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Lifshitz-Ben-Basat A, Taitelbaum-Swead R, Fostick L. Speech perception following transcranial direct current stimulation (tDCS) over left superior temporal gyrus (STG) (including Wernicke's area) versus inferior frontal gyrus (IFG) (including Broca's area). Neuropsychologia 2024; 202:108959. [PMID: 39029652 DOI: 10.1016/j.neuropsychologia.2024.108959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 07/17/2024] [Accepted: 07/17/2024] [Indexed: 07/21/2024]
Abstract
Imaging and neurocognitive studies have searched for the brain areas involved in speech perception, specifically when speech is accompanied by noise, attempting to identify the underlying neural mechanism(s). Transcranial direct current stimulation (tDCS), a noninvasive, painless cortical neuromodulation technique, has been used to either excite or inhibit brain activity in order to better understand the neural mechanism underlying speech perception in noise. In the present study, anodal (excitatory) and cathodal (inhibitory) stimulations were performed on 48 participants, either over the left Inferior Frontal Gyrus (IFG), which includes Broca's area (n = 10 anodal, and n = 10 cathodal) or over the left Superior Temporal Gyrus (STG), which includes Wernicke's area (n = 13 anodal, n = 15 cathodal). Speech perception was measured using a sentence recognition task accompanied by white noise with a signal-to-noise ratio of -10 dB. Speech perception performance was measured four times: at baseline, after each of the two sessions of stimulation (one active and one sham session, the order of which was randomized between participants), and at a two-week follow-up session. Groups receiving anodal and cathodal stimulation over the left IFG did not show an effect of stimulation type. For groups receiving left STG stimulation, anodal stimulation resulted in higher scores, regardless of whether it was given before or after sham stimulation. However, cathodal stimulation showed an effect only when active stimulation was applied following sham stimulation. These results showed that tDCS had a direct effect on improving speech perception only over left STG. Furthermore, while anodal stimulation was effective in whatever order it was given, cathodal stimulation was effective only following sham stimulation, thereby allowing some amount of training. These findings carry both theoretical and clinical implications for the relationship between the DMN's left IFG and left STG areas during speech perception accompanied by background noise.
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Affiliation(s)
| | | | - Leah Fostick
- Department of Communication Disorders, Ariel University, Israel
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Meng H, Houston M, Zhang Y, Li S. Exploring the Prospects of Transcranial Electrical Stimulation (tES) as a Therapeutic Intervention for Post-Stroke Motor Recovery: A Narrative Review. Brain Sci 2024; 14:322. [PMID: 38671974 PMCID: PMC11047964 DOI: 10.3390/brainsci14040322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Revised: 03/12/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Stroke survivors often have motor impairments and related functional deficits. Transcranial Electrical Stimulation (tES) is a rapidly evolving field that offers a wide range of capabilities for modulating brain function, and it is safe and inexpensive. It has the potential for widespread use for post-stroke motor recovery. Transcranial Direct Current Stimulation (tDCS), Transcranial Alternating Current Stimulation (tACS), and Transcranial Random Noise Stimulation (tRNS) are three recognized tES techniques that have gained substantial attention in recent years but have different mechanisms of action. tDCS has been widely used in stroke motor rehabilitation, while applications of tACS and tRNS are very limited. The tDCS protocols could vary significantly, and outcomes are heterogeneous. PURPOSE the current review attempted to explore the mechanisms underlying commonly employed tES techniques and evaluate their prospective advantages and challenges for their applications in motor recovery after stroke. CONCLUSION tDCS could depolarize and hyperpolarize the potentials of cortical motor neurons, while tACS and tRNS could target specific brain rhythms and entrain neural networks. Despite the extensive use of tDCS, the complexity of neural networks calls for more sophisticated modifications like tACS and tRNS.
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Affiliation(s)
- Hao Meng
- Department of Physical Medicine & Rehabilitation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Michael Houston
- Department of Biomedical Engineering, University of Houston, Houston, TX 77204, USA;
| | - Yingchun Zhang
- Department of Biomedical Engineering, University of Miami, Coral Gables, FL 33146, USA;
| | - Sheng Li
- Department of Physical Medicine & Rehabilitation, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
- TIRR Memorial Hermann Hospital, Houston, TX 77030, USA
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Sandrini M, Manenti R, Gobbi E, Pagnoni I, Geviti A, Alaimo C, Campana E, Binetti G, Cotelli M. Cognitive reserve predicts episodic memory enhancement induced by transcranial direct current stimulation in healthy older adults. Sci Rep 2024; 14:4879. [PMID: 38418583 PMCID: PMC10902403 DOI: 10.1038/s41598-024-53507-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 02/01/2024] [Indexed: 03/01/2024] Open
Abstract
Episodic memory shows the largest degree of age-related decline. Anodal transcranial Direct Current Stimulation (tDCS) can enhance episodic memory in aging but there is also evidence of response variability even when using identical stimulation parameters. To explore which inter-individual factors (i.e. age, education, encoding performance, cognitive reserve, tDCS group and timing of tDCS application) may directly and/or indirectly modulate verbal memory recall, we used data from our previous tDCS studies that showed enhanced episodic memory recall in 80 healthy older adults. In these studies we used the same paradigm and stimulation parameters but tDCS was applied during different memory stages. Memory recall was tested 48 hours and 30 days after encoding. Univariate regression models showed that tDCS group (Anodal vs. Sham) predicted memory recall, indicating higher scores in the Anodal group than in the Sham group. Encoding performance predicted memory recall in both tDCS groups. Multiple regression models revealed that cognitive reserve, measured with a life experience questionnaire, predicted memory recall only for the Anodal group. Higher cognitive reserve was linked to better memory recall. Accounting for individual differences in cognitive reserve at baseline helps to explain tDCS responsiveness. This knowledge may contribute to optimize its use in older adults.
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Affiliation(s)
- Marco Sandrini
- School of Psychology, University of Roehampton, London, UK
| | - Rosa Manenti
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Gobbi
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
| | - Ilaria Pagnoni
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Andrea Geviti
- Statistics Service, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Cristina Alaimo
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elena Campana
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Giuliano Binetti
- MAC Memory Clinic and Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
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Mitsutake T, Nakazono H, Shiozaki T, Fujita D, Sakamoto M. Changes in vestibular-related responses to combined noisy galvanic vestibular stimulation and cerebellar transcranial direct current stimulation. Exp Brain Res 2024; 242:99-108. [PMID: 37966504 DOI: 10.1007/s00221-023-06731-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
Vestibular nuclei and cerebellar function comprise vestibular neural networks that control vestibular-related responses. However, the vestibular-related responses to simultaneous stimulation of these regions are unclear. This study aimed to examine whether the combination of noisy galvanic vestibular stimulation (nGVS) and cerebellar transcranial direct current stimulation (ctDCS) using a complex transcranial electrical stimulation device alters vestibular-dominant standing stability and vestibulo-ocular reflex (VOR) function. The center of foot pressure (COP) sway and VOR of participants (28 healthy, young adults) were assessed under four conditions of transcranial electrical stimulation using nGVS and ctDCS. The COP was calculated with the participant standing on a soft-foam surface with eyes closed using a force plate to evaluate body sway. VOR measurements were collected via passive head movements and fixation on a target projected onto the front wall using a video head impulse test (vHIT). VOR gain was calculated in six directions using a semicircular canal structure based on the ratio of eye movement to head movement. The nGVS + ctDCS and nGVS + sham ctDCS conditions decreased COP sway compared to the sham nGVS + ctDCS and sham nGVS + sham ctDCS conditions. No significant differences were observed in the main effect of stimulation or the interaction of stimulation and direction on the vHIT parameters. The results of this study suggest that postural stability may be independently affected by nGVS. Our findings contribute to the basic neurological foundation for the clinical application of neurorehabilitation using transcranial electrical stimulation of the vestibular system.
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Affiliation(s)
- Tsubasa Mitsutake
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-Ku, Fukuoka, 814-0001, Japan.
| | - Hisato Nakazono
- Department of Occupational Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Tomoyuki Shiozaki
- Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Nara, Japan
| | - Daisuke Fujita
- Department of Physical Therapy, Faculty of Medical Science, Fukuoka International University of Health and Welfare, 3-6-40 Momochihama, Sawara-Ku, Fukuoka, 814-0001, Japan
| | - Maiko Sakamoto
- Education and Research Centre for Community Medicine, Faculty of Medicine, Saga University, Saga, Japan
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Takano K, Katagiri N, Sato T, Jin M, Koseki T, Kudo D, Yoshida K, Tanabe S, Tsujikawa M, Kondo K, Yamaguchi T. Changes in Corticospinal Excitability and Motor Control During Cerebellar Transcranial Direct Current Stimulation in Healthy Individuals. CEREBELLUM (LONDON, ENGLAND) 2023; 22:905-914. [PMID: 36053392 DOI: 10.1007/s12311-022-01469-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 06/15/2023]
Abstract
Cerebellar transcranial direct current stimulation (ctDCS) modulates the primary motor cortex (M1) via cerebellar brain inhibition (CBI), which affects motor control in humans. However, the effects of ctDCS on motor control are inconsistent because of an incomplete understanding of the real-time changes in the M1 excitability that occur during ctDCS, which determines motor output under regulation by the cerebellum. This study investigated changes in corticospinal excitability and motor control during ctDCS in healthy individuals. In total, 37 healthy individuals participated in three separate experiments. ctDCS (2 mA) was applied to the cerebellar hemisphere during the rest condition or a pinch force-tracking task. Motor-evoked potential (MEP) amplitude and the F-wave were assessed before, during, and after ctDCS, and pinch force control was assessed before and during ctDCS. The MEP amplitudes were significantly decreased during anodal ctDCS from 13 min after the onset of stimulation, whereas the F-wave was not changed. No significant changes in MEP amplitudes were observed during cathodal and sham ctDCS conditions. The MEP amplitudes were decreased during anodal ctDCS when combined with the pinch force-tracking task, and pinch force control was impaired during anodal ctDCS relative to sham ctDCS. The MEP amplitudes were not significantly changed before and after all ctDCS conditions. Motor cortical excitability was suppressed during anodal ctDCS, and motor control was unskilled during anodal ctDCS when combined with a motor task in healthy individuals. Our findings provided a basic understanding of the clinical application of ctDCS to neurorehabilitation.
