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Ehsani F, Hafez Yousefi MS, Jafarzadeh A, Zoghi M, Jaberzadeh S. Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sci 2023; 13:1381. [PMID: 37891750 PMCID: PMC10605034 DOI: 10.3390/brainsci13101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Mohaddeseh Sadat Hafez Yousefi
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 5166614711, Iran
| | - Abbas Jafarzadeh
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Victoria, Ballarat, VIC 3350, Australia;
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
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Aust S, Brakemeier EL, Spies J, Herrera-Melendez AL, Kaiser T, Fallgatter A, Plewnia C, Mayer SV, Dechantsreiter E, Burkhardt G, Strauß M, Mauche N, Normann C, Frase L, Deuschle M, Böhringer A, Padberg F, Bajbouj M. Efficacy of Augmentation of Cognitive Behavioral Therapy With Transcranial Direct Current Stimulation for Depression: A Randomized Clinical Trial. JAMA Psychiatry 2022; 79:528-537. [PMID: 35442431 PMCID: PMC9021985 DOI: 10.1001/jamapsychiatry.2022.0696] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
IMPORTANCE Major depressive disorder (MDD) affects approximately 10% of the population globally. Approximately 20% to 30% of patients with MDD do not sufficiently respond to standard treatment. Therefore, there is a need to develop more effective treatment strategies. OBJECTIVE To investigate whether the efficacy of cognitive behavioral therapy (CBT) for the treatment of MDD can be enhanced by concurrent transcranial direct current stimulation (tDCS). DESIGN, SETTING, AND PARTICIPANTS The double-blind, placebo-controlled randomized clinical trial PsychotherapyPlus was conducted at 6 university hospitals across Germany. Enrollment took place between June 2, 2016, and March 10, 2020; follow-up was completed August 27, 2020. Adults aged 20 to 65 years with a single or recurrent depressive episode were eligible. They were either not receiving medication or were receiving a stable regimen of antidepressant medication (selective serotonin reuptake inhibitor and/or mirtazapine). A total of 148 women and men underwent randomization: 53 individuals were assigned to CBT alone (group 0), 48 to CBT plus tDCS (group 1), and 47 to CBT plus sham-tDCS (group 2). INTERVENTIONS Participants attended a 6-week group intervention comprising 12 sessions of CBT. If assigned, tDCS was applied simultaneously. Active tDCS included stimulation with an intensity of 2 mA for 30 minutes (anode over F3, cathode over F4). MAIN OUTCOMES AND MEASURES The primary outcome was the change in Montgomery-Åsberg Depression Rating Scale (MADRS) score from baseline to posttreatment in the intention-to-treat sample. Scores of 0 to 6 indicate no depression; 7 to 19, mild depression; 20 to 34, moderate depression; and 34 and higher, severe depression. RESULTS A total of 148 patients (89 women, 59 men; mean [SD] age, 41.1 [13.7] years; MADRS score at baseline, 23.0 [6.4]) were randomized. Of these, 126 patients (mean [SD] age, 41.5 [14.0] years; MADRS score at baseline, 23.0 [6.3]) completed the study. In each of the intervention groups, intervention was able to reduce MADRS scores by a mean of 6.5 points (95% CI, 3.82-9.14 points). The Cohen d value was -0.90 (95% CI, -1.43 to -0.50), indicating a significant effect over time. However, there was no significant effect of group and no significant interaction of group × time, indicating the estimated additive effects were not statistically significant. There were no severe adverse events throughout the whole trial, and there were no significant differences of self-reported adverse effects during and after stimulation between groups 1 and 2. CONCLUSIONS AND RELEVANCE Based on MADRS score changes, this trial did not indicate superior efficacy of tDCS-enhanced CBT compared with 2 CBT control conditions. The study confirmed that concurrent group CBT and tDCS is safe and feasible. However, additional research on mechanisms of neuromodulation to complement CBT and other behavioral interventions is needed. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02633449.
