Corticospinal excitability enhancement with simultaneous transcranial near-infrared stimulation and anodal direct current stimulation of motor cortex

Does Cathodal Preconditioning Enhance the Effects of Subsequent Anodal Transcranial Direct Current Stimulation on Corticospinal Excitability and Grip Strength?

ABSTRACT

Lewis, A, Rattray, B, and Flood, A. Does cathodal preconditioning enhance the effects of subsequent anodal transcranial direct current stimulation on corticospinal excitability and grip strength? J Strength Cond Res XX(X): 000-000, 2024-Inconsistent effects of transcranial direct current stimulation (tDCS) on corticospinal excitability (CSE) and exercise performance are commonly reported. Cathodal preconditioning, involving cathodal tDCS delivered before anodal tDCS over the same region, may enhance changes in CSE and exercise beyond that resulting from anodal tDCS alone. This study aimed to investigate whether the effects of anodal tDCS on CSE and isometric grip strength can be enhanced by cathodal preconditioning. Thirty-five healthy subjects aged 19-37 years completed a familiarization session followed by 4 stimulation conditions presented in a randomized cross-over design across 4 separate sessions. tDCS doses were applied at 2 mA over the primary motor cortex for 10 minutes. Corticospinal excitability was assessed using 120% of resting motor threshold and an input/output curve of motor evoked potentials of the first dorsal interosseous. Grip strength was evaluated as time to exhaustion (TTE) in a sustained isometric contraction. Relative to conventional sham stimulation, TTE was significantly increased by 15% after conventional anodal tDCS. Corticospinal excitability increased in response to tDCS, but this effect did not differ across conditions. Cathodal preconditioning before anodal stimulation did not increase CSE or grip strength beyond that seen in the other stimulation conditions. Our findings did not reveal any significant impact of stimulation type on CSE. Notably, anodal tDCS led to a significant improvement in grip strength endurance. However, cathodal preconditioning did not seem to increase the effect of subsequent anodal stimulation on CSE nor grip strength.

Exploring the Prospects of Transcranial Electrical Stimulation (tES) as a Therapeutic Intervention for Post-Stroke Motor Recovery: A Narrative Review

INTRODUCTION

Stroke survivors often have motor impairments and related functional deficits. Transcranial Electrical Stimulation (tES) is a rapidly evolving field that offers a wide range of capabilities for modulating brain function, and it is safe and inexpensive. It has the potential for widespread use for post-stroke motor recovery. Transcranial Direct Current Stimulation (tDCS), Transcranial Alternating Current Stimulation (tACS), and Transcranial Random Noise Stimulation (tRNS) are three recognized tES techniques that have gained substantial attention in recent years but have different mechanisms of action. tDCS has been widely used in stroke motor rehabilitation, while applications of tACS and tRNS are very limited. The tDCS protocols could vary significantly, and outcomes are heterogeneous.

PURPOSE

the current review attempted to explore the mechanisms underlying commonly employed tES techniques and evaluate their prospective advantages and challenges for their applications in motor recovery after stroke.

CONCLUSION

tDCS could depolarize and hyperpolarize the potentials of cortical motor neurons, while tACS and tRNS could target specific brain rhythms and entrain neural networks. Despite the extensive use of tDCS, the complexity of neural networks calls for more sophisticated modifications like tACS and tRNS.

Efficacy of transcranial photobiomodulation in the treatment for major depressive disorder: A TMS-EEG and pilot study

BACKGROUND

Major depressive disorder (MDD) was a prevalent mental condition that may be accompanied by decreased excitability of left frontal pole (FP) and abnormal brain connections. An 820 nm tPBM can induce an increase in stimulated cortical excitability. The purpose of our study was to establish how clinical symptoms and time-varying brain network connectivity of MDD were affected by transcranial photobiomodulation (tPBM).

METHODS

A total of 11 patients with MDD received 820 nm tPBM targeting the left FP for 14 consecutive days. The severity of symptoms was evaluated by neuropsychological assessments at baseline, after treatment, 4-week and 8-week follow-up; 8-min transcranial magnetic stimulation combined electroencephalography (TMS-EEG) was performed for five healthy controls and five patients with MDD before and after treatment, and time-varying EEG network was analyzed using the adaptive-directed transfer function.

RESULTS

All of scales scores in the 11 patients decreased significantly after 14-day tPBM (p < .01) and remained at 8-week follow-up. The time-varying brain network analysis suggested that the brain regions with enhanced connection information outflow in MDD became gradually more similar to healthy controls after treatment.

CONCLUSIONS

This study showed that tPBM of the left FP could improve symptoms of patients with MDD and normalize the abnormal network connections.

Advances in the Regulation of Neural Function by Infrared Light

In recent years, with the rapid development of optical technology, infrared light has been increasingly used in biomedical fields. Research has shown that infrared light could play roles in light stimulation and biological regulation. Infrared light has been used to regulate neural function due to its high spatial resolution, safety and neural sensitivity and has been considered a useful method to replace traditional neural regulation approaches. Infrared neuromodulation methods have been used for neural activation, central nervous system disorder treatment and cognitive enhancement. Research on the regulation of neural function by infrared light stimulation began only recently, and the underlying mechanism remains unclear. This article reviews the characteristics of infrared light, the advantages and disadvantages of infrared neuromodulation, its effects on improving individual health, and its mechanism. This article aims to provide a reference for future research on the use of infrared neural regulation to treat neuropsychological disorders.

820-nm Transcranial Near-infrared Stimulation on the Left DLPFC Relieved Anxiety: A Randomized, Double-blind, Sham-controlled Study

OBJECTIVE

Generalized anxiety disorder (GAD) is a chronic mood disease associated with abnormal brain network connections, including decreased activity in the left dorsolateral prefrontal cortex (DLPFC). Cortical excitability can be increased with 820-nm transcranial near-infrared stimulation (tNIRS), while transcranial magnetic stimulation with electroencephalography (TMS-EEG) can help evaluate time-varying brain network connectivity. A randomized, double-blind, sham-controlled trial was conducted to assess the efficacy of tNIRS on the left DLPFC and the impact on time-varying brain network connections in GAD patients.

METHODS

A total of 36 GAD patients were randomized to receive active or sham tNIRS for 2 weeks. Clinical psychological scales were assessed before, after, and at the 2-, 4-, and 8-week follow-ups. TMS-EEG was performed for 20minutes before and immediately after tNIRS treatment. The healthy controls did not receive tNIRS and only had TMS-EEG data collected once in the resting state.

RESULTS

The Hamilton Anxiety Scale (HAMA) scores of the active stimulation group decreased post-treatment compared with the sham group (P=0.021). The HAMA scores of the active stimulation group at the 2-, 4-, and 8-week follow-up assessments were lower than those before treatment (P<0.05). The time-varying EEG network pattern showed an information outflow from the left DLPFC and the left posterior temporal region after active treatment.

CONCLUSION

Herein, 820-nm tNIRS targeting the left DLPFC had significant positive effects on therapy for GAD that lasted at least 2 months. tNIRS may reverse the abnormality of time-varying brain network connections in GAD.