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Affiliation(s)
- Keita Takano
- Department of Physical Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino-shi, Chiba, 275-0026, Japan
| | - Natsuki Katagiri
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino-shi, Chiba, 275-0026, Japan
| | - Takatsugu Sato
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino-shi, Chiba, 275-0026, Japan
| | - Masafumi Jin
- Department of Physical Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan
| | - Tadaki Koseki
- Department of Physical Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan
| | - Daisuke Kudo
- Department of Physical Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan
| | - Kaito Yoshida
- Department of Occupational Therapy, Graduate School of Health Sciences, Yamagata Prefectural University of Health Sciences, 260 Kamiyanagi, Yamagata-shi, Yamagata, 990-2212, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake-shi, Aichi, 470-1192, Japan
| | - Masahiro Tsujikawa
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino-shi, Chiba, 275-0026, Japan
| | - Kunitsugu Kondo
- Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, 4-1-1 Yatsu, Narashino-shi, Chiba, 275-0026, Japan
| | - Tomofumi Yamaguchi
- Department of Physical Therapy, Faculty of Health Science, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-8421, Japan.
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Manjarrez E, Campana G, Mirasso C, Battelli L. Editorial: Insights into the mechanisms of transcranial electrical stimulation. Front Neurosci 2023; 17:1286239. [PMID: 37795182 PMCID: PMC10545846 DOI: 10.3389/fnins.2023.1286239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 08/31/2023] [Indexed: 10/06/2023] Open
Affiliation(s)
- Elias Manjarrez
- Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Mexico
| | - Gianluca Campana
- Department of General Psychology, University of Padova, Padua, Italy
| | - Claudio Mirasso
- Instituto de Física Interdisciplinar y Sistemas Complejos (IFISC, UIB-CSIC), Palma de Mallorca, Spain
| | - Lorella Battelli
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
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Guidetti M, Giannoni-Luza S, Bocci T, Pacheco-Barrios K, Bianchi AM, Parazzini M, Ionta S, Ferrucci R, Maiorana NV, Verde F, Ticozzi N, Silani V, Priori A. Modeling Electric Fields in Transcutaneous Spinal Direct Current Stimulation: A Clinical Perspective. Biomedicines 2023; 11:biomedicines11051283. [PMID: 37238953 DOI: 10.3390/biomedicines11051283] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/12/2023] [Accepted: 04/21/2023] [Indexed: 05/28/2023] Open
Abstract
Clinical findings suggest that transcutaneous spinal direct current stimulation (tsDCS) can modulate ascending sensitive, descending corticospinal, and segmental pathways in the spinal cord (SC). However, several aspects of the stimulation have not been completely understood, and realistic computational models based on MRI are the gold standard to predict the interaction between tsDCS-induced electric fields and anatomy. Here, we review the electric fields distribution in the SC during tsDCS as predicted by MRI-based realistic models, compare such knowledge with clinical findings, and define the role of computational knowledge in optimizing tsDCS protocols. tsDCS-induced electric fields are predicted to be safe and induce both transient and neuroplastic changes. This could support the possibility to explore new clinical applications, such as spinal cord injury. For the most applied protocol (2-3 mA for 20-30 min, active electrode over T10-T12 and the reference on the right shoulder), similar electric field intensities are generated in both ventral and dorsal horns of the SC at the same height. This was confirmed by human studies, in which both motor and sensitive effects were found. Lastly, electric fields are strongly dependent on anatomy and electrodes' placement. Regardless of the montage, inter-individual hotspots of higher values of electric fields were predicted, which could change when the subjects move from a position to another (e.g., from the supine to the lateral position). These characteristics underlines the need for individualized and patient-tailored MRI-based computational models to optimize the stimulation protocol. A detailed modeling approach of the electric field distribution might contribute to optimizing stimulation protocols, tailoring electrodes' configuration, intensities, and duration to the clinical outcome.
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Affiliation(s)
- Matteo Guidetti
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Stefano Giannoni-Luza
- Sensory-Motor Lab (SeMoLa), Department of Ophthalmology-University of Lausanne, Jules Gonin Eye Hospital/Fondation Asile des Aveugles, 1015 Lausanne, Switzerland
| | - Tommaso Bocci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
| | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Boston, MA 02129, USA
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Lima 15024, Peru
| | - Anna Maria Bianchi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milan, Italy
| | - Marta Parazzini
- Istituto di Elettronica e di Ingegneria Dell'Informazione e delle Telecomunicazioni (IEIIT), Consiglio Nazionale delle Ricerche (CNR), 10129 Milan, Italy
| | - Silvio Ionta
- Sensory-Motor Lab (SeMoLa), Department of Ophthalmology-University of Lausanne, Jules Gonin Eye Hospital/Fondation Asile des Aveugles, 1015 Lausanne, Switzerland
| | - Roberta Ferrucci
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Natale Vincenzo Maiorana
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
| | - Federico Verde
- Department of Neurology, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, 20122 Milan, Italy
| | - Nicola Ticozzi
- Department of Neurology, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, 20122 Milan, Italy
| | - Vincenzo Silani
- Department of Neurology, Istituto Auxologico Italiano IRCCS, 20149 Milan, Italy
- Department of Pathophysiology and Transplantation, 'Dino Ferrari' Center, Università degli Studi di Milano, 20122 Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
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Byczynski G, Vanneste S. Modulating motor learning with brain stimulation: Stage-specific perspectives for transcranial and transcutaneous delivery. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110766. [PMID: 37044280 DOI: 10.1016/j.pnpbp.2023.110766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/22/2023] [Accepted: 04/09/2023] [Indexed: 04/14/2023]
Abstract
Brain stimulation has been used in motor learning studies with success in improving aspects of task learning, retention, and consolidation. Using a variety of motor tasks and stimulus parameters, researchers have produced an array of literature supporting the efficacy of brain stimulation to modulate motor task learning. We discuss the use of transcranial direct current stimulation, transcranial alternating current stimulation, and peripheral nerve stimulation to modulate motor learning. In a novel approach, we review literature of motor learning modulation in terms of learning stage, categorizing learning into acquisition, consolidation, and retention. We endeavour to provide a current perspective on the stage-specific mechanism behind modulation of motor task learning, to give insight into how electrical stimulation improves or hinders motor learning, and how mechanisms differ depending on learning stage. Offering a look into the effectiveness of peripheral nerve stimulation for motor learning, we include potential mechanisms and overlapping features with transcranial stimulation. We conclude by exploring how peripheral stimulation may contribute to the results of studies that employed brain stimulation intracranially.
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Affiliation(s)
- Gabriel Byczynski
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; Global Brain Health Institute, Trinity College Dublin, D02 PN40, Ireland
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; School of Psychology, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; Global Brain Health Institute, Trinity College Dublin, D02 PN40, Ireland.
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Serup J, Alsing KK, Olsen O, Koch CB, Hansen RH. On the mechanism of painful burn sensation in tattoos on magnetic resonance imaging (MRI). Magnetic substances in tattoo inks used for permanent makeup (PMU) identified: Magnetite, goethite, and hematite. Skin Res Technol 2023; 29:e13281. [PMID: 36973979 PMCID: PMC10155845 DOI: 10.1111/srt.13281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 01/06/2023] [Indexed: 03/19/2023]
Abstract
BACKGROUND Persons with cosmetic tattoos occasionally experience severe pain and burning sensation on magnetic resonance imaging (MRI). OBJECTIVE To explore the culprit magnetic substances in commonly used permanent makeup inks. MATERIAL AND METHODS 20 inks used for cosmetic tattooing of eyebrows, eyeliners, and lips were selected. Ink bottles were tested for magnetic behavior with a neodymium magnet. Eight iron oxide inks qualified for the final study. Metals were analyzed by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). The magnetic fraction of inks was isolated and analyzed by X-ray fluorescence (XRF). Magnetic iron compounds were characterized by Mössbauer spectroscopy and powder X-ray diffraction (XRD). RESULTS ICP-MS showed iron in all magnetic samples, and some nickel and chromium. Mössbauer spectroscopy and XRD detected ferromagnetic minerals, particularly magnetite, followed by goethite and hematite. CONCLUSION This original study of cosmetic ink stock products made with iron oxide pigments reports magnetic impurities in inks for cosmetic tattooing, e.g., magnetite, goethite, and hematite. These may be the main cause of MRI burn sensation in cosmetic tattoos. The mechanism behind sensations is hypothesized to be induction of electrical stimuli of axons from periaxonal pigment/impurity activated by magnetic force. Magnetite is considered the lead culprit.
