Transcranial random noise stimulation mitigates increased difficulty in an arithmetic learning task

The distinct and potentially conflicting effects of tDCS and tRNS on brain connectivity, cortical inhibition, and visuospatial memory

Noninvasive brain stimulation (NIBS) techniques, including transcranial direct current stimulation (tDCS) and transcranial random noise stimulation (tRNS), are emerging as promising tools for enhancing cognitive functions by modulating brain activity and enhancing cognitive functions. Despite their potential, the specific and combined effects of tDCS and tRNS on brain functions, especially regarding functional connectivity, cortical inhibition, and memory performance, are not well-understood. This study aims to explore the distinct and combined impacts of tDCS and tRNS on these neural and cognitive parameters. Using a within-subject design, ten participants underwent four stimulation conditions: sham, tDCS, tRNS, and combined tDCS + tRNS. We assessed the impact on resting-state functional connectivity, cortical inhibition via Cortical Silent Period (CSP), and visuospatial memory performance using the Corsi Block-tapping Test (CBT). Our results indicate that while tDCS appears to induce brain lateralization, tRNS has more generalized and dispersive effects. Interestingly, the combined application of tDCS and tRNS did not amplify these effects but rather suggested a non-synergistic interaction, possibly due to divergent mechanistic pathways, as observed across fMRI, CSP, and CBT measures. These findings illuminate the complex interplay between tDCS and tRNS, highlighting their non-additive effects when used concurrently and underscoring the necessity for further research to optimize their application for cognitive enhancement.

Probing Our Built-in Calculator: A Systematic Narrative Review of Noninvasive Brain Stimulation Studies on Arithmetic Operation-Related Brain Areas

This systematic review presented a comprehensive survey of studies that applied transcranial magnetic stimulation and transcranial electrical stimulation to parietal and nonparietal areas to examine the neural basis of symbolic arithmetic processing. All findings were compiled with regard to the three assumptions of the triple-code model (TCM) of number processing. Thirty-seven eligible manuscripts were identified for review (33 with healthy participants and 4 with patients). Their results are broadly consistent with the first assumption of the TCM that intraparietal sulcus both hold a magnitude code and engage in operations requiring numerical manipulations such as subtraction. However, largely heterogeneous results conflicted with the second assumption of the TCM that the left angular gyrus subserves arithmetic fact retrieval, such as the retrieval of rote-learned multiplication results. Support is also limited for the third assumption of the TCM, namely, that the posterior superior parietal lobule engages in spatial operations on the mental number line. Furthermore, results from the stimulation of brain areas outside of those postulated by the TCM show that the bilateral supramarginal gyrus is involved in online calculation and retrieval, the left temporal cortex in retrieval, and the bilateral dorsolateral prefrontal cortex and cerebellum in online calculation of cognitively demanding arithmetic problems. The overall results indicate that multiple cortical areas subserve arithmetic skills.

Effects of online tDCS and hf-tRNS on reading performance in children and adolescents with developmental dyslexia: a study protocol for a cross sectional, within-subject, randomized, double-blind, and sham-controlled trial

Background

Developmental Dyslexia (DD) is a brain-based developmental disorder causing severe reading difficulties. The extensive data on the neurobiology of DD have increased interest in brain-directed approaches, such as transcranial direct current stimulation (tDCS), which have been proposed for DD. While positive outcomes have been observed, results remain heterogeneous. Various methodological approaches have been employed to address this issue. However, no studies have compared the effects of different transcranial electrical stimulation techniques (e.g., tDCS and transcranial random noise stimulation, tRNS), on reading in children and adolescents with DD.

Methods

The present within-subject, double-blind, and sham-controlled trial aims to investigate the effects of tDCS and hf-tRNS on reading in children and adolescents with DD. Participants will undergo three conditions with a one-week interval session: (A) single active tDCS session; (B) single active hf-tRNS session; and (C) single sham session (tDCS/hf-tRNS). Left anodal/right cathodal tDCS and bilateral tRNS will be applied over the temporo-parietal regions for 20 min each. Reading measures will be collected before and during each session. Safety and blinding parameters will be recordered.

Discussion

We hypothesize that tRNS will demonstrate comparable effectiveness to tDCS in improving reading compared to sham conditions. Additionally, we anticipate that hf-tRNS will exhibit a similar safety profile to tDCS. This study will contribute novel insights into the effectiveness of hf-tRNS, expediting the validation of brain-based treatments for DD.

tDCS effects in basic symbolic number magnitude processing are not significantly lateralized

Functional lateralization was previously established for various cognitive domains-but not for number processing. Although numbers are considered to be bilaterally represented in the intraparietal sulcus (IPS), there are some indications of different functional roles of the left vs. right IPS in processing number pairs with small vs. large distance, respectively. This raises the question whether number size plays a distinct role in the lateralization within the IPS. In our preregistered study, we applied anodal transcranial direct current stimulation (tDCS) over the left vs. right IPS to investigate the effect of stimulation as compared to sham on small vs. large distance, in both single-digit and two-digit number comparison. We expected that anodal tDCS over the left IPS facilitates number comparison with small distance, while anodal tDCS over the right IPS facilitates number comparison with large distance. Results indicated no effect of stimulation; however, exploratory analyses revealed that tDCS over the right IPS slowed down single-digit number processing after controlling for the training effect. In conclusion, number magnitude processing might be bilaterally represented in the IPS, however, our exploratory analyses emphasise the need for further investigation on functional lateralization of number processing.

Effects of prefrontal and parietal neuromodulation on magnitude processing and integration

Numerical cognition is an essential skill for survival, which includes the processing of discrete and continuous quantities, involving a mainly right fronto-parietal network. However, the neurocognitive systems underlying the processing and integration of discrete and continuous quantities are currently under debate. Noninvasive brain stimulation techniques have been used in the study of the neural basis of numerical cognition with a spatial, temporal and functional resolution superior to other neuroimaging techniques. The present randomized sham-controlled single-blinded trial addresses the involvement of the right dorsolateral prefrontal cortex and the right intraparietal sulcus in magnitude processing and integration. Multifocal anodal transcranial direct current stimulation was applied online during the execution of magnitude comparison tasks in three conditions: right prefrontal, right parietal and sham stimulation. The results show that prefrontal stimulation produced a moderated decrease in response times in all magnitude processing and integration tasks compared to sham condition. While parietal stimulation had no significant effect on any of the tasks. The effect found is interpreted as a generalized improvement in processing speed and magnitude integration due to right prefrontal neuromodulation, which may be attributable to domain-general or domain-specific factors.

