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Zarifkar AH, Zarifkar A, Safaei S. Different paradigms of transcranial electrical stimulation induce structural changes in the CA1 region of the hippocampus in a rat model of Alzheimer's disease. Neurosci Lett 2024; 818:137570. [PMID: 38000774 DOI: 10.1016/j.neulet.2023.137570] [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: 10/07/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 11/26/2023]
Abstract
One of the prominent sign of Alzheimer's disease (AD) is structural changes in the hippocampus. Recently, the new methods used to treat this disease is transcranial electrical stimulation (tES). This study evaluated the effect of four primary standards of tES, including tDCS, tACS, tRNS, and tPCS on beta-amyloid 25-35 (Aβ25-35)-induced structural changes in the CA1 region of hippocampus in male rats. For this purpose, rats weighing 250-275 g were selected, the cannula was embedded reciprocally into the hippocampi. Aβ25-35 (5 μg/ 2.5 ml/ day) was infused reciprocally for four continuous days.Then, animals were then given tES for 6 days.Subsequently, structural changes in the hippocampal CA1 were evaluated using the stereological method. Aβ25-35 resulted in loss of neurons (P < 0.01) and decreased hippocampal volume (P < 0.05). However, the administration of tES paradigms prevented these changes. The results proposed that through the improvement of hippocampal cell number and volume, tES paradigms can retain efficiency in remediating structural impairments in AD. From this, it can be concluded that other tES paradigms besides tDCS can also be considered for the treatment of AD.
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Affiliation(s)
- Amir Hossein Zarifkar
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran; Cellular and Molecular Biology Research Center, Larestan University of Medical Sciences, Larestan, Iran.
| | - Asadollah Zarifkar
- Department of Physiology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Safaei
- Gerash Amir-al-Momenin Medical and Educational Center, Gerash University of Medical Sciences, Gerash, Iran
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2
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Dávila G, Torres-Prioris MJ, López-Barroso D, Berthier ML. Turning the Spotlight to Cholinergic Pharmacotherapy of the Human Language System. CNS Drugs 2023; 37:599-637. [PMID: 37341896 PMCID: PMC10374790 DOI: 10.1007/s40263-023-01017-4] [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] [Accepted: 05/24/2023] [Indexed: 06/22/2023]
Abstract
Even though language is essential in human communication, research on pharmacological therapies for language deficits in highly prevalent neurodegenerative and vascular brain diseases has received little attention. Emerging scientific evidence suggests that disruption of the cholinergic system may play an essential role in language deficits associated with Alzheimer's disease and vascular cognitive impairment, including post-stroke aphasia. Therefore, current models of cognitive processing are beginning to appraise the implications of the brain modulator acetylcholine in human language functions. Future work should be directed further to analyze the interplay between the cholinergic system and language, focusing on identifying brain regions receiving cholinergic innervation susceptible to modulation with pharmacotherapy to improve affected language domains. The evaluation of language deficits in pharmacological cholinergic trials for Alzheimer's disease and vascular cognitive impairment has thus far been limited to coarse-grained methods. More precise, fine-grained language testing is needed to refine patient selection for pharmacotherapy to detect subtle deficits in the initial phases of cognitive decline. Additionally, noninvasive biomarkers can help identify cholinergic depletion. However, despite the investigation of cholinergic treatment for language deficits in Alzheimer's disease and vascular cognitive impairment, data on its effectiveness are insufficient and controversial. In the case of post-stroke aphasia, cholinergic agents are showing promise, particularly when combined with speech-language therapy to promote trained-dependent neural plasticity. Future research should explore the potential benefits of cholinergic pharmacotherapy in language deficits and investigate optimal strategies for combining these agents with other therapeutic approaches.
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Affiliation(s)
- Guadalupe Dávila
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - María José Torres-Prioris
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Diana López-Barroso
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain
- Department of Psychobiology and Methodology of Behavioral Sciences, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain
| | - Marcelo L Berthier
- Cognitive Neurology and Aphasia Unit, Centro de Investigaciones Médico-Sanitarias, University of Malaga, Marqués de Beccaria 3, 29010, Malaga, Spain.
- Instituto de Investigación Biomédica de Malaga-IBIMA, Malaga, Spain.
- Language Neuroscience Research Laboratory, Faculty of Psychology and Speech Therapy, University of Malaga, Malaga, Spain.
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10 Minutes Frontal 40 Hz tACS-Effects on Working Memory Tested by Luck-Vogel Task. Behav Sci (Basel) 2022; 13:bs13010039. [PMID: 36661611 PMCID: PMC9855106 DOI: 10.3390/bs13010039] [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: 11/20/2022] [Revised: 12/21/2022] [Accepted: 12/27/2022] [Indexed: 01/03/2023] Open
Abstract
Working memory is a cognitive process that involves short-term active maintenance, flexible updating, and processing of goal- or task-relevant information. All frequency bands are involved in working memory. The activities of the theta and gamma frequency bands in the frontoparietal network are highly involved in working memory processes; theta oscillations play a role in the temporal organization of working memory items, and gamma oscillations influence the maintenance of information in working memory. Transcranial alternating current stimulation (tACS) results in frequency-specific modulation of endogenous oscillations and has shown promising results in cognitive neuroscience. The electrophysiological and behavioral changes induced by the modulation of endogenous gamma frequency in the prefrontal cortex using tACS have not been extensively studied in the context of working memory. Therefore, we aimed to investigate the effects of frontal gamma-tACS on working memory outcomes. We hypothesized that a 10-min gamma tACS administered over the frontal cortex would significantly improve working memory outcomes. Young healthy participants performed Luck-Vogel cognitive behavioral tasks with simultaneous pre- and post-intervention EEG recording (Sham versus 40 Hz tACS). Data from forty-one participants: sham (15 participants) and tACS (26 participants), were used for the statistical and behavioral analysis. The relative changes in behavioral outcomes and EEG due to the intervention were analyzed. The results show that tACS caused an increase in the power spectral density in the high beta and low gamma EEG bands and a decrease in left-right coherence. On the other hand, tACS had no significant effect on success rates and response times. Conclusion: 10 min of frontal 40 Hz tACS was not sufficient to produce detectable behavioral effects on working memory, whereas electrophysiological changes were evident. The limitations of the current stimulation protocol and future directions are discussed in detail in the following sections.