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Affiliation(s)
- Jørgen Serup
- The Tattoo Clinic, Department of DermatologyCopenhagen University Hospital, BispebjergCopenhagenDenmark
| | - Kasper Køhler Alsing
- The Tattoo Clinic, Department of DermatologyCopenhagen University Hospital, BispebjergCopenhagenDenmark
| | | | | | - Rasmus Hvass Hansen
- Section for Radiation Therapy, Department of Oncology, Center for Cancer and Organ DiseasesCopenhagen University Hospital, RigshospitaletCopenhagenDenmark
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Schwell G, Kozol Z, Tarshansky D, Einat M, Frenkel-Toledo S. The effect of action observation combined with high-definition transcranial direct current stimulation on motor performance in healthy adults: A randomized controlled trial. Front Hum Neurosci 2023; 17:1126510. [PMID: 36936614 PMCID: PMC10014919 DOI: 10.3389/fnhum.2023.1126510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
Action observation (AO) can improve motor performance in humans, probably via the human mirror neuron system. In addition, there is some evidence that transcranial direct current stimulation (tDCS) can improve motor performance. However, it is yet to be determined whether AO combined with tDCS has an enhanced effect on motor performance. We investigated the effect of AO combined with high-definition tDCS (HD-tDCS) targeting the inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), the main aggregates of the human mirror neuron system, on motor performance in healthy adults and compared the immediate vs. 24-h retention test effects (anodal electrodes were placed over these regions of interest). Sixty participants were randomly divided into three groups that received one of the following single-session interventions: (1) observation of a video clip that presented reaching movement sequences toward five lighted units + active HD-tDCS stimulation (AO + active HD-tDCS group); (2) observation of a video clip that presented the same reaching movement sequences + sham HD-tDCS stimulation (AO + sham HD-tDCS group); and (3) observation of a video clip that presented neutral movie while receiving sham stimulation (NM + sham HD-tDCS group). Subjects' reaching performance was tested before and immediately after each intervention and following 24 h. Subjects performed reaching movements toward units that were activated in the same order as the observed sequence during pretest, posttest, and retest. Occasionally, the sequence order was changed by beginning the sequence unexpectedly with a different activated unit. Outcome measures included mean Reaching Time and difference between the Reaching Time of the unexpected and expected reaching movements (Delta). In the posttest and retest, Reaching Time and Delta improved in the AO + sham HD-tDCS group compared to the NM + HD-sham tDCS group. In addition, at posttest, Delta improved in the AO + active HD-tDCS group compared to the NM + sham HD-tDCS group. It appears that combining a montage of active HD-tDCS, which targets the IPL and IFG, with AO interferes with the positive effects of AO alone on the performance of reaching movement sequences.
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Affiliation(s)
- Gidon Schwell
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Zvi Kozol
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - David Tarshansky
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Moshe Einat
- Department of Electrical and Electronic Engineering, Ariel University, Ariel, Israel
| | - Silvi Frenkel-Toledo
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Neurological Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
- *Correspondence: Silvi Frenkel-Toledo,
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Yuan K, Ti CHE, Wang X, Chen C, Lau CCY, Chu WCW, Tong RKY. Individual electric field predicts functional connectivity changes after anodal transcranial direct-current stimulation in chronic stroke. Neurosci Res 2023; 186:21-32. [PMID: 36220454 DOI: 10.1016/j.neures.2022.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 11/05/2022]
Abstract
The neuromodulation effect of anodal tDCS is not thoroughly studied, and the heterogeneous profile of stroke individuals with brain lesions would further complicate the stimulation outcomes. This study aimed to investigate the functional changes in sensorimotor areas induced by anodal tDCS and whether individual electric field could predict the functional outcomes. Twenty-five chronic stroke survivors were recruited and divided into tDCS group (n = 12) and sham group (n = 13). Increased functional connectivity (FC) within the surrounding areas of ipsilesional primary motor cortex (M1) was only observed after anodal tDCS. Averaged FC among the ipsilesional sensorimotor regions was observed to be increased after anodal tDCS (t(11) = 2.57, p = 0.026), but not after sham tDCS (t(12) = 0.69, p = 0.50). Partial least square analysis identified positive correlations between electric field (EF) strength normal to the ipsilesional M1 surface and individual FC changes in tDCS group (r = 0.84, p < 0.001) but not in sham group (r = 0.21, p = 0.5). Our results indicated anodal tDCS facilitates the FC within the ipsilesional sensorimotor network in chronic stroke subjects, and individual electric field predicts the functional outcomes.
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Affiliation(s)
- Kai Yuan
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Chun-Hang Eden Ti
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Xin Wang
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cheng Chen
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Cathy Choi-Yin Lau
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Winnie Chiu-Wing Chu
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Raymond Kai-Yu Tong
- Department of Biomedical Engineering, Faculty of Engineering, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
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12
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Yasaroglu S, Liepert J. Transcranial direct current stimulation in stroke - Motor excitability and motor function. Clin Neurophysiol 2022; 144:16-22. [PMID: 36208617 DOI: 10.1016/j.clinph.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/28/2022] [Accepted: 09/08/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To characterize motor excitability changes and changes of motor performance induced by a single anodal and cathodal transcranial direct current stimulation (tDCS) session in stroke patients. METHODS Twenty subacute stroke patients participated. Motor performance was tested with the Box and Block Test [BBT]. Motor cortex excitability (short interval intracortical inhibition [SICI], intracortical facilitation [ICF], long interval intracortical inhibition [LICI]) was examined by paired pulse transcranial magnetic stimulation before and after a single tDCS session (20 minutes, 1,0 mA). On two different occasions, patients received anodal and cathodal tDCS over the affected hemisphere. TMS recordings were taken from both hands consecutively. RESULTS Anodal tDCS significantly reduced SICI without changing ICF or LICI. Cathodal tDCS did not change motor excitability. Both types of tDCS did not alter motor performance. Even prior to anodal tDCS, SICI in the affected hemisphere was lower than in the unaffected hemisphere and was correlated with BBT changes after anodal tDCS. CONCLUSIONS Anodal, but not cathodal tDCS specifically modulated intracortical inhibitory circuits, leading to a disinhibition. SIGNIFICANCE The results amplify our knowledge on excitability modulations of tDCS in stroke patients.
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13
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Cardon E, Jacquemin L, Vermeersch H, Joossen I, Moyaert J, Mertens G, Vanderveken OM, Lammers MJW, Van de Heyning P, Van Rompaey V, Gilles A. Dual-site transcranial direct current stimulation to treat tinnitus: a randomized controlled trial. Brain 2022; 145:4222-4231. [PMID: 36450310 PMCID: PMC9762937 DOI: 10.1093/brain/awac263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/17/2022] [Accepted: 07/03/2022] [Indexed: 12/03/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a potential intervention for subjective tinnitus, but supporting evidence remains limited. We aimed to investigate the effect of anodal high-definition tDCS of the left temporal area and right dorsolateral prefrontal cortex on tinnitus severity. This double-blind randomized controlled trial included 77 patients (age range 18-79, 43 male) with chronic subjective tinnitus as their primary complaint. Thirty-eight subjects received six consecutive sessions of dual-site sequential high-definition-tDCS with electrodes positioned over the left temporal area and right dorsolateral prefrontal cortex. Both areas were stimulated for 15 min per session, with total stimulation time amounting to 30 min. Thirty-nine subjects received sham stimulation. The primary outcome measure was the change in tinnitus severity, as evaluated by the Tinnitus Functional Index, from baseline to a follow-up visit at 8 ± 2 weeks after treatment completion. Secondary outcomes included changes in perceived tinnitus loudness, as measured with a visual analogue scale and a tinnitus matching procedure, as well as scores on the Hospital Anxiety and Depression Scale, and the Hyperacusis Questionnaire. No differences in Tinnitus Functional Index change scores were identified between the active treatment and sham control groups (linear regression: P = 0.86). The Tinnitus Functional Index scores decreased significantly over time in both groups (P = 0.0012), indicating the presence of a considerable placebo effect. These change scores were significantly influenced by sex (linear regression: P = 0.037) and baseline symptoms of anxiety (linear regression: P = 0.049) in both groups. In general, Tinnitus Functional Index scores decreased more profoundly in males and in subjects with a higher degree of anxiety at baseline. None of the included secondary measures differed significantly between experimental arms. Our results suggest that dual-site sequential high-definition-tDCS of the left temporal area and right dorsolateral prefrontal cortex does not alleviate tinnitus severity. Interestingly, in our study population, fluctuations in tinnitus severity were influenced by gender and concurrent mental condition. It is therefore important to take these factors into account when conducting or planning randomized controlled trials in tinnitus populations.