Investigating the role of the fusiform face area and occipital face area using multifocal transcranial direct current stimulation

The functional role of the occipital face area (OFA) and the fusiform face area (FFA) in face recognition is inconclusive to date. While some research has shown that the OFA and FFA are involved in early (i.e., featural processing) and late (i.e., holistic processing) stages of face recognition respectively, other research suggests that both regions are involved in both early and late stages of face recognition. Thus, the current study aims to further examine the role of the OFA and the FFA using multifocal transcranial direct current stimulation (tDCS). In Experiment 1, we used computer-generated faces. Thirty-five participants completed whole face and facial features (i.e., eyes, nose, mouth) recognition tasks after OFA and FFA stimulation in a within-subject design. No difference was found in recognition performance after either OFA or FFA stimulation. In Experiment 2 with 60 participants, we used real faces, provided stimulation following a between-subjects design and included a sham control group. Results showed that FFA stimulation led to enhanced efficiency of facial features recognition. Additionally, no effect of OFA stimulation was found for either facial feature or whole face recognition. These results suggest the involvement of FFA in the recognition of facial features.

The contribution of the supplementary motor area to explicit and implicit timing: A high-definition transcranial Random Noise Stimulation (HD-tRNS) study

It is becoming increasingly accepted that timing tasks, and underlying temporal processes, can be partitioned on the basis of whether they require an explicit or implicit temporal judgement. Most neuroimaging studies of timing associated explicit timing tasks with activation of the supplementary motor area (SMA). However, transcranial magnetic stimulation (TMS) studies perturbing SMA functioning across explicit timing tasks have generally reported null effects, thus failing to causally link SMA to explicit timing. The present study probed the involvement of SMA in both explicit and implicit timing tasks within a single experiment and using High-Definition transcranial Random Noise Stimulation (HD-tRNS), a previously less used technique in studies of the SMA. Participants performed two tasks that comprised the same stimulus presentation but differed in the received task instructions, which might or might not require explicit temporal judgments. Results showed a significant HD-tRNS-induced shift of perceived durations (i.e., overestimation) in the explicit timing task, whereas there was no modulation of implicit timing by HD-tRNS. Overall, these results provide initial non-invasive brain stimulation evidence on the contribution of the SMA to explicit and implicit timing tasks.

High-frequency transcranial random noise stimulation enhances unfamiliar face matching of high resolution and pixelated faces

Face identification is useful for social interactions and its impairment can lead to severe social and mental problems. This ability is also remarkably important in applied settings, including eyewitness identification and ID verification. Several studies have demonstrated the potential of Transcranial Random Noise Stimulation (tRNS) to enhance different cognitive skills. However, research has produced inconclusive results about the effectiveness of tRNS to improve face identification. The present study aims to further explore the effect of tRNS on face identification using an unfamiliar face matching task. Observers firstly received either high-frequency bilateral tRNS or sham stimulation for 20 min. The stimulation targeted occipitotemporal areas, which have been previously involved in face processing. In a subsequent stage, observers were asked to perform an unfamiliar face matching task consisting of unaltered and pixelated face pictures. Compared to the sham stimulation group, the high-frequency tRNS group showed better unfamiliar face matching performance with both unaltered and pixelated faces. Our results show that a single high-frequency tRNS session might suffice to improve face identification abilities. These results have important consequences for the treatment of face recognition disorders, and potential applications in those scenarios whereby the identification of faces is primordial.

First few seconds for flow: A comprehensive proposal of the neurobiology and neurodynamics of state onset

Flow is a cognitive state that manifests when there is complete attentional absorption while performing a task. Flow occurs when certain internal as well as external conditions are present, including intense concentration, a sense of control, feedback, and a balance between the challenge of the task and the relevant skillset. Phenomenologically, flow is accompanied by a loss of self-consciousness, seamless integration of action and awareness, and acute changes in time perception. Research has begun to uncover some of the neurophysiological correlates of flow, as well as some of the state's neuromodulatory processes. We comprehensively review this work and consider the neurodynamics of the onset of the state, considering large-scale brain networks, as well as dopaminergic, noradrenergic, and endocannabinoid systems. To accomplish this, we outline an evidence-based hypothetical situation, and consider the flow state in a broader context including other profound alterations in consciousness, such as the psychedelic state and the state of traumatic stress that can induce PTSD. We present a broad theoretical framework which may motivate future testable hypotheses.

Examining the Effect of Transcranial Electrical Stimulation and Cognitive Training on Processing Speed in Pediatric Attention Deficit Hyperactivity Disorder: A Pilot Study

Objective

Processing Speed (PS), the ability to perceive and react fast to stimuli in the environment, has been shown to be impaired in children with attention deficit hyperactivity disorder (ADHD). However, it is unclear whether PS can be improved following targeted treatments for ADHD. Here we examined potential changes in PS following application of transcranial electric stimulation (tES) combined with cognitive training (CT) in children with ADHD. Specifically, we examined changes in PS in the presence of different conditions of mental fatigue.

Methods

We used a randomized double-blind active-controlled crossover study of 19 unmedicated children with ADHD. Participants received either anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (dlPFC) or transcranial random noise stimulation (tRNS), while completing CT, and the administration order was counterbalanced. PS was assessed before and after treatment using the MOXO-CPT, which measures PS in the presence of various conditions of mental fatigue and cognitive load.

Results

tRNS combined with CT yielded larger improvements in PS compared to tDCS combined with CT, mainly under condition of increased mental fatigue. Further improvements in PS were also seen in a 1-week follow up testing.