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Bonassi G, Lagravinese G, Putzolu M, Botta A, Bove M, Pelosin E, Avanzino L. Transcranial direct current stimulation alters sensorimotor modulation during cognitive representation of movement. Front Hum Neurosci 2022; 16:862013. [PMID: 36277054 PMCID: PMC9583391 DOI: 10.3389/fnhum.2022.862013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
We recently demonstrated, by means of short latency afferent inhibition (SAI), that before an imagined movement, during the reaction time (RT), SAI decreases only in the movement-related muscle (sensorimotor modulation) and that a correlation exists between sensorimotor modulation and motor imagery (MI) ability. Excitatory anodal transcranial direct current stimulation (a-tDCS) on M1 could enhance the MI outcome; however, mechanisms of action are not completely known. Here, we assessed if a-tDCS on M1 prior to an MI task could affect sensorimotor modulation. Participants imagined abducting the index or little finger in response to an acoustic signal. SAI was evaluated from the first dorsal interosseus after the “go” signal, before the expected electromyographic (EMG) activity. Participants received 20-min 1.5 mA a-tDCS or sham-tDCS on M1 on two different days, in random order. Results showed that a-tDCS on M1 increases the sensorimotor modulation consisting of a weakening of SAI after the Go signal with respect to sham-tDCS, in the movement-related muscle right before the beginning of MI. These results suggest that a-tDCS on M1 further potentiate those circuits responsible for sensorimotor modulation in the RT phase of MI. Increased sensorimotor modulation during MI may be one of the mechanisms involved in MI improvement after a-tDCS over M1.
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Affiliation(s)
- Gaia Bonassi
- S.C. Medicina Fisica e Riabilitazione Ospedaliera, ASL4, Azienda Sanitaria Locale Chiavarese, Chiavari, Italy
| | - Giovanna Lagravinese
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Martina Putzolu
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Alessandro Botta
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Marco Bove
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Elisa Pelosin
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
| | - Laura Avanzino
- Ospedale Policlinico San Martino, IRCCS, Genoa, Italy
- Section of Human Physiology, Department of Experimental Medicine, University of Genoa, Genoa, Italy
- *Correspondence: Laura Avanzino
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Oh E, Park J, Youn J, Jang W. Anodal Transcranial Direct Current Stimulation Could Modulate Cortical Excitability and the Central Cholinergic System in Akinetic Rigid-Type Parkinson's Disease: Pilot Study. Front Neurol 2022; 13:830976. [PMID: 35401397 PMCID: PMC8987019 DOI: 10.3389/fneur.2022.830976] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/11/2022] [Indexed: 12/12/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive technique that has been widely studied as an alternative treatment for Parkinson's disease (PD). However, its clinical benefit remains unclear. In this study, we aimed to investigate the effect of tDCS on the central cholinergic system and cortical excitability in mainly akinetic rigid-type patients with PD. Methods In total, 18 patients with PD were prospectively enrolled and underwent 5 sessions of anodal tDCS on the M1 area, which is on the contralateral side of the dominant hand. We excluded patients with PD who had evident resting tremor of the hand to reduce the artifact of electrophysiologic findings. We compared clinical scales reflecting motor, cognitive, and mood symptoms between pre- and post-tDCS. Additionally, we investigated the changes in electrophysiologic parameters, such as short latency afferent inhibition (SAI) (%), which reflects the central cholinergic system. Results The United Parkinson's Disease Rating Scale Part 3 (UPDRS-III), the Korean-Montreal Cognitive Assessment (MoCA-K), and Beck Depression Inventory (BDI) scores were significantly improved after anodal tDCS (p < 0.01, p < 0.01, and p < 0.01). Moreover, motor evoked potential amplitude ratio (MEPAR) (%) and integrated SAI showed significant improvement after tDCS (p < 0.01 and p < 0.01). The mean values of the change in integrated SAI (%) were significantly correlated with the changes in UPDRS-III scores; however, the MoCA-K and BDI scores did not show differences. Conclusions Anodal tDCS could influence the central cholinergic system, such as frontal cortical excitability and depression in PD. This mechanism could underlie the clinical benefit of tDCS in patients with PD.
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Affiliation(s)
- Eungseok Oh
- Department of Neurology, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Jinse Park
- Department of Neurology, Haeundae Paik Hospital, Inje University, Busan, South Korea
| | - Jinyoung Youn
- Department of Neurology, Samsung Medical Center, Seoul, South Korea
| | - Wooyoung Jang
- Department of Neurology, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, South Korea
- *Correspondence: Wooyoung Jang
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Cengiz B, Boran HE, Alaydın HC, Tankisi H, Samusyte G, Howells J, Koltzenburg M, Bostock H. Short latency afferent inhibition: comparison between threshold-tracking and conventional amplitude recording methods. Exp Brain Res 2022; 240:1241-1247. [PMID: 35192042 DOI: 10.1007/s00221-022-06327-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 02/05/2022] [Indexed: 11/04/2022]
Abstract
Short-latency afferent inhibition (SAI), which is conventionally measured as a reduction in motor evoked potential amplitude (A-SAI), is of clinical interest as a potential biomarker for cognitive impairment. Since threshold-tracking has some advantages for clinical studies of short-interval cortical inhibition, we have compared A-SAI with a threshold-tracking alternative method (T-SAI). In the T-SAI method, inhibition was calculated by tracking the required TMS intensity for the targeted MEP amplitude (200 uV) both for the test (TMS only) and paired (TMS and peripheral stimulation) stimuli. A-SAI and T-SAI were recorded from 31 healthy subjects using ten stimuli at each of 12 inter-stimulus intervals, once in the morning and again in the afternoon. There were no differences between morning and afternoon recordings. When A-SAI was normalized by log conversion it was closely related to T-SAI. Between subjects, variability was similar for the two techniques, but within-subject variability was significantly smaller for normalized A-SAI. Conventional amplitude measurements appear more sensitive for detecting changes within-subjects, such as in interventional studies, but threshold-tracking may be as sensitive as detecting abnormal SAI in a patient.
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Affiliation(s)
- Bülent Cengiz
- Department of Neurology, Gazi University Faculty of Medicine, Beşevler, 06500, Ankara, Turkey.
| | - H Evren Boran
- Department of Neurology, Gazi University Faculty of Medicine, Beşevler, 06500, Ankara, Turkey
| | - Halil Can Alaydın
- Department of Neurology, Gazi University Faculty of Medicine, Beşevler, 06500, Ankara, Turkey
| | - Hatice Tankisi
- Department of Clinical Neurophysiology, Aarhus University Hospital, Aarhus, Denmark
| | - Gintaute Samusyte
- Department of Neurology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - James Howells
- Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Martin Koltzenburg
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK.,Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, WC1N 3BG, UK
| | - Hugh Bostock
- Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, UK
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Kojima S, Miyaguchi S, Yokota H, Saito K, Inukai Y, Otsuru N, Onishi H. The Number or Type of Stimuli Used for Somatosensory Stimulation Affected the Modulation of Corticospinal Excitability. Brain Sci 2021; 11:brainsci11111494. [PMID: 34827493 PMCID: PMC8615945 DOI: 10.3390/brainsci11111494] [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: 10/08/2021] [Revised: 10/29/2021] [Accepted: 11/10/2021] [Indexed: 12/04/2022] Open
Abstract
Motor evoked potentials (MEPs) evoked by transcranial magnetic stimulation (TMS) a few milliseconds after this cortical activity following electrical stimulation (ES) result in an inhibition comparable to that by TMS alone; this is called short-latency afferent inhibition (SAI). Cortical activity is observed after mechanical tactile stimulation (MS) and is affected by the number of stimuli by ES. We determined the effects of somatosensory stimulus methods and multiple conditioning stimuli on SAI in 19 participants. In experiment 1, the interstimulus intervals between the conditioning stimulation and TMS were 25, 27 and 29 ms for ES and 28, 30 and 32 ms for MS. In experiment 2, we used 1, 2, 3 and 4 conditioning stimulations of ES and MS. The interstimulus interval between the ES or MS and TMS was 27 or 30 ms, respectively. In experiment 1, MEPs were significantly decreased in both the ES and MS conditions. In experiment 2, MEPs after ES were significantly decreased in all conditions. Conversely, MEPs after MS were significantly decreased after one stimulus and increased after four stimulations, indicating the SAI according to the number of stimuli. Therefore, the somatosensory stimulus methods and multiple conditioning stimuli affected the SAI.
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Conceição NR, Gobbi LTB, Nóbrega-Sousa P, Orcioli-Silva D, Beretta VS, Lirani-Silva E, Okano AH, Vitório R. Aerobic Exercise Combined With Transcranial Direct Current Stimulation Over the Prefrontal Cortex in Parkinson Disease: Effects on Cortical Activity, Gait, and Cognition. Neurorehabil Neural Repair 2021; 35:717-728. [PMID: 34047235 DOI: 10.1177/15459683211019344] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Since people with Parkinson disease (PD) rely on limited prefrontal executive resources for the control of gait, interventions targeting the prefrontal cortex (PFC) may help in managing PD-related gait impairments. Transcranial direct current stimulation (tDCS) can be used to modulate PFC excitability and improve prefrontal cognitive functions and gait. OBJECTIVE We investigated the effects of adding anodal tDCS applied over the PFC to a session of aerobic exercise on gait, cognition, and PFC activity while walking in people with PD. METHODS A total of 20 people with PD participated in this randomized, double-blinded, sham-controlled crossover study. Participants attended two 30-minute sessions of aerobic exercise (cycling at moderate intensity) combined with different tDCS conditions (active- or sham-tDCS), 1 week apart. The order of sessions was counterbalanced across the sample. Anodal tDCS (2 mA for 20 minutes [active-tDCS] or 10 s [sham-tDCS]) targeted the PFC in the most affected hemisphere. Spatiotemporal gait parameters, cognitive functions, and PFC activity while walking were assessed before and immediately after each session. RESULTS Compared with the pre-assessment, participants decreased step time variability (effect size: -0.4), shortened simple and choice reaction times (effect sizes: -0.73 and -0.57, respectively), and increased PFC activity in the stimulated hemisphere while walking (effect size: 0.54) only after aerobic exercise + active-tDCS. CONCLUSION The addition of anodal tDCS over the PFC to a session of aerobic exercise led to immediate positive effects on gait variability, processing speed, and executive control of walking in people with PD.
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Affiliation(s)
- Núbia Ribeiro Conceição
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil
| | - Lilian Teresa Bucken Gobbi
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil
| | - Priscila Nóbrega-Sousa
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil
| | - Diego Orcioli-Silva
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil
| | - Victor Spiandor Beretta
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil
| | - Ellen Lirani-Silva
- Oregon Health and Science University, Department of Neurology, Portland, OR, USA
| | - Alexandre Hideki Okano
- Federal University of ABC (UFABC), Center for Mathematics, Computation and Cognition, São Bernardo do Campo, SP, Brazil
| | - Rodrigo Vitório
- São Paulo State University (UNESP), Institute of Biosciences, Graduate Program in Movement Sciences, Rio Claro, SP, Brazil.,Oregon Health and Science University, Department of Neurology, Portland, OR, USA
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Bashir S, Ahmad S, Alatefi M, Hamza A, Sharaf M, Fecteau S, Yoo WK. Effects of anodal transcranial direct current stimulation on motor evoked potentials variability in humans. Physiol Rep 2020; 7:e14087. [PMID: 31301123 PMCID: PMC6640590 DOI: 10.14814/phy2.14087] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/24/2022] Open
Abstract
Motor evoked potentials (MEPs) obtained from transcranial magnetic stimulation (TMS) allow corticospinal excitability (CSE) to be measured in the human primary motor cortex (M1). CSE responses to transcranial direct current stimulation (tDCS) protocols are highly variable. Here, we tested the reproducibility and reliability of individual MEPs following a common anodal tDCS protocol. In this study, 32 healthy subjects received anodal tDCS stimulation over the left M1 for three durations (tDCS‐T5, tDCS‐T10, and tDCS‐T20 min) on separate days in a crossover‐randomized order. After the resting motor threshold (RMT) was determined for the contralateral first dorsal interosseous muscle, 15 single pulses 4–8 sec apart at an intensity of 120% RMT were delivered to the left M1 to determine the baseline MEP amplitude at T0, T5, T10, T20, T30, T40, T50, and T60 min after stimulation for each durations. During TMS delivery, 3D images of the participant's cortex and hot spot were visualized for obtaining MEPs from same position. Our findings revealed that there was a significant MEPs improvement at T0 (P = 0.01) after 10 min of anodal stimulation. After the 20‐min stimulation duration, MEPs differed specifically at T0, T5, T30 min (P < 0.05). This indicates that tDCS is a promising tool to improve MEPs. Our observed variability in response to the tDCS protocol is consistent with other noninvasive brain stimulation studies.
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Affiliation(s)
- Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital Dammam, Dammam, Saudi Arabia
| | - Shafiq Ahmad
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
| | - Moath Alatefi
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
| | - Ali Hamza
- Department of Electrical Engineering, National University of Computer and Emerging Sciences, Lahore, Pakistan
| | - Mohamed Sharaf
- Department of Industrial Engineering, College of Engineering, King Saud University, Riyadh, Saudi Arabia
| | | | - Woo Kyoung Yoo
- Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Anyang, South Korea.,Hallym Institute for Translational Genomics & Bioinformatics, Hallym University Sacred Heart Hospital, Anyang, South Korea
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Yamaguchi T, Moriya K, Tanabe S, Kondo K, Otaka Y, Tanaka S. Transcranial direct-current stimulation combined with attention increases cortical excitability and improves motor learning in healthy volunteers. J Neuroeng Rehabil 2020; 17:23. [PMID: 32075667 PMCID: PMC7031972 DOI: 10.1186/s12984-020-00665-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 02/14/2020] [Indexed: 11/24/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has the potential to induce motor cortical plasticity in humans. It is well known that motor cortical plasticity plays an essential role in motor learning and recovery in patients with stroke and neurodegenerative disorders. However, it remains unclear how cognitive function influences motor cortical plasticity induced by tDCS. The present study aimed to investigate whether anodal tDCS combined with attention to a target muscle could enhance motor cortical plasticity and improve motor learning in healthy individuals. Methods Thirty-three healthy volunteers were assigned to two experiments. In experiment 1, there were three interventional conditions: 1) anodal tDCS was applied while participants paid attention to the first dorsal interosseous (FDI) muscle, 2) anodal tDCS was applied while participants paid attention to the sound, and 3) anodal tDCS was applied without the participants paying attention to the FDI muscle or the sound. Anodal tDCS (2 mA, 10 min) was applied over the primary motor cortex (M1). Changes in motor evoked potentials (MEPs), short-interval intracortical inhibition (SICI), and intracortical facilitation (ICF) were assessed before and immediately after (0 min), and then 10 min, 30 min, and 60 min after each intervention. In experiment 2, we investigated whether the combination of anodal tDCS and attention to the abductor pollicis brevis (APB) muscle could facilitate the learning of a ballistic thumb movement. Results Anodal tDCS increased cortical excitability in all conditions immediately after the stimulation. Significant increases in MEPs and significant decreases in SICI were observed for at least 60 min after anodal tDCS, but only when participants paid attention to the FDI muscle. In contrast, no significant changes in ICF were observed in any condition. In experiment 2, the combination of tDCS and attention to the APB muscle significantly enhanced the acquisition of a ballistic thumb movement. The higher performance was still observed 7 days after the stimulation. Conclusions This study shows that anodal tDCS over M1 in conjunction with attention to the target muscle enhances motor cortex plasticity and improves motor learning in healthy adults. These findings suggest that a combination of attention and tDCS may be an effective strategy to promote rehabilitation training in patients with stroke and neurodegenerative disorders. Trial registration Retrospectively registered (UMIN000036848).
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Affiliation(s)
- Tomofumi Yamaguchi
- Department of Physical Therapy, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan. .,Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Kouhei Moriya
- Laboratory for Rehabilitation, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino, Chiba, 275-0026, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Kunitsugu Kondo
- Laboratory for Rehabilitation, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino, Chiba, 275-0026, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
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11
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Guo T, Fang J, Tong ZY, He S, Luo Y. Transcranial Direct Current Stimulation Ameliorates Cognitive Impairment via Modulating Oxidative Stress, Inflammation, and Autophagy in a Rat Model of Vascular Dementia. Front Neurosci 2020; 14:28. [PMID: 32063834 PMCID: PMC7000631 DOI: 10.3389/fnins.2020.00028] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 01/10/2020] [Indexed: 12/11/2022] Open
Abstract
To investigate the potential applications and the molecular mechanisms of transcranial direct current stimulation (tDCS) on cognitive impairment in a vascular dementia (VD) animal model. Sprague-Dawley rats were used in this study. VD rat model was induced by modified permanent bilateral common carotid artery occlusion (2-VO) approach. Anodal tDCS was applied to the animals. Morris water maze was used to analyze spatial memory and navigation ability. The pathological changes in the hippocampal CA1 region and cerebral cortex were examined via Hematoxylin-Eosin staining. The rats were sacrificed for the measurement of the level of superoxide (SOD), glutathione (GSH), reactive oxidative species (ROS), malondialdehyd (MDA), Interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α level in the hippocampus. Western blot was carried out to measure the hippocampal expression of microtubule-associated protein 1 light chain 3 (LC-3) and p62. Rats with VD have decreased number of neurons in the hippocampus and cerebral cortex, as well as worse cognitive impairment. The proliferation of activated microglia and astroglia, accompanied with attenuation of myelination were observed in the white matter about 1 month after 2-VO operation. These abnormalities were significantly ameliorated by tDCS treatment. Further study revealed that anodal tDCS could suppress the MDA and ROS level, while enhance the SOD and GSH level to reduce the oxidative stress. Anodal tDCS could inhibit hypoperfusion-induced IL-1β, IL-6, and TNF-α expression to attenuate inflammatory response in hippocampus. Moreover, anodal tDCS treatment could alleviate autophagy level. The study has demonstrated a possible therapeutic role of tDCS in the treatment of cognitive impairment in VD.
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Affiliation(s)
- Tao Guo
- Department of Emergency, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jia Fang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhong Y Tong
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shasha He
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yingying Luo
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
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12
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Yamazaki Y, Sato D, Yamashiro K, Nakano S, Onishi H, Maruyama A. Acute Low-Intensity Aerobic Exercise Modulates Intracortical Inhibitory and Excitatory Circuits in an Exercised and a Non-exercised Muscle in the Primary Motor Cortex. Front Physiol 2019; 10:1361. [PMID: 31787901 PMCID: PMC6853900 DOI: 10.3389/fphys.2019.01361] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 10/14/2019] [Indexed: 11/17/2022] Open
Abstract
Recent studies have reported that acute aerobic exercise modulates intracortical excitability in the primary motor cortex (M1). However, whether acute low-intensity aerobic exercise can also modulate M1 intracortical excitability, particularly intracortical excitatory circuits, remains unclear. In addition, no previous studies have investigated the effect of acute aerobic exercise on short-latency afferent inhibition (SAI). The aim of this study was to investigate whether acute low-intensity aerobic exercise modulates intracortical circuits in the M1 hand and leg areas. Intracortical excitability of M1 (Experiments 1, 2) and spinal excitability (Experiment 3) were measured before and after acute low-intensity aerobic exercise. In Experiment 3, skin temperature was also measured throughout the experiment. Transcranial magnetic stimulation was applied over the M1 non-exercised hand and exercised leg areas in Experiments 1, 2, respectively. Participants performed 30 min of low-intensity pedaling exercise or rested while sitting on the ergometer. Short- and long-interval intracortical inhibition (SICI and LICI), and SAI were measured to assess M1 inhibitory circuits. Intracortical facilitation (ICF) and short-interval intracortical facilitation (SICF) were measured to assess M1 excitatory circuits. We found that acute low-intensity aerobic exercise decreased SICI and SAI in the M1 hand and leg areas. After exercise, ICF in the M1 hand area was lower than in the control experiment, but was not significantly different to baseline. The single motor-evoked potential, resting motor threshold, LICI, SICF, and spinal excitability did not change following exercise. In conclusion, acute low-intensity pedaling modulates M1 intracortical circuits of both exercised and non-exercised areas, without affecting corticospinal and spinal excitability.
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Affiliation(s)
- Yudai Yamazaki
- Major in Health and Welfare, Niigata University of Health and Welfare, Niigata, Japan.,Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan
| | - Daisuke Sato
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Koya Yamashiro
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Health and Sports, Niigata University of Health and Welfare, Niigata, Japan
| | - Saki Nakano
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Field of Health and Sports, Major in Health and Science, Niigata University of Health and Welfare, Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, Niigata, Japan.,Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Atsuo Maruyama
- Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
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13
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Turco CV, El-Sayes J, Savoie MJ, Fassett HJ, Locke MB, Nelson AJ. Short- and long-latency afferent inhibition; uses, mechanisms and influencing factors. Brain Stimul 2018; 11:59-74. [DOI: 10.1016/j.brs.2017.09.009] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Revised: 08/28/2017] [Accepted: 09/14/2017] [Indexed: 12/11/2022] Open
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Dissanayaka T, Zoghi M, Farrell M, Egan GF, Jaberzadeh S. Does transcranial electrical stimulation enhance corticospinal excitability of the motor cortex in healthy individuals? A systematic review and meta-analysis. Eur J Neurosci 2017; 46:1968-1990. [DOI: 10.1111/ejn.13640] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 07/03/2017] [Accepted: 07/04/2017] [Indexed: 12/12/2022]
Affiliation(s)
- Thusharika Dissanayaka
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Melbourne Victoria Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport; School of Allied Health; La Trobe University; Bundoora Victoria Australia
| | - Michael Farrell
- Monash Biomedical Imaging; Monash University; Melbourne Victoria Australia
- Biomedicine Discovery Institute and Department of Medical Imaging and Radiation Sciences; Monash University; Melbourne Victoria Australia
| | - Gary F. Egan
- Monash Biomedical Imaging; Monash University; Melbourne Victoria Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy; School of Primary Health Care; Faculty of Medicine; Nursing and Health Sciences; Monash University; Melbourne Victoria Australia
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15
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Horvath JC, Vogrin SJ, Carter O, Cook MJ, Forte JD. Effects of a common transcranial direct current stimulation (tDCS) protocol on motor evoked potentials found to be highly variable within individuals over 9 testing sessions. Exp Brain Res 2016; 234:2629-42. [PMID: 27150317 DOI: 10.1007/s00221-016-4667-8] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/27/2016] [Indexed: 11/28/2022]
Abstract
Transcranial direct current stimulation (tDCS) uses a weak electric current to modulate neuronal activity. A neurophysiologic outcome measure to demonstrate reliable tDCS modulation at the group level is transcranial magnetic stimulation engendered motor evoked potentials (MEPs). Here, we conduct a study testing the reliability of individual MEP response patterns following a common tDCS protocol. Fourteen participants (7m/7f) each underwent nine randomized sessions of 1 mA, 10 min tDCS (3 anode; 3 cathode; 3 sham) delivered using an M1/orbito-frontal electrode montage (sessions separated by an average of ~5.5 days). Fifteen MEPs were obtained prior to, immediately following and in 5 min intervals for 30 min following tDCS. TMS was delivered at 130 % resting motor threshold using neuronavigation to ensure consistent coil localization. A number of non-experimental variables were collected during each session. At the individual level, considerable variability was seen among different testing sessions. No participant demonstrated an excitatory response ≥20 % to all three anodal sessions, and no participant demonstrated an inhibitory response ≥20 % to all three cathodal sessions. Intra-class correlation revealed poor anodal and cathodal test-retest reliability [anode: ICC(2,1) = 0.062; cathode: ICC(2,1) = 0.055] and moderate sham test-retest reliability [ICC(2,1) = 0.433]. Results also revealed no significant effect of tDCS at the group level. Using this common protocol, we found the effects of tDCS on MEP amplitudes to be highly variable at the individual level. In addition, no significant effects of tDCS on MEP amplitude were found at the group level. Future studies should consider utilizing a more strict experimental protocol to potentially account for intra-individual response variations.
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Affiliation(s)
- Jared Cooney Horvath
- Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Melbourne, VIC, 3010, Australia. .,Departments of Medicine and Neurology, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia. .,Melbourne Graduate School of Education, University of Melbourne, Melbourne, VIC, Australia.
| | - Simon J Vogrin
- Departments of Medicine and Neurology, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Melbourne, VIC, 3010, Australia
| | - Mark J Cook
- Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Melbourne, VIC, 3010, Australia.,Departments of Medicine and Neurology, St. Vincent's Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Jason D Forte
- Melbourne School of Psychological Sciences, University of Melbourne, Redmond Barry Building, Melbourne, VIC, 3010, Australia
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16
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Cho HJ, Panyakaew P, Thirugnanasambandam N, Wu T, Hallett M. Dynamic modulation of corticospinal excitability and short-latency afferent inhibition during onset and maintenance phase of selective finger movement. Clin Neurophysiol 2016; 127:2343-9. [PMID: 27178851 DOI: 10.1016/j.clinph.2016.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/22/2016] [Accepted: 02/18/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE During highly selective finger movement, corticospinal excitability is reduced in surrounding muscles at the onset of movement but this phenomenon has not been demonstrated during maintenance of movement. Sensorimotor integration may play an important role in selective movement. We sought to investigate how corticospinal excitability and short-latency afferent inhibition changes in active and surrounding muscles during onset and maintenance of selective finger movement. METHODS Using transcranial magnetic stimulation (TMS) and paired peripheral stimulation, input-output recruitment curve and short-latency afferent inhibition (SAI) were measured in the first dorsal interosseus and abductor digiti minimi muscles during selective index finger flexion. RESULTS Motor surround inhibition was present only at the onset phase, but not at the maintenance phase of movement. SAI was reduced at onset but not at the maintenance phase of movement in both active and surrounding muscles. CONCLUSIONS Our study showed dynamic changes in corticospinal excitability and sensorimotor modulation for active and surrounding muscles in different movement states. SAI does not appear to contribute to motor surround inhibition at the movement onset phase. Also, there seems to be different inhibitory circuit(s) other than SAI for the movement maintenance phase in order to delineate the motor output selectively when corticospinal excitability is increased in both active and surrounding muscles. SIGNIFICANCE This study enhances our knowledge of dynamic changes in corticospinal excitability and sensorimotor interaction in different movement states to understand normal and disordered movements.
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Affiliation(s)
- Hyun Joo Cho
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Pattamon Panyakaew
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA; Department of Medicine, Faculty of Medicine, Chulalongkorn Center of Excellence on Parkinson Disease and Related Disorders, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Nivethida Thirugnanasambandam
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Tianxia Wu
- Clinical Neurosciences Program, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA.
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Effects of cathodal transcranial direct current stimulation to primary somatosensory cortex on short-latency afferent inhibition. Neuroreport 2016; 26:634-7. [PMID: 26103117 DOI: 10.1097/wnr.0000000000000402] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of this study was to investigate the effects of cathodal transcranial direct current stimulation (tDCS) applied over the primary somatosensory cortex (S1) on short-interval afferent inhibition (SAI). Thirteen healthy individuals participated in this study. Cathodal tDCS was applied for 15 min at 1 mA over the left S1. Motor-evoked potentials (MEPs) were measured from the right first dorsal interosseous muscle in response to transcranial magnetic stimulation (TMS) of the left motor cortex before tDCS (pre), immediately after tDCS (immediately), and 15 min after tDCS (post-15 min). SAI was evaluated by measuring MEPs in response to TMS pulses applied 40 ms after peripheral electrical stimulation of the index finger. For each measurement period (pre, immediately, and post-15 min), MEP amplitude was significantly smaller when TMS followed index finger stimulation (SAI condition) than when TMS was delivered alone (single TMS) (P<0.01), indicating expression of SAI. The MEP ratio (MEP of SAI/MEP of single TMS) at post-15 min was significantly larger than that of pre (P<0.05), indicating suppression of SAI. However, no significant difference was observed between pre and immediately, and immediately and post-15 min. These results suggest that cathodal tDCS applied over the S1 causes a decrease in S1 excitability following peripheral electrical stimulation and cathodal tDCS applied over the S1 decreased the inhibitory effects of SAI.
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18
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Sasaki R, Miyaguchi S, Kotan S, Kojima S, Kirimoto H, Onishi H. Modulation of Cortical Inhibitory Circuits after Cathodal Transcranial Direct Current Stimulation over the Primary Motor Cortex. Front Hum Neurosci 2016; 10:30. [PMID: 26869909 PMCID: PMC4740366 DOI: 10.3389/fnhum.2016.00030] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Accepted: 01/18/2016] [Indexed: 12/22/2022] Open
Abstract
Here, we aimed to evaluate whether cathodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) and primary somatosensory cortex (S1) can modulate cortical inhibitory circuits. Sixteen healthy subjects participated in this study. Cathodal tDCS was positioned over the left M1 (M1 cathodal) or left S1 (S1 cathodal) with an intensity of 1 mA for 10 min. Sham tDCS was applied for 10 min over the left M1 (sham). Motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) were recorded from the right abductor pollicis brevis (APB) muscle before the intervention (pre) and 10 and 30 min after the intervention (post 1 and post 2, respectively). Cortical inhibitory circuits were evaluated using short-interval intracortical inhibition (SICI) and short-latency afferent inhibition (SAI). M1 cathodal decreased single-pulse MEP amplitudes at post 1 and decreased SAI at post 1 and post 2; however, SICI did not exhibit any change. S1 cathodal and sham did not show any changes in MEP amplitudes at any of the three time points. These results demonstrated that cathodal tDCS over the M1 not only decreases the M1 excitability but also affects the cortical inhibitory circuits related to SAI.
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Affiliation(s)
- Ryoki Sasaki
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Shota Miyaguchi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Shinichi Kotan
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Sho Kojima
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Hikari Kirimoto
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
| | - Hideaki Onishi
- Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare Niigata, Japan
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Nardone R, Höller Y, Tezzon F, Christova M, Schwenker K, Golaszewski S, Trinka E, Brigo F. Neurostimulation in Alzheimer's disease: from basic research to clinical applications. Neurol Sci 2015; 36:689-700. [PMID: 25721941 DOI: 10.1007/s10072-015-2120-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Accepted: 02/20/2015] [Indexed: 02/02/2023]
Abstract
The development of different methods of brain stimulation provides a promising therapeutic tool with potentially beneficial effects on subjects with impaired cognitive functions. We performed a systematic review of the studies published in the field of neurostimulation in Alzheimer's disease (AD), from basic research to clinical applications. The main methods of non-invasive brain stimulation are repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Preliminary findings have suggested that both techniques can enhance performances on several cognitive functions impaired in AD. Another non-invasive emerging neuromodulatory approach, the transcranial electromagnetic treatment, was found to reverse cognitive impairment in AD transgenic mice and even improves cognitive performance in normal mice. Experimental studies suggest that high-frequency electromagnetic fields may be critically important in AD prevention and treatment through their action at mitochondrial level. Finally, the application of a widely known invasive technique, the deep brain stimulation (DBS), has increasingly been considered as a therapeutic option also for patients with AD; it has been demonstrated that DBS of fornix/hypothalamus and nucleus basalis of Meynert might improve or at least stabilize cognitive functioning in AD. Initial encouraging results provide support for continuing to investigate non-invasive and invasive brain stimulation approaches as an adjuvant treatment for AD patients.
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Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University and Center for Cognitive Neuroscience, Salzburg, Austria,
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20
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Horvath JC, Forte JD, Carter O. Evidence that transcranial direct current stimulation (tDCS) generates little-to-no reliable neurophysiologic effect beyond MEP amplitude modulation in healthy human subjects: A systematic review. Neuropsychologia 2015; 66:213-36. [PMID: 25448853 DOI: 10.1016/j.neuropsychologia.2014.11.021] [Citation(s) in RCA: 354] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 10/25/2014] [Accepted: 11/14/2014] [Indexed: 12/12/2022]
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21
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Tazoe T, Endoh T, Kitamura T, Ogata T. Polarity specific effects of transcranial direct current stimulation on interhemispheric inhibition. PLoS One 2014; 9:e114244. [PMID: 25478912 PMCID: PMC4257682 DOI: 10.1371/journal.pone.0114244] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/05/2014] [Indexed: 11/19/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been used as a useful interventional brain stimulation technique to improve unilateral upper-limb motor function in healthy humans, as well as in stroke patients. Although tDCS applications are supposed to modify the interhemispheric balance between the motor cortices, the tDCS after-effects on interhemispheric interactions are still poorly understood. To address this issue, we investigated the tDCS after-effects on interhemispheric inhibition (IHI) between the primary motor cortices (M1) in healthy humans. Three types of tDCS electrode montage were tested on separate days; anodal tDCS over the right M1, cathodal tDCS over the left M1, bilateral tDCS with anode over the right M1 and cathode over the left M1. Single-pulse and paired-pulse transcranial magnetic stimulations were given to the left M1 and right M1 before and after tDCS to assess the bilateral corticospinal excitabilities and mutual direction of IHI. Regardless of the electrode montages, corticospinal excitability was increased on the same side of anodal stimulation and decreased on the same side of cathodal stimulation. However, neither unilateral tDCS changed the corticospinal excitability at the unstimulated side. Unilateral anodal tDCS increased IHI from the facilitated side M1 to the unchanged side M1, but it did not change IHI in the other direction. Unilateral cathodal tDCS suppressed IHI both from the inhibited side M1 to the unchanged side M1 and from the unchanged side M1 to the inhibited side M1. Bilateral tDCS increased IHI from the facilitated side M1 to the inhibited side M1 and attenuated IHI in the opposite direction. Sham-tDCS affected neither corticospinal excitability nor IHI. These findings indicate that tDCS produced polarity-specific after-effects on the interhemispheric interactions between M1 and that those after-effects on interhemispheric interactions were mainly dependent on whether tDCS resulted in the facilitation or inhibition of the M1 sending interhemispheric volleys.
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Affiliation(s)
- Toshiki Tazoe
- Department of Rehabilitation for Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
- Japan Society for the Promotion of Science, Tokyo, Japan
- * E-mail:
| | - Takashi Endoh
- Department of Rehabilitation for Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
- Faculty of Child Development and Education, Uekusa Gakuen University, Chiba, Japan
| | - Taku Kitamura
- Department of Rehabilitation for Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
- Division of Functional Control Systems, Graduate School of Engineering and Science, Shibaura Institute of Technology, Saitama, Japan
| | - Toru Ogata
- Department of Rehabilitation for Movement Functions, Research Institute, National Rehabilitation Center for Persons with Disabilities, Tokorozawa, Japan
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Horvath JC, Carter O, Forte JD. Transcranial direct current stimulation: five important issues we aren't discussing (but probably should be). Front Syst Neurosci 2014; 8:2. [PMID: 24478640 PMCID: PMC3901383 DOI: 10.3389/fnsys.2014.00002] [Citation(s) in RCA: 248] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 01/08/2014] [Indexed: 12/12/2022] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) is a neuromodulatory device often publicized for its ability to enhance cognitive and behavioral performance. These enhancement claims, however, are predicated upon electrophysiological evidence and descriptions which are far from conclusive. In fact, a review of the literature reveals a number of important experimental and technical issues inherent with this device that are simply not being discussed in any meaningful manner. In this paper, we will consider five of these topics. The first, inter-subject variability, explores the extensive between- and within-group differences found within the tDCS literature and highlights the need to properly examine stimulatory response at the individual level. The second, intra-subject reliability, reviews the lack of data concerning tDCS response reliability over time and emphasizes the importance of this knowledge for appropriate stimulatory application. The third, sham stimulation and blinding, draws attention to the importance (yet relative lack) of proper control and blinding practices in the tDCS literature. The fourth, motor and cognitive interference, highlights the often overlooked body of research that suggests typical behaviors and cognitions undertaken during or following tDCS can impair or abolish the effects of stimulation. Finally, the fifth, electric current influences, underscores several largely ignored variables (such as hair thickness and electrode attachments methods) influential to tDCS electric current density and flow. Through this paper, we hope to increase awareness and start an ongoing dialog of these important issues which speak to the efficacy, reliability, and mechanistic foundations of tDCS.
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Affiliation(s)
- Jared C. Horvath
- Psychological Sciences, University of MelbourneMelbourne, VIC, Australia
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Lesemann A, List J, Floeel A. P 94. Influence of transcranial direct current stimulation on cortical plasticity and on cholinergic cortical activity in Alzheimer’s disease. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Knechtel L, Thienel R, Schall U. Transcranial direct current stimulation: neurophysiology and clinical applications. ACTA ACUST UNITED AC 2013. [DOI: 10.2217/npy.12.78] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
Transcranial magnetic stimulation (TMS) has been used extensively to characterize motor system pathophysiology in Alzheimer's disease (AD) and other forms of dementia, as well to monitor the effects of certain pharmacological agents. Among the studies focusing on motor cortical excitability measures, the most consistent finding is a significant reduction of short-latency afferent inhibition (SAI) in AD and other forms of dementia in which the cholinergic system is affected, such as dementia with Lewy bodies. SAI evaluation may thus provide a reliable biomarker of cortical cholinergic dysfunction in dementias. Moreover, most TMS studies have demonstrated cortical hyperexcitability and asymptomatic motor cortex functional reorganization in the early stages of the disease. Integrated approaches utilizing TMS together with high-density EEG have indicated impaired cortical plasticity and functional connectivity across different neural networks in AD. Paired associative stimulation-induced plasticity has also been found to be abnormal in patients with AD. The development of novel noninvasive methods of brain stimulation, in particular repetitive TMS (rTMS) and transcranial direct current stimulation (tDCS), has increased the interest in neuromodulatory techniques as potential therapeutic tools for cognitive rehabilitation in AD. Preliminary studies have revealed that rTMS and tDCS can induce beneficial effects on specific cognitive functions in AD. Future studies are warranted to replicate and extend the initial findings.
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Affiliation(s)
- Raffaele Nardone
- Department of Neurology, Christian Doppler Clinic, Paracelsus Medical University, Salzburg, Austria; Department of Neurology, Franz Tappeiner Hospital, Merano, Italy.
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Abstract
Learning and memory functions are crucial in the interaction of an individual with the environment and involve the interplay of large, distributed brain networks. Recent advances in technologies to explore neurobiological correlates of neuropsychological paradigms have increased our knowledge about human learning and memory. In this chapter we first review and define memory and learning processes from a neuropsychological perspective. Then we provide some illustrations of how noninvasive brain stimulation can play a major role in the investigation of memory functions, as it can be used to identify cause-effect relationships and chronometric properties of neural processes underlying cognitive steps. In clinical medicine, transcranial magnetic stimulation may be used as a diagnostic tool to understand memory and learning deficits in various patient populations. Furthermore, noninvasive brain stimulation is also being applied to enhance cognitive functions, offering exciting translational therapeutic opportunities in neurology and psychiatry.
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Affiliation(s)
- Anna-Katharine Brem
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Medeiros LF, de Souza ICC, Vidor LP, de Souza A, Deitos A, Volz MS, Fregni F, Caumo W, Torres ILS. Neurobiological effects of transcranial direct current stimulation: a review. Front Psychiatry 2012; 3:110. [PMID: 23293607 PMCID: PMC3531595 DOI: 10.3389/fpsyt.2012.00110] [Citation(s) in RCA: 167] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Accepted: 12/04/2012] [Indexed: 12/20/2022] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique that is affordable and easy to operate compared to other neuromodulation techniques. Anodal stimulation increases cortical excitability, while the cathodal stimulation decreases it. Although tDCS is a promising treatment approach for chronic pain as well as for neuropsychiatric diseases and other neurological disorders, several complex neurobiological mechanisms that are not well understood are involved in its effect. The purpose of this systematic review is to summarize the current knowledge regarding the neurobiological mechanisms involved in the effects of tDCS. The initial search resulted in 171 articles. After applying inclusion and exclusion criteria, we screened 32 full-text articles to extract findings about the neurobiology of tDCS effects including investigation of cortical excitability parameters. Overall, these findings show that tDCS involves a cascade of events at the cellular and molecular levels. Moreover, tDCS is associated with glutamatergic, GABAergic, dopaminergic, serotonergic, and cholinergic activity modulation. Though these studies provide important advancements toward the understanding of mechanisms underlying tDCS effects, further studies are needed to integrate these mechanisms as to optimize clinical development of tDCS.
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Affiliation(s)
- Liciane Fernandes Medeiros
- Post-Graduate Program in Biological Sciences, Department of Physiology, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil ; Pharmacology Department, Institute of Basic Health Science, Universidade Federal do Rio Grande do Sul Porto Alegre, Brazil ; Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre Porto Alegre, Brazil
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Effect of transcranial brain stimulation for the treatment of Alzheimer disease: a review. Int J Alzheimers Dis 2011; 2012:687909. [PMID: 22114748 PMCID: PMC3202129 DOI: 10.1155/2012/687909] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 08/26/2011] [Indexed: 11/17/2022] Open
Abstract
Available pharmacological treatments for Alzheimer disease (AD) have limited effectiveness, are expensive, and sometimes induce side effects. Therefore, alternative or complementary adjuvant therapeutic strategies have gained increasing attention.
The development of novel noninvasive methods of brain stimulation has increased the interest in neuromodulatory techniques as potential therapeutic tool for cognitive rehabilitation in AD. In particular, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive approaches that induce prolonged functional changes in the cerebral cortex.
Several studies have begun to therapeutically use rTMS or tDCS to improve cognitive performances in patients with AD. However, most of them induced short-duration beneficial effects and were not adequately powered to establish evidence for therapeutic efficacy. Therefore, TMS and tDCS approaches, seeking to enhance cognitive function, have to be considered still very preliminary. In future studies, multiple rTMS or tDCS sessions might also interact, and metaplasticity effects could affect the outcome.
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