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Affiliation(s)
- Emilie Cardon
- Correspondence to: Emilie Cardon Department of Translational Neuroscience, Faculty of Medicine and Health Science University of Antwerp, Campus Drie Eiken, Antwerp, Belgium E-mail:
| | - Laure Jacquemin
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Hanne Vermeersch
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Iris Joossen
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Julie Moyaert
- University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Griet Mertens
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Olivier M Vanderveken
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Marc J W Lammers
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Paul Van de Heyning
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Vincent Van Rompaey
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium
| | - Annick Gilles
- Department of Translational Neuroscience, Faculty of Medicine and Health Science, University of Antwerp, Antwerp, Belgium,University Department of Otorhinolaryngology and Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium,Department of Education, Health and Social Work, University College Ghent, Ghent, Belgium
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14
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Qurat-ul-ain, Ahmad Z, Ishtiaq S, Ilyas S, Shahid I, Tariq I, Malik AN, Liu T, Wang J. Short term effects of anodal cerebellar vs. anodal cerebral transcranial direct current stimulation in stroke patients, a randomized control trial. Front Neurosci 2022; 16:1035558. [PMID: 36507323 PMCID: PMC9730515 DOI: 10.3389/fnins.2022.1035558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Balance and gait impairments are major motor deficits in stroke patients that require intensive neuro-rehabilitation. Anodal transcranial direct current stimulation is a neuro-modulatory technique recently used in stroke patients for balance and gait improvement. Majority of studies focusing on tDCS have assessed its effects on cerebral motor cortex and more recently cerebellum as well but to our best knowledge the comparison of stimulating these two regions in stroke patients is not investigated so far. Objective The current study aimed to compare the effect of anodal transcranial direct current stimulation on cerebellar and cerebral motor cortex M1 in stroke patients. Materials and methods This double-blinded, parallel, randomized, sham controlled trial included 66 patients with a first-ever ischemic stroke were recruited into three groups; Cerebellar stimulation group (CbSG), M1 Stimulation Group (MSG), and Sham stimulation group (SSG). A total of three sessions of anodal transcranial direct current stimulation were given on consecutive days in addition to non-immersive virtual reality using Xbox 360 with kinect. Anodal tDCS with an intensity of 2 mA was applied for a duration of 20 min. Primary outcome measures berg balance scale (BBS), timed up and go test (TUG), BESTest Balance Evaluation-Systems Test (BESTest) and secondary outcomes measures montreal cognitive assessment (MoCA), mini mental state examination (MMSE), Johns Hopkins Fall Risk Assessment Tool (JHFRAT), twenty five feet walk test (25FWT), six minute walk test (6MWT), and tDCS Adverse Effects was assessed before initiation of treatment (T0) and at the end of third session of stimulation (T1). Results The results of between group's analysis using mean difference showed a significant difference with p-value <0.05 for balance (BBS, TUG, BESTest), walking ability (6MWT, 25FWT), risk of fall (JHFRAT). Cognitive function did not show any significant change among the groups for MoCA with p-value >0.05 but MMSE was improved having significant p-value (p = 0.013). However, 6MWT and 25FWT showed non-significant results for both between group and within group analysis. In pairwise comparison both the cerebellar and cerebral stimulation groups showed Significant difference with p-value <0.05 in comparison to sham stimulation; BBS (cerebellar vs. sham p ≤ 0.001, cerebral vs. sham p = 0.011), TUG (cerebellar vs. sham p = 0.001, cerebral vs. sham p = 0.041), Bestest (cerebellar vs. sham p = 0.007, cerebral vs. sham p = 0.003). Whereas for JHFRAT only cerebellar stimulation in comparison to sham and motor cortex stimulation showed significant improvements (cerebellar vs. M1 p = 0.037, cerebellar vs. sham p = 0.037). MMSE showed significant improvement in M1 stimulation (M1 vs. cerebellar p = 0.036, M1 vs. sham p = 0.011). Conclusion Findings of the study suggest anodal tDCS stimulation of the cerebellum and cerebral motor cortex both improves gait, balance and risk of fall in stroke patients. However, both stimulation sites do not induce any notable improvement in cognitive function. Effects of both stimulation sites have similar effects on mobility in stroke patients.
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Affiliation(s)
- Qurat-ul-ain
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China
| | - Zafran Ahmad
- School of Economics and Management, Yunnan University, Kunming, China
| | - Summaiya Ishtiaq
- Department of Rehabilitation Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Saad Ilyas
- Faculty of Computing, Capital University of Science and Technology, Islamabad, Pakistan
| | - Irum Shahid
- Institute of Physical Medical and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Iqbal Tariq
- Faculty of Rehabilitation and Allied Health Sciences, Riphah College of Rehabilitation and Allied Health Sciences, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation and Allied Health Sciences, Riphah College of Rehabilitation and Allied Health Sciences, Islamabad, Pakistan
| | - Tian Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China
| | - Jue Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China,*Correspondence: Jue Wang,
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15
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Guidetti M, Arlotti M, Bocci T, Bianchi AM, Parazzini M, Ferrucci R, Priori A. Electric Fields Induced in the Brain by Transcranial Electric Stimulation: A Review of In Vivo Recordings. Biomedicines 2022; 10:biomedicines10102333. [PMID: 36289595 PMCID: PMC9598743 DOI: 10.3390/biomedicines10102333] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/10/2022] [Accepted: 09/14/2022] [Indexed: 01/12/2023] Open
Abstract
Transcranial electrical stimulation (tES) techniques, such as direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), cause neurophysiological and behavioral modifications as responses to the electric field are induced in the brain. Estimations of such electric fields are based mainly on computational studies, and in vivo measurements have been used to expand the current knowledge. Here, we review the current tDCS- and tACS-induced electric fields estimations as they are recorded in humans and non-human primates using intracerebral electrodes. Direct currents and alternating currents were applied with heterogeneous protocols, and the recording procedures were characterized by a tentative methodology. However, for the clinical stimulation protocols, an injected current seems to reach the brain, even at deep structures. The stimulation parameters (e.g., intensity, frequency and phase), the electrodes’ positions and personal anatomy determine whether the intensities might be high enough to affect both neuronal and non-neuronal cell activity, also deep brain structures.
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Affiliation(s)
- Matteo Guidetti
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | | | - Tommaso Bocci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
| | - Anna Maria Bianchi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Piazza Leonardo da Vinci 32, 20133 Milan, Italy
| | - Marta Parazzini
- Istituto di Elettronica e di Ingegneria dell’Informazione e delle Telecomunicazioni (IEIIT), Consiglio Nazionale delle Ricerche (CNR), 20133 Milan, Italy
| | - Roberta Ferrucci
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Via Antonio di Rudinì 8, 20142 Milan, Italy
- III Neurology Clinic, ASST-Santi Paolo e Carlo University Hospital, 20142 Milan, Italy
- Correspondence:
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16
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Masina F, Montemurro S, Marino M, Manzo N, Pellegrino G, Arcara G. State-dependent tDCS modulation of the somatomotor network: A MEG study. Clin Neurophysiol 2022; 142:133-142. [PMID: 36037749 DOI: 10.1016/j.clinph.2022.07.508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Transcranial direct current stimulation (tDCS) is a non-invasive technique widely used to investigate brain excitability and activity. However, the variability in both brain and behavioral responses to tDCS limits its application for clinical purposes. This study aims to shed light on state-dependency, a phenomenon that contributes to the variability of tDCS. METHODS To this aim, we investigated changes in spectral activity and functional connectivity in somatomotor regions after Real and Sham tDCS using generalized additive mixed models (GAMMs), which allowed us to investigate how modulation depends on the initial state of the brain. RESULTS Results showed that changes in spectral activity, but not connectivity, in the somatomotor regions depend on the initial state of the brain, confirming state-dependent effects. Specifically, we found a non-linear interaction between stimulation conditions (Real vs Sham) and initial state: a reduction of alpha and beta power was observed only in participants that had higher alpha and beta power before Real tDCS. CONCLUSIONS This study highlights the importance of considering state-dependency to tDCS and shows how it can be taken into account with appropriate statistical models. SIGNIFICANCE Our findings bear insight into tDCS mechanisms, potentially leading to discriminate between tDCS responders and non-responders.
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Affiliation(s)
| | | | - Marco Marino
- IRCCS San Camillo Hospital, Venice, Italy; Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU Leuven, Belgium.
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Venice, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.
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17
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Kold S, Kragh AJ, Graven-Nielsen CS, Elnegaard FS, Lund F, Vittrup IV, Cliff KL, Sivarooban R, Petrini L. Neuromodulation of somatosensory pain thresholds of the neck musculature using a novel transcranial direct current stimulation montage: a randomized double-blind, sham controlled study. Scand J Pain 2022; 22:622-630. [PMID: 35130374 DOI: 10.1515/sjpain-2021-0187] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/25/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Anodal transcranial direct current stimulation (tDCS) of primary motor cortex (M1) and cathodal of the primary sensory cortex (S1) have previously shown to modulate the sensory thresholds when administered with the reference electrode located over the contralateral supraorbital area (SO). Combining the two stimulation paradigms into one with simultaneous stimulation of the two brain areas (M1 + S1 - tDCS) may result in a synergistic effect inducing a prominent neuromodulation, noticeable in the pain thresholds. The aim of this study is to assess the efficacy of the novel M1 + S1 - tDCS montage compared to sham-stimulation in modulating the pain thresholds in healthy adults. METHODS Thirty-nine (20 males) subjects were randomly assigned to either receiving 20 min. active M1 + S1 - tDCS or sham tDCS in a double-blinded single session study. Thermal and mechanical pain thresholds were assessed before and after the intervention. RESULTS There were no significant differences in the pain thresholds within either group, or between the M1 + S1 - tDCS group and the Sham-tDCS group (p>0.05), indicating that the intervention was ineffective in inducing a neuromodulation of the somatosensory system. CONCLUSIONS Experimental investigations of novel tDCS electrode montages, that are scientifically based on existing studies or computational modelling, are essential to establish better tDCS protocols. Here simultaneous transcranial direct current stimulation of the primary motor cortex and primary sensory cortex showed no effect on the pain thresholds of the neck musculature in healthy subjects. This tDCS montage may have been ineffective due to how the electrical field reaches the targeted neurons, or may have been limited by the design of a single tDCS administration. The study adds to the existing literature of the studies investigating effects of new tDCS montages with the aim of establishing novel non-invasive brain stimulation interventions for chronic neck pain rehabilitation. North Denmark Region Committee on Health Research Ethics (VN-20180085) ClinicalTrials.gov (NCT04658485).