Conclusion

This study provides initial support for the efficacy of tRNS combined with CT in improving PS in the presence of mental fatigue in pediatric ADHD.

Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior

Van der Groen, O., Potok, W., Wenderoth, N., Edwards, G., Mattingley, J.B. and Edwards, D. Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. NEUROSCI BIOBEHAV REV X (X) XXX-XXX 2021.- Transcranial random noise stimulation (tRNS) is a non-invasive electrical brain stimulation method that is increasingly employed in studies of human brain function and behavior, in health and disease. tRNS is effective in modulating perception acutely and can improve learning. By contrast, its effectiveness for modulating higher cognitive processes is variable. Prolonged stimulation with tRNS, either as one longer application, or multiple shorter applications, may engage plasticity mechanisms that can result in long-term benefits. Here we provide an overview of the current understanding of the effects of tRNS on the brain and behavior and provide some specific recommendations for future research.

How Should Transcranial Direct Current Stimulation be Used in Populations With Severe Alcohol Use Disorder? A Clinically Oriented Systematic Review

Background and rationale. Severe alcohol use disorder (SAUD) is a major public health concern, given its massive individual, interpersonal, and societal consequences. The available prevention and treatment programs have proven limited effectiveness, as relapse rates are still high in this clinical population. Developing effective interventions reducing the appearance and persistence of SAUD thus constitutes an experimental and clinical priority. Among the new therapeutic approaches, there is a growing interest for noninvasive neuromodulation techniques, and particularly for transcranial direct current stimulation (tDCS) as an adjunctive treatment in neuropsychiatric disorders, including SAUD. Methods. We propose a systematic review, based on preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, evaluating the available evidence on the effectiveness of tDCS to improve clinical interventions in SAUD. Results. We provide an integrative overview of studies applying tDCS in clinical populations with SAUD, together with a standardized methodological quality assessment. We show that the currently available data remain inconsistent. Some data suggested that tDCS can (1) reduce craving, relapse or alcohol-cue reactivity and (2) improve cognitive control and inhibition. However, other studies did not observe any beneficial effect of tDCS in SAUD. Conclusions. Capitalizing on the identified strengths and shortcomings of available results, we present evidence-based clinical guidelines to integrate tDCS in current clinical settings and to combine it with neurocognitive training.

Understanding the Effects of Transcranial Electrical Stimulation in Numerical Cognition: A Systematic Review for Clinical Translation

Atypical development of numerical cognition (dyscalculia) may increase the onset of neuropsychiatric symptoms, especially when untreated, and it may have long-term detrimental social consequences. However, evidence-based treatments are still lacking. Despite plenty of studies investigating the effects of transcranial electrical stimulation (tES) on numerical cognition, a systematized synthesis of results is still lacking. In the present systematic review (PROSPERO ID: CRD42021271139), we found that the majority of reports (20 out of 26) showed the effectiveness of tES in improving both number (80%) and arithmetic (76%) processing. In particular, anodal tDCS (regardless of lateralization) over parietal regions, bilateral tDCS (regardless of polarity/lateralization) over frontal regions, and tRNS (regardless of brain regions) strongly enhance number processing. While bilateral tDCS and tRNS over parietal and frontal regions and left anodal tDCS over frontal regions consistently improve arithmetic skills. In addition, tACS seems to be more effective than tDCS at ameliorating arithmetic learning. Despite the variability of methods and paucity of clinical studies, tES seems to be a promising brain-based treatment to enhance numerical cognition. Recommendations for clinical translation, future directions, and limitations are outlined.

Performance after training in a complex cognitive task is enhanced by high-definition transcranial random noise stimulation

Interest for neuromodulation, and transcranial random noise stimulation (tRNS) in particular, is growing. It concerns patients rehabilitation, but also healthy people who want or need to improve their cognitive and learning abilities. However, there is no consensus yet regarding the efficacy of tRNS on learning and performing a complex task. In particular, the most effective electrode montage is yet to be determined. Here, we examined the effect of two different tRNS montages on learning rate, short- and long-term performance in a video game (Space Fortress) that engages multiple cognitive abilities. Sixty-one participants were randomly assigned to one of three groups (sham vs. simple-definition tRNS vs. high-definition tRNS) in a double-blind protocol. Their performance on the Space Fortress task was monitored during a 15-day experiment with baseline (day 1), stimulation (day 2 to 4), short- (day 5) and long-term (day 15) evaluations. Our results show that the high-definition tRNS group improved more on the long term than simple-definition tRNS group, tended to learn faster and had better performance retention compared to both simple-definition tRNS and sham groups. This study is the first to report that high-definition tRNS is more effective than conventional simple-definition tRNS to enhance performance in a complex task.

Theta Band Transcranial Alternating Current Stimulation Enhances Arithmetic Learning: A Systematic Comparison of Different Direct and Alternating Current Stimulations

Over the last decades, interest in transcranial electrical stimulation (tES) has grown, as it might allow for causal investigations of the associations between cortical activity and cognition as well as to directly influence cognitive performance. The main objectives of the present work were to assess whether tES can enhance the acquisition and application of arithmetic abilities, and whether it enables a better assessment of underlying neurophysiological processes. To this end, the present, double-blind, sham-controlled study assessed the effects of six active stimulations (three tES protocols: anodal transcranial direct current stimulation (tDCS), alpha band transcranial alternating current stimulation (tACS), and theta band tACS; targeting the left dorsolateral prefrontal cortex or the left posterior parietal cortex) on the acquisition of an arithmetic procedure, arithmetic facts, and event-related synchronization/desynchronization (ERS/ERD) patterns. 137 healthy adults were randomly assigned to one of seven groups, each receiving one of the tES-protocols during learning. Results showed that frontal theta band tACS reduced the repetitions needed to learn novel facts and both, frontal and parietal theta band tACS accelerated the decrease in calculation times in fact learning problems. The beneficial effect of frontal theta band tACS may reflect enhanced executive functions, allowing for better control and inhibition processes and hence, a faster acquisition and integration of novel fact knowledge. However, there were no significant effects of the stimulations on procedural learning or ERS/ERD patterns. Overall, theta band tACS appears promising as a support for arithmetic fact training, but effects on procedural calculations and neurophysiological processes remain ambiguous.

Boosting Numerical Cognition in Children and Adolescents with Mathematical Learning Disabilities by a Brain-Based Intervention: A Study Protocol for a Randomized, Sham-Controlled Clinical Trial

Numbers are everywhere, and supporting difficulties in numerical cognition (e.g., mathematical learning disability (MLD)) in a timely, effective manner is critical for their daily use. To date, only low-efficacy cognitive-based interventions are available. The extensive data on the neurobiology of MLD have increased interest in brain-directed approaches. The overarching goal of this study protocol is to provide the scientific foundation for devising brain-based and evidence-based treatments in children and adolescents with MLD. In this double-blind, between-subject, sham-controlled, randomized clinical trial, transcranial random noise stimulation (tRNS) plus cognitive training will be delivered to participants. Arithmetic, neuropsychological, psychological, and electrophysiological measures will be collected at baseline (T0), at the end of the interventions (T1), one week (T2) and three months later (T3). We expect that tRNS plus cognitive training will significantly improve arithmetic measures at T1 and at each follow-up (T2, T3) compared with placebo and that such improvements will correlate robustly and positively with changes in the neuropsychological, psychological, and electrophysiological measures. We firmly believe that this clinical trial will produce reliable and positive results to accelerate the validation of brain-based treatments for MLD that have the potential to impact quality of life.

Personalized brain stimulation for effective neurointervention across participants

Accumulating evidence from human-based research has highlighted that the prevalent one-size-fits-all approach for neural and behavioral interventions is inefficient. This approach can benefit one individual, but be ineffective or even detrimental for another. Studying the efficacy of the large range of different parameters for different individuals is costly, time-consuming and requires a large sample size that makes such research impractical and hinders effective interventions. Here an active machine learning technique is presented across participants-personalized Bayesian optimization (pBO)-that searches available parameter combinations to optimize an intervention as a function of an individual's ability. This novel technique was utilized to identify transcranial alternating current stimulation (tACS) frequency and current strength combinations most likely to improve arithmetic performance, based on a subject's baseline arithmetic abilities. The pBO was performed across all subjects tested, building a model of subject performance, capable of recommending parameters for future subjects based on their baseline arithmetic ability. pBO successfully searches, learns, and recommends parameters for an effective neurointervention as supported by behavioral, simulation, and neural data. The application of pBO in human-based research opens up new avenues for personalized and more effective interventions, as well as discoveries of protocols for treatment and translation to other clinical and non-clinical domains.

On a Quantitative Approach to Clinical Neuroscience in Psychiatry: Lessons from the Kuramoto Model

The human brain is a complex system comprising subregions that dynamically exchange information between its various parts through synchronization. These dynamic, complex interactions ultimately play a role in perception, emotion, cognition, and behavior, as well as in various maladaptive neurologic and psychiatric processes. It is therefore important to understand how brain dynamics might be implicated in these processes. Over the past few years, network neuroscience and computational neuroscience have highlighted the importance of measures such as metastability (a property whereby members of an oscillating system tend to linger at the edge of synchronicity without permanently becoming synchronized) in quantifying brain dynamics. Altered metastability has been implicated in various psychiatric illnesses, such as traumatic brain injury and Alzheimer's disease. Computational models, which range in complexity, have been used to assess how various parameters affect metastability, synchronization, and functional connectivity. These models, though limited, can act as heuristics in understanding brain dynamics. This article (aimed at the clinical psychiatrist who might not possess an extensive mathematical background) is intended to provide a brief and qualitative summary of studies that have used a specific, highly simplified computational model of coupled oscillators (Kuramoto model) for understanding brain dynamics-which might bear some relevance to clinical psychiatry.

The effects of direct current stimulation and random noise stimulation on attention networks

Attention is a complex cognitive process that selects specific stimuli for further processing. Previous research suggested the existence of three attentional networks: alerting, orienting and executive. However, one important topic is how to enhance the efficiency of attentional networks. In this context, understanding how this system behaves under two different modulatory conditions, namely transcranial direct current stimulation (tDCS) and transcranial Random Noise Stimulation (tRNS), will provide important insights towards the understanding of the attention network system. Twenty-seven healthy students took part on a randomized single-blinded crossover study, testing the effects that involved three modalities of unilateral stimulation (tRNS, anodal tDCS, and sham) over the DLPFC, during the performance of the attention network test (ANT) in three different conditions: standard, speed and accuracy. Results showed that tRNS was able to increase attention during more complex situations, namely by increasing alerting and decreasing conflict effect in the executive network. Under the Speed condition, tRNS increased efficiency of the alerting network, as well as under the more demanding conflict network, tRNS overall increased the performance when comparing to sham. No statistical significant effects of tDCS were observed. These results are compatible with the attention requiring the synchronization of pre-existing networks, rather the reinforcement or creation of new pathways.

Modification of Eye-Head Coordination With High Frequency Random Noise Stimulation

The vestibulo-ocular reflex (VOR) plays an important role in controlling the gaze at a visual target. Although patients with vestibular hypofunction aim to improve their VOR function, some retain dysfunction for a long time. Previous studies have explored the effects of direct current stimulation on vestibular function; however, the effects of random noise stimulation on eye–head coordination have not previously been tested. Therefore, we aimed to clarify the effects of high frequency noisy vestibular stimulation (HF-nVS) on eye–head coordination related to VOR function. Thirteen healthy young adult participants with no serious disease took part in our study. The current amplitude and density used were 0.4 mA and 0.2 mA/cm², respectively, with a random noise frequency of 100–640 Hz. The electrodes were located on both mastoid processes. The stimulus duration and fade in/out duration were 600 and 10 s, respectively. Subjects oscillated their head horizontally, gazing at the fixation point, at 1 Hz (0.5 cycles/s) for 30 repetitions. The coordination of eye–head movements was measured by eye-tracking and a motion capture system. Peak-to-peak angles for eye and head movement and deviation of the visual line from the fixation target revealed no significant differences between HF-nVS and sham. The lag time between the eye and head movement with HF-nVS post-stimulation was significantly shorter than that of the sham. We found that HF-nVS can reduce the lag time between eye and head movement and improve coordination, contributing to a clear retinal image. This technique could be applied as a form of VOR training for patients with vestibular hypofunction.

The Effects of 1 mA tACS and tRNS on Children/Adolescents and Adults: Investigating Age and Sensitivity to Sham Stimulation

The aim of this study was to investigate the effect of transcranial random noise (tRNS) and transcranial alternating current (tACS) stimulation on motor cortex excitability in healthy children and adolescents. Additionally, based on our recent results on the individual response to sham in adults, we explored this effect in the pediatric population. We included 15 children and adolescents (10-16 years) and 28 adults (20-30 years). Participants were stimulated four times with 20 Hz and 140 Hz tACS, tRNS, and sham stimulation (1 mA) for 10 minutes over the left M1_HAND. Single-pulse MEPs (motor evoked potential), short-interval intracortical inhibition, and facilitation were measured by TMS before and after stimulation (baseline, 0, 30, 60 minutes). We also investigated aspects of tolerability. According to the individual MEPs response immediately after sham stimulation compared to baseline (Wilcoxon signed-rank test), subjects were regarded as responders or nonresponders to sham. We did not find a significant age effect. Regardless of age, 140 Hz tACS led to increased excitability. Incidence and intensity of side effects did not differ between age groups or type of stimulation. Analyses on responders and nonresponders to sham stimulation showed effects of 140 Hz, 20 Hz tACS, and tRNS on single-pulse MEPs only for nonresponders. In this study, children and adolescents responded to 1 mA tRNS and tACS comparably to adults regarding the modulation of motor cortex excitability. This study contributes to the findings that noninvasive brain stimulation is well tolerated in children and adolescents including tACS, which has not been studied before. Finally, our study supports a modulating role of sensitivity to sham stimulation on responsiveness to a broader stimulation and age range.

Transcranial Random Noise Stimulation for the Acute Treatment of Depression: A Randomized Controlled Trial

BACKGROUND

Transcranial electrical stimulation has broad potential as a treatment for depression. Transcranial random noise stimulation, which delivers randomly fluctuating current intensities, may have greater cortical excitatory effects compared with other forms of transcranial electrical stimulation. We therefore aimed to investigate the antidepressant efficacy of transcranial random noise stimulation.

METHODS

Depressed participants were randomly assigned by computer number generator to receive 20 sessions of either active or sham transcranial random noise stimulation over 4 weeks in a double-blinded, parallel group randomized-controlled trial. Transcranial random noise stimulation was delivered for 30 minutes with a direct current offset of 2 mA and a random noise range of 2 mA. Primary analyses assessed changes in depression severity using the Montgomery-Asperg Depression Rating Scale. Neuroplasticity, neuropsychological, and safety outcomes were analyzed as secondary measures.

RESULTS

Sixty-nine participants were randomized, of which 3 discontinued treatment early, leaving 66 (sham n = 34, active n = 32) for per-protocol analysis. Depression severity scores reduced in both groups (Montgomery-Asperg Depression Rating Scale reduction in sham = 7.0 [95% CI = 5.0-8.9]; and active = 5.2 [95% CI = 3.2-7.3]). However, there were no differences between active and sham groups in the reduction of depressive symptoms or the number of participants meeting response (sham = 14.7%; active = 3.1%) and remission criteria (sham = 5.9%; active = 0%). Erythema, paresthesia, fatigue, and dizziness/light-headedness occurred more frequently in the active transcranial random noise stimulation group. Neuroplasticity, neuropsychological, and acute cognitive effects were comparable between groups.

CONCLUSION

Our results do not support the use of transcranial random noise stimulation with the current stimulation parameters as a therapeutic intervention for the treatment of depression.

CLINICAL TRIAL REGISTRATION AT CLINICALTRIALS

gov/NCT01792414.

Anodal High-definition Transcranial Direct Current Stimulation over the Posterior Parietal Cortex Modulates Approximate Mental Arithmetic

The representation and processing of numerosity is a crucial cognitive capacity. Converging evidence points to the posterior parietal cortex (PPC) as primary "number" region. However, the exact role of the left and right PPC for different types of numerical and arithmetic tasks remains controversial. In this study, we used high-definition transcranial direct current stimulation (HD-tDCS) to further investigate the causal involvement of the PPC during approximative, nonsymbolic mental arithmetic. Eighteen healthy participants received three sessions of anodal HD-tDCS at 1-week intervals in counterbalanced order: left PPC, right PPC, and sham stimulation. Results showed an improved performance during online parietal HD-tDCS (vs. sham) for subtraction problems. Specifically, the general tendency to underestimate the results of subtraction problems (i.e., the "operational momentum effect") was reduced during online parietal HD-tDCS. There was no difference between left and right stimulation. This study thus provides new evidence for a causal involvement of the left and right PPC for approximate nonsymbolic arithmetic and advances the promising use of noninvasive brain stimulation in increasing cognitive functions.

Transcranial random noise stimulation (tRNS): a wide range of frequencies is needed for increasing cortical excitability

Transcranial random noise stimulation (tRNS) is a recent neuromodulation protocol. The high-frequency band (hf-tRNS) has shown to be the most effective in enhancing neural excitability. The frequency band of hf-tRNS typically spans from 100 to 640 Hz. Here we asked whether both the lower and the higher half of the high-frequency band are needed for increasing neural excitability. Three frequency ranges (100–400 Hz, 400–700 Hz, 100–700 Hz) and Sham conditions were delivered for 10 minutes at an intensity of 1.5 mA over the primary motor cortex (M1). Single-pulse transcranial magnetic stimulation (TMS) was delivered over the same area at baseline, 0, 10, 20, 30, 45 and 60 minutes after stimulation, while motor evoked potentials (MEPs) were recorded to evaluate changes in cortical excitability. Only the full-band condition (100–700 Hz) was able to modulate excitability by enhancing MEPs at 10 and 20 minutes after stimulation: neither the higher nor the lower sub-range of the high-frequency band significantly modulated cortical excitability. These results show that the efficacy of tRNS is strictly related to the width of the selected frequency range.

FAST: A Novel, Executive Function-Based Approach to Cognitive Enhancement

The present study introduces a novel cognitive intervention aimed at improving fluid intelligence (Gf), based on a framework we refer to as FAST: Flexible, Adaptive, Synergistic Training. FAST leverages a combination of novel game-based executive function (EF) training—designed specifically to enhance the likelihood of transfer—and transcranial electrical stimulation (tES), with aims to synergistically activate and strengthen mechanisms of cognitive control critical to Gf. To test our intervention, we collected three Gf measures from 113 participants [the advanced short Bochumer Matrizen-Test (BOMAT), Raven’s Advanced Progressive Matrices (APM), and matrices similar to Raven’s generated by Sandia labs], prior to and following one of three interventions: (1) the FAST + tRNS intervention, a combination of 30 min of daily training with our novel training game, Robot Factory, and 20 min of concurrent transcranial random noise stimulation applied to bilateral dorsolateral prefrontal cortex (DLPFC); (2) an adaptively difficult Active Control intervention comprised of visuospatial tasks that specifically do not target Gf; or (3) a no-contact control condition. Analyses of changes in a Gf factor from pre- to post-test found numerical increases for the FAST + tRNS group compared to the two control conditions, with a 0.3 SD increase relative to Active Control (p = 0.07), and a 0.19 SD increase relative to a No-contact control condition (p = 0.26). This increase was found to be largely driven by significant differences in pre- and post-test Gf as measured on the BOMAT test. Progression through the FAST training game (Robot Factory) was significantly correlated with changes in Gf. This is in contrast with progress in the Active Control condition, as well as with changes in individual EFs during FAST training, which did not significantly correlate with changes in Gf. Taken together, this research represents a useful step forward in providing new insights into, and new methods for studying, the nature of Gf and its malleability. Though our results await replication and extension, they provide preliminary evidence that the crucial characteristic of Gf may, in fact, be the ability to combine EFs rapidly and adaptively according to changing demand, and that Gf may be susceptible to targeted training.

Neuroenhancement of High-Level Cognition: Evidence for Homeostatic Constraints of Non-invasive Brain Stimulation

Neuroenhancement aims to improve cognitive performance in typically and atypically functioning populations. However, it is currently debated whether it is also effective in exceptionally high-functioning individuals. Present theories suggest that homeostatic set points for learning and cortical plasticity limit the beneficial effects of neuroenhancement. To examine this possibility, we used transcranial random noise stimulation (tRNS) to non-invasively stimulate bilateral dorsolateral prefrontal cortices (DLPFC) of the world champion in mental calculation, G.M. TRNS did not change G.M.’s calculation performance compared to sham stimulation on an exceptionally complex arithmetic task. However, a sample of mathematicians who were not calculation prodigies (N = 6) showed reduced accuracy on a complex multiplication task in response to tRNS, relative to sham. Our findings suggest that there may be an upper limit for cognitive enhancement and that further attempts to enhance performance using tRNS (at least with the current parameters) may impair optimal functioning. The discussion of potential negative effects of brain stimulation for cognitive enhancement is critical, as it may lead to unintended impairments in different subgroups of the population.

Effects of Short-Term Random Noise Electrical Stimulation on Dissociated Pyramidal Neurons from the Cerebral Cortex

Transcranial random noise electrical stimulation (tRNS) of the human brain is a non-invasive technique that can be employed to increase the excitability of the cerebral cortex; however, the physiological mechanisms remain unclear. Here we report for the first time the effects of short-term (250 ms) random noise electrical stimulation (RNS) on in-vitro acutely-isolated brain pyramidal neurons from the somatosensory and auditory cerebral cortex. We analyzed the correlation between the peak amplitude of the Na⁺ current and its latency for different levels of RNS. We found three groups of neurons. The first group exhibited a positive correlation, the second, a negative correlation, and the third group of neurons did not exhibit correlation. In the first group, both the peak amplitude of a TTX-sensitive Na⁺ current and its inverse of latency followed similar inverted U-like functions relative to the electrical RNS level. In this group, the RNS levels in which the maximal values of the inverted U-like functions occurred were the same. In the second group, the maximal values of the inverted U-like functions occurred at different levels. In the third group, only the peak amplitude of the Na⁺ current exhibited a clear inverted U-like function, but the inverse of the latency versus the electrical RNS, did not exhibit a clear inverted U-like function. A Hodgkin-Huxley neuron model reproduces our experimental results and shows that the observed behavior in the Na⁺ current could be due to the impact of RNS on the kinetics of activation and inactivation of the Na⁺ channels.

Using High Frequency Transcranial Random Noise Stimulation to Modulate Face Memory Performance in Younger and Older Adults: Lessons Learnt From Mixed Findings

High-frequency transcranial random noise stimulation (tRNS) has been shown to improve a range of cognitive and perceptual abilities. Here we sought to examine the effects of a single session of tRNS targeted at the ventrolateral prefrontal cortices (VLPFC) on face memory in younger and older adults. To do so, we conducted three experiments. In Experiment 1, we found that younger adults receiving active tRNS outperformed those receiving sham stimulation (i.e., using a between-participant factor for stimulation condition; Experiment 1). This effect was not observed for object memory (car memory) in younger adults (Experiment 2), indicating that the effect is not a general memory effect. In Experiment 3, we sought to replicate the effects of Experiment 1 using a different design (within-participant factor of stimulation – active or sham tRNS to the same individual) and to extend the study by including older adult participants. In contrast to Experiment 1, we found that active tRNS relative to sham tRNS reduced face memory performance in both younger and older adults. We also found that the degree of decline in performance in the active tRNS relative to sham tRNS condition was predicted by baseline ability, with higher performing participants showing the largest decreases in performance. Overall, the results indicate that tRNS to the VLPFC modulates face memory, but that there may be performance and protocol specific moderators of this effect. We discuss these findings in the context of the broader literature showing the importance of individual variation in the outcome of non-invasive brain stimulation intervention approaches. We conclude that while tRNS may have potential as an intervention approach, generalizing from single experiment studies to wide application is risky and caution should be adopted in interpreting findings.

Learning while multitasking: short and long-term benefits of brain stimulation

We employed a simulated production task that mimics the real-world skill acquisition required of operators working in control rooms of power plants to assess short and long-term effects of transcranial random noise stimulation (tRNS). tRNS has shown potential for enhancing learning and performance of cognitive skills. Forty subjects (24 female) learned how to execute the simulated production task during the training phase and were required to perform a secondary task during the skill acquisition phase while they received active (12 min) or sham tRNS on DLPFC. After 2 weeks they had to recall the task again without any stimulation. The results demonstrate that tRNS promoted better multitasking as reflected by better performance in a secondary task during and immediately after tRNS. However, 2 weeks later, beneficial effect of tRNS on retention was moderated by general mental ability. Particularly, tRNS benefited those with lower general mental ability. Practitioner summary: By using a simulated production task, we assessed the effects of tRNS on learning and skill retention. The study indicates that neurostimulation can enhance the learning of multiple complex tasks. Moreover, it shows that retention of those tasks can be supported by neurostimulation, especially for those with lower general mental ability.

Translating molecular advances in Down syndrome and Fragile X syndrome into therapies

Ongoing treatments for genetic developmental disorders of the central nervous system are mostly symptomatic and do not correct the genetic cause. Recent identification of common mechanisms between diseases has suggested that new therapeutic targets could be applied across intellectual disabilities with potential disease-modifying properties. The European Down syndrome and other genetic developmental disorders (DSG2D) network joined basic and clinical scientists to foster this research and carry out clinical trials. Here we discuss common mechanisms between several intellectual disabilities from genetic origin including Down's and Fragile X syndromes: i) how to model these complex diseases using neuronal cells and brain organoids derived from induced pluripotent stem cells; ii) how to integrate genomic, proteomic and interactome data to help defining common mechanisms and boundaries between diseases; iii) how to target common pathways for designing clinical trials and assessing their efficacy; iv) how to bring new neuro-therapies, such as noninvasive brain stimulations and cognitive training to clinical research. The basic and translational research efforts of the last years have utterly transformed our understanding of the molecular pathology of these diseases but much is left to be done to bring them to newborn babies and children to improve their quality of life.

Low to No Effect: Application of tRNS During Two-Digit Addition

Transcranial electric stimulation such as transcranial random noise stimulation (tRNS) and transcranial direct current stimulation (tDCS) have been used to investigate structure-function relationships in numerical cognition. Recently, tRNS was suggested to be more effective than tDCS. However, so far there is no evidence on the differential impact of tDCS and tRNS on numerical cognition using the same experimental paradigm. In the present study, we used a two-digit addition paradigm for which significant-albeit small-effects of tDCS were observed previously to evaluate the impact of parietal and frontal tRNS on specific numerical effects. While previous studies reported a modulation of numerical effects of this task through tDCS applied to parietal areas, we did not observe any effect of parietal tRNS on performance in two-digit addition. These findings suggest that tRNS seemed to influence concurrent mental arithmetic less than tDCS at least when applied over the IPS. These generally small to absent effects of tES on actual arithmetic performance in the current addition paradigm are in line with the results of a recent meta-analysis indicating that influences of tES may be more pronounced in training paradigms.

The Effects of 10 Hz Transcranial Alternating Current Stimulation on Audiovisual Task Switching

Neural oscillations in the alpha band (7–13 Hz) are commonly associated with disengagement of visual attention. However, recent studies have also associated alpha with processes of attentional control and stability. We addressed this issue in previous experiments by delivering transcranial alternating current stimulation at 10 Hz over posterior cortex during visual tasks (alpha tACS). As this stimulation can induce reliable increases in EEG alpha power, and given that performance on each of our visual tasks was negatively associated with alpha power, we assumed that alpha tACS would reliably impair visual performance. However, alpha tACS was instead found to prevent both deteriorations and improvements in visual performance that otherwise occurred during sham & 50 Hz tACS. Alpha tACS therefore appeared to exert a stabilizing effect on visual attention. This hypothesis was tested in the current, pre-registered experiment by delivering alpha tACS during a task that required rapid switching of attention between motion, color, and auditory subtasks. We assumed that, if alpha tACS stabilizes visual attention, this stimulation should make it harder for people to switch between visual tasks, but should have little influence on transitions between auditory and visual subtasks. However, in contrast to this prediction, we observed no evidence of impairments in visuovisual vs. audiovisual switching during alpha vs. control tACS. Instead, we observed a trend-level reduction in visuoauditory switching accuracy during alpha tACS. Post-hoc analyses showed no effects of alpha tACS in response time variability, diffusion model parameters, or on performance of repeat trials. EEG analyses also showed no effects of alpha tACS on endogenous or stimulus-evoked alpha power. We discuss possible explanations for these results, as well as their broader implications for current efforts to study the roles of neural oscillations in cognition using tACS.

Transcranial random noise stimulation and cognitive training to improve learning and cognition of the atypically developing brain: A pilot study

Learning disabilities that affect about 10% of human population are linked to atypical neurodevelopment, but predominantly treated by behavioural interventions. Behavioural interventions alone have shown little efficacy, indicating limited success in modulating neuroplasticity, especially in brains with neural atypicalities. Even in healthy adults, weeks of cognitive training alone led to inconsistent generalisable training gains, or "transfer effects" to non-trained materials. Meanwhile, transcranial random noise stimulation (tRNS), a painless and more direct neuromodulation method was shown to further promote cognitive training and transfer effects in healthy adults without harmful effects. It is unknown whether tRNS on the atypically developing brain might promote greater learning and transfer outcomes than training alone. Here, we show that tRNS over the bilateral dorsolateral prefrontal cortices (dlPFCs) improved learning and performance of children with mathematical learning disabilities (MLD) during arithmetic training compared to those who received sham (placebo) tRNS. Training gains correlated positively with improvement on a standardized mathematical diagnostic test, and this effect was strengthened by tRNS. These findings mirror those in healthy adults, and encourage replications using larger cohorts. Overall, this study offers insights into the concept of combining tRNS and cognitive training for improving learning and cognition of children with learning disabilities.

Transcranial Random Noise Stimulation (tRNS) Shapes the Processing of Rapidly Changing Auditory Information

Neural oscillations in the gamma range are the dominant rhythmic activation pattern in the human auditory cortex. These gamma oscillations are functionally relevant for the processing of rapidly changing acoustic information in both speech and non-speech sounds. Accordingly, there is a tight link between the temporal resolution ability of the auditory system and inherent neural gamma oscillations. Transcranial random noise stimulation (tRNS) has been demonstrated to specifically increase gamma oscillation in the human auditory cortex. However, neither the physiological mechanisms of tRNS nor the behavioral consequences of this intervention are completely understood. In the present study we stimulated the human auditory cortex bilaterally with tRNS while EEG was continuously measured. Modulations in the participants’ temporal and spectral resolution ability were investigated by means of a gap detection task and a pitch discrimination task. Compared to sham, auditory tRNS increased the detection rate for near-threshold stimuli in the temporal domain only, while no such effect was present for the discrimination of spectral features. Behavioral findings were paralleled by reduced peak latencies of the P50 and N1 component of the auditory event-related potentials (ERP) indicating an impact on early sensory processing. The facilitating effect of tRNS was limited to the processing of near-threshold stimuli while stimuli clearly below and above the individual perception threshold were not affected by tRNS. This non-linear relationship between the signal-to-noise level of the presented stimuli and the effect of stimulation further qualifies stochastic resonance (SR) as the underlying mechanism of tRNS on auditory processing. Our results demonstrate a tRNS related improvement in acoustic perception of time critical auditory information and, thus, provide further indices that auditory tRNS can amplify the resonance frequency of the auditory system.

Self-generation and positivity effects following transcranial random noise stimulation in medial prefrontal cortex: A reality monitoring task in older adults

Activation of medial Prefrontal Cortex (mPFC) has been typically found during reality monitoring tasks (i.e., distinguishing between internal self-generated vs external information). No study, however, has yet investigated whether transcranial Random Noise Stimulation (tRNS) over the mPFC leads to a reduction in reality-monitoring misattributions in aging. In particular, stimulating mPFC should increase the number of cognitive operations engaged while encoding and this distinctive information may help older adults to discriminate between internal and external sources better. In addition, given that older adults are more sensitive to positively-charged information compared to younger adults and that mPFC is typically recruited during encoding of positive stimuli with reference to themselves, activation of mPFC should further sustain source retrieval in older adults. In this double-blind, sham-controlled study, we examined whether tRNS over the mPFC of healthy younger and older adults during encoding enhances subsequent reality monitoring for seen versus imagined emotionally-charged words. Our findings show that tRNS enhances reality monitoring for positively-charged imagined words in the older adult group alone, highlighting the role that mPFC plays in their memory for positive information. In line with the control-based account of positivity effects, our results add evidence about the neurocognitive processes involved in reality monitoring when older adults face emotionally-charged events.

Adaptive Plasticity in the Healthy Language Network: Implications for Language Recovery after Stroke

Across the last three decades, the application of noninvasive brain stimulation (NIBS) has substantially increased the current knowledge of the brain's potential to undergo rapid short-term reorganization on the systems level. A large number of studies applied transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in the healthy brain to probe the functional relevance and interaction of specific areas for different cognitive processes. NIBS is also increasingly being used to induce adaptive plasticity in motor and cognitive networks and shape cognitive functions. Recently, NIBS has been combined with electrophysiological techniques to modulate neural oscillations of specific cortical networks. In this review, we will discuss recent advances in the use of NIBS to modulate neural activity and effective connectivity in the healthy language network, with a special focus on the combination of NIBS and neuroimaging or electrophysiological approaches. Moreover, we outline how these results can be transferred to the lesioned brain to unravel the dynamics of reorganization processes in poststroke aphasia. We conclude with a critical discussion on the potential of NIBS to facilitate language recovery after stroke and propose a phase-specific model for the application of NIBS in language rehabilitation.

Mathematics Anxiety: What Have We Learned in 60 Years?

The construct of mathematics anxiety has been an important topic of study at least since the concept of “number anxiety” was introduced by Dreger and Aiken (1957), and has received increasing attention in recent years. This paper focuses on what research has revealed about mathematics anxiety in the last 60 years, and what still remains to be learned. We discuss what mathematics anxiety is; how distinct it is from other forms of anxiety; and how it relates to attitudes to mathematics. We discuss the relationships between mathematics anxiety and mathematics performance. We describe ways in which mathematics anxiety is measured, both by questionnaires, and by physiological measures. We discuss some possible factors in mathematics anxiety, including genetics, gender, age, and culture. Finally, we describe some research on treatment. We conclude with a brief discussion of what still needs to be learned.

Enhancing duration processing with parietal brain stimulation

Numerosity and duration are thought to share common magnitude-based mechanisms in brain regions including the right parietal and frontal cortices like the supplementary motor area, SMA. Numerosity and duration are, however, also different in several intrinsic features. For instance, in a quantification context, numerosity is known for being more automatically accessed than temporal events, and durations are by definition sequential whereas numerosity can be both sequential and simultaneous. Moreover, numerosity and duration processing diverge in terms of their neuronal correlates. Whether these observed neuronal specificities can be accounted for by differences in automaticity or presentation-mode is however not clear. To address this issue, we used brain stimulation (transcranial random noise stimulation, tRNS) to the right parietal cortex or the SMA combined with experimental stimuli differing in their level of automaticity (numerosity and duration) and presentation mode (sequential or simultaneous). Compared to a no stimulation group, performance changed in duration but not in numerosity categorisation following right parietal but not SMA stimulation. These results indicate that the right parietal cortex is critical for duration processing, and suggest that tRNS has a stronger effect on less automatic processes such as duration.