minute session of tDCS at 2 mA for one week. Balance function was assessed pre- and post-intervention and the data were analyzed using generalized estimating equations. The CA group exhibited a significant reduction in sway area when standing on the left leg and on both stable and unstable surfaces with eyes open, compared to both the AC and sham groups. However, there were no significant differences among the groups in terms of sway length, anteroposterior velocity, or mediolateral velocity. Our results indicate the polarity-dependent effects of bilateral cerebellar tDCS on balance functions, with enhanced stability observed only following cathodal tDCS over the right cerebellum paired with anodal tDCS over the left cerebellum. This polarity-specific modulation may have implications for developing cerebellar neuromodulation interventions for movement disorders.
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Affiliation(s)
- Xin Huang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Zhiqin Xu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Lingxiang Zhou
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Ke Dong
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Qingqing Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Jiating Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Di Lei
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510080, China.
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510080, China.
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Marar C, Jiang Y, Li Y, Lan L, Zheng N, Chen G, Yang C, Cheng JX. Wireless neuromodulation at submillimeter precision via a microwave split-ring resonator. SCIENCE ADVANCES 2024; 10:eado5560. [PMID: 39365865 PMCID: PMC11451527 DOI: 10.1126/sciadv.ado5560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 09/03/2024] [Indexed: 10/06/2024]
Abstract
A broad spectrum of electromagnetic waves has been explored for wireless neuromodulation. Transcranial magnetic stimulation, with long wavelengths, cannot provide submillimeter spatial resolution. Visible light, with its short wavelengths, suffers from strong scattering in the deep tissue. Microwaves have centimeter-scale penetration depth and have been shown to reversibly inhibit neuronal activity. Yet, microwaves alone do not provide sufficient spatial precision to modulate target neurons without affecting surrounding tissues. Here, we report a split-ring resonator (SRR) that generates an enhanced microwave field at its gap with submillimeter spatial precision. With the SRR, microwaves at dosages below the safe exposure limit are shown to inhibit the firing of neurons within 1 mm of the SRR gap site. The microwave SRR reduced seizure activity at a low dose in both in vitro and in vivo models of epilepsy. This microwave dosage is confirmed to be biosafe via histological and biochemical assessment of brain tissue.
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Affiliation(s)
- Carolyn Marar
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
| | - Ying Jiang
- Graduate Program for Neuroscience, Boston University, Boston, MA 02215, USA
| | - Yueming Li
- Department of Mechanical Engineering, Boston University, Boston, MA 02215, USA
| | - Lu Lan
- Department of Electrical & Computer Engineering, Boston University, Boston, MA 02215, USA
| | - Nan Zheng
- Division of Materials Science and Engineering, Boston University, Boston, MA 02215, USA
| | - Guo Chen
- Department of Electrical & Computer Engineering, Boston University, Boston, MA 02215, USA
| | - Chen Yang
- Department of Electrical & Computer Engineering, Boston University, Boston, MA 02215, USA
- Department of Chemistry, Boston University, Boston, MA 02215, USA
| | - Ji-Xin Cheng
- Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
- Department of Electrical & Computer Engineering, Boston University, Boston, MA 02215, USA
- Department of Chemistry, Boston University, Boston, MA 02215, USA
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Aydin BN, Stinson EJ, Travis KT, Krakoff J, Rodzevik T, Chang DC, Gluck ME. Reduced plasma interleukin-6 concentration after transcranial direct current stimulation to the prefrontal cortex. Behav Brain Res 2024; 474:115201. [PMID: 39151649 PMCID: PMC11401619 DOI: 10.1016/j.bbr.2024.115201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/26/2024] [Accepted: 08/10/2024] [Indexed: 08/19/2024]
Abstract
OBJECTIVES Transcranial direct stimulation (tDCS) targeted to the dorsolateral prefrontal cortex (DLPFC) reduces food intake and hunger, but its effects on circulating factors are unclear. We assessed the effect of repeated administration of tDCS to the left DLPFC (L-DLPFC) on concentrations of pro/anti-inflammatory and appetitive hormone concentrations. MATERIALS AND METHODS Twenty-nine healthy adults with obesity (12 M; 42±11 y; BMI=39±8 kg/m2) received 3 consecutive inpatient sessions of either anodal or sham tDCS targeted to the L-DLPFC during a period of ad libitum food intake. Fasting plasma concentrations of IL-6, orexin, cortisol, TNF-α, IL-1β, ghrelin, PYY, and GLP-1 were measured before the initial and after the final tDCS sessions. RESULTS IL-6 (β=-0.92 pg/ml p=0.03) decreased in the anodal group compared with sham, even after adjusting for kcal intake; there were no changes in other hormones. Mean kcal intake was associated with higher IL-1β and ghrelin concentrations after the ad libitum period (β=0.00018 pg/ml/kcal, p=0.03; β=0.00011 pg/ml/kcal, p=0.02; respectively), but not differ by intervention groups. CONCLUSIONS IL-6 concentrations were reduced following anodal tDCS to the L-DLPFC independent of ad libitum intake. IL-6 concentrations reflect the inflammatory state of adiposity and may affect eating behavior and weight gain. These findings provide evidence of therapeutic benefit of tDCS.
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Affiliation(s)
- Beyza N Aydin
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Emma J Stinson
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Katherine T Travis
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Jonathan Krakoff
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Theresa Rodzevik
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Douglas C Chang
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States
| | - Marci E Gluck
- Obesity and Diabetes Clinical Research Section, Phoenix Epidemiology and Clinical Research Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ, United States.
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Lanni I, Chiacchierini G, Papagno C, Santangelo V, Campolongo P. Treating Alzheimer's disease with brain stimulation: From preclinical models to non-invasive stimulation in humans. Neurosci Biobehav Rev 2024; 165:105831. [PMID: 39074672 DOI: 10.1016/j.neubiorev.2024.105831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/20/2024] [Accepted: 07/24/2024] [Indexed: 07/31/2024]
Abstract
Alzheimer's disease (AD) is a severe and progressive neurodegenerative condition that exerts detrimental effects on brain function. As of now, there is no effective treatment for AD patients. This review explores two distinct avenues of research. The first revolves around the use of animal studies and preclinical models to gain insights into AD's underlying mechanisms and potential treatment strategies. Specifically, it delves into the effectiveness of interventions such as Optogenetics and Chemogenetics, shedding light on their implications for understanding pathophysiological mechanisms and potential therapeutic applications. The second avenue focuses on non-invasive brain stimulation (NiBS) techniques in the context of AD. Evidence suggests that NiBS can successfully modulate cognitive functions associated with various neurological and neuropsychiatric disorders, including AD, as demonstrated by promising findings. Here, we critically assessed recent findings in AD research belonging to these lines of research and discuss their potential impact on the clinical horizon of AD treatment. These multifaceted approaches offer hope for advancing our comprehension of AD pathology and developing novel therapeutic interventions.
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Affiliation(s)
- Ilenia Lanni
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy; Behavioral Neuropharmacology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Giulia Chiacchierini
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy; Behavioral Neuropharmacology Unit, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, Italy
| | - Valerio Santangelo
- Functional Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Philosophy, Social Sciences & Education, University of Perugia, Perugia, Italy
| | - Patrizia Campolongo
- Department of Physiology and Pharmacology, Sapienza University of Rome, Rome, Italy; Behavioral Neuropharmacology Unit, IRCCS Santa Lucia Foundation, Rome, Italy.
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Wang D, Guo X, Huang Q, Wang Z, Chen J, Hu S. Efficacy and Safety of Transcranial Direct Current Stimulation as an Add-On Trial Treatment for Acute Bipolar Depression Patients With Suicidal Ideation. CNS Neurosci Ther 2024; 30:e70077. [PMID: 39385316 PMCID: PMC11464394 DOI: 10.1111/cns.70077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 09/18/2024] [Accepted: 09/26/2024] [Indexed: 10/12/2024] Open
Abstract
AIMS Bipolar depression poses an overwhelming suicide risk. We aimed to examine the efficacy and safety of transcranial direct current stimulation (tDCS) combined with quetiapine in bipolar patients as a suicidal intervention. METHODS In a single-center, double-blind, treatment-naive bipolar depression patients with suicidal ideation were randomly assigned to quetiapine in combination with either active (n = 16) or sham (n = 15) tDCS over the left dorsolateral prefrontal cortex for three consecutive weeks. The 30-min, 2-mA tDCS was conducted twice a day on the weekday of the first week and then once a day on the weekdays of the two following weeks. Primary efficacy outcome measure was the change in the Beck Scale for Suicidal Ideation (BSSI). Secondary outcomes included changes on the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Outcome was evaluated on Day 3 and weekend. Safety outcome was based on the reported adverse reactions. RESULTS Active tDCS was superior to sham tDCS on the BSSI at Day 3 and tended to sustain every weekend during the treatment process, compared to baseline. However, no difference between active and sham in HDRS-17 and MADRS was found. Response and remission rate also supported the antisuicide effect of tDCS, with higher response and remission rate in BSSI, but no antidepressant effect, compared to sham, over time. Regarding safety, active tDCS was well tolerated and all the adverse reactions reported were mild and limited to transient scalp discomfort. CONCLUSION The tDCS was effective as an antisuicide treatment for acute bipolar depression patients with suicidal ideation, with minimal side effects reported.
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Affiliation(s)
- Dandan Wang
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- The Zhejiang Key Laboratory of Precision PsychiatryHangzhouChina
| | - Xiaonan Guo
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- The Zhejiang Key Laboratory of Precision PsychiatryHangzhouChina
| | - Qi Huang
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- Nanchong Psychosomatic HospitalNanchongChina
| | - Zhong Wang
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- The Zhejiang Key Laboratory of Precision PsychiatryHangzhouChina
| | - Jingkai Chen
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- The Zhejiang Key Laboratory of Precision PsychiatryHangzhouChina
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated HospitalZhejiang University School of MedicineHangzhouChina
- The Zhejiang Key Laboratory of Precision PsychiatryHangzhouChina
- Nanhu Brain‐computer Interface InstituteHangzhouChina
- Zhejiang Engineering Center for Mathematical Mental HealthHangzhouChina
- School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain‐Machine IntegrationZhejiang University School of MedicineHangzhouChina
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Yeh TC, Lin YY, Tzeng NS, Kao YC, Chung YA, Chang CC, Fang HW, Chang HA. Effects of online high-definition transcranial direct current stimulation over left dorsolateral prefrontal cortex on predominant negative symptoms and EEG functional connectivity in patients with schizophrenia: a randomized, double-blind, controlled trial. Psychiatry Clin Neurosci 2024. [PMID: 39317963 DOI: 10.1111/pcn.13745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 08/12/2024] [Accepted: 09/02/2024] [Indexed: 09/26/2024]
Abstract
AIMS Schizophrenia, a debilitating mental disorder, is characterized by persistent negative symptoms such as avolition and anhedonia. Currently, there are no effective treatments available for these symptoms. Thus, our study aims to assess the efficacy of online high-definition transcranial direct current stimulation (online HD-tDCS) in addressing the negative symptoms of schizophrenia, utilizing a double-blind, randomized, sham-controlled trial design. METHODS Fifty-nine patients with schizophrenia were randomized to receive either active HD-tDCS or sham stimulation, targeting the left dorsolateral prefrontal cortex. Outcomes were measured by changes in the Positive and Negative Syndrome Scale Factor Score for Negative Symptom (PANSS-FSNS). Exact low-resolution electromagnetic tomography was used to assess the functional connectivity. RESULTS All 59 participants, including 50.84% females with an average age of 43.36 years, completed the trial. In the intention-to-treat analysis, patients receiving active HD-tDCS showed greater improvement in PANSS-FSNS scores compared to those receiving the sham procedure. The differences were 2.34 (95% confidence interval [CI], 1.28-3.40), 4.28 (95% CI, 2.93-5.62), and 4.91 (95% CI, 3.29-6.52) after the intervention, as well as at 1-week and 1-month follow-ups, respectively. A tingling sensation on the scalp was more common in the active group (63.3%) compared to the sham group (10.3%). Additionally, HD-tDCS was associated with a decrease in delta-band connectivity within the default mode network. CONCLUSIONS High-definition transcranial direct current stimulation was effective and safe in ameliorating negative symptoms in patients with schizophrenia when combined with online functional targeting.
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Affiliation(s)
- Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
| | - Yen-Yue Lin
- Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
- Department of Emergency Medicine, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
- Department of Life Sciences, National Central University, Taoyuan, Taiwan
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Chen Kao
- Department of Psychiatry, Tri-Service General Hospital Beitou Branch, National Defense Medical Center, Taipei, Taiwan
| | - Yong-An Chung
- Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chuan-Chia Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsu-Wei Fang
- Department of Chemical Engineering and Biotechnology, National Taipei University of Technology, Taipei, Taiwan
- Institute of Biomedical Engineering and Nanomedicine, National Health Research Institutes, Miaoli County, Taiwan
- High-Value Biomaterials Research and Commercialization Center, National Taipei University of Technology, Taipei, Taiwan
| | - Hsin-An Chang
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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Liu J, Li C, Fang J, Xu H, Zhang X, Zhao F. Effects of physical training combined with transcranial direct current stimulation on maximal strength and lower limb explosive strength in healthy adults. Front Sports Act Living 2024; 6:1446588. [PMID: 39371110 PMCID: PMC11449775 DOI: 10.3389/fspor.2024.1446588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 08/20/2024] [Indexed: 10/08/2024] Open
Abstract
Objective The purpose of this systematic review and meta-analysis was to investigates whether transcranial direct current stimulation applied during physical training increases muscle strength in comparison with sham tDCS combined with physical training. Methods Randomized controlled trials of the effects of tDCS combined physical training intervention on muscle strength and cortical excitability were collected by searching Web of Science, Pubmed, EBSCO, CNKI. The retrieval date ends in April 2024. 11 randomized controlled trials are finally included. The total sample size of the study is 338. The experimental group was subjected to tDCS combined with physical training intervention, and the control group was physical training combined with sham tDCS intervention. Results There is a significant increase in maximal strength (SMD = 0.38; 95% CI: 0.09, 0.67; p = 0.01) and lower limb explosive strength (MD = 2.90; 95% CI: 1.06, 4.74; p = 0.002) when physical training was performed with tDCS, but not following physical training combined with sham tDCS. Subgroup analysis of the subject population showed an increase in muscle strength in those with training experience following tDCS combined with physical training (SMD = 0.39; 95% CI: 0.08, 0.70; p = 0.01), but not for those without training experience (SMD = 0.29; 95% CI: -0.06, 0.63; p = 0.10). Motor evoked potential (MEP) wave amplitude increased significantly following physical training with tDCS (SMD = 0.71; 95% CI: 0.18, 1.24; p = 0.008), but was not different between groups (SMD = 0.16; 95% CI: -0.33, 0.65; p = 0.52). Conclusions tDCS combined with physical training intervention can improve muscle strength, lower limb explosive strength and cerebral cortex excitability. Compared to tDCS combined with training of small muscle groups, tDCS combined with training of large muscle groups was more effective in improving muscle strength. Muscle strength was more likely to improve after tDCS combined with physical training in people with physical training experience compared with people without physical training experience. The combination of tDCS with physical training intervention and the sham-tDCS with physical training intervention both increased cortical excitability. Systematic Review Registration https://www.crd.york.ac.uk/, PROSPERO, identifier (CRD42024550454).
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Affiliation(s)
- Jintong Liu
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Chunlei Li
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Junhui Fang
- Sport Training Center, China Institute of Sport Science, Beijing, China
| | - Haokai Xu
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Xingyue Zhang
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Fan Zhao
- Competitive Sports Department, Beijing Research Institute of Sports Science, Beijing, China
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Chu YC, Chen SSS, Chen KB, Sun JS, Shen TK, Chen LK. Enhanced labor pain monitoring using machine learning and ECG waveform analysis for uterine contraction-induced pain. BioData Min 2024; 17:32. [PMID: 39243100 PMCID: PMC11380346 DOI: 10.1186/s13040-024-00383-z] [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: 12/11/2023] [Accepted: 08/23/2024] [Indexed: 09/09/2024] Open
Abstract
OBJECTIVES This study aims to develop an innovative approach for monitoring and assessing labor pain through ECG waveform analysis, utilizing machine learning techniques to monitor pain resulting from uterine contractions. METHODS The study was conducted at National Taiwan University Hospital between January and July 2020. We collected a dataset of 6010 ECG samples from women preparing for natural spontaneous delivery (NSD). The ECG data was used to develop an ECG waveform-based Nociception Monitoring Index (NoM). The dataset was divided into training (80%) and validation (20%) sets. Multiple machine learning models, including LightGBM, XGBoost, SnapLogisticRegression, and SnapDecisionTree, were developed and evaluated. Hyperparameter optimization was performed using grid search and five-fold cross-validation to enhance model performance. RESULTS The LightGBM model demonstrated superior performance with an AUC of 0.96 and an accuracy of 90%, making it the optimal model for monitoring labor pain based on ECG data. Other models, such as XGBoost and SnapLogisticRegression, also showed strong performance, with AUC values ranging from 0.88 to 0.95. CONCLUSIONS This study demonstrates that the integration of machine learning algorithms with ECG data significantly enhances the accuracy and reliability of labor pain monitoring. Specifically, the LightGBM model exhibits exceptional precision and robustness in continuous pain monitoring during labor, with potential applicability extending to broader healthcare settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04461704.
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Affiliation(s)
- Yuan-Chia Chu
- Department of Information Management, Taipei Veterans General Hospital, Taipei, 11267, Taiwan, R.O.C
- Big Data Center, Taipei Veterans General Hospital, Taipei, 11267, Taiwan, R.O.C
- Department of Information Management, National Taipei University of Nursing and Health Sciences, Taipei, 11219, Taiwan, R.O.C
| | - Saint Shiou-Sheng Chen
- Division of Urology, Taipei City Hospital Renai Branch, Taipei, 106243, Taiwan, R.O.C
- Commission for General Education, National Taiwan University of Science and Technology, Taipei, 10607, Taiwan, R.O.C
- Department of Urology, College of Medicine and Shu-Tien Urological Research Center, National Yang-Ming Chiao Tung University School of Medicine, Taipei, 11221, Taiwan, R.O.C
- General Education Center, University of Taipei, Taipei, 10617, Taiwan, R.O.C
| | - Kuen-Bao Chen
- College of Medicine, China Medical University, Taichung, 40402, Taiwan, R.O.C
- Department of Anesthesiology, North Dist, China Medical University Hospital, No.2, Yude Rd, Taichung City, 404327, Taiwan, R.O.C
| | - Jui-Sheng Sun
- Department of Orthopedic Surgery, National Taiwan University Hospital, Taipei, 10617, Taiwan, R.O.C
- Department of Orthopedic Surgery, En Chu Kong Hospital, New Taipei City, Taiwan, R.O.C
| | - Tzu-Kuei Shen
- Vice President & CTO, R&D and Production Department, V5med Inc., Hsinchu, 30078, Taiwan, R.O.C
| | - Li-Kuei Chen
- College of Medicine, China Medical University, Taichung, 40402, Taiwan, R.O.C..
- Department of Anesthesiology, North Dist, China Medical University Hospital, No.2, Yude Rd, Taichung City, 404327, Taiwan, R.O.C..
- Anhe Rd, Xitun Dist, Dainthus MFM Clinic Anhe, No. 118-18, Taichung City, 407, Taiwan, R.O.C..
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Ganho-Ávila A, Sobral M, Berg MLVD. Transcranial magnetic stimulation and transcranial direct current stimulation in reducing depressive symptoms during the peripartum period. Curr Opin Psychiatry 2024; 37:337-349. [PMID: 38994808 DOI: 10.1097/yco.0000000000000954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
PURPOSE OF REVIEW To present the latest data on the efficacy, safety, and acceptability of transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in peripartum depression (PPD), complemented by notes emerging from our clinical and research experience. RECENT FINDINGS TMS and tDCS show promising results to manage mild to moderate depressive symptoms in the peripartum period. Evidence of TMS efficacy during pregnancy and the postpartum comes from two small randomized controlled trials (RCTs) with encouraging but still inconsistent results. Evidence of tDCS efficacy during pregnancy comes from one small RCT and in the postpartum the first RCT is just now being conducted and results are highly expected. The safety profile (with transient mild adverse effect to women and no known risk to the foetus/newborn) and acceptability by women seems overall good. However, the perspectives from health professionals and managers are unclear. SUMMARY Whereas TMS accelerated protocols (e.g., more than one session/day) and shorter sessions (e.g., theta burst stimulation) could address the need for fast results in PPD, home-based tDCS systems could address accessibility issues. Currently, the evidence on the efficacy of TMS and tDCS in PPD is limited warranting further research to support stronger evidence-based clinical guidelines.
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Affiliation(s)
- Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra (Portugal), Coimbra, Portugal
| | - Mónica Sobral
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra (Portugal), Coimbra, Portugal
| | - Mijke Lambregtse-van den Berg
- Departments of Psychiatry and Child & Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
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12
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Kim E, Yun SJ, Oh BM, Seo HG. Impact of Electric Field Magnitude in the Left Dorsolateral Prefrontal Cortex on Changes in Intrinsic Functional Connectivity Using Transcranial Direct Current Stimulation: A Randomized Crossover Study. J Neurosci Res 2024; 102:e25378. [PMID: 39225477 DOI: 10.1002/jnr.25378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 08/06/2024] [Accepted: 08/10/2024] [Indexed: 09/04/2024]
Abstract
This study investigated whether the electric field magnitude (E-field) delivered to the left dorsolateral prefrontal cortex (L-DLPFC) changes resting-state brain activity and the L-DLPFC resting-state functional connectivity (rsFC), given the variability in tDCS response and lack of understanding of how rsFC changes. Twenty-one healthy participants received either 2 mA anodal or sham tDCS targeting the L-DLPFC for 10 min. Brain imaging was conducted before and after stimulation. The fractional amplitude of low-frequency fluctuation (fALFF), reflecting resting brain activity, and the L-DLPFC rsFC were analyzed to investigate the main effect of tDCS, main effect of time, and interaction effects. The E-field was estimated by modeling tDCS-induced individual electric fields and correlated with fALFF and L-DLPFC rsFC. Anodal tDCS increased fALFF in the left rostral middle frontal area and decreased fALFF in the midline frontal area (FWE p < 0.050), whereas sham induced no changes. Overall rsFC decreased after sham (positive and negative connectivity, p = 0.001 and 0.020, respectively), with modest and nonsignificant changes after anodal tDCS (p = 0.063 and 0.069, respectively). No significant differences in local rsFC were observed among the conditions. Correlations were observed between the E-field and rsFC changes in the L-DLPFC (r = 0.385, p = 0.115), left inferior parietal area (r = 0.495, p = 0.037), and right lateral visual area (r = 0.683, p = 0.002). Single-session tDCS induced resting brain activity changes and may help maintain overall rsFC. The E-field in the L-DLPFC is associated with rsFC changes in both proximal and distally connected brain regions to the L-DLPFC.
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Affiliation(s)
- Eunkyung Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seo Jung Yun
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute on Aging, Seoul National University, Seoul, Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Lapenta OM, Rêgo GG, Boggio PS. Transcranial electrical stimulation for procedural learning and rehabilitation. Neurobiol Learn Mem 2024; 213:107958. [PMID: 38971460 DOI: 10.1016/j.nlm.2024.107958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/26/2024] [Accepted: 07/01/2024] [Indexed: 07/08/2024]
Abstract
Procedural learning is the acquisition of motor and non-motor skills through a gradual process that increases with practice. Impairments in procedural learning have been consistently demonstrated in neurodevelopmental, neurodegenerative, and neuropsychiatric disorders. Considering that noninvasive brain stimulation modulates brain activity and boosts neuroplastic mechanisms, we reviewed the effects of coupling transcranial direct current stimulation (tDCS) with training methods for motor and non-motor procedural learning to explore tDCS potential use as a tool for enhancing implicit learning in healthy and clinical populations. The review covers tDCS effects over i. motor procedural learning, from basic to complex activities; ii. non-motor procedural learning; iii. procedural rehabilitation in several clinical populations. We conclude that targeting the primary motor cortex and prefrontal areas seems the most promising for motor and non-motor procedural learning, respectively. For procedural rehabilitation, the use of tDCS is yet at an early stage but some effectiveness has been reported for implicit motor and memory learning. Still, systematic comparisons of stimulation parameters and target areas are recommended for maximising the effectiveness of tDCS and its robustness for procedural rehabilitation.
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Affiliation(s)
- Olivia Morgan Lapenta
- Psychological Neuroscience Laboratory, Psychology Research Center, School of Psychology, University of Minho - Rua da Universidade, 4710-057 Braga, Portugal.
| | - Gabriel Gaudencio Rêgo
- Social and Cognitive Neuroscience Laboratory, Mackenzie Presbyterian University - Rua Piauí, 181, 01241-001 São Paulo, Brazil; National Institute of Science and Technology on Social and Affective Neuroscience (INCT-SANI), São Paulo, Brazil
| | - Paulo Sérgio Boggio
- Social and Cognitive Neuroscience Laboratory, Mackenzie Presbyterian University - Rua Piauí, 181, 01241-001 São Paulo, Brazil; National Institute of Science and Technology on Social and Affective Neuroscience (INCT-SANI), São Paulo, Brazil
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Lammers B, Sydnor MJ, Cust S, Kim JH, Yenokyan G, Hillis AE, Sebastian R. Protocol for Cerebellar Stimulation for Aphasia Rehabilitation (CeSAR): A randomized, double-blind, sham-controlled trial. PLoS One 2024; 19:e0298991. [PMID: 39186573 PMCID: PMC11346736 DOI: 10.1371/journal.pone.0298991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 07/09/2024] [Indexed: 08/28/2024] Open
Abstract
In this randomized, double-blind, sham-controlled trial of Cerebellar Stimulation for Aphasia Rehabilitation (CeSAR), we will determine the effectiveness of cathodal tDCS (transcranial direct current stimulation) to the right cerebellum for the treatment of chronic aphasia (>6 months post stroke). We will test the hypothesis that cerebellar tDCS in combination with an evidenced-based anomia treatment (semantic feature analysis, SFA) will be associated with greater improvement in naming untrained pictures (as measured by the change in Philadelphia Picture Naming Test), 1-week post-treatment, compared to sham plus SFA. We will also evaluate the effects of cerebellar tDCS on naming trained items as well as the effects on functional communication, content, efficiency, and word-retrieval of picture description, and quality of life. Finally, we will identify imaging and linguistic biomarkers to determine the characteristics of stroke patients that benefit from cerebellar tDCS and SFA treatment. We expect to enroll 60 participants over five years. Participants will receive 15, 25-minute sessions of cerebellar tDCS (3-5 sessions per week) or sham tDCS combined with 1 hour of SFA treatment. Participants will be evaluated prior to the start of treatment, one-week post-treatment, 1-, 3-, and 6-months post-treatment on primary and secondary outcome variables. The long-term aim of this study is to provide the basis for a Phase III randomized controlled trial of cerebellar tDCS vs sham with concurrent language therapy for treatment of chronic aphasia. Trial registration: The trial is registered with ClinicalTrials.gov NCT05093673.
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Affiliation(s)
- Becky Lammers
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Myra J. Sydnor
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Sarah Cust
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Ji Hyun Kim
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
| | - Gayane Yenokyan
- Johns Hopkins Biostatistics Center, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America
| | - Argye E. Hillis
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD, United States of America
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD, United States of America
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Shahbazi N, Heirani A, Amiri E, da Silva Machado DG. Effects of repeated unihemispheric concurrent dual-site tDCS and virtual reality games on motor coordination of sedentary adolescent girls. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2024; 20:20. [PMID: 39174998 PMCID: PMC11342668 DOI: 10.1186/s12993-024-00247-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 08/14/2024] [Indexed: 08/24/2024]
Abstract
BACKGROUND This study investigated the effects of repetitive unihemispheric concurrent dual-site anodal transcranial direct current stimulation (a-tDCSUHCDS) associated with the use of virtual reality games (VR) on the motor coordination of sedentary adolescent girls. METHODS Thirty-six inactive adolescent girls were randomly assigned into 3 groups (n = 12 per group): (1) VR + a-tDCSUHCDS, (2) VR + sham-tDCSUHCDS, and (3) Control. The VR + a-tDCSUHCDS and VR + s-tDCSUHCDS groups received the intervention three times a week for four weeks. In each experimental session, participants first received either 20 min of a-tDCSUHCDS (2 mA at each anodal electrode) targeting the primary motor cortex (M1) and the left dorsolateral prefrontal cortex (DLPFC) or sham and then performed VR for 1 h. The control group received no intervention. Eye-hand coordination (EHC) and bimanual coordination (BC) were measured at baseline, post-intervention, and two weeks later (retention test) using the automatic scoring mirror tracer and continuous two-arm coordination test, respectively. RESULTS Results showed that the EHC was significantly higher in the VR + a-tDCS and VR + s-tDCS groups at post-intervention (all ps< 0.001) and the retention test (all ps< 0.001) compared to the control group. Moreover, the EHC was significantly higher in the VR + a-tDCS group compared to the VR + s-tDCS group (p = 0.024) at the retention. Similarly, VR + a-tDCS and VR + s-tDCS improved BC compared to the control group at post-intervention (all ps< 0.001) and retention test (all ps< 0.001). In addition, higher BC was observed in the VR + a-tDCS group compared to the VR + s-tDCS group (p< 0.001) at the retention test. CONCLUSIONS Our results suggest that adding a-tDCSUHCDS to VR over 12 sessions may have an additional effect on VR training for improving and retaining motor coordination in sedentary adolescent girls.
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Affiliation(s)
- Nasrin Shahbazi
- Department of Motor Behavior and Corrective Exercises, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Ali Heirani
- Department of Motor Behavior and Corrective Exercises, Faculty of Sport Sciences, Razi University, Kermanshah, Iran.
| | - Ehsan Amiri
- Exercise Metabolism and Performance Lab (EMPL), Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah, Iran
| | - Daniel Gomes da Silva Machado
- Research Group in Neuroscience of Human Movement (NeuroMove), Department of Physical Education, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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Hu M, Nitsche MA, Lv Y, Han H, Lin X, Qi F. The effects of repetitive transcranial magnetic and transcranial direct current stimulation on memory functions in older adults with mild cognitive impairment: a systematic review and meta-analysis. Front Hum Neurosci 2024; 18:1436448. [PMID: 39206423 PMCID: PMC11350562 DOI: 10.3389/fnhum.2024.1436448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 07/26/2024] [Indexed: 09/04/2024] Open
Abstract
Mild cognitive impairment (MCI) is a condition that impairs activities of daily living, and often transforms to dementia. Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) show promise in improving cognitive functions in MCI patients. In this meta-analysis, we aimed to compare the effects of rTMS and tDCS on memory functions in MCI patients. We explored eight databases from their inception to March 16, 2024. We obtained 11 studies with 406 patients with MCI. We used the standardized mean difference (SMD) with a 95% confidence interval (CI) to synthesize the effect size. rTMS and tDCS significantly improved memory functions in MCI patients (SMD = 0.61; 95% CI: 0.41-0.82; p < 0.00001; I2 = 22%). In subgroup analysis of number of stimulation sessions, both rTMS and tDCS over 10 sessions (SMD = 0.84; 95% CI: 0.50-1.17, p < 0.00001, I2 = 0%) significantly improved the memory function in MCI patients. The subgroup analyses on different stimulation types (SMD = 0.78; 95% CI: 0.51-1.06; p < 0.00001; I2 = 0%) and treatment persistent effects (SMD = 0.93; 95% CI: 0.51-1.35, p < 0.0001, I2 = 0%) showed that rTMS was more effective than tDCS. rTMS with a stimulation frequency of 10 Hz (SMD = 0.86; 95% CI: 0.51-1.21; p < 0.00001; I2 = 0%) and over 10 sessions (SMD = 0.98; 95% CI: 0.58-1.38; p < 0.00001; I2 = 0%) at multiple sites (SMD = 0.97; 95% CI: 0.44-1.49; p = 0.0003; I2 = 0%) showed a great improvement in the memory performance of patients with MCI. rTMS was more likely to appear temporary side effects (risk ratio (RR) = 3.18, 95% CI: 1.29-7.83, p = 0.01). This meta-analysis suggests that rTMS and tDCS are safe and efficient tools to improve memory functions in patients with MCI, while rTMS had a larger effect than tDCS. rTMS with a stimulation frequency of 10 Hz targeted on multiple sites over 10 sessions showed the greatest effect. We could not conclude parameters of tDCS because of insufficient data. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024558991.
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Affiliation(s)
- Mengdie Hu
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
- German Center for Mental Health (DZPG), Bochum, Germany
| | - Yanxin Lv
- Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
| | - Hairong Han
- Blood Purification Department, The Eighth People’s Hospital of Jinan, Shandong, China
| | - Xu Lin
- Shandong Mental Health Center, Shandong University, Jinan, China
| | - Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing, China
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Camila de Lima Alves da Silva T, da Silva Dantas H, Eduarda Macedo L, Duarte Martins T, Silva-Filho E, Pegado R, McLean L, Thereza Albuquerque Barbosa Cabral Micussi M. Investigating the efficacy of transcranial direct current stimulation on chronic pain management in endometriosis patients: A randomized controlled trial protocol. PLoS One 2024; 19:e0306405. [PMID: 39088433 PMCID: PMC11293689 DOI: 10.1371/journal.pone.0306405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/23/2024] [Indexed: 08/03/2024] Open
Abstract
INTRODUCTION Similar to chronic pain conditions, individuals with endometriosis can be affected by central sensitization syndrome (CSS), which is characterized by a loss of analgesia and central amplification of pain. Transcranial direct current stimulation (tDCS) has shown potential as an effective intervention to improve pain generated by other chronic pain conditions impacted by CSS, such as fibromyalgia and chronic pelvic issues. This study aims to evaluate the effectiveness of tDCS on pain, fatigue, and quality of life among patients affected by endometriosis. METHODS This is a single-center, parallel, double-blinded, randomized, controlled clinical trial protocol study. We aim to recruit 40 participants affected by endometriosis (active group, n = 20; sham group, n = 20). Anodal tDCS will be delivered at an intensity of 2mA, applied over the primary motor cortex for 20 minutes per day for 10 consecutive days. There will be four assessment times: 1 week before beginning the intervention; on the 10th day following the last tDCS session; and 1 and 2 months after the last tDCS session. Pain evaluated by the algometry will be the primary outcome. Pain intensity, quality of life, fatigue, and global perception of change will be the secondary outcomes. We will calculate the effects of the active versus sham stimulation on primary and secondary outcomes by using generalized estimated equations or mixed model analysis. The effect size calculation will represent the effect measure. We expect that only the active group show reductions in pain, fatigue, and quality of life. The results of this trial will produce an important first step in providing evidence on the effectiveness of neuromodulation for the management of pain and will provide data to support new studies on tDCS. REGISTRATION Brazilian Clinical Trials Registry (RBR-4q69573).
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Affiliation(s)
| | - Hégila da Silva Dantas
- Physical Therapy Graduate Student, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Luiza Eduarda Macedo
- Physical Therapy Undergraduate Student, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Talita Duarte Martins
- Physical Therapy Undergraduate Student, Physical Therapy Department, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Edson Silva-Filho
- Ph.D, Physical Therapy, Physical Therapy Department Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Rodrigo Pegado
- Ph.D, Physical Therapy, Physical Therapy Department Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Linda McLean
- School of Rehabilitation Sciences, University of Ottawa, Ottawa, Canada
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Feng T, Zhang L, Wu Y, Tang L, Chen X, Li Y, Shan C. 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. CEREBELLUM (LONDON, ENGLAND) 2024; 23:1593-1603. [PMID: 37962773 PMCID: PMC11269344 DOI: 10.1007/s12311-023-01632-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
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.
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Affiliation(s)
- Tingyi Feng
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lichao Zhang
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuwei Wu
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lin Tang
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xixi Chen
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yuanli Li
- Engineering Research Center of Traditional Chinese Medicine Intelligent Rehabilitation, Ministry of Education, Shanghai, China
- Department of Rehabilitation, Shanghai Seventh People's Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunlei Shan
- Department of Rehabilitation Medicine, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Institute of Rehabilitation, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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19
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Yue T, Liu L, Nitsche MA, Kong Z, Zhang M, Qi F. Effects of high-intensity interval training combined with dual-site transcranial direct current stimulation on inhibitory control and working memory in healthy adults. Hum Mov Sci 2024; 96:103240. [PMID: 38875731 DOI: 10.1016/j.humov.2024.103240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/06/2024] [Accepted: 05/30/2024] [Indexed: 06/16/2024]
Abstract
Transcranial direct current stimulation (tDCS) and high-intensity interval training (HIIT) have been demonstrated to enhance inhibitory control and working memory (WM) performance in healthy adults. However, the potential benefits of combining these two interventions have been rarely explored and remain largely speculative. This study aimed to explore the effects of acute HIIT combined with dual-site tDCS over the dorsolateral prefrontal cortex (DLPFC, F3 and F4) on inhibitory control and WM in healthy young adults. Twenty-five healthy college students (20.5 ± 1.3 years; 11 females) were recruited to complete HIIT + tDCS, HIIT + sham-tDCS, rest + tDCS, and rest + sham-tDCS (CON) sessions in a randomized crossover design. tDCS or sham-tDCS was conducted after completing HIIT or a rest condition of the same duration. The Stroop and 2-back tasks were used to evaluate the influence of this combined intervention on cognitive tasks involving inhibitory control and WM performance in post-trials, respectively. Response times (RTs) of the Stroop task significantly improved in the HIIT + tDCS session compared to the CON session across all conditions (all p values <0.05), in the HIIT + tDCS session compared to the rest + tDCS session in the congruent and neutral conditions (all p values <0.05), in the HIIT + sham-tDCS session compared to the CON session in the congruent and neutral conditions (all p values <0.05), in the HIIT + sham-tDCS session compared to the rest + tDCS session in the congruent condition (p = 0.015). No differences were found between sessions in composite score of RT and accuracy in the Stroop task (all p values >0.05) and in the 2-back task reaction time and accuracy (all p values >0.05). We conclude that acute HIIT combined with tDCS effectively improved inhibitory control but it failed to yield cumulative benefits on inhibitory control and WM in healthy adults. These preliminary findings help to identify beneficial effects of combined interventions on cognitive performance and might guide future research with clinical populations.
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Affiliation(s)
- Tian Yue
- School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China; Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing 100084, China
| | - Liang Liu
- School of Design, Jianghan University, Wuhan 430056, China
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund 44139, Germany; University Clinic of Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld 33615, Germany; German Centre for Mental Health (DZPG), Bochum, Germany
| | - Zhaowei Kong
- Faculty of Education, University of Macau, Taipa, Macau, China
| | - Ming Zhang
- China Volleyball College, Beijing Sport University, Beijing 100084, China.
| | - Fengxue Qi
- Sports, Exercise and Brain Sciences Laboratory, Sports Coaching College, Beijing Sport University, Beijing 100084, China.
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James EC, Tomaskovic-Crook E, Crook JM. Engineering 3D Scaffold-Free Nanoparticle-Laden Stem Cell Constructs for Piezoelectric Enhancement of Human Neural Tissue Formation and Function. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2310010. [PMID: 39049737 DOI: 10.1002/advs.202310010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 07/04/2024] [Indexed: 07/27/2024]
Abstract
Electrical stimulation (ES) of cellular systems can be utilized for biotechnological applications and electroceuticals (bioelectric medicine). Neural cell stimulation especially has a long history in neuroscience research and is increasingly applied for clinical therapies. Application of ES via conventional electrodes requires external connectors and power sources, hindering scientific and therapeutic applications. Here engineering novel 3D scaffold-free human neural stem cell constructs with integrated piezoelectric nanoparticles for enhanced neural tissue induction and function is described. Tetragonal barium titanate (BaTi03) nanoparticles are employed as piezoelectric stimulators prepared as cytocompatible dispersions, incorporated into 3D self-organizing neural spheroids, and activated wirelessly by ultrasound. Ultrasound delivery (low frequency; 40 kHz) is optimized for cell survival, and nanoparticle activation enabled ES throughout the spheroids during differentiation, tissue formation, and maturation. The resultant human neural tissues represent the first example of direct tissue loading with piezoelectric particles for ensuing 3D ultrasound-mediated piezoelectric enhancement of human neuronal induction from stem cells, including augmented neuritogenesis and synaptogenesis. It is anticipated that the platform described will facilitate advanced tissue engineering and in vitro modeling of human neural (and potentially non-neural) tissues, with modeling including tissue development and pathology, and applicable to preclinical testing and prototyping of both electroceuticals and pharmaceuticals.
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Affiliation(s)
- Emma Claire James
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, AIIM Facility, University of Wollongong, Fairy Meadow, NSW, 2519, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
| | - Eva Tomaskovic-Crook
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, AIIM Facility, University of Wollongong, Fairy Meadow, NSW, 2519, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Jeremy Micah Crook
- ARC Centre of Excellence for Electromaterials Science, Intelligent Polymer Research Institute, AIIM Facility, University of Wollongong, Fairy Meadow, NSW, 2519, Australia
- Arto Hardy Family Biomedical Innovation Hub, Chris O'Brien Lifehouse, Camperdown, NSW, 2050, Australia
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
- Institute of Innovative Materials, AIIM Facility, Innovation Campus, Faculty of Engineering and Information Systems, University of Wollongong, Fairy Meadow, NSW, 2519, Australia
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21
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Tseng PT, Zeng BY, Wang HY, Zeng BS, Liang CS, Chen YCB, Stubbs B, Carvalho AF, Brunoni AR, Su KP, Tu YK, Wu YC, Chen TY, Li DJ, Lin PY, Chen YW, Hsu CW, Hung KC, Shiue YL, Li CT. Efficacy and acceptability of noninvasive brain stimulation for treating posttraumatic stress disorder symptoms: A network meta-analysis of randomized controlled trials. Acta Psychiatr Scand 2024; 150:5-21. [PMID: 38616056 DOI: 10.1111/acps.13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/02/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Despite its high lifetime prevalence rate and the elevated disability caused by posttraumatic stress disorder (PTSD), treatments exhibit modest efficacy. In consideration of the abnormal connectivity between the dorsolateral prefrontal cortex (DLPFC) and amygdala in PTSD, several randomized controlled trials (RCTs) addressing the efficacy of different noninvasive brain stimulation (NIBS) modalities for PTSD management have been undertaken. However, previous RCTs have reported inconsistent results. The current network meta-analysis (NMA) aimed to compare the efficacy and acceptability of various NIBS protocols in PTSD management. METHODS We systematically searched ClinicalKey, Cochrane Central Register of Controlled Trials, Embase, ProQuest, PubMed, ScienceDirect, Web of Science, and ClinicalTrials.gov to identify relevant RCTs. The targeted RCTs was those comparing the efficacy of NIBS interventions, such as transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation (rTMS), and transcutaneous cervical vagal nerve stimulation, in patients with PTSD. The NMA was conducted using a frequentist model. The primary outcomes were changes in the overall severity of PTSD and acceptability (to be specific, rates of dropouts for any reason). RESULTS We identified 14 RCTs that enrolled 686 participants. The NMA demonstrated that among the investigated NIBS types, high-frequency rTMS over bilateral DLPFCs was associated with the greatest reduction in overall PTSD severity. Further, in comparison with the sham controls, excitatory stimulation over the right DLPFC with/without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms, including depression and anxiety symptoms, and overall PTSD severity. CONCLUSIONS This NMA demonstrated that excitatory stimulation over the right DLPFC with or without excitatory stimulation over left DLPFC were associated with significant reductions in PTSD-related symptoms. TRIAL REGISTRATION PROSPERO CRD42023391562.
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Affiliation(s)
- Ping-Tao Tseng
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Bing-Yan Zeng
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
- Department of Internal Medicine, E-Da Dachang Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Hung-Yu Wang
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Bing-Syuan Zeng
- Department of Internal Medicine, E-Da Cancer Hospital, Kaohsiung, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Yang-Chieh Brian Chen
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Brendon Stubbs
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK
| | - Andre F Carvalho
- Innovation in Mental and Physical Health and Clinical Treatment (IMPACT) Strategic Research Centre, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation, National Institute of Biomarkers in Psychiatry, Laboratory of Neurosciences (LIM-27), Departamento e Instituto de Psiquiatria, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
- Departamento de Ciências Médicas, Faculdade de Medicina da University of Sao Paulo, Sao Paulo, Brazil
| | - Kuan-Pin Su
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Department of Psychiatry & Mind-Body Interface Laboratory (MBI-Lab), China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
- An-Nan Hospital, China Medical University, Tainan, Taiwan
| | - Yu-Kang Tu
- Institute of Health Data Analytics & Statistics, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yi-Cheng Wu
- Department of Sports Medicine, Landseed International Hospital, Taoyuan, Taiwan
| | - Tien-Yu Chen
- Department of Psychiatry, Tri-Service General Hospital; School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Institute of Brain Science, National Yang Ming Chiao Tung University, Taiwan
| | - Dian-Jeng Li
- Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan
| | - Pao-Yen Lin
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Yen-Wen Chen
- Prospect Clinic for Otorhinolaryngology & Neurology, Kaohsiung, Taiwan
| | - Chih-Wei Hsu
- Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Kuo-Chuan Hung
- Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
| | - Yow-Ling Shiue
- Institute of Precision Medicine, National Sun Yat-sen University, Kaohsiung City, Taiwan
- Institute of Biomedical Sciences, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
- Institute of Brain Science and Brain Research Center, School of Medicine, National Yang Ming Chiao Tung University, Taiwan
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22
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Brabenec L, Kovac D, Mekyska J, Rehulkova L, Kabrtova V, Rektorova I. Short-term effects of transcranial direct current stimulation on motor speech in Parkinson's disease: a pilot study. J Neural Transm (Vienna) 2024; 131:791-797. [PMID: 38592459 PMCID: PMC11199203 DOI: 10.1007/s00702-024-02771-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Hypokinetic dysarthria (HD) is a common motor speech symptom of Parkinson's disease (PD) which does not respond well to PD treatments. We investigated short-term effects of transcranial direct current stimulation (tDCS) on HD in PD using acoustic analysis of speech. Based on our previous studies we focused on stimulation of the right superior temporal gyrus (STG) - an auditory feedback area. METHODS In 14 PD patients with HD, we applied anodal, cathodal and sham tDCS to the right STG using a cross-over design. A protocol consisting of speech tasks was performed prior to and immediately after each stimulation session. Linear mixed models were used for the evaluation of the effects of each stimulation condition on the relative change of acoustic parameters. We also performed a simulation of the mean electric field induced by tDCS. RESULTS Linear mixed model showed a statistically significant effect of the stimulation condition on the relative change of median duration of silences longer than 50 ms (p = 0.015). The relative change after the anodal stimulation (mean = -5.9) was significantly lower as compared to the relative change after the sham stimulation (mean = 12.8), p = 0.014. We also found a correlation between the mean electric field magnitude in the right STG and improvement of articulation precision after anodal tDCS (R = 0.637; p = 0.019). CONCLUSIONS The exploratory study showed that anodal tDCS applied over the auditory feedback area may lead to shorter pauses in a speech of PD patients.
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Affiliation(s)
- Lubos Brabenec
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
| | - Daniel Kovac
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Jiri Mekyska
- Department of Telecommunications, Brno University of Technology, Brno, Czech Republic
| | - Lenka Rehulkova
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
- Faculty of Medicine and St. Anne's University Hospital, First Department of Neurology, Brno, Czech Republic
| | - Veronika Kabrtova
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic
- Faculty of Medicine and St. Anne's University Hospital, First Department of Neurology, Brno, Czech Republic
| | - Irena Rektorova
- Applied Neuroscience Research Group, Central European Institute of Technology - CEITEC, Masaryk University, Brno, Czech Republic.
- Faculty of Medicine and St. Anne's University Hospital, First Department of Neurology, Brno, Czech Republic.
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23
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Ma Y, Jiao F, Batsikadze G, Yavari F, Nitsche MA. The impact of the left inferior frontal gyrus on fear extinction: A transcranial direct current stimulation study. Brain Stimul 2024; 17:816-825. [PMID: 38997105 DOI: 10.1016/j.brs.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Revised: 06/03/2024] [Accepted: 07/06/2024] [Indexed: 07/14/2024] Open
Abstract
INTRODUCTION Fear extinction is a fundamental component of exposure-based therapies for anxiety-related disorders. The renewal of fear in a different context after extinction highlights the importance of contextual factors. In this study, we aimed to investigate the causal role of the left inferior frontal gyrus (LiFG) in the context-dependency of fear extinction learning via administration of transcranial direct current stimulation (tDCS) over this area. METHODS 180 healthy subjects were assigned to 9 groups: 3 tDCS conditions (anodal, cathodal, and sham) × 3 context combinations (AAA, ABA, and ABB). The fear conditioning/extinction task was conducted over three consecutive days: acquisition, extinction learning, and extinction recall. tDCS (2 mA, 10min) was administered during the extinction learning phase over the LiFG via a 4-electrode montage. Skin conductance response (SCR) data and self-report assessments were collected. RESULTS During the extinction learning phase, groups with excitability-enhancing anodal tDCS showed a significantly higher fear response to the threat cues compared to cathodal and sham stimulation conditions, irrespective of contextual factors. This effect was stable until the extinction recall phase. Additionally, excitability-reducing cathodal tDCS caused a significant decrease of the response difference between the threat and safety cues during the extinction recall phase. The self-report assessments showed no significant differences between the conditions throughout the experiment. CONCLUSION Independent of the context, excitability enhancement of the LiFG did impair fear extinction, and led to preservation of fear memory. In contrast, excitability reduction of this area enhanced fear extinction retention. These findings imply that the LiFG plays a role in the fear extinction network, which seems to be however context-independent.
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Affiliation(s)
- Yuanbo Ma
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Fujia Jiao
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai, China
| | - Giorgi Batsikadze
- Department of Neurology and Center for Translational Neuro and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Hufelandstraße 55, Essen, 45147, Germany
| | - Fatemeh Yavari
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Bielefeld, Germany; German Center for Mental Health (DZPG), Bochum, Germany.
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24
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Spiroiu FI, Minuzzi L, Duarte D, McCabe RE, Soreni N. Neurocognitive effects of transcranial direct current stimulation in obsessive-compulsive disorder: a systematic review. Int J Neurosci 2024:1-14. [PMID: 38913323 DOI: 10.1080/00207454.2024.2371303] [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: 11/16/2023] [Accepted: 06/15/2024] [Indexed: 06/25/2024]
Abstract
Transcranial direct current stimulation (tDCS) has been used with increasing frequency as a therapeutic tool to alleviate clinical symptoms of obsessive compulsive-disorder (OCD). However, little is known about the effects of tDCS on neurocognitive functioning among OCD patients. The aim of this review was to provide a comprehensive overview of the literature examining the effects of tDCS on specific neurocognitive functions in OCD. A literature search following PRISMA guidelines was conducted on the following databases: PubMed, PsycINFO, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science. The search yielded 4 results: one randomized, sham-controlled study (20 patients), one randomized, controlled, partial crossover trial (12 patients), one open-label study (5 patients), and one randomized, double-blind, sham-controlled, parallel-group trial (37 patients). A total of 51 patients received active tDCS with some diversity in electrode montages targeting the dorsolateral prefrontal cortex, the pre-supplementary motor area, or the orbitofrontal cortex. tDCS was associated with improved decision-making in study 1, enhanced attentional monitoring and response inhibition in study 2, improved executive and inhibitory control in study 3, and reduced attentional bias and improved response inhibition and working memory in study 4. Limitations of this review include its small sample, the absence of a sham group in half of the studies, and the heterogeneity in tDCS parameters. These preliminary results highlight the need for future testing in randomized, sham-controlled trials to examine whether and how tDCS induces relevant cognitive benefits in OCD.
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Affiliation(s)
- Flavia I Spiroiu
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Luciano Minuzzi
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Dante Duarte
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Randi E McCabe
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Noam Soreni
- Department of Psychiatry & Behavioural Neurosciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Pediatric OCD Consultation Clinic, St. Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
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25
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Takahashi MTC, Balardin JB, Bazán PR, Boasquevisque DDS, Amaro E, Conforto AB. Effect of transcranial direct current stimulation in the initial weeks post-stroke: a pilot randomized study. EINSTEIN-SAO PAULO 2024; 22:eAO0450. [PMID: 38922218 PMCID: PMC11196089 DOI: 10.31744/einstein_journal/2024ao0450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/18/2023] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE This study aimed at assessing the alterations in upper limb motor impairment and connectivity between motor areas following the post-stroke delivery of cathodal transcranial direct current stimulation sessions. METHODS Modifications in the Fugl-Meyer Assessment scores, connectivity between the primary motor cortex of the unaffected and affected hemispheres, and between the primary motor and premotor cortices of the unaffected hemisphere were compared prior to and following six sessions of cathodal transcranial direct current stimulation application in 13 patients (active = 6; sham = 7); this modality targets the primary motor cortex of the unaffected hemisphere early after a stroke. RESULTS Clinically relevant distinctions in Fugl-Meyer Assessment scores (≥9 points) were observed more frequently in the Sham Group than in the Active Group. Between-group differences in the alterations in Fugl-Meyer Assessment scores were not statistically significant (Mann-Whitney test, p=0.133). ROI-to-ROI correlations between the primary motor cortices of the affected and unaffected hemispheres post-therapeutically increased in 5/6 and 2/7 participants in the Active and Sham Groups, respectively. Between-group differences in modifications in connectivity between the aforementioned areas were not statistically significant. Motor performance enhancements were more frequent in the Sham Group compared to the Active Group. CONCLUSION The results of this hypothesis-generating investigation suggest that heightened connectivity may not translate into early clinical benefits following a stroke and will be crucial in designing larger cohort studies to explore mechanisms underlying the impacts of this intervention. ClinicalTrials.gov Identifier: NCT02455427.
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Affiliation(s)
- Marcela Tengler Carvalho Takahashi
- Hospital Municipal da Vila Santa Catarina Dr. Gilson Cássia Marques de CarvalhoHospital Israelita Albert EinsteinSão PauloSPBrazilHospital Municipal da Vila Santa Catarina Dr. Gilson Cássia Marques de Carvalho ; Hospital Israelita Albert Einstein,São Paulo, SP, Brazil.
| | - Joana Bisol Balardin
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Paulo Rodrigo Bazán
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Danielle de Sá Boasquevisque
- Division of NeurologyPopulation Health Research InstitutMcMaster UniversityHamiltonOntarioCanada Division of Neurology, Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
| | - Edson Amaro
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
| | - Adriana Bastos Conforto
- Hospital Israelita Albert EinsteinSão PauloSPBrazil Hospital Israelita Albert Einstein, São Paulo, SP, Brazil.
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Manenti R, Baglio F, Pagnoni I, Gobbi E, Campana E, Alaimo C, Rossetto F, Di Tella S, Pagliari C, Geviti A, Bonfiglio NS, Calabrò RS, Cimino V, Binetti G, Quartarone A, Bramanti P, Cappa SF, Rossini PM, Cotelli M. Long-lasting improvements in episodic memory among subjects with mild cognitive impairment who received transcranial direct current stimulation combined with cognitive treatment and telerehabilitation: a multicentre, randomized, active-controlled study. Front Aging Neurosci 2024; 16:1414593. [PMID: 38966802 PMCID: PMC11223647 DOI: 10.3389/fnagi.2024.1414593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 05/31/2024] [Indexed: 07/06/2024] Open
Abstract
Background In recent years, an increasing number of studies have examined the potential efficacy of cognitive training procedures in individuals with normal ageing and mild cognitive impairment (MCI). Objective The aims of this study were to (i) evaluate the efficacy of the cognitive Virtual Reality Rehabilitation System (VRRS) combined with anodal transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex compared to placebo tDCS stimulation combined with VRRS and (ii) to determine how to prolong the beneficial effects of the treatment. A total of 109 subjects with MCI were assigned to 1 of 5 study groups in a randomized controlled trial design: (a) face-to-face (FTF) VRRS during anodal tDCS followed by cognitive telerehabilitation (TR) (clinic-atDCS-VRRS+Tele@H-VRRS); (b) FTF VRRS during placebo tDCS followed by TR (clinic-ptDCS-VRRS+Tele@H-VRRS); (c) FTF VRRS followed by cognitive TR (clinic-VRRS+Tele@H-VRRS); (d) FTF VRRS followed by at-home unstructured cognitive stimulation (clinic-VRRS+@H-UCS); and (e) FTF cognitive treatment as usual (clinic-TAU). Results An improvement in episodic memory was observed after the end of clinic-atDCS-VRRS (p < 0.001). We found no enhancement in episodic memory after clinic-ptDCS-VRRS or after clinic-TAU.Moreover, the combined treatment led to prolonged beneficial effects (clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-ptDCS-VRRS+Tele@H-VRRS: p = 0.047; clinic-atDCS-VRRS+Tele@H-VRRS vs. clinic-VRRS+Tele@H-VRRS: p = 0.06). Discussion The present study provides preliminary evidence supporting the use of individualized VRRS combined with anodal tDCS and cognitive telerehabilitation for cognitive rehabilitation. Clinical trial registration https://clinicaltrials.gov/study/NCT03486704?term=NCT03486704&rank=1, NCT03486704.
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Affiliation(s)
- Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Sonia Di Tella
- IRCCS Fondazione Don Carlo Gnocchi – ONLUS, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Andrea Geviti
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | | | | | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - Placido Bramanti
- IRCCS Centro Neurolesi “Bonino Pulejo”, Messina, Italy
- Università Degli Studi eCAMPUS, Novedrate, Italy
| | - Stefano F. Cappa
- Istituto Universitario Studi Superiori IUSS, Pavia, Italy
- IRCCS Fondazione Mondino, Pavia, Italy
| | - Paolo Maria Rossini
- Department Neuroscience and Neurorehabilitation, IRCCS San Raffaele Roma, Rome, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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27
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Imperio CM, Chua EF. Lack of effects of online HD-tDCS over the left or right DLPFC in an associative memory and metamemory monitoring task. PLoS One 2024; 19:e0300779. [PMID: 38848375 PMCID: PMC11161112 DOI: 10.1371/journal.pone.0300779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 02/20/2024] [Indexed: 06/09/2024] Open
Abstract
Neuroimaging studies have shown that activity in the prefrontal cortex correlates with two critical aspects of normal memory functioning: retrieval of episodic memories and subjective "feelings-of-knowing" about our memory. Brain stimulation can be used to test the causal role of the prefrontal cortex in these processes, and whether the role differs for the left versus right prefrontal cortex. We compared the effects of online High-Definition transcranial Direct Current Stimulation (HD-tDCS) over the left or right dorsolateral prefrontal cortex (DLPFC) compared to sham during a proverb-name associative memory and feeling-of-knowing task. There were no significant effects of HD-tDCS on either associative recognition or feeling-of-knowing performance, with Bayesian analyses showing moderate support for the null hypotheses. Despite past work showing effects of HD-tDCS on other memory and feeling-of-knowing tasks, and neuroimaging showing effects with similar tasks, these findings add to the literature of non-significant effects with tDCS. This work highlights the need to better understand factors that determine the effectiveness of tDCS, especially if tDCS is to have a successful future as a clinical intervention.
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Affiliation(s)
- Casey M Imperio
- The Graduate Center of the City University of New York, New York, New York, United States of America
| | - Elizabeth F Chua
- The Graduate Center of the City University of New York, New York, New York, United States of America
- Brooklyn College of the City University of New York, New York, New York, United States of America
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Hou JF, Nayeem MOG, Caplan KA, Ruesch EA, Caban-Murillo A, Criado-Hidalgo E, Ornellas SB, Williams B, Pearce AA, Dagdeviren HE, Surets M, White JA, Shapiro MG, Wang F, Ramirez S, Dagdeviren C. An implantable piezoelectric ultrasound stimulator (ImPULS) for deep brain activation. Nat Commun 2024; 15:4601. [PMID: 38834558 PMCID: PMC11150473 DOI: 10.1038/s41467-024-48748-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/13/2024] [Indexed: 06/06/2024] Open
Abstract
Precise neurostimulation can revolutionize therapies for neurological disorders. Electrode-based stimulation devices face challenges in achieving precise and consistent targeting due to the immune response and the limited penetration of electrical fields. Ultrasound can aid in energy propagation, but transcranial ultrasound stimulation in the deep brain has limited spatial resolution caused by bone and tissue scattering. Here, we report an implantable piezoelectric ultrasound stimulator (ImPULS) that generates an ultrasonic focal pressure of 100 kPa to modulate the activity of neurons. ImPULS is a fully-encapsulated, flexible piezoelectric micromachined ultrasound transducer that incorporates a biocompatible piezoceramic, potassium sodium niobate [(K,Na)NbO3]. The absence of electrochemically active elements poses a new strategy for achieving long-term stability. We demonstrated that ImPULS can i) excite neurons in a mouse hippocampal slice ex vivo, ii) activate cells in the hippocampus of an anesthetized mouse to induce expression of activity-dependent gene c-Fos, and iii) stimulate dopaminergic neurons in the substantia nigra pars compacta to elicit time-locked modulation of nigrostriatal dopamine release. This work introduces a non-genetic ultrasound platform for spatially-localized neural stimulation and exploration of basic functions in the deep brain.
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Affiliation(s)
- Jason F Hou
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | | | - Kian A Caplan
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Evan A Ruesch
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Albit Caban-Murillo
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Ernesto Criado-Hidalgo
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Sarah B Ornellas
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Brandon Williams
- Center for Systems Neuroscience, Neurophotonics Center, Department of Biomedical Engineering, Boston University, 610 Commonwealth Ave., Boston, MA, 02215, USA
| | - Ayeilla A Pearce
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Huseyin E Dagdeviren
- Department of Neurosurgery, Faculty of Medicine, Istanbul University, Istanbul, 34093, Turkey
| | - Michelle Surets
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - John A White
- Center for Systems Neuroscience, Neurophotonics Center, Department of Biomedical Engineering, Boston University, 610 Commonwealth Ave., Boston, MA, 02215, USA
| | - Mikhail G Shapiro
- Division of Chemistry and Chemical Engineering, California Institute of Technology, Pasadena, CA, 91125, USA
| | - Fan Wang
- Department of Brain and Cognitive Sciences, McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA
| | - Steve Ramirez
- Department of Psychological and Brain Sciences, The Center for Systems Neuroscience, Boston University, Boston, 02215, MA, USA
| | - Canan Dagdeviren
- Media Lab, Massachusetts Institute of Technology, Cambridge, MA, 02139, USA.
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Du Z, Chen G, Li Y, Zheng N, Cheng JX, Yang C. Photoacoustic: A Versatile Nongenetic Method for High-Precision Neuromodulation. Acc Chem Res 2024; 57:1595-1607. [PMID: 38759211 PMCID: PMC11154953 DOI: 10.1021/acs.accounts.4c00119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
High-precision neuromodulation plays a pivotal role in elucidating fundamental principles of neuroscience and treating specific neurological disorders. Optical neuromodulation, enabled by spatial resolution defined by the diffraction limit at the submicrometer scale, is a general strategy to achieve such precision. Optogenetics offers single-neuron spatial resolution with cellular specificity, whereas the requirement of genetic transfection hinders its clinical application. Direct photothermal modulation, an alternative nongenetic optical approach, often associates a large temperature increase with the risk of thermal damage to surrounding tissues.Photoacoustic (also called optoacoustic) neural stimulation is an emerging technology for neural stimulation with the following key features demonstrated. First, the photoacoustic approach demonstrated high efficacy without the need for genetic modification. The generated pulsed ultrasound upon ns laser pulses with energy ranging from a few μJ to tens of μJ is sufficient to activate wild-type neurons. Second, the photoacoustic approach provides sub-100-μm spatial precision. It overcomes the fundamental wave diffraction limit of ultrasound by harnessing the localized ultrasound field generated through light absorption. A spatial precision of 400 μm has been achieved in rodent brains using a fiber-based photoacoustic emitter. Single-cell stimulation in neuronal cultures in vitro and in brain slices ex vivo is achieved using tapered fiber-based photoacoustic emitters. This precision is 10 to 100 times better than that for piezo-based low-frequency ultrasound and is essential to pinpoint a specific region or cell population in a living brain. Third, compared to direct photothermal stimulation via temperature increase, photoacoustic stimulation requires 40 times less laser energy dose to evoke neuron activities and is associated with a minimal temperature increase of less than 1 °C, preventing potential thermal damage to neurons. Fourth, photoacoustics is a versatile approach and can be designed in various platforms aiming at specific applications. Our team has shown the design of fiber-based photoacoustic emitters, photoacoustic nanotransducers, soft biocompatible photoacoustic films, and soft photoacoustic lenses. Since they interact with neurons through ultrasound without the need for direct contact, photoacoustic enables noninvasive transcranial and dura-penetrating brain stimulation without compromising high precision.In this Account, we will first review the basic principles of photoacoustic and discuss the key design elements of PA transducers for neural modulation guided by the principle. We will also highlight how these design goals were achieved from a materials chemistry perspective. The design of different PA interfaces, their unique capability, and their applications in neural systems will be reviewed. In the end, we will discuss the remaining challenges and future perspectives for this technology.
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Affiliation(s)
- Zhiyi Du
- Department
of Chemistry, Boston University, Boston, Massachusetts 02215, United States
| | - Guo Chen
- Department
of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Yueming Li
- Department
of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Nan Zheng
- Division
of Materials Science and Engineering, Boston
University, Boston, Massachusetts 02215, United States
| | - Ji-Xin Cheng
- Department
of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, United States
- Department
of Biomedical Engineering, Boston University, Boston, Massachusetts 02215, United States
| | - Chen Yang
- Department
of Chemistry, Boston University, Boston, Massachusetts 02215, United States
- Department
of Electrical and Computer Engineering, Boston University, Boston, Massachusetts 02215, United States
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Montilla-Herrador J, Lozano-Meca J, Lozano-Guadalajara JV, Gacto-Sánchez M. The Efficacy of the Addition of tDCS and TENS to an Education and Exercise Program in Subjects with Knee Osteoarthritis: A Randomized Controlled Trial. Biomedicines 2024; 12:1186. [PMID: 38927392 PMCID: PMC11200463 DOI: 10.3390/biomedicines12061186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 05/17/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024] Open
Abstract
Knee osteoarthritis (KOA) has a significant impact on patients' quality of life. This study aimed to assess the effectiveness of integrating transcranial direct current stimulation (tDCS) and transcutaneous electrical nerve stimulation (TENS) into an education and exercise program with the aim of decreasing pain and improving physical function in KOA. A randomized controlled trial with 65 KOA patients was conducted. The subjects were assigned to one of the following three groups: education and active exercise plus (1) double active tDCS and TENS, (2) active tDCS and sham TENS, and (3) double sham tDCS and TENS. Sessions were conducted over a 20 min period, whilst data on pain, chronic pain clinical variables, and physical function were collected. Although all groups showed improvement in pain-related symptoms in the short and medium term, the addition of tDCS and/or TENS did not significantly enhance the benefits of the exercise and education program. These findings suggest that an education and active exercise program in the treatment of KOA has a positive effect on pain, with or without the addition of tDCS and/or TENS.
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Affiliation(s)
- Joaquina Montilla-Herrador
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum, University of Murcia, Instituto de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB), El Palmar, 30120 Murcia, Spain; (J.M.-H.); (M.G.-S.)
| | - Jose Lozano-Meca
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum, University of Murcia, Instituto de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB), El Palmar, 30120 Murcia, Spain; (J.M.-H.); (M.G.-S.)
| | | | - Mariano Gacto-Sánchez
- Department of Physical Therapy, Faculty of Medicine, CEIR Campus Mare Nostrum, University of Murcia, Instituto de Investigación Biosanitaria-Virgen de la Arrixaca (IMIB), El Palmar, 30120 Murcia, Spain; (J.M.-H.); (M.G.-S.)
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Di Fuccio R, Lardone A, De Luca M, Ali L, Limone P, Marangolo P. Neurobiological Effects of Transcranial Direct Current Stimulation over the Inferior Frontal Gyrus: A Systematic Review on Cognitive Enhancement in Healthy and Neurological Adults. Biomedicines 2024; 12:1146. [PMID: 38927353 PMCID: PMC11200721 DOI: 10.3390/biomedicines12061146] [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: 04/16/2024] [Revised: 05/16/2024] [Accepted: 05/21/2024] [Indexed: 06/28/2024] Open
Abstract
The neurobiological effects of transcranial direct current stimulation (tDCS) have still not been unequivocally clarified. Some studies have suggested that the application of tDCS over the inferior frontal gyrus (IFG) enhances different aspects of cognition in healthy and neurological individuals, exerting neural changes over the target area and its neural surroundings. In this systematic review, randomized sham-controlled trials in healthy and neurological adults were selected through a database search to explore whether tDCS over the IFG combined with cognitive training modulates functional connectivity or neural changes. Twenty studies were finally included, among which twelve measured tDCS effects through functional magnetic resonance (fMRI), two through functional near-infrared spectroscopy (fNIRS), and six through electroencephalography (EEG). Due to the high heterogeneity observed across studies, data were qualitatively described and compared to assess reliability. Overall, studies that combined fMRI and tDCS showed widespread changes in functional connectivity at both local and distant brain regions. The findings also suggested that tDCS may also modulate electrophysiological changes underlying the targeted area. However, these outcomes were not always accompanied by corresponding significant behavioral results. This work raises the question concerning the general efficacy of tDCS, the implications of which extend to the steadily increasing tDCS literature.
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Affiliation(s)
- Raffaele Di Fuccio
- Department of Psychology and Educational Sciences, Telematic University of Pegaso, Piazza dei Santi Apostoli 49, 00187 Rome, Italy; (R.D.F.); (L.A.); (P.L.)
| | - Anna Lardone
- Department of Humanities Studies, University Federico II, Via Porta di Massa 1, 80133 Naples, Italy; (A.L.); (M.D.L.)
| | - Mariagiovanna De Luca
- Department of Humanities Studies, University Federico II, Via Porta di Massa 1, 80133 Naples, Italy; (A.L.); (M.D.L.)
| | - Leila Ali
- Department of Psychology and Educational Sciences, Telematic University of Pegaso, Piazza dei Santi Apostoli 49, 00187 Rome, Italy; (R.D.F.); (L.A.); (P.L.)
| | - Pierpaolo Limone
- Department of Psychology and Educational Sciences, Telematic University of Pegaso, Piazza dei Santi Apostoli 49, 00187 Rome, Italy; (R.D.F.); (L.A.); (P.L.)
| | - Paola Marangolo
- Department of Humanities Studies, University Federico II, Via Porta di Massa 1, 80133 Naples, Italy; (A.L.); (M.D.L.)
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Chmiel J, Kurpas D, Rybakowski F, Leszek J. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) in Binge Eating Disorder (BED)-Review and Insight into the Mechanisms of Action. Nutrients 2024; 16:1521. [PMID: 38794759 PMCID: PMC11123682 DOI: 10.3390/nu16101521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/12/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Binge eating disorder (BED) is the most common eating disorder among those contributing to the development of obesity, and thus acts as a significant burden on the lives and health of patients. It is characterized by complex neurobiology, which includes changes in brain activity and neurotransmitter secretion. Existing treatments are moderately effective, and so the search for new therapies that are effective and safe is ongoing. AIM AND METHODS This review examines the use of transcranial direct current stimulation (tDCS) in the treatment of binge eating disorder. Searches were conducted on the PubMed/Medline, Research Gate, and Cochrane databases. RESULTS Six studies were found that matched the review topic. All of them used the anodal stimulation of the right dorsolateral prefrontal cortex (DLPFC) in BED patients. tDCS proved effective in reducing food cravings, the desire to binge eat, the number of binging episodes, and food intake. It also improved the outcomes of inhibitory control and the treatment of eating disorder psychopathology. The potential mechanisms of action of tDCS in BED are explained, limitations in current research are outlined, and recommendations for future research are provided. CONCLUSIONS Preliminary evidence suggests that the anodal application of tDCS to the right DLPFC reduces the symptoms of BED. However, caution should be exercised in the broader use of tDCS in this context due to the small number of studies performed and the small number of patients included. Future studies should incorporate neuroimaging and neurophysiological measurements to elucidate the potential mechanisms of action of tDCS in BED.
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Affiliation(s)
- James Chmiel
- Institute of Neurofeedback and tDCS Poland, 70-393 Szczecin, Poland
| | - Donata Kurpas
- Department of Family and Pediatric Nursing, Faculty of Health Sciences, Wrocław Medical University, 51-618 Wrocław, Poland
| | - Filip Rybakowski
- Department and Clinic of Psychiatry, Poznan University of Medical Sciences, 61-701 Poznań, Poland
| | - Jerzy Leszek
- Department and Clinic of Psychiatry, Wrocław Medical University, 54-235 Wrocław, Poland
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Metelski N, Gu Y, Quinn L, Friel KM, Gordon AM. Safety and efficacy of non-invasive brain stimulation for the upper extremities in children with cerebral palsy: A systematic review. Dev Med Child Neurol 2024; 66:573-597. [PMID: 37528530 DOI: 10.1111/dmcn.15720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
AIM To evaluate available evidence examining safety and efficacy of non-invasive brain stimulation (NIBS) on upper extremity outcomes in children with cerebral palsy (CP). METHOD We electronically searched 12 sources up to May 2023 using JBI and Cochrane guidelines. Two reviewers selected articles with predetermined eligibility criteria, conducted data extraction, and assessed risk of bias using the Cochrane Risk of Bias criteria. RESULTS Nineteen studies were included: eight using repetitive transcranial magnetic stimulation (rTMS) and 11 using transcranial direct current stimulation (tDCS). Moderate certainty evidence supports the safety of rTMS and tDCS for children with CP. Very low to moderate certainty evidence suggests that rTMS and tDCS result in little to no difference in upper extremity outcomes. INTERPRETATION Evidence indicates that NIBS is a safe and feasible intervention to target upper extremity outcomes in children with CP, although it also indicates little to no significant impact on upper extremity outcomes. These findings are discussed in relation to the heterogeneous participants' characteristics and stimulation parameters. Larger studies of high methodological quality are required to inform future research and protocols for NIBS.
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Affiliation(s)
- Nicole Metelski
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Yu Gu
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Lori Quinn
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
| | - Kathleen M Friel
- Burke Neurological Institute, White Plains, New York, and Weill Cornell Medicine, New York, New York, USA
| | - Andrew M Gordon
- Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, New York, USA
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Wang Y, Monai H. Transcranial direct current stimulation alters cerebrospinal fluid-interstitial fluid exchange in mouse brain. Brain Stimul 2024; 17:620-632. [PMID: 38688399 DOI: 10.1016/j.brs.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 03/28/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has gained prominence recently. Clinical studies have explored tDCS as an adjunct to neurologic disease rehabilitation, with evidence suggesting its potential in modulating brain clearance mechanisms. The glymphatic system, a proposed brain waste clearance system, posits that cerebrospinal fluid-interstitial fluid (CSF-ISF) exchange aids in efficient metabolic waste removal. While some studies have linked tDCS to astrocytic inositol trisphosphate (IP3)/Ca2+ signaling, the impact of tDCS on CSF-ISF exchange dynamics remains unclear. HYPOTHESIS tDCS influences the dynamics of CSF-ISF exchange through astrocytic IP3/Ca2+ signaling. METHODS In this study, we administered tDCS (0.1 mA for 10 min) to C57BL/6N mice anesthetized with ketamine-xylazine (KX). The anode was positioned on the cranial bone above the cortex, and the cathode was inserted into the neck. Following tDCS, we directly assessed brain fluid dynamics by injecting biotinylated dextran amine (BDA) as a CSF tracer into the cisterna magna (CM). The brain was then extracted after either 30 or 60 min and fixed. After 24 h, the sectioned brain slices were stained with Alexa 594-conjugated streptavidin (SA) to visualize BDA using immunohistochemistry. We conducted Electroencephalography (EEG) recordings and aquaporin 4 (AQP4)/CD31 immunostaining to investigate the underlying mechanisms of tDCS. Additionally, we monitored the efflux of Evans blue, injected into the cisterna magna, using cervical lymph node imaging. Some experiments were subsequently repeated with inositol trisphosphate receptor type 2 (IP3R2) knockout (KO) mice. RESULTS Post-tDCS, we observed an increased CSF tracer influx, indicating a modulation of CSF-ISF exchange by tDCS. Additionally, tDCS appeared to enhance the brain's metabolic waste efflux. EEG recordings showed an increase in delta wave post-tDCS. But no significant change in AQP4 expression was detected 30 min post-tDCS. Besides, we found no alteration in CSF-ISF exchange and delta wave activity in IP3R2 KO mice after tDCS. CONCLUSION Our findings suggest that tDCS augments the glymphatic system's influx and efflux. Through astrocytic IP3/Ca2+ signaling, tDCS was found to modify the delta wave, which correlates positively with brain clearance. This study underscores the potential of tDCS in modulating brain metabolic waste clearance.
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Affiliation(s)
- Yan Wang
- Graduate School of Humanities and Sciences, Ochanomizu University, Ohtsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Hiromu Monai
- Graduate School of Humanities and Sciences, Ochanomizu University, Ohtsuka, Bunkyo-ku, Tokyo, 112-8610, Japan.
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Jahromi MM, Vlček P, Kvašňák E, Lippertová MG. Posture enhancement with cerebellum transcranial electrical stimulation: a systematic review of current methods and findings. Exp Brain Res 2024; 242:991-1009. [PMID: 38546838 DOI: 10.1007/s00221-024-06808-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/13/2024] [Indexed: 07/13/2024]
Abstract
Recently, transcranial electrical stimulation (tES) has gained increasing popularity among researchers, especially for recovery and improvement, but interpretation of these results is difficult due to variations in study methods and outcome measurements. The main goal of this study was to better understand the postural and balance indicators affected by cerebellar tES, as the cerebellum is the main brain region responsible for controlling balance. For this systematic literature review, three databases were searched for articles where the cerebellum was stimulated by any type of tES in either healthy participants or those with neurologic disorders. Postural, dynamic, and/or static stability measurements were recorded, and risk of bias was assessed on the PEDro scale. A total of 21 studies were included in the analysis. 17 studies reported improvements after application of tES. 14 studies stimulated the cerebellum unilaterally and 15 used this modality for 20 min. Moreover, all studies exclusively used transcranial direct current as the type of stimulation. Evaluation of PEDro results showed that studies included in the analysis utilized good methodology. Although there were some inconsistencies in study results, overall, it was demonstrated that tES can improve balance and postural index under both healthy and neurological conditions. Further research of bilateral cerebellar stimulation or the use of transcranial alternating current stimulation, transcranial random noise stimulation, and transcranial pulsed current stimulation is needed for a more comprehensive assessment of the potential positive effects of cerebellar tES on the balance system.
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Affiliation(s)
| | - Přemysl Vlček
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
- Applied Brain Electroencephalography, National Institute of Mental Health, Topolova 748, 25067, Klecany, Czech Republic.
| | - Eugen Kvašňák
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Yang X, Wu J, Tang Y, Ren Z. Effects of anodic transcranial direct current stimulation combined with physical training on the performance of elite swimmers. Front Physiol 2024; 15:1383491. [PMID: 38665598 PMCID: PMC11043593 DOI: 10.3389/fphys.2024.1383491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024] Open
Abstract
Objective Anodal transcranial direct current stimulation (a-tDCS) has been used to improve athletic performance in various populations; however, its role in improving performance in elite athletes is unclear. This study aimed to investigate the effects of a-tDCS on athletic performance in elite athletes. Methods We used a single-blind, randomized controlled experimental design and recruited 24 national-level freestyle swimmers from China. All athletes were randomly divided into two groups; the experimental group underwent a-tDCS (current 2 mA for 20 min) combined with physical training, and the control group underwent a-tDCS sham stimulation combined with physical training. The physical training program was identical in the experimental and control groups. The intervention period was 6 weeks, with five weekly sessions of 110 min each, consisting of 20 min of a-tDCS and 90 min of physical training. Base strength, explosive strength, aerobic endurance, and anaerobic endurance were measured in the athletes before and after the intervention. Results The results were as follows. 1) Basic strength: There was a significant improvement in 5RM pull-ups in the experimental and control groups before and after the intervention (p < 0.05). 2) Explosive strength: There was a significant improvement in vertical jump and swimming start distance into the water in the experimental and control groups before and after the intervention (p < 0.05). 3) Aerobic endurance: There was no significant improvement in the experimental and control groups before and after the intervention. 4) Anaerobic endurance: There was a significant improvement in 400 m running performance in the experimental and control groups before and after the intervention (p < 0.05). Conclusion Compared to physical training alone, a-tDCS combined with physical training can better improve the athletic performance of high-level swimmers, especially in basic strength, explosive strength, and aerobic endurance.
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Affiliation(s)
- Xipeng Yang
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Jinlong Wu
- College of Physical Education, Southwest University, Chongqing, China
| | - Yucheng Tang
- College of Physical Education, Shenzhen University, Shenzhen, China
| | - Zhanbing Ren
- College of Physical Education, Shenzhen University, Shenzhen, China
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Drane DL, Acerbo E, Rogers A, Pedersen NP, Williamson A, Stern MA, Dickey AS, Howard BM, Bearden DJ, Okada N, Staikova E, Gutekunst CA, Alwaki A, Gershon T, Jirsa V, Gross RE, Loring DW, Kheder A, Willie JT. Selective Posterior Cerebral Artery Wada Better Predicts Good Memory and Naming Outcomes Following Selective Stereotactic Thermal Ablation for Medial Temporal Lobe Epilepsy Than Internal Carotid Artery Wada. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.24.24304488. [PMID: 38585976 PMCID: PMC10996748 DOI: 10.1101/2024.03.24.24304488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
The conventional intracarotid amobarbital (Wada) test has been used to assess memory function in patients being considered for temporal lobe epilepsy (TLE) surgery. Minimally invasive approaches that target the medial temporal lobe (MTL) and spare neocortex are increasingly used, but a knowledge gap remains in how to assess memory and language risk from these procedures. We retrospectively compared results of two versions of the Wada test, the intracarotid artery (ICA-Wada) and posterior cerebral artery (PCA-Wada) approaches, with respect to predicting subsequent memory and language outcomes, particularly after stereotactic laser amygdalohippocampotomy (SLAH). We included all patients being considered for SLAH who underwent both ICA-Wada and PCA-Wada at a single institution. Memory and confrontation naming assessments were conducted using standardized neuropsychological tests to assess pre- to post-surgical changes in cognitive performance. Of 13 patients who initially failed the ICA-Wada, only one patient subsequently failed the PCA-Wada (p=0.003, two-sided binomial test with p 0 =0.5) demonstrating that these tests assess different brain regions or networks. PCA-Wada had a high negative predictive value for the safety of SLAH, compared to ICA-Wada, as none of the patients who underwent SLAH after passing the PCA-Wada experienced catastrophic memory decline (0 of 9 subjects, p <.004, two-sided binomial test with p 0 =0.5), and all experienced a good cognitive outcome. In contrast, the single patient who received a left anterior temporal lobectomy after failed ICA- and passed PCA-Wada experienced a persistent, near catastrophic memory decline. On confrontation naming, few patients exhibited disturbance during the PCA-Wada. Following surgery, SLAH patients showed no naming decline, while open resection patients, whose surgeries all included ipsilateral temporal lobe neocortex, experienced significant naming difficulties (Fisher's exact test, p <.05). These findings demonstrate that (1) failing the ICA-Wada falsely predicts memory decline following SLAH, (2) PCA-Wada better predicts good memory outcomes of SLAH for MTLE, and (3) the MTL brain structures affected by both PCA-Wada and SLAH are not directly involved in language processing.
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Jiang S, Jones M, von Bastian CC. TDCS over PPC or DLPFC does not improve visual working memory capacity. COMMUNICATIONS PSYCHOLOGY 2024; 2:20. [PMID: 39242793 PMCID: PMC11332112 DOI: 10.1038/s44271-024-00067-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 02/13/2024] [Indexed: 09/09/2024]
Abstract
Non-invasive brain stimulation has been highlighted as a possible intervention to induce cognitive benefits, including on visual working memory (VWM). However, findings are inconsistent, possibly due to methodological issues. A recent high-profile study by Wang et al.1 reported that anodal transcranial direct current stimulation (tDCS) over posterior parietal cortex (PPC), but not over dorsolateral prefrontal cortex (DLPFC), selectively improved VWM capacity but not precision, especially at a high VWM load. Thus, in the current pre-registered conceptual replication study, we accounted for the key potential methodological issues in the original study and tested an adequate number of participants required to demonstrate the previously reported effects (n = 48 compared to n = 20). Participants underwent counterbalanced PPC, DLPFC and sham stimulation before completing 360 trials of a continuous orientation-reproduction task with a slight variation of task stimuli and setup. We found no evidence for the selective effect of PPC stimulation. Instead, our results showed that tDCS effects were absent regardless of stimulation region and VWM load, which was largely supported by substantial to strong Bayesian evidence. Therefore, our results challenge previously reported benefits of single-session anodal PPC-tDCS on VWM.
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Affiliation(s)
- Shuangke Jiang
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK.
| | - Myles Jones
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK
| | - Claudia C von Bastian
- Department of Psychology and Neuroscience Institute, University of Sheffield, Sheffield, UK.
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Li S, Tang Y, Zhou Y, Ni Y. Effects of Transcranial Direct Current Stimulation on Cognitive Function in Older Adults with and without Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Gerontology 2024; 70:544-560. [PMID: 38452749 DOI: 10.1159/000537848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
INTRODUCTION Noninvasive brain stimulation (NIBS) has shown benefits for cognitive function in older adults. However, the effects of transcranial direct current stimulation (tDCS) on cognitive function in older adults are inconsistent across studies, and the evidence for tDCS has limitations. We aim to explore whether tDCS can improve cognitive function and different cognitive domains (i.e., learning and memory and executive function) in adults aged 65 years and older with and without mild cognitive impairment and to further analyze the influencing factors of tDCS. METHODS Five English databases (PubMed, Cochrane Library, EMBASE, Web of Science, the cumulative Index to Nursing and Allied Health Literature [CINAHL]) and four Chinese databases were searched from inception to October 14, 2023. Literature screening, data extraction, and quality assessment were completed independently by two reviewers. All statistical analyses were conducted using RevMan software (version 5.3). Standardized mean difference (SMD) along with a 95% confidence interval (CI) was used to express the effect size of the outcomes, and a random-effect model was also used. RESULTS A total of 10 RCTs and 1,761 participants were included in the meta-analysis, and the risk of bias in those studies was relatively low. A significant effect favoring tDCS on immediate postintervention cognitive function (SMD = 0.16, Z = 2.36, p = 0.02) was found. However, the effects on immediate postintervention learning and memory (SMD = 0.20, Z = 2.00, p = 0.05) and executive function (SMD = 0.10, Z = 1.22, p = 0.22), and 1-month postintervention cognitive function (SMD = 0.12, Z = 1.50, p = 0.13), learning and memory (SMD = 0.17, Z = 1.39, p = 0.16), and executive function (SMD = 0.08, Z = 0.67, p = 0.51) were not statistically significant. CONCLUSION tDCS can significantly improve the immediate postintervention cognitive function of healthy older adults and MCI elderly individuals. Additional longitudinal extensive sample studies are required to clarify the specific effects of tDCS on different cognitive domains, and the optimal tDCS parameters need to be explored to guide clinical practice.
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Affiliation(s)
- Sijia Li
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China,
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China,
| | - Ying Tang
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - You Zhou
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunxia Ni
- Department of Cardiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
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Tamura R, Dezawa S, Kato J, Nakata M, Kunori N, Takashima I. Transcranial direct current stimulation improves motor function in rats with 6-hydroxydopamine-induced Parkinsonism. Behav Brain Res 2024; 460:114815. [PMID: 38122905 DOI: 10.1016/j.bbr.2023.114815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/02/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023]
Abstract
Transcranial direct current stimulation (tDCS) is increasingly being used for Parkinson's disease (PD); however, the evaluation of its clinical impact remains complex owing to the heterogeneity of patients and treatments. Therefore, we used a unilateral 6-hydroxydopamine-induced PD rat model to investigate whether anodal tDCS of the primary motor cortex (M1) alleviates PD motor deficits. Before tDCS treatment, unilateral PD rats preferentially used the forelimb ipsilateral to the lesion in the exploratory cylinder test and showed reduced locomotor activity in the open field test. In addition, PD-related clumsy forelimb movements during treadmill walking were detected using deep learning-based video analysis (DeepLabCut). When the 5-day tDCS treatment began, the forelimb-use asymmetry was ameliorated gradually, and locomotor activity increased to pre-lesion levels. tDCS treatment also normalized unnatural forelimb movement during walking and restored a balanced gait. However, these therapeutic effects were rapidly lost or gradually disappeared when the tDCS treatment was terminated. Histological analysis at the end of the experiment revealed that the animals had moderately advanced PD, with 40-50% of dopamine neurons and fibers preserved on the injured side compared with those on the intact side. Although it remains a challenge to elucidate the neural mechanisms of the transient improvement in motor function induced by tDCS, the results of this study provide evidence that tDCS of the M1 produces positive behavioral outcomes in PD animals and provides the basis for further clinical research examining the application of tDCS in patients with PD.
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Affiliation(s)
- Ryota Tamura
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Shinnosuke Dezawa
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan; Faculty of Medical and Health Sciences, Tsukuba International University, Tsuchiura, Japan
| | - Junpei Kato
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - Mariko Nakata
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan; Laboratory of Behavioral Neuroendocrinology, University of Tsukuba, Tsukuba, Japan
| | - Nobuo Kunori
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan
| | - Ichiro Takashima
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology (AIST), Tsukuba, Japan; Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan; Department of Informatics and Electronics, Daiichi Institute of Technology, Tokyo, Japan.
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Nejati V, Nozari M, Mirzaian B, Pourshahriar H, Salehinejad MA. Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms. J Nerv Ment Dis 2024; 212:141-151. [PMID: 38198673 DOI: 10.1097/nmd.0000000000001745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
ABSTRACT This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group ( p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD.
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Affiliation(s)
- Vahid Nejati
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Masoumeh Nozari
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
| | - Bahram Mirzaian
- Department of Psychology, Shahid Beheshti University, Tehran, Iran
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Lau CI, Liu MN, Cheng FY, Wang HC, Walsh V, Liao YY. Can transcranial direct current stimulation combined with interactive computerized cognitive training boost cognition and gait performance in older adults with mild cognitive impairment? a randomized controlled trial. J Neuroeng Rehabil 2024; 21:26. [PMID: 38365761 PMCID: PMC10874043 DOI: 10.1186/s12984-024-01313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/24/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Older adults with Mild Cognitive Impairment (MCI) are often subject to cognitive and gait deficits. Interactive Computerized Cognitive Training (ICCT) may improve cognitive function; however, the effect of such training on gait performance is limited. Transcranial Direct Current Stimulation (tDCS) improves cognition and gait performance. It remains unclear whether combining tDCS with ICCT produces an enhanced synergistic effect on cognition and complex gait performance relative to ICCT alone. This study aimed to compare the effects of tDCS combined with ICCT on cognition and gait performance in older adults with MCI. METHOD Twenty-one older adults with MCI were randomly assigned to groups receiving either anodal tDCS and ICCT ( tDCS + ICCT ) or sham tDCS and ICCT ( sham + ICCT ). Participants played Nintendo Switch cognitive games for 40 min per session, simultaneously receiving either anodal or sham tDCS over the left dorsolateral prefrontal cortex for the first 20 min. Cognitive and gait assessments were performed before and after 15 training sessions. RESULTS The global cognition, executive function, and working-memory scores improved in both groups, but there were no significant interaction effects on cognitive outcomes. Additionally, the group × time interactions indicated that tDCS + ICCT significantly enhanced dual-task gait performance in terms of gait speed (p = 0.045), variability (p = 0.016), and dual-task cost (p = 0.039) compared to sham + ICCT. CONCLUSION The combined effect of tDCS and ICCT on cognition was not superior to that of ICCT alone; however, it had a significant impact on dual-task gait performance. Administering tDCS as an adjunct to ICCT may thus provide additional benefits for older adults with MCI. TRIAL REGISTRATION This trial was registered at http://www. CLINICALTRIALS in.th/ (TCTR 20,220,328,009).
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Affiliation(s)
- Chi Ieong Lau
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
- Institute of Biophotonics, National Yang Ming Chiao Tung University, Taipei, Taiwan
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fang-Yu Cheng
- Institute of Long-Term Care, MacKay Medical College, New Taipei, Taiwan
| | - Han-Cheng Wang
- Dementia Center, Department of Neurology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
- College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Vincent Walsh
- Applied Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London, London, UK
| | - Ying-Yi Liao
- Department of Gerontological Health Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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Alipour M, Seok S, Mednick SC, Malerba P. A classification-based generative approach to selective targeting of global slow oscillations during sleep. Front Hum Neurosci 2024; 18:1342975. [PMID: 38415278 PMCID: PMC10896842 DOI: 10.3389/fnhum.2024.1342975] [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: 11/22/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
Background Given sleep's crucial role in health and cognition, numerous sleep-based brain interventions are being developed, aiming to enhance cognitive function, particularly memory consolidation, by improving sleep. Research has shown that Transcranial Alternating Current Stimulation (tACS) during sleep can enhance memory performance, especially when used in a closed-loop (cl-tACS) mode that coordinates with sleep slow oscillations (SOs, 0.5-1.5Hz). However, sleep tACS research is characterized by mixed results across individuals, which are often attributed to individual variability. Objective/Hypothesis This study targets a specific type of SOs, widespread on the electrode manifold in a short delay ("global SOs"), due to their close relationship with long-term memory consolidation. We propose a model-based approach to optimize cl-tACS paradigms, targeting global SOs not only by considering their temporal properties but also their spatial profile. Methods We introduce selective targeting of global SOs using a classification-based approach. We first estimate the current elicited by various stimulation paradigms, and optimize parameters to match currents found in natural sleep during a global SO. Then, we employ an ensemble classifier trained on sleep data to identify effective paradigms. Finally, the best stimulation protocol is determined based on classification performance. Results Our study introduces a model-driven cl-tACS approach that specifically targets global SOs, with the potential to extend to other brain dynamics. This method establishes a connection between brain dynamics and stimulation optimization. Conclusion Our research presents a novel approach to optimize cl-tACS during sleep, with a focus on targeting global SOs. This approach holds promise for improving cl-tACS not only for global SOs but also for other physiological events, benefiting both research and clinical applications in sleep and cognition.
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Affiliation(s)
- Mahmoud Alipour
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- The Ohio State University School of Medicine, Columbus, OH, United States
| | - SangCheol Seok
- Center for Gene Therapy, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
| | - Sara C. Mednick
- Department of Cognitive Sciences, University of California, Irvine, Irvine CA, United States
| | - Paola Malerba
- Center for Biobehavioral Health, Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, United States
- The Ohio State University School of Medicine, Columbus, OH, United States
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Lammers B, Sydnor MJ, Cust S, Kim JH, Yenokyan G, Hillis AE, Sebastian R. Protocol for Cerebellar Stimulation for Aphasia Rehabilitation (CeSAR): A randomized, double-blind, sham-controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.05.24302365. [PMID: 38370630 PMCID: PMC10871367 DOI: 10.1101/2024.02.05.24302365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
In this randomized, double-blind, sham-controlled trial of Cerebellar Stimulation for Aphasia Rehabilitation (CeSAR), we will determine the effectiveness of cathodal tDCS (transcranial direct current stimulation) to the right cerebellum for the treatment of chronic aphasia (>6 months post stroke). We will test the hypothesis that cerebellar tDCS in combination with an evidenced-based anomia treatment (semantic feature analysis, SFA) will be associated with greater improvement in naming untrained pictures (as measured by the change in Philadelphia Picture Naming Test), 1-week post treatment, compared to sham plus SFA. We will also evaluate the effects of cerebellar tDCS on naming trained items as well as the effects on functional communication, content, efficiency, and word-retrieval of picture description, and quality of life. Finally, we will identify imaging and linguistic biomarkers to determine the characteristics of stroke patients that benefit from cerebellar tDCS and SFA treatment. We expect to enroll 60 participants over five years. Participants will receive 15, 25-minute sessions of cerebellar tDCS (3-5 sessions per week) or sham tDCS combined with 1 hour of SFA treatment. Participants will be evaluated prior to the start of treatment, one-week post-treatment, 1-, 3-, and 6-months post treatment on primary and secondary outcome variables. The long-term aim of this study is to provide the basis for a Phase III randomized controlled trial of cerebellar tDCS vs sham with concurrent language therapy for treatment of chronic aphasia. Trial registration: The trial is registered with ClinicalTrials.gov NCT05093673.
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Affiliation(s)
- Becky Lammers
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Myra J. Sydnor
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Sarah Cust
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Ji Hyun Kim
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Gayane Yenokyan
- Johns Hopkins Biostatistics Center, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Argye E. Hillis
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD
- Department of Cognitive Science, Krieger School of Arts and Sciences, Johns Hopkins University, Baltimore, MD
| | - Rajani Sebastian
- Department of Physical Medicine and Rehabilitation, School of Medicine, Johns Hopkins University, Baltimore, MD
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Shoaib Z, Chang WK, Lee J, Lee SH, Phillips V Z, Lee SH, Paik NJ, Hwang HJ, Kim WS. Investigation of Neuromodulatory Effect of Anodal Cerebellar Transcranial Direct Current Stimulation on the Primary Motor Cortex Using Functional Near-Infrared Spectroscopy. CEREBELLUM (LONDON, ENGLAND) 2024; 23:56-66. [PMID: 36633829 DOI: 10.1007/s12311-023-01511-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
Cerebellar brain inhibition (CBI), a neural connection between the cerebellum and primary motor cortex (M1), has been researched as a target pathway for neuromodulation to improve clinical outcomes in various neurological diseases. However, conflicting results of anodal cerebellar transcranial direct current stimulation (acb-tDCS) on M1 excitability indicate that additional investigation is required to examine its precise effect. This study aimed to gather evidence of the neuromodulatory effect of acb-tDCS on the M1 using functional near-infrared spectroscopy (fNIRS). Sixteen healthy participants were included in this cross-over study. Participants received real and sham acb-tDCS randomly, with a minimum 1-week washout period between them. The anode and cathode were placed on the right cerebellum and the right buccinator muscle, respectively. Stimulation lasted 20 min at an intensity of 2 mA, and fNIRS data were recorded for 42 min (including a 4-min baseline before stimulation and an 18-min post-stimulation duration) using eight channels attached bilaterally on the M1. acb-tDCS induced a significant decrease in oxyhemoglobin (HbO) concentration (inhibitory effect) in the left (contralateral) M1, whereas it induced a significant increase in HbO concentration (excitatory effect) in the right (ipsilateral) M1 compared to sham tDCS during (p < 0.05) and after stimulation (p < 0.01) in a group level analysis. At the individual level, variations in response to acb-tDCS were observed. Our findings demonstrate the neuromodulatory effects of acb-tDCS on the bilateral M1 in terms of neuronal hemodynamics.
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Affiliation(s)
- Zeshan Shoaib
- Department of Electronics and Information Engineering, Korea University, Sejong City, South Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Won Kee Chang
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Jongseung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Stephanie Hyeyoung Lee
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Zephaniah Phillips V
- Global Health Technology Research Center, College of Health Science, Korea University, Seoul, South Korea
| | - Seung Hyun Lee
- Interdisciplinary Program in Precision Public Health, Korea University, Seoul, South Korea
| | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Han-Jeong Hwang
- Department of Electronics and Information Engineering, Korea University, Sejong City, South Korea.
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong City, South Korea.
| | - Won-Seok Kim
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
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Caumo W, Lopes Ramos R, Vicuña Serrano P, da Silveira Alves CF, Medeiros L, Ramalho L, Tomeddi R, Bruck S, Boher L, Sanches PRS, Silva DP, Ls Torres I, Fregni F. Efficacy of Home-Based Transcranial Direct Current Stimulation Over the Primary Motor Cortex and Dorsolateral Prefrontal Cortex in the Disability Due to Pain in Fibromyalgia: A Factorial Sham-Randomized Clinical Study. THE JOURNAL OF PAIN 2024; 25:376-392. [PMID: 37689323 DOI: 10.1016/j.jpain.2023.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/07/2023] [Accepted: 09/01/2023] [Indexed: 09/11/2023]
Abstract
This randomized, double-blind, controlled clinical trial compared the effectiveness of home-based-(HB) active transcranial direct current stimulation (a-tDCS) over the left dorsolateral prefrontal cortex (l-DLPFC) or primary motor cortex (M1) with their respective sham-(s)-tDCS to determine whether a-tDCS would be more effective than s-tDCS in reducing pain and improving disability due to pain. The study included 102 patients with fibromyalgia aged 30 to 65 years old randomly assigned to 1 of 4 tDCS groups using a ratio of 2:1:2:1. The groups included l-DLPFC (a-tDCS, n = 34) and (s-tDCS, n = 17), or tDCS on the M1 (a-tDCS, n = 34) or (s-tDCS, n = 17). Patients self-administered 20 sessions of tDCS, with 2 mA for 20 minutes each day under remote supervision after in-person training. The Mixed Model for Repeated Measurements revealed that a-tDCS on DLPFC significantly reduced pain scores by 36.53% compared to 25.79% in s-tDCS. From baseline to the fourth week of treatment, a-tDCS on M1 reduced pain scores by 45.89% compared to 22.92% over s-tDCS. A generalized linear model showed a significant improvement in the disability scale in the groups that received a-tDCS compared to s-tDCS over M1 20.54% versus 2.49% (χ2 = 11.06, df = 1, P < .001]), while on DLPFC the improvement was 14.29% and 5.77%, with a borderline significance (χ2 = 3.19, df = 1, P = .06]), respectively. A higher reduction in serum brain-derived neurotrophic factor from baseline to treatment end was positively correlated with decreased pain scores regardless of the treatment group. The application of a-tDCS over M1 increased the heat pain threshold and the function of the descending pain inhibitory system. PERSPECTIVE: These findings provide important insights: (1) HB-tDCS has effectively reduced pain scores and improved disability due to fibromyalgia. (2) The study provides evidence that HB-a-tDCS is a viable and effective therapeutic approach. (3) HB-a-tDCS over M1 improved the function of the descending pain inhibitory system and increased the heat pain threshold. Finally, our findings also emphasize that brain-derived neurotrophic factor, as an index of neuroplasticity, may serve as a valuable marker associated with changes in clinical pain measures. TRIAL REGISTRATION: Number NCT03843203.
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Affiliation(s)
- Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Pain and Palliative Care Service at HCPA, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil; Department of Surgery, School of Medicine, Porto Alegre, Rio Grande do Sul, Brazil
| | - Rael Lopes Ramos
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Paul Vicuña Serrano
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Camila Fernanda da Silveira Alves
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Liciane Medeiros
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Pain Pharmacology and Neuromodulation Laboratory, Preclinical Investigations, Experimental Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Postgraduate Program in Health and Human Development, La Salle University, Canoas, Rio Grande do Sul, Brazil
| | - Leticia Ramalho
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Rafalea Tomeddi
- Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Samara Bruck
- Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas Boher
- Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil; Pain and Palliative Care Service at HCPA, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil; Department of Surgery, School of Medicine, Porto Alegre, Rio Grande do Sul, Brazil
| | - Paulo R S Sanches
- Laboratory of Biomedical Engineer at HCPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Danton P Silva
- Laboratory of Biomedical Engineer at HCPA, Porto Alegre, Rio Grande do Sul, Brazil
| | - Iraci Ls Torres
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil; Pain Pharmacology and Neuromodulation Laboratory, Preclinical Investigations, Experimental Research Center, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Rio Grande do Sul, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation and Center for Clinical Research Learning, Physics and Rehabilitation Department, Spaulding Rehabilitation Hospital, Boston, Massachusetts
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Di Lazzaro V, Ranieri F, Bączyk M, de Carvalho M, Dileone M, Dubbioso R, Fernandes S, Kozak G, Motolese F, Ziemann U. Novel approaches to motoneuron disease/ALS treatment using non-invasive brain and spinal stimulation: IFCN handbook chapter. Clin Neurophysiol 2024; 158:114-136. [PMID: 38218077 DOI: 10.1016/j.clinph.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/28/2023] [Accepted: 12/17/2023] [Indexed: 01/15/2024]
Abstract
Non-invasive brain stimulation techniques have been exploited in motor neuron disease (MND) with multifold objectives: to support the diagnosis, to get insights in the pathophysiology of these disorders and, more recently, to slow down disease progression. In this review, we consider how neuromodulation can now be employed to treat MND, with specific attention to amyotrophic lateral sclerosis (ALS), the most common form with upper motoneuron (UMN) involvement, taking into account electrophysiological abnormalities revealed by human and animal studies that can be targeted by neuromodulation techniques. This review article encompasses repetitive transcranial magnetic stimulation methods (including low-frequency, high-frequency, and pattern stimulation paradigms), transcranial direct current stimulation as well as experimental findings with the newer approach of trans-spinal direct current stimulation. We also survey and discuss the trials that have been performed, and future perspectives.
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Affiliation(s)
- Vincenzo Di Lazzaro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy; Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy.
| | - Federico Ranieri
- Neurology Unit, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, P.Le L.A. Scuro 10, 37134 Verona, Italy
| | - Marcin Bączyk
- Department of Neurobiology, Poznań University of Physical Education, Królowej Jadwigi Street 27/39, 61-871 Poznań, Poland
| | - Mamede de Carvalho
- Institute of Physiology, Institute of Molecular Medicine-JLA, Egas Moniz Study Centre, Faculty of Medicine, University of Lisbon, Lisbon 1649-028, Portugal; Department of Neurosciences and Mental Health, CHULN, Lisbon, Portugal
| | - Michele Dileone
- Faculty of Health Sciences, UCLM Talavera de la Reina, Toledo, Spain; Neurology Department, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain
| | - Raffaele Dubbioso
- Neurophysiology Unit, Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples "Federico II", Napoli, Italy
| | - Sofia Fernandes
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Campo Grande, 1749-016-Lisboa, Portugal
| | - Gabor Kozak
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Francesco Motolese
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Roma, Italy
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Tübingen, Germany; Hertie-Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.
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Tabasi M, Mostafavi SA, Oreyzi H, Mohammadi MR, Khaleghi A. The Effectiveness of Transcranial Direct Current Stimulation (tDCS) and Omega-3 on Food Craving, Executive Functions, Weight, and Depressive Symptoms in Patients with Depression and Overweight: A Randomized Controlled Trial. IRANIAN JOURNAL OF PSYCHIATRY 2024; 19:158-173. [PMID: 38686306 PMCID: PMC11055968 DOI: 10.18502/ijps.v19i2.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/14/2024] [Indexed: 05/02/2024]
Abstract
Objective: The most important hypothesis of this research was based on the fact that the mechanism of the effect of omega-3 on depression and obesity is formed through its accumulation in the dorsolateral prefrontal cortex (DLPFC), especially in women. Accordingly, we investigated the omega-3 intake and the concurrent stimulation of the DLPFC by tDCS and hypothesized that the synergy of these two treatments can increase the obtained effect size in patients with depression and overweight. Method : This research was a double-blind randomized controlled trial (RCT) with a factorial design consisting of four treatment and control groups. The participants were females with depression and overweight on an outpatient basis. They received 5 ml/day omega-3 syrup (545 mg DHA, 620 mg EPA) or placebo adjunct with 12 sessions sham/tDCS stimulation administered for 3 weeks with anode-left/cathode-right protocol in the prefrontal cortex (1.5 mA, 15 minutes' stimulation / 15-20 minutes' rest intervals/one visit per week, 4 stimulations per visit). Results: tDCS or omega-3 alone did not significantly improve the executive functions, depression, food cravings, and weight in the experimental groups compared to the control group (P > 0.05). However, tDCS adjunct with the omega-3 had a significant and positive effect on improving weight change (P = 0.011; df = 1; F = 1.27; Eta = 0.108) with a power of 0.73 compared to the control group. Furthermore, their interaction led to an improving trend in executive functions and a decreasing trend in food cravings which are clinically important. Conclusion: tDCS could strengthen the omega-3 mechanisms of effect through stimulating its accumulation site in the brain (i.e., the DLPFC) and the synergistic effects of these two treatments result in weight control as well as an improvement trend in the executive functions and food craving in women.
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Affiliation(s)
- Mahla Tabasi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Seyed-Ali Mostafavi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Department of Psychology, University of Religions and Denominations, Qom, Iran
| | - Hamidreza Oreyzi
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Roozbeh Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Naji F, Sharbafchi MR, Khorvash F, Maracy MR, Ghasemi Mobarak Abadi N. The Efficacy of Repetitive Transcranial Magnetic Stimulation (rTMS) versus Transcranial Direct-Current Stimulation (tDCS) on Migraine Headaches: A Randomized Clinical Trial. Adv Biomed Res 2024; 13:7. [PMID: 38525392 PMCID: PMC10958735 DOI: 10.4103/abr.abr_142_23] [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: 04/29/2023] [Revised: 06/27/2023] [Accepted: 07/01/2023] [Indexed: 03/26/2024] Open
Abstract
Background Non-pharmacologic prophylactic methods for chronic migraine have been developed, including the promising non-invasive techniques of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). This study aimed to compare the efficacy of rTMS and tDCS on pain intensity, the impact of headaches on daily life, anxiety, and depression in migraine headaches patients. Materials and Methods This randomized clinical trial was conducted on 72 patients with migraine headaches, randomly allocated to the rTMS and tDCS groups. Participants received 3 and 12 sessions of stimulation over the left dorsolateral prefrontal cortex (DLPFC), respectively. Follow-up measurements, including pain intensity, anxiety, depression, and impact on daily life, were performed one month after the last sessions. Analyses were done by IBM SPSS statistics version 26 software. Results Of 72 patients enrolled in the study, 19 were male (8 in the rTMS group and 11 in the tDCS group). There was no significant difference in baseline characteristics between groups. During the follow-up visit, both groups showed a decrease in anxiety levels (P values = 0.005 and 0.015), while only the rTMS group displayed a significant improvement in depression (P value = 0.01). However, no statistically significant difference was found among the groups regarding changes in pain intensity, anxiety, and the impact of headaches on daily life (P values >0.05). Conclusion Our findings suggest that both rTMS and tDCS may be effective in reducing pain intensity and improving the impact of headaches on daily life and anxiety in patients with chronic migraine. However, significant improvement in depression was only observed in the rTMS group patients.
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Affiliation(s)
- Fatemeh Naji
- Department of Psychiatry, School of Medicine, Nour and Ali-Asghar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Reza Sharbafchi
- Department of Psychiatry, School of Medicine, Nour and Ali-Asghar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Khorvash
- Department of Neurology, School of Medicine, Neurosciences Research Center, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad R. Maracy
- Department of Psychiatry, School of Medicine, Nour and Ali-Asghar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Epidemiology and Biostatistics, School of Health, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Niloofar Ghasemi Mobarak Abadi
- Department of Psychiatry, School of Medicine, Nour and Ali-Asghar Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Epidemiology and Biostatistics, School of Health, Environment Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Lee YK, Gold MS, Blum K, Thanos PK, Hanna C, Fuehrlein BS. Opioid use disorder: current trends and potential treatments. Front Public Health 2024; 11:1274719. [PMID: 38332941 PMCID: PMC10850316 DOI: 10.3389/fpubh.2023.1274719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
Opioid use disorder (OUD) is a major public health threat, contributing to morbidity and mortality from addiction, overdose, and related medical conditions. Despite our increasing knowledge about the pathophysiology and existing medical treatments of OUD, it has remained a relapsing and remitting disorder for decades, with rising deaths from overdoses, rather than declining. The COVID-19 pandemic has accelerated the increase in overall substance use and interrupted access to treatment. If increased naloxone access, more buprenorphine prescribers, greater access to treatment, enhanced reimbursement, less stigma and various harm reduction strategies were effective for OUD, overdose deaths would not be at an all-time high. Different prevention and treatment approaches are needed to reverse the concerning trend in OUD. This article will review the recent trends and limitations on existing medications for OUD and briefly review novel approaches to treatment that have the potential to be more durable and effective than existing medications. The focus will be on promising interventional treatments, psychedelics, neuroimmune, neutraceutical, and electromagnetic therapies. At different phases of investigation and FDA approval, these novel approaches have the potential to not just reduce overdoses and deaths, but attenuate OUD, as well as address existing comorbid disorders.
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Affiliation(s)
- Yu Kyung Lee
- Department of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United States
| | - Mark S. Gold
- Department of Psychiatry, Washington University in St. Louis Euclid Ave, St. Louis, MO, United States
| | - Kenneth Blum
- Division of Addiction Research and Education, Center for Sports, Exercise, and Mental Health, Western University Health Sciences, Pomona, CA, United States
| | - Panayotis K. Thanos
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, Clinical Research Institute on Addictions, State University of New York at Buffalo, Buffalo, NY, United States
| | - Colin Hanna
- Behavioral Neuropharmacology and Neuroimaging Laboratory on Addictions, Department of Pharmacology and Toxicology, Jacobs School of Medicine and Biosciences, Clinical Research Institute on Addictions, State University of New York at Buffalo, Buffalo, NY, United States
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