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Affiliation(s)
- Sebastian Kold
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Anna J Kragh
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Christoffer S Graven-Nielsen
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Frederikke S Elnegaard
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Fredrik Lund
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Ida V Vittrup
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Katja L Cliff
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Rathiba Sivarooban
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
| | - Laura Petrini
- Department of Health Science and Technology Faculty of Medicine, Center for Neuroplasticity and Pain (CNAP), Aalborg University, Aalborg, Denmark
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18
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Singh MF, Cole MW, Braver TS, Ching S. Developing control-theoretic objectives for large-scale brain dynamics and cognitive enhancement. ANNUAL REVIEWS IN CONTROL 2022; 54:363-376. [PMID: 38250171 PMCID: PMC10798814 DOI: 10.1016/j.arcontrol.2022.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
The development of technologies for brain stimulation provides a means for scientists and clinicians to directly actuate the brain and nervous system. Brain stimulation has shown intriguing potential in terms of modifying particular symptom clusters in patients and behavioral characteristics of subjects. The stage is thus set for optimization of these techniques and the pursuit of more nuanced stimulation objectives, including the modification of complex cognitive functions such as memory and attention. Control theory and engineering will play a key role in the development of these methods, guiding computational and algorithmic strategies for stimulation. In particular, realizing this goal will require new development of frameworks that allow for controlling not only brain activity, but also latent dynamics that underlie neural computation and information processing. In the current opinion, we review recent progress in brain stimulation and outline challenges and potential research pathways associated with exogenous control of cognitive function.
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Affiliation(s)
- Matthew F Singh
- Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, 63130, MO, USA
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, 07102, NJ, USA
- Psychological and Brain Science, Washington University in St. Louis, St. Louis, 63130, MO, USA
| | - Michael W Cole
- Center for Molecular and Behavioral Neuroscience, Rutgers University, Newark, 07102, NJ, USA
| | - Todd S Braver
- Psychological and Brain Science, Washington University in St. Louis, St. Louis, 63130, MO, USA
| | - ShiNung Ching
- Electrical and Systems Engineering, Washington University in St. Louis, St. Louis, 63130, MO, USA
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19
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Kold S, Graven-Nielsen T. Modulation Of Experimental Prolonged Pain and Sensitization Using High-Definition Transcranial Direct Current Stimulation: A Double-Blind, Sham-Controlled Study. THE JOURNAL OF PAIN 2022; 23:1220-1233. [PMID: 35202795 DOI: 10.1016/j.jpain.2022.01.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/05/2022] [Accepted: 01/27/2022] [Indexed: 10/19/2022]
Abstract
High definition transcranial direct current stimulation (HD-tDCS) targeting brain areas involved in pain processing has shown analgesic effects in some chronic pain conditions, but less modulatory effect on mechanical and thermal pain thresholds in asymptomatic subjects. This double-blinded study assessed the HD-tDCS effects on experimental pain and hyperalgesia maintained for several days in healthy participants. Hyperalgesia and pain were assessed during three consecutive days following provocation of experimental pain (nerve growth factor injected into the right-hand muscle) and daily HD-tDCS sessions (20-minutes). Forty subjects were randomly assigned to Active-tDCS targeting primary motor cortex and dorsolateral prefrontal cortex simultaneously or Sham-tDCS. Tactile and pressure pain sensitivity were assessed before and after each HD-tDCS session, as well as the experimentally-induced pain intensity scored on a numerical rating scale (NRS). Subjects were effectively blinded to the type of HD-tDCS protocol. The Active-tDCS did not significantly reduce the NGF-induced NRS pain score (3.5±2.4) compared to Sham-tDCS (3.9±2.0, P > .05) on day 3 and both groups showed similarly NGF-decreased pressure pain threshold in the right hand (P < .001). Comparing Active-tDCS with Sham-tDCS, the manifestation of pressure hyperalgesia was delayed on day 1, and an immediate (pre-HD-tDCS to post-HD-tDCS) reduction in pressure hyperalgesia was found across all days (P < .05). PERSPECTIVE: The non-significant differences between Active-tDCS and Sham-tDCS on experimental prolonged pain and hyperalgesia suggest that HD-tDCS has no effect on moderate persistent experimental pain. The intervention may still have a positive effect in more severe pain conditions, with increased intensity, more widespread distribution, or increased duration and/or involving stronger affective components.
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Affiliation(s)
- Sebastian Kold
- Center for Neuroplasticity and Pain (CNAP), Aalborg University, Denmark
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20
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Efficacy of Transcranial Direct Current Stimulation (tDCS) on Balance and Gait in Multiple Sclerosis Patients: A Machine Learning Approach. J Clin Med 2022; 11:jcm11123505. [PMID: 35743575 PMCID: PMC9224780 DOI: 10.3390/jcm11123505] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/05/2022] [Accepted: 06/15/2022] [Indexed: 02/06/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) has emerged as an appealing rehabilitative approach to improve brain function, with promising data on gait and balance in people with multiple sclerosis (MS). However, single variable weights have not yet been adequately assessed. Hence, the aim of this pilot randomized controlled trial was to evaluate the tDCS effects on balance and gait in patients with MS through a machine learning approach. In this pilot randomized controlled trial (RCT), we included people with relapsing−remitting MS and an Expanded Disability Status Scale >1 and <5 that were randomly allocated to two groups—a study group, undergoing a 10-session anodal motor cortex tDCS, and a control group, undergoing a sham treatment. Both groups underwent a specific balance and gait rehabilitative program. We assessed as outcome measures the Berg Balance Scale (BBS), Fall Risk Index and timed up-and-go and 6-min-walking tests at baseline (T0), the end of intervention (T1) and 4 (T2) and 6 weeks after the intervention (T3) with an inertial motion unit. At each time point, we performed a multiple factor analysis through a machine learning approach to allow the analysis of the influence of the balance and gait variables, grouping the participants based on the results. Seventeen MS patients (aged 40.6 ± 14.4 years), 9 in the study group and 8 in the sham group, were included. We reported a significant repeated measures difference between groups for distances covered (6MWT (meters), p < 0.03). At T1, we showed a significant increase in distance (m) with a mean difference (MD) of 37.0 [−59.0, 17.0] (p = 0.003), and in BBS with a MD of 2.0 [−4.0, 3.0] (p = 0.03). At T2, these improvements did not seem to be significantly maintained; however, considering the machine learning analysis, the Silhouette Index of 0.34, with a low cluster overlap trend, confirmed the possible short-term effects (T2), even at 6 weeks. Therefore, this pilot RCT showed that tDCS may provide non-sustained improvements in gait and balance in MS patients. In this scenario, machine learning could suggest evidence of prolonged beneficial effects.
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Random Forest Classification to Predict Response to High-Definition Transcranial Direct Current Stimulation for Tinnitus Relief: A Preliminary Feasibility Study. Ear Hear 2022; 43:1816-1823. [PMID: 35666538 PMCID: PMC9592176 DOI: 10.1097/aud.0000000000001246] [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] [Indexed: 02/04/2023]
Abstract
OBJECTIVES Transcranial direct current stimulation (tDCS) of the right dorsolateral prefrontal cortex has been hypothesized to reduce tinnitus severity by modifying cortical activity in brain regions associated with the perception of tinnitus. However, individual response to tDCS has proven to be variable. We investigated the feasibility of using random forest classification to predict the response to high-definition (HD) tDCS for tinnitus relief. DESIGN A retrospective analysis was performed on a dataset consisting of 99 patients with subjective tinnitus receiving six consecutive sessions of HD-tDCS at the Antwerp University Hospital. A baseline assessment consisted of pure-tone audiometry and a set of questionnaires including the Tinnitus Functional Index (TFI), Hospital Anxiety and Depression Scale, and Edinburgh Handedness Inventory. Random forest classification was applied to predict, based on baseline questionnaire scores and hearing levels, whether each individual responded positively to the treatment (defined as a decrease of at least 13 points on the TFI). Further testing of the model was performed on an independent cohort of 32 patients obtained from the tinnitus center at the University of Regensburg. RESULTS Twenty-four participants responded positively to the HD-tDCS treatment. The random forest classifier predicted treatment response with an accuracy of 85.71% (100% sensitivity, 81.48% specificity), significantly outperforming a more traditional logistic regression approach. Performance of the classifier on an independent cohort was slightly but not significantly above chance level (71.88% accuracy, 66.67% sensitivity, 73.08% specificity). Feature importance analyses revealed that baseline tinnitus severity, co-occurrence of depressive symptoms and handedness were the most important predictors of treatment response. Baseline TFI scores were significantly higher in responders than in nonresponders. CONCLUSIONS The proposed random forest classifier predicted treatment response with a high accuracy, significantly outperforming a more traditional statistical approach. Machine learning methods to predict treatment response might ultimately be used in a clinical setting to guide targeted treatment recommendations for individual tinnitus patients.