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Affiliation(s)
- Sabine Aust
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Campus Benjamin Franklin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, Universität Greifswald, Greifswald, Germany
| | - Jan Spies
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Campus Benjamin Franklin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ana Lucia Herrera-Melendez
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Campus Benjamin Franklin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tim Kaiser
- Department of Clinical Psychology and Psychotherapy, Universität Greifswald, Greifswald, Germany
| | - Andreas Fallgatter
- Universitätsklinik für Psychiatrie und Psychotherapie, Neurophysiologie & Interventionelle Neuropsychiatrie, Tübingen Center for Mental Health, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Christian Plewnia
- Universitätsklinik für Psychiatrie und Psychotherapie, Neurophysiologie & Interventionelle Neuropsychiatrie, Tübingen Center for Mental Health, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Sarah V. Mayer
- Universitätsklinik für Psychiatrie und Psychotherapie, Neurophysiologie & Interventionelle Neuropsychiatrie, Tübingen Center for Mental Health, Universitätsklinikum Tübingen, Tübingen, Germany
| | - Esther Dechantsreiter
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Gerrit Burkhardt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Maria Strauß
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Nicole Mauche
- Department of Psychiatry and Psychotherapy, University Hospital Leipzig, Leipzig, Germany
| | - Claus Normann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine & Center for Basics in NeuroModulation, University of Freiburg, Freiburg, Germany
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine & Center for Basics in NeuroModulation, University of Freiburg, Freiburg, Germany
| | - Michael Deuschle
- Central Institute for Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Andreas Böhringer
- Central Institute for Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, LMU University Hospital, Munich, Germany
| | - Malek Bajbouj
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Campus Benjamin Franklin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Smart Device-Driven Corticolimbic Plasticity in Cognitive–Emotional Restructuring of Space-Related Neuropsychiatric Disease and Injury. Life (Basel) 2022; 12:life12020236. [PMID: 35207523 PMCID: PMC8875345 DOI: 10.3390/life12020236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/16/2022] Open
Abstract
Escalating government and commercial efforts to plan and deploy viable manned near-to-deep solar system exploration and habitation over the coming decades now drives next-generation space medicine innovations. The application of cutting-edge precision medicine, such as brain stimulation techniques, provides powerful clinical and field/flight situation methods to selectively control vagal tone and neuroendocrine-modulated corticolimbic plasticity, which is affected by prolonged cosmic radiation exposure, social isolation or crowding, and weightlessness in constricted operational non-terran locales. Earth-based clinical research demonstrates that brain stimulation approaches may be combined with novel psychotherapeutic integrated memory structure rationales for the corrective reconsolidation of arousing or emotional experiences, autobiographical memories, semantic schema, and other cognitive structures to enhance neuropsychiatric patient outcomes. Such smart cotherapies or countermeasures, which exploit natural, pharmaceutical, and minimally invasive neuroprosthesis-driven nervous system activity, may optimize the cognitive-emotional restructuring of astronauts suffering from space-related neuropsychiatric disease and injury, including mood, affect, and anxiety symptoms of any potential severity and pathophysiology. An appreciation of improved neuropsychiatric healthcare through the merging of new or rediscovered smart theragnostic medical technologies, capable of rendering personalized neuroplasticity training and managed psychotherapeutic treatment protocols, will reveal deeper insights into the illness states experienced by astronauts. Future work in this area should emphasize the ethical role of telemedicine and/or digital clinicians to advance the (semi)autonomous, technology-assisted medical prophylaxis, diagnosis, treatment, monitoring, and compliance of astronauts for elevated health, safety, and performance in remote extreme space and extraterrestrial environments.
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Herrera-Melendez AL, Bajbouj M, Aust S. Application of Transcranial Direct Current Stimulation in Psychiatry. Neuropsychobiology 2021; 79:372-383. [PMID: 31340213 DOI: 10.1159/000501227] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/28/2019] [Indexed: 11/19/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulation technique, which noninvasively alters cortical excitability via weak polarizing currents between two electrodes placed on the scalp. Since it is comparably easy to handle, cheap to use and relatively well tolerated, tDCS has gained increasing interest in recent years. Based on well-known behavioral effects, a number of clinical studies have been performed in populations including patients with major depressive disorder followed by schizophrenia and substance use disorders, in sum with heterogeneous results with respect to efficacy. Nevertheless, the potential of tDCS must not be underestimated since it could be further improved by systematically investigating the various stimulation parameters to eventually increase clinical efficacy. The present article briefly explains the underlying physiology of tDCS, summarizes typical stimulation protocols and then reviews clinical efficacy for various psychiatric disorders as well as prevalent adverse effects. Future developments include combined and more complex interactions of tDCS with pharmacological or psychotherapeutic interventions. In particular, using computational models to individualize stimulation protocols, considering state dependency and applying closed-loop technologies will pave the way for tDCS-based personalized interventions as well as the development of home treatment settings promoting the role of tDCS as an effective treatment option for patients with mental health problems.
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Affiliation(s)
- Ana-Lucia Herrera-Melendez
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany,
| | - Malek Bajbouj
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sabine Aust
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Andò A, Vasilotta ML, Zennaro A. The modulation of emotional awareness using non-invasive brain stimulation techniques: a literature review on TMS and tDCS. JOURNAL OF COGNITIVE PSYCHOLOGY 2021. [DOI: 10.1080/20445911.2021.1954013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Agata Andò
- Department of Psychology, University of Turin, Turin, Italy
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Weigand A, Trilla I, Enk L, O’Connell G, Prehn K, Brick TR, Dziobek I. How Much of Me Do I See in Other Minds? Modulating Egocentricity in Emotion Judgments by tDCS. Brain Sci 2021; 11:brainsci11040512. [PMID: 33923752 PMCID: PMC8073044 DOI: 10.3390/brainsci11040512] [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: 03/15/2021] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 11/30/2022] Open
Abstract
When inferring the mental states of others, individuals’ judgments are influenced by their own state of mind, an effect often referred to as egocentricity. Self–other differentiation is key for an accurate interpretation of other’s mental states, especially when these differ from one’s own states. It has been suggested that the right supramarginal gyrus (rSMG) is causally involved in overcoming egocentricity in the affective domain. In a double-blind randomized study, 47 healthy adults received anodal (1 mA, 20 min) or sham transcranial direct current stimulation (tDCS) to the rSMG prior to performing a newly developed paradigm, the self–other facial emotion judgment (SOFE) task. In this task, participants made judgments of facial emotional expressions while having been previously confronted with congruent or incongruent emotion-inducing situations. To differentiate between emotional and cognitive egocentricity, participants additionally completed an established visual perspective-taking task. Our results confirmed the occurrence of emotional egocentric biases during the SOFE task. No conclusive evidence of a general role of the rSMG in emotional egocentricity was found. However, active as compared to sham tDCS induced descriptively lower egocentric biases when judging incongruent fearful faces, and stronger biases when judging incongruent happy faces, suggesting emotion-specific tDCS effects on egocentric biases. Further, we found significant tDCS effects on cognitive egocentricity. Results of the present study expanded our understanding of emotional egocentricity and point towards emotion-specific patterns of the underlying functionality.
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Affiliation(s)
- Anne Weigand
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany; (I.T.); (L.E.); (G.O.); (I.D.)
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
- Correspondence:
| | - Irene Trilla
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany; (I.T.); (L.E.); (G.O.); (I.D.)
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Lioba Enk
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany; (I.T.); (L.E.); (G.O.); (I.D.)
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Garret O’Connell
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany; (I.T.); (L.E.); (G.O.); (I.D.)
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
| | - Kristin Prehn
- MSH Medical School Hamburg, University of Applied Sciences and Medical University, Am Kaiserkai 1, 20457 Hamburg, Germany;
| | - Timothy R. Brick
- Department of Human Development and Family Studies and Institute for Computational and Data Sciences, The Pennsylvania State University, State College, 231 Health and Human Development Building, University Park, PA 16802, USA;
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany; (I.T.); (L.E.); (G.O.); (I.D.)
- Department of Psychology, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099 Berlin, Germany
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Light-Dependent Effects of Prefrontal rTMS on Emotional Working Memory. Brain Sci 2021; 11:brainsci11040446. [PMID: 33807349 PMCID: PMC8065741 DOI: 10.3390/brainsci11040446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 11/17/2022] Open
Abstract
Growing evidence suggests that colored light exposure can affect several brain functions in addition to conscious visual perception. Blue as compared to green light has especially been shown to enhance alertness and vigilance, as well as cognitive functions. However, the role of light exposure in studies using non-invasive brain stimulation remains unclear. Here, we examined the impact of light on cognitive-emotional effects of prefrontal repetitive transcranial magnetic stimulation (rTMS). In a randomized within-subjects design, twenty participants (12 males, 26 ± 4 years) were exposed to blue or green light prior and concomitant to active or sham rTMS (1Hz, 15min, 110% of the resting motor threshold), applied over the right dorsolateral prefrontal cortex (DLPFC). In each condition, an emotional working memory task (EMOBACK) was presented pre- and post-intervention. Stimuli of the EMOBACK task were positive, negative and neutral words. Our results revealed valence-specific stimulation effects in dependence of colored light exposure. More specifically, task accuracy was significantly increased for positive stimuli under blue light and for negative stimuli under green light exposure. Our findings highlight the importance of state-dependency in studies using non-invasive brain stimulation and show blue light exposure to be a potential adjunctive technique to rTMS for enhancing cognitive-emotional modulation.
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Lei H, Pan Y, Wu R, Lv Y. Innate Immune Regulation Under Magnetic Fields With Possible Mechanisms and Therapeutic Applications. Front Immunol 2020; 11:582772. [PMID: 33193393 PMCID: PMC7649827 DOI: 10.3389/fimmu.2020.582772] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 09/28/2020] [Indexed: 11/13/2022] Open
Abstract
With the wide applications of magnetic fields (MFs) in medicine, researchers from different disciplines have gained interest in understanding the effect of various types of MFs on living cells and organisms. In this paper, we mainly focus on the immunological and physical aspects of the immune responses and their mechanisms under different types of MFs. Immune cells were slightly affected by low-frequency alternating MFs but were strongly influenced by moderate-intensity MFs and high-gradient MFs (HGMFs). Larger immune cells, such as macrophages, were more sensitive to HGMFs, which biased the cell polarization into the anti-inflammatory M2 phenotype. Subject to the gradient forces of varying directions and strength, the elongated M2 macrophage also remodeled the cytoskeleton with actin polymerization and changed the membrane receptors and ion channel gating. These alterations were very similar to changes caused by the small GTPase RhoA interference in macrophage. Regulation of iron metabolism may also contribute to the MF effects in macrophages. High MFs were found to regulate the iron content in monocyte-/macrophage-derived osteoclasts by affecting the expression of iron-regulation genes. On the other hand, paramagnetic nanoparticles (NPs) combined with external MFs play an important role in T-cell immunity. Paramagnetic NP-coated T-cells can cluster their T-cell receptors (TCRs) by using an external MF, thus increasing the cell–cell contact and communication followed by enhanced tumor killing capacity. The external MF can also guide the adoptively transferred magnetic NP-coated T-cells to their target sites in vivo, thus dramatically increasing the efficiency of cell therapy. Additionally, iron oxide NPs for ferroptosis-based cancer therapy and other MF-related therapeutic applications with obstacles were also addressed. Furthermore, for a profound understanding of the effect of MFs on immune cells, multidisciplinary research involving both experimental research and theoretical modeling is essential.
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Affiliation(s)
- Hong Lei
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Pan
- Center for Spintronics and Quantum Systems, State Key Laboratory for Mechanical Behavior of Materials, Xi'an Jiaotong University, Xi'an, China
| | - Rongqian Wu
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Lv
- National Local Joint Engineering Research Center for Precision Surgery and Regenerative Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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Kaczmarczyk M, Regen F, Heuser I, Bajbouj M, Hellmann-Regen J. Inhibition of monoamine oxidase activity by repetitive transcranial magnetic stimulation: implications for inter-train interval and frequency. Eur Arch Psychiatry Clin Neurosci 2020; 270:119-126. [PMID: 30560291 DOI: 10.1007/s00406-018-0969-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 12/11/2018] [Indexed: 10/27/2022]
Abstract
Repetitive transcranial magnetic stimulation (rTMS) is a neuromodulation technique that stimulates cortical regions via time-varying electromagnetic fields; in several countries this technique has been approved as a treatment for major depressive disorder. One empirically established target in antidepressant pharmacotherapy is the flavin-containing monoamine oxidoreductase (MAO). The function of MAO enzymes is based on oxidation processes that may be sensitive towards strong electromagnetic fields. Therefore, we hypothesized that rTMS-induced electromagnetic fields impact the activity of this enzyme. Using crude synaptosomal cell preparations from human SH-SY5Y neuroblastoma cells and rat cortex as well as viable cells, we assessed the effects of rTMS on MAO-A and -B activity in a well-controlled in vitro set up. In short, samples were stimulated at maximal intensity with an equal number of total stimuli at frequencies of 5, 20, and 100 Hz. Sham stimulation was performed in parallel. Treatment at frequencies of 5 and 20 Hz significantly decreased mainly MAO-B activity in all tissue preparations and species, whereas 100 Hz stimulation remained without effect on any MAO activity. Our results support the hypothesis, that rTMS-induced electromagnetic fields affect MAO activity and provide further evidence for intracellular effects possibly contributing to therapeutic effects of this neuromodulatory method. On a cautionary note, however, our findings are solely based on in vitro evidence.
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Affiliation(s)
- Michael Kaczmarczyk
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Francesca Regen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Isabella Heuser
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Malek Bajbouj
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
| | - Julian Hellmann-Regen
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Klinik für Psychiatrie und Psychotherapie, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Germany
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Yosephi MH, Ehsani F, Daghiani M, Zoghi M, Jaberzadeh S. The effects of trans-cranial direct current stimulation intervention on fear: A systematic review of literature. J Clin Neurosci 2019; 62:7-13. [DOI: 10.1016/j.jocn.2019.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
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Continuous theta-burst stimulation over the dorsolateral prefrontal cortex inhibits improvement on a working memory task. Sci Rep 2018; 8:14835. [PMID: 30287868 PMCID: PMC6172210 DOI: 10.1038/s41598-018-33187-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 09/24/2018] [Indexed: 01/12/2023] Open
Abstract
Theta-burst stimulation (TBS) over the dorsolateral prefrontal cortex (DLPFC) may be more effective for modulating cortical excitability compared to standard repetitive transcranial magnetic stimulation. However, the impact of intermittent (iTBS) and continuous TBS (cTBS) on working memory (WM) is poorly studied. The aim of our study was to compare the effects of iTBS and cTBS on WM over the left and right DLPFC. iTBS, cTBS or sham stimulation was administered over the right and left hemisphere of fifty-one healthy human subjects. WM was assessed before and after TBS using the 1-back, 2-back, and 3-back tasks. We found classical practice effects in the iTBS and the sham group: WM performance improved following stimulation as measured by the discriminability index. However, this effect could not be observed in the cTBS group. We did not find any hemisphere-dependent effects, suggesting that the practice effect is not lateralized, and TBS affects WM performance in a comparable manner if administered either over the left or the right hemisphere. We propose that our findings represent a useful addition to the literature of TBS-induced effects on WM. Moreover, these results indicate the possibility of clarifying processes underlying WM performance changes by using non-invasive brain stimulation.
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Johnson JM, Durrant SJ. The effect of cathodal transcranial direct current stimulation during rapid eye-movement sleep on neutral and emotional memory. ROYAL SOCIETY OPEN SCIENCE 2018; 5:172353. [PMID: 30109059 PMCID: PMC6083708 DOI: 10.1098/rsos.172353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
Sleep-dependent memory consolidation has been extensively studied. Neutral declarative memories and serial reaction time task (SRTT) performance can benefit from slow-wave activity, characterized by less than 1 Hz frequency cortical slow oscillations (SO). Emotional memories can benefit from theta activity, characterized by 4-8 Hz frequency cortical oscillations. Applying transcranial direct current stimulation (tDCS) during sleep entrains specific frequencies to alter sleep architecture. When applying cathodal tDCS (CtDCS), neural inhibition or excitation may depend on the waveform at the applied frequency. A double dissociation was predicted, with CtDCS at SO frequency improving neutral declarative memory and SRTT performance, and theta frequency CtDCS inhibiting negative emotional memory. Participants completed three CtDCS conditions (Theta: 5 Hz, SO: 0.75 Hz and control: sham) and completed an SRTT and word recognition task pre- and post-sleep, comprising emotional and neutral words to assess memory. In line with predictions, CtDCS improved neutral declarative memory when applied at SO frequency. When applied at theta frequency, no negative emotional word memory impairment was found but a positive association was found between post-stimulation theta power and emotional word recognition. SRTT performance was also not altered by either CtDCS frequency. Future studies should investigate overnight theta CtDCS and examine the effects of CtDCS during and after stimulation.
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Affiliation(s)
| | - Simon J. Durrant
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
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Nasehi M, Soltanpour R, Ebrahimi-Ghiri M, Zarrabian S, Zarrindast MR. Interference effects of transcranial direct current stimulation over the right frontal cortex and adrenergic system on conditioned fear. Psychopharmacology (Berl) 2017; 234:3407-3416. [PMID: 28887641 DOI: 10.1007/s00213-017-4722-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 08/20/2017] [Indexed: 02/08/2023]
Abstract
RATIONALE The effects of pharmacological interventions on fear memory have widely been studied, but there are very few studies about the effects of brain electrical stimulation on fear memory function. OBJECTIVE Therefore, our aim was to determine whether anodal/cathodal transcranial direct current stimulation (tDCS) over the right frontal cortex would modify propranolol-induced contextual and auditory fear memory deficits, before or after training. METHODS The adult NMRI male mice were randomly assigned into three groups: the sham group, the anodal tDCS group, and the cathodal tDCS group. Fear memories were evaluated using a classical fear conditioning apparatus. RESULTS While the anodal stimulation did not affect fear retrieval, post-training cathodal stimulation improved fear memory retrieval. Regardless of when propranolol (0.1 mg/kg) was administered, it impaired fear memory retrieval. However, when anodal stimulation and propranolol were applied prior to the training, contextual fear memory retrieval was increased and auditory fear memory was reversed. An enhanced contextual retrieval was also observed when propranolol was administered prior to the training and stimulation occurred after the training. Only when the stimulation occurred prior to the training and propranolol was administered after the training was there a selective improvement in contextual fear memory retrieval, leaving the auditory fear memory retrieval impaired. Interestingly, cathodal stimulation improved the effects of propranolol on auditory fear memory only when it occurred prior to the training. CONCLUSION The results highlight possible improving effects for anodal/cathodal tDCS on propranolol-induced deficits on fear memories. The timing of the interventions related to the specific phases of memory formation is important in modulating fear behaviors.
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Affiliation(s)
- Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
| | - Reyhaneh Soltanpour
- Department of Psychology, Faculty of Education, Islamic Azad University, Garmsar Branch, Tehran, Iran
| | | | - Shahram Zarrabian
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, P.O. Box 13145-784, Tehran, Iran. .,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran. .,Medical Genomics Research Center, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. .,Institute for Cognitive Science Studies (ICSS), Tehran, Iran. .,University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
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Emotional processing and rTMS: does inhibitory theta burst stimulation affect the human startle reflex? J Neural Transm (Vienna) 2016; 123:1121-31. [DOI: 10.1007/s00702-016-1568-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 04/30/2016] [Indexed: 12/21/2022]
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Jantz TK, Katz B, Reuter-Lorenz PA. Uncertainty and Promise: the Effects of Transcranial Direct Current Stimulation on Working Memory. Curr Behav Neurosci Rep 2016. [DOI: 10.1007/s40473-016-0071-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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16
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Jacobs AM, Võ MLH, Briesemeister BB, Conrad M, Hofmann MJ, Kuchinke L, Lüdtke J, Braun M. 10 years of BAWLing into affective and aesthetic processes in reading: what are the echoes? Front Psychol 2015; 6:714. [PMID: 26089808 PMCID: PMC4452804 DOI: 10.3389/fpsyg.2015.00714] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 05/13/2015] [Indexed: 11/13/2022] Open
Abstract
Reading is not only "cold" information processing, but involves affective and aesthetic processes that go far beyond what current models of word recognition, sentence processing, or text comprehension can explain. To investigate such "hot" reading processes, standardized instruments that quantify both psycholinguistic and emotional variables at the sublexical, lexical, inter-, and supralexical levels (e.g., phonological iconicity, word valence, arousal-span, or passage suspense) are necessary. One such instrument, the Berlin Affective Word List (BAWL) has been used in over 50 published studies demonstrating effects of lexical emotional variables on all relevant processing levels (experiential, behavioral, neuronal). In this paper, we first present new data from several BAWL studies. Together, these studies examine various views on affective effects in reading arising from dimensional (e.g., valence) and discrete emotion features (e.g., happiness), or embodied cognition features like smelling. Second, we extend our investigation of the complex issue of affective word processing to words characterized by a mixture of affects. These words entail positive and negative valence, and/or features making them beautiful or ugly. Finally, we discuss tentative neurocognitive models of affective word processing in the light of the present results, raising new issues for future studies.
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Affiliation(s)
- Arthur M. Jacobs
- Department of Experimental and Neurocognitive Psychology, Freie Universität BerlinBerlin, Germany
- Cluster of Excellence “Languages of Emotion”, Freie Universität BerlinBerlin, Germany
- Dahlem Institute for Neuroimaging of EmotionBerlin, Germany
| | - Melissa L.-H. Võ
- Scene Grammar Lab, Department of Cognitive Psychology, Goethe University FrankfurtFrankfurt, Germany
| | - Benny B. Briesemeister
- Department of Experimental and Neurocognitive Psychology, Freie Universität BerlinBerlin, Germany
| | - Markus Conrad
- Cluster of Excellence “Languages of Emotion”, Freie Universität BerlinBerlin, Germany
- Department of Cognitive, Social and Organizational Psychology, Universidad de La LagunaSan Cristóbal de La Laguna, Spain
| | - Markus J. Hofmann
- Department of Experimental and Neurocognitive Psychology, Freie Universität BerlinBerlin, Germany
- Department of Psychology, General and Biological Psychology, University of WuppertalWuppertal, Germany
| | - Lars Kuchinke
- Cluster of Excellence “Languages of Emotion”, Freie Universität BerlinBerlin, Germany
- Experimental Psychology and Methods, Faculty of Psychology, Ruhr Universität BochumBochum, Germany
| | - Jana Lüdtke
- Department of Experimental and Neurocognitive Psychology, Freie Universität BerlinBerlin, Germany
- Cluster of Excellence “Languages of Emotion”, Freie Universität BerlinBerlin, Germany
| | - Mario Braun
- Department of Experimental and Neurocognitive Psychology, Freie Universität BerlinBerlin, Germany
- Centre for Cognitive Neuroscience, Universität SalzburgSalzburg, Austria
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Tremblay S, Lepage JF, Latulipe-Loiselle A, Fregni F, Pascual-Leone A, Théoret H. The uncertain outcome of prefrontal tDCS. Brain Stimul 2014; 7:773-83. [PMID: 25456566 PMCID: PMC4342747 DOI: 10.1016/j.brs.2014.10.003] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/07/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is increasingly used in research and clinical settings, and the dorsolateral prefrontal cortex (DLPFC) is often chosen as a target for stimulation. While numerous studies report modulation of cognitive abilities following DLPFC stimulation, the wide array of cognitive functions that can be modulated makes it difficult to predict its precise outcome. OBJECTIVE The present review aims at identifying and characterizing the various cognitive domains affected by tDCS over DLPFC. METHODS Articles using tDCS over DLPFC indexed in PubMed and published between January 2000 and January 2014 were included in the present review. RESULTS tDCS over DLPFC affects a wide array of cognitive functions, with sometimes apparent conflicting results. CONCLUSION Prefrontal tDCS has the potential to modulate numerous cognitive functions simultaneously, but to properly interpret the results, a clear a priori hypothesis is necessary, careful technical consideration are mandatory, further insights into the neurobiological impact of tDCS are needed, and consideration should be given to the possibility that some behavioral effects may be partly explained by parallel modulation of related functions.
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Affiliation(s)
- Sara Tremblay
- Department of Psychology, University de Montreal, Canada; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Jean-François Lepage
- Neuromodulation Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Alex Latulipe-Loiselle
- Department of Psychology, University de Montreal, Canada; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada
| | - Felipe Fregni
- Neuromodulation Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Alvaro Pascual-Leone
- Berenson Allen Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, USA
| | - Hugo Théoret
- Department of Psychology, University de Montreal, Canada; Research Center, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Canada.
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Bajbouj M, Padberg F. A perfect match: noninvasive brain stimulation and psychotherapy. Eur Arch Psychiatry Clin Neurosci 2014; 264 Suppl 1:S27-33. [PMID: 25253645 DOI: 10.1007/s00406-014-0540-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 09/08/2014] [Indexed: 01/02/2023]
Abstract
One out of four patients with a psychiatric disorder does not tolerate or sufficiently respond to standard treatments, leading to impaired quality of life, significant morbidity and mortality, as well as high socioeconomic costs. There is increasing evidence that-apart from psychopharmacologic and psychotherapeutic interventions-targeted modulation of neural networks by brain stimulation techniques might serve as a third treatment modality. In the whole spectrum of treatment modalities, combined approaches are often used for difficult-to-treat patients. They may be superior strategies compared to monotherapy and could possible also include brain stimulation interventions. However, systematic research is lacking for the latter issue. Particularly, noninvasive brain stimulation (NIBS), e.g., transcranial direct current stimulation (tDCS) can be easily combined with psychotherapy approaches. Here, we introduce NIBS techniques for priming and augmenting psychotherapy, review preliminary data and propose a future research strategy. Interestingly, this strategy parallels the promising development in neurology and neurorehabilitation where tDCS is currently combined with functional training tasks to enhance motor or cognitive performance.
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Affiliation(s)
- Malek Bajbouj
- Department of Psychiatry, Center for Affective Sciences (CAS), Charité and Freie Universität Berlin, Campus Benjamin Franklin (CBF), Eschenallee 3, 14050, Berlin, Germany,
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