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Griffin L, Kamarunas E, Kuo C, O'Donoghue C. Comparing amplitudes of transcranial direct current stimulation (tDCS) to the sensorimotor cortex during swallowing. Exp Brain Res 2022; 240:1811-1822. [PMID: 35551431 DOI: 10.1007/s00221-022-06381-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/25/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Transcranial direct current stimulation (tDCS) can alter cortical excitability, making it a useful tool for promoting neuroplasticity in dysphagia rehabilitation. Clinical trials show functional improvements in swallowing following anodal tDCS despite varying dosing parameters and outcomes. The aim of the current study was to determine the most effective amplitude criterion (e.g., 0 mA [sham/control], 1 mA, 2 mA) of anodal tDCS for upregulating the swallowing sensorimotor cortex. METHOD As a novel paradigm, tDCS, functional near-infrared spectroscopy (fNIRS), and surface electromyography (sEMG) were simultaneously administered while participants completed a swallowing task. This allowed for measurement of the cortical hemodynamic response and submental muscle contraction before, during, and after tDCS. At the conclusion of the study, participants were asked to rate their level of discomfort associated with tDCS using a visual analog scale. RESULTS There was no significant difference in the hemodynamic response by time or amplitude. However, post-hoc analyses indicated that in the post-stimulation period, changes to the hemodynamic response in the left (stimulated) hemisphere were significantly different for the groups receiving 1 mA and 2 mA of tDCS compared to baseline. Participants receiving 1 mA of tDCS demonstrated reduced hemodynamic response. There was no significant difference in submental muscle contraction during or after tDCS regardless of amplitude. Anodal tDCS was well tolerated in healthy adults with no difference among participant discomfort scores across tDCS amplitude. CONCLUSIONS During a swallowing task, healthy volunteers receiving 1 mA of anodal tDCS demonstrated a suppressed hemodynamic response during and after stimulation whereas those receiving 2 mA of anodal tDCS had an increase in the hemodynamic response. tDCS remains a promising tool in dysphagia rehabilitation, but dosing parameters require further clarification.
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Affiliation(s)
- Lindsay Griffin
- School of Communication, Communication Sciences and Disorders, Emerson College, 120 Boylston St., Boston, MA, 02116, USA. .,College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA.
| | - Erin Kamarunas
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
| | - Christina Kuo
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
| | - Cynthia O'Donoghue
- College of Health and Behavioral Studies, Communication Sciences and Disorders, James Madison University, 235 Martin Luther King Jr. Way, Harrisonburg, VA, 22807, USA
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Tedla JS, Rodrigues E, Ferreira AS, Vicente J, Reddy RS, Gular K, Sangadala DR, Kakaraparthi VN, Asiri F, Midde AK, Dixit S. Transcranial direct current stimulation combined with trunk-targeted, proprioceptive neuromuscular facilitation in subacute stroke: a randomized controlled trial. PeerJ 2022; 10:e13329. [PMID: 35505681 PMCID: PMC9057289 DOI: 10.7717/peerj.13329] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 04/04/2022] [Indexed: 01/13/2023] Open
Abstract
Background Stroke is the foremost cause of death and disability worldwide. Improving upper extremity function and quality of life are two paramount therapeutic targets during rehabilitation. Aim of the study To investigate the effects of transcranial direct current stimulation (tDCS) combined with trunk-targeted proprioceptive neuromuscular facilitation (PNF) on impairments, activity limitations, and participation restrictions of subjects with subacute stroke. Methodology Fifty-four subjects with subacute stroke were divided into three groups using block randomization. All three groups received rehabilitation sessions lasting 90 min in duration, four times per week, for 6 weeks. Group 1 (n = 18) received conventional physical therapy (CPT); group 2 (n = 18) received CPT, trunk-targeted PNF, and sham tDCS; and group 3 (n = 18) received CPT, trunk-targeted PNF, and bihemispheric motor cortex stimulation with tDCS. Changes in motor impairment, motor activity, and health-related quality of life assessments were outcome measures. Results A two-way linear mixed model analysis revealed interaction effects (group × time) for all outcome measurements (Trunk Impairment Scale, Fugl-Meyer Assessment of Motor Recovery after stroke upper extremity subsection, Wolf Motor Function Test, 10-Meter Walk Test, and the Stroke-Specific Quality of Life scale; all p < 0.01 or lower). Overall, post-pre mean differences demonstrate more substantial improvement in the active tDCS group, followed by sham stimulation associated with the PNF group and the group that received CPT alone. Conclusion Trunk-targeted PNF combined with bihemispheric tDCS along with CPT engender larger improvements in upper extremity and trunk impairment, upper limb function, gait speed, and quality of life in the subacute stroke population.
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Affiliation(s)
- Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia,Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Erika Rodrigues
- Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Arthur S. Ferreira
- Postgraduate Program in Rehabilitation Science, University Center Augusto Motta UNISUAM, Rio de Janeiro, Brazil
| | - Jose Vicente
- Professor of Neurological Physiotherapy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Devika Rani Sangadala
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Faisal Asiri
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
| | - Ajaya Kumar Midde
- Head of Neurorehabilitation, Department of Physiotherapy, Krishna Institute of Medical Sciences, Secunderabad, Telangana, India
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Aseer, Saudi Arabia
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Wei YY, Koh CL, Hsu MJ, Lo SK, Chen CH, Lin JH. Effects of Transcranial Direct Current Stimulation Combined With Neuromuscular Electrical Stimulation on Upper Extremity Motor Function in Patients With Stroke. Am J Phys Med Rehabil 2022; 101:145-151. [PMID: 33901041 DOI: 10.1097/phm.0000000000001759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the treatment effects of transcranial direct current stimulation combined with neuromuscular electrical stimulation on the motor function of upper extremity in persons with stroke. DESIGN This study was a pilot double-blind randomized controlled trial. Twenty-six patients due to stroke onset of more than 6 mos were randomly allocated to three groups: transcranial direct current stimulation combined with neuromuscular electrical stimulation group, transcranial direct current stimulation group, or control group. In addition to conventional rehabilitation, all subjects received one of the three protocols in a total of 15 sessions for 3 wks. RESULTS A significant difference among the three groups was found for the change scores of the Fugl-Meyer Assessment upper extremity subscale from pretreatment to 1-mo follow-up (P = 0.02), in favor of the transcranial direct current stimulation combined with neuromuscular electrical stimulation group. Moreover, the transcranial direct current stimulation combined with neuromuscular electrical stimulation group showed significant within-group improvement on the Fugl-Meyer Assessment upper extremity (from preintervention to postintervention, P = 0.01) and the Action Research Arm Test (from preintervention to postintervention and to 1-mo postintervention, P = 0.03 and P = 0.04, respectively). CONCLUSIONS This preliminary study reveals that combining transcranial direct current stimulation and neuromuscular electrical stimulation with regular rehabilitation programs may enhance better upper extremity functional improvement than regular rehabilitation programs alone in patients with chronic stroke.
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Affiliation(s)
- Ya-Ying Wei
- From the Department of Physical Therapy, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan (Y-YW, M-JH, J-HL); Department of Physical Medicine and Rehabilitation, Kaohsiung Armed Forces General Hospital, Taiwan (Y-YW); Department of Occupational Therapy, National Cheng Kung University, Tainan, Taiwan (C-LK); Faculty of Liberal Arts and Social Sciences, Education University of Hong Kong, Hong Kong (S-KL); School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan (C-HC); Department of Physical Medicine and Rehabilitation, Kaohsiung Medical University Chung Ho Memorial Hospital, Kaohsiung, Taiwan (C-HC); and Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan (J-HL)
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Alizadehgoradel J, Imani S, Nejati V, Vanderhasselt MA, Molaei B, Salehinejad MA, Ahmadi S, Taherifard M. Improved Executive Functions and Reduced Craving in Youths with Methamphetamine Addiction: Evidence from Combined Transcranial Direct Current Stimulation with Mindfulness Treatment. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:653-668. [PMID: 34690120 PMCID: PMC8553531 DOI: 10.9758/cpn.2021.19.4.653] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/26/2020] [Accepted: 11/01/2020] [Indexed: 11/18/2022]
Abstract
Objective Transcranial direct current stimulation (tDCS) and mindfulness practices have been proposed as a potential approach to improve executive functions (EFs) and reduce craving in persons with substance use disorders. Based on the neural mechanisms of action of each of these interventions, the combination of both non-pharmacological interventions might have additive effects. In the current study, the effects of tDCS combined with mindfulness-based substance abuse treatment (MBSAT) to improve EFs and reduce craving were investigated in early abstinent methamphetamine abuse. Methods Eighty (youths aged between 18 and 21) early-abstinent methamphetamine users were randomly assigned to the research groups (tDCS group [n = 20], mindfulness group [n = 20], combined mindfulness-tDCS group [n = 20], and sham group [n = 20]). Active tDCS (1.5 mA,20 min, 12 sessions) or sham tDCS was appliedover the left dorsolateral prefrontal cortex and the MBSAT protocol was used over twelve 50-min sessions. Results Both in the post-test phase (immediately after the intervention) and follow-up phase (one month after the intervention), performance in most EFs tasks significantly improved in the combination group which received real tDCS + MBSAT, as compared to baseline values and sham stimulation group. Similarly, a significant reduction in craving was observed after intervention inall treatment groups, but not the sham stimulation group. Interestingly, the increase in EFs and the reduction in craving post versus pre tDCS + MBSAT intervention were correlated. Conclusion Findings from the current study provide initial support for the clinical effectiveness of combination tDCS + MBSAT, possibly influencing cognitive/affective processes.
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Affiliation(s)
- Jaber Alizadehgoradel
- Department of Clinical and Health Psychology, Shahid Beheshti University, Tehran, Iran
| | - Saeed Imani
- Department of Clinical and Health Psychology & Counseling Group, Shahid Beheshti University, Tehran, Iran
| | - Vahid Nejati
- Department of Clinical and Health Psychology, Faculty of Education & Psychology, Shahid Beheshti University, Tehran, Iran
| | - Marie-Anne Vanderhasselt
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium.,Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent, Belgium
| | - Behnam Molaei
- Department of Psychiatry, Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Ruhr-University Bochum, International Graduate School of Neuroscience, Bochum, Germany
| | - Shirin Ahmadi
- Department of Psychology, Mohaghegh-Ardabili University, Ardabil, Iran
| | - Mina Taherifard
- Department of Psychology, Mohaghegh-Ardabili University, Ardabil, Iran
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Yaqub MA, Hong KS, Zafar A, Kim CS. Control of Transcranial Direct Current Stimulation Duration by Assessing Functional Connectivity of Near-Infrared Spectroscopy Signals. Int J Neural Syst 2021; 32:2150050. [PMID: 34609264 DOI: 10.1142/s0129065721500507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been shown to create neuroplasticity in healthy and diseased populations. The control of stimulation duration by providing real-time brain state feedback using neuroimaging is a topic of great interest. This study presents the feasibility of a closed-loop modulation for the targeted functional network in the prefrontal cortex. We hypothesize that we cannot improve the brain state further after reaching a specific state during a stimulation therapy session. A high-definition tDCS of 1[Formula: see text]mA arranged in a ring configuration was applied at the targeted right prefrontal cortex of 15 healthy male subjects for 10[Formula: see text]min. Functional near-infrared spectroscopy was used to monitor hemoglobin chromophores during the stimulation period continuously. The correlation matrices obtained from filtered oxyhemoglobin were binarized to form subnetworks of short- and long-range connections. The connectivity in all subnetworks was analyzed individually using a new quantification measure of connectivity percentage based on the correlation matrix. The short-range network in the stimulated hemisphere showed increased connectivity in the initial stimulation phase. However, the increase in connection density reduced significantly after 6[Formula: see text]min of stimulation. The short-range network of the left hemisphere and the long-range network gradually increased throughout the stimulation period. The connectivity percentage measure showed a similar response with network theory parameters. The connectivity percentage and network theory metrics represent the brain state during the stimulation therapy. The results from the network theory metrics, including degree centrality, efficiency, and connection density, support our hypothesis and provide a guideline for feedback on the brain state. The proposed neuro-feedback scheme is feasible to control the stimulation duration to avoid overdosage.
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Affiliation(s)
- M Atif Yaqub
- ICFO-Institut de Ciències Fotòniques, The Barcelona Institute of Science and Technology, 08860 Castelldefels (Barcelona), Spain
| | - Keum-Shik Hong
- School of Mechanical Engineering, Pusan National University, 2 Busandaehak-ro, Geumjeong-gu, Busan 46241, Korea
| | - Amad Zafar
- Department of Electrical Engineering, University of Lahore, Sihala Zone V, Islamabad, Pakistan
| | - Chang-Seok Kim
- Department of Cogno-Mechatronics Engineering, Pusan National University, 2 Busandaehak-ro, Geumjeong-gu, Busan 46241, Korea
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Effect of anodal high-definition transcranial direct current stimulation on the pain sensitivity in a healthy population: a double-blind, sham-controlled study. Pain 2021; 162:1659-1668. [PMID: 33449508 DOI: 10.1097/j.pain.0000000000002187] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 12/30/2020] [Indexed: 02/07/2023]
Abstract
ABSTRACT High-definition transcranial direct current stimulation (HD-tDCS) of brain areas related to pain processing may provide analgesic effects evident in the sensory detection and pain thresholds. The somatosensory sensitivity was assessed after HD-tDCS targeting the primary motor cortex (M1) and/or the dorsolateral prefrontal cortex (DLPFC). Eighty-one (40 females) subjects were randomly assigned to 1 of 4 anodal HD-tDCS protocols (20 minutes) applied on 3 consecutive days: Sham-tDCS, DLPFC-tDCS, M1-tDCS, and DLPFC&M1-tDCS (simultaneous transcranial direct current stimulation [tDCS] of DLPFC and M1). Subjects and experimenter were blinded to the tDCS protocols. The somatosensory sensitivity were assessed each day, before and after each tDCS by detection and pain thresholds to thermal and mechanical skin stimulation, vibration detection thresholds, and pressure pain thresholds. Subjects were effectively blinded to the protocol, with no significant difference in rates of whether they received real or placebo tDCS between the 4 groups. Compared with the Sham-tDCS, none of the active HD-tDCS protocols caused significant changes in detection or pain thresholds. Independent of tDCS protocols, pain and detection thresholds except vibration detection were increased immediately after the first tDCS protocol compared with baseline (P < 0.05). Overall, the active stimulation protocols were not able to induce significant modulation of the somatosensory thresholds in this healthy population compared with sham-tDCS. Unrelated to the HD-tDCS protocol, a decreased sensitivity was found after the first intervention, indicating a placebo effect or possible habituation to the quantitative sensory testing assessments. These findings add to the increasing literature of null findings in the modulatory effects of HD-tDCS on the healthy somatosensory system.
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Neurovascular-modulation: A review of primary vascular responses to transcranial electrical stimulation as a mechanism of action. Brain Stimul 2021; 14:837-847. [PMID: 33962079 DOI: 10.1016/j.brs.2021.04.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 04/19/2021] [Accepted: 04/21/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The ubiquitous vascular response to transcranial electrical stimulation (tES) has been attributed to the secondary effect of neuronal activity forming the classic neurovascular coupling. However, the current density delivered transcranially concentrates in: A) the cerebrospinal fluid of subarachnoid space where cerebral vasculature resides after reaching the dural and pial surfaces and B) across the blood-brain-barrier after reaching the brain parenchyma. Therefore, it is anticipated that tES has a primary vascular influence. OBJECTIVES Focused review of studies that demonstrated the direct vascular response to electrical stimulation and studies demonstrating evidence for tES-induced vascular effect in coupled neurovascular systems. RESULTS tES induces both primary and secondary vascular phenomena originating from four cellular elements; the first two mediating a primary vascular phenomenon mainly in the form of an immediate vasodilatory response and the latter two leading to secondary vascular effects and as parts of classic neurovascular coupling: 1) The perivascular nerves of more superficially located dural and pial arteries and medium-sized arterioles with multilayered smooth muscle cells; and 2) The endothelial lining of all vessels including microvasculature of blood-brain barrier; 3) Astrocytes; and 4) Neurons of neurovascular units. CONCLUSION A primary vascular effect of tES is highly suggested based on various preclinical and clinical studies. We explain how the nature of vascular response can depend on vessel anatomy (size) and physiology and be controlled by stimulation waveform. Further studies are warranted to investigate the mechanisms underlying the vascular response and its contribution to neural activity in both healthy brain and pathological conditions - recognizing many brain diseases are associated with alteration of cerebral hemodynamics and decoupling of neurovascular units.
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Prathum T, Piriyaprasarth P, Aneksan B, Hiengkaew V, Pankhaew T, Vachalathiti R, Klomjai W. Effects of home-based dual-hemispheric transcranial direct current stimulation combined with exercise on upper and lower limb motor performance in patients with chronic stroke. Disabil Rehabil 2021; 44:3868-3879. [PMID: 33645368 DOI: 10.1080/09638288.2021.1891464] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to determine the effects of home-based dual-hemispheric transcranial direct current stimulation (dual-tDCS) combined with exercise on motor performance in patients with chronic stroke. MATERIALS AND METHODS We allocated 24 participants to the active or sham group. They completed 1-h home-based exercise after 20-min dual-tDCS at 2-mA, thrice a week for 4 weeks. The patients were assessed using the Fugl-Meyer Assessment (FMA), Wolf Motor Function Test, Timed Up and Go test, Five Times Sit-to-Stand Test, Six-meter Walk Test, and muscle strength assessment. RESULTS Compared with the sham group, the active group showed improved FMA scores, which were sustained for at least 1 month. There was no between-group difference in the outcomes of the functional tasks. CONCLUSION Home-based dual-tDCS could facilitate motor recovery in patients with chronic stroke with its effect lasting for at least 1 month. However, its effects on functional tasks remain unclear. tDCS is safe and easy for home-based self-administration for patients who can use their paretic arms. This could benefit patients without access to health care centres or in situations requiring physical distancing. This home-based tDCS combined with exercise has the potential to be incorporated into telemedicine in stroke rehabilitation.IMPLICATIONS FOR REHABILITATIONTwelve sessions of home-based dual-tDCS combined with exercises (3 days/week for 4 weeks) facilitated upper and lower limb motor recovery in patients with chronic stroke compared with exercise alone, with a post-effect for at least 1 month.Home-based tDCS could be safe and easily self-administrable by patients who can use their paretic arms.This intervention could be beneficial for patients living in the community without easy access to a health care centre or in situations where physical distancing is required.
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Affiliation(s)
- Thatchaya Prathum
- Faculty of Physical Therapy, Neuro Electrical Stimulation laboratory (NeuE), Mahidol University, Nakhon Pathom, Thailand.,Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Pagamas Piriyaprasarth
- Faculty of Physical Therapy, Neuro Electrical Stimulation laboratory (NeuE), Mahidol University, Nakhon Pathom, Thailand.,Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Benchaporn Aneksan
- Faculty of Physical Therapy, Neuro Electrical Stimulation laboratory (NeuE), Mahidol University, Nakhon Pathom, Thailand.,Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Vimonwan Hiengkaew
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Wanalee Klomjai
- Faculty of Physical Therapy, Neuro Electrical Stimulation laboratory (NeuE), Mahidol University, Nakhon Pathom, Thailand.,Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
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Li N, Wang Y, Jing F, Zha R, Wei Z, Yang LZ, Geng X, Tanaka K, Zhang X. A role of the lateral prefrontal cortex in the congruency sequence effect revealed by transcranial direct current stimulation. Psychophysiology 2021; 58:e13784. [PMID: 33559273 DOI: 10.1111/psyp.13784] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 11/27/2022]
Abstract
Congruency effect is the increase in response time when relevant and irrelevant cues indicate incongruent rather than congruent responses. The congruency effect is smaller in the trial after an incongruent trial than after a congruent trial: this difference is known as the congruency sequence effect (CSE). Psychophysical and neural studies have suggested that the lateral prefrontal cortex (LPFC) and the medial prefrontal cortex are associated with the CSE. In the present study, we applied anodal and cathodal transcranial direct current stimulation, which is thought to result in excitation and inhibition, respectively, on the LPFC, while human participants were performing a flanker task. We found that the CSE was increased under cathodal stimulation (inhibition) of the LPFC. Moreover, the LPFC stimulation modulated the congruency effect after a congruent trial. Further analyses suggested that the results cannot be explained by any of the currently prevailing hypotheses of the CSE, including the conflict monitoring hypothesis, feature integration hypothesis, and temporal learning account. Based on our findings, we propose that a new distinct mechanism might be involved in the CSE. Specifically, the LPFC might contribute to the CSE by maintaining the attention to the task-relevant information, which is an endogenous goal-oriented function and reduces the carry-over of the task-irrelevant information after a congruent trial.
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Affiliation(s)
- Nan Li
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.,Cognitive Brain Mapping Laboratory, RIKEN Center for Brain Science, Wako, Japan
| | - Ying Wang
- Department of Neurosurgery, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science & Technology of China, Hefei, China.,Anhui Provincial Stereotactic Neurosurgical Institute, Hefei, China.,Anhui Province Key Laboratory of Brain Function and Brain Disease, Hefei, China
| | - Fang Jing
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Rujing Zha
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Zhengde Wei
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li-Zhuang Yang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.,Center of Medical Physics and Technology, Hefei Institute of Physical Science, CAS, Hefei, China
| | - Xiujuan Geng
- Brain and Mind Institute, Chinese University of Hong Kong, Hong Kong, China
| | - Keiji Tanaka
- Cognitive Brain Mapping Laboratory, RIKEN Center for Brain Science, Wako, Japan
| | - Xiaochu Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.,Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.,Department of Psychology, School of Humanities & Social Science, University of Science & Technology of China, Hefei, China.,Hefei Medical Research Center on Alcohol Addiction, Anhui Mental Health Center, Hefei, China
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Azarpaikan A, Taherii Torbati HR, Sohrabi M, Boostani R, Ghoshuni M. The Effect of Parietal and Cerebellar Transcranial Direct Current Stimulation on Bimanual Coordinated Adaptive Motor Learning. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Abstract. Many daily activities, such as typing, eating, playing the piano, and passing the ball in volleyball, require the proficient coordination of both hands. In this study, the effects of anodal transcranial direct current stimulation (atDCS) on the acquisition, retention, and transfer of bimanual adaptive motor tasks were investigated. To this end, 64 volunteers ( Mage = 24.36 years; SD = 2.51; 16 females) participated in this double-blind study and were categorized randomly into 4 groups. During the pretest, posttest, 24-h and 48-h retention, and transfer tests, two forms of bimanual coordination (BC) of the Vienna test system were performed. Between the pretest and posttest, all participants were trained in a bimanual coordination adaptive task with concurrent brain stimulation (1.5 mA for 15 min) for two consecutive days. The first experimental group (parietal-stim) received atDCS over the right parietal cortex (P4), while the second experimental group (cerebellar-stim) received atDCS over the bilateral cerebellum (2.5 cm bilateral to the inion). The third group (sham) received a sham stimulation. Finally, the control group did not receive any stimulation at all (control). Repeated-measure analysis of variance (ANOVARM) results indicated that parietal tDCS affected motor performance in the posttest, while overall mean duration and overall error mean duration of movement decreased. The results also revealed a significant impact of cerebellar tDCS on the posttest, 24-h and 48-h retention, and transfer tests. The overall mean duration and overall error mean durations of movement in this group were significantly lower than those in the other groups. Accordingly, we found evidence that atDCS over the cerebellum leads to more improvement in motor performance and transfer in a bimanual coordination task than atDCS over the right parietal. Finally, these results point to the possibly beneficial application of atDCS for learning and recovery of bimanual motor skills, especially when subjects are faced with a new challenging situation.
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Affiliation(s)
- Atefeh Azarpaikan
- Department of Motor Behavior, Faculty of Physical Education and Sport Science, Ferdowsi University of Mashhad, Iran
| | - Hamid Reza Taherii Torbati
- Department of Motor Behavior, Faculty of Physical Education and Sport Science, Ferdowsi University of Mashhad, Iran
| | - Mehdi Sohrabi
- Department of Motor Behavior, Faculty of Physical Education and Sport Science, Ferdowsi University of Mashhad, Iran
| | - Reza Boostani
- Department of Neurology, Mashhad University of Medical sciences, Mashhad, Iran
| | - Majid Ghoshuni
- Department of Biomedical Engineering, Mashhad Branch, Islamic Azad University, Mashhad, Iran
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Vestibular rehabilitation therapy in combination with transcranial direct current stimulation (tDCS) for treatment of chronic vestibular dysfunction in the elderly: a double-blind randomized controlled trial. Braz J Otorhinolaryngol 2020; 88:758-766. [PMID: 33339758 PMCID: PMC9483938 DOI: 10.1016/j.bjorl.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/10/2020] [Accepted: 11/02/2020] [Indexed: 01/21/2023] Open
Abstract
Introduction Dizziness and imbalance are common dysfunctions in the elderly. Vestibular rehabilitation therapy is an effective method to alleviate chronic dizziness in patients with vestibular dysfunction. Transcranial direct current stimulation has reportedly improved balance function in patients with vestibular dysfunction. Objective This study was conducted to investigate the therapeutic efficacy of vestibular rehabilitation combined with transcranial direct current stimulation in elderly patients with vestibular dysfunction. Methods In a double-blinded randomized controlled trial, 36 elderly patients with chronic vestibular dysfunction were randomly assigned to either vestibular rehabilitation and transcranial direct current stimulation (n = 18) or vestibular rehabilitation alone (n = 18) group. The transcranial stimulation protocol consisted of multisession bifrontal electrical stimulation of the dorsolateral prefrontal cortex (2 mA intensity and 20 min duration), followed by rehabilitation exercises. The vestibular rehabilitation protocol consisted of habituation and adaptation exercises combined with gait exercises during a three week period. The primary outcome of this study was the dizziness handicap inventory score, and the secondary outcomes were activities-specific balance confidence and Beck anxiety inventory scores. Results For the dizziness handicap score, the repeated-measures analysis of variance showed a significant main effect of “time”, “stimulation” and stimulation × time interaction effect. There was a significant reduction in the overall dizziness handicap score with “time” for both the groups, which was more pronounced in the vestibular rehabilitation and electrical stimulation group. In terms of activities-specific balance confidence change scores, we found a significant main effect of “time” and “stimulation” main factors, but this effect for stimulation × time interaction was not significant. For the Beck anxiety score, we observed a significant main effect of “time”, but no evidence for the main effect of the “stimulation” factor. Conclusion Bifrontal transcranial direct current stimulation in combination with vestibular rehabilitation therapy is a promising approach to improve chronic vestibular symptoms in the elderly.
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Birba A, Vitale F, Padrón I, Dottori M, de Vega M, Zimerman M, Sedeño L, Ibáñez A, García AM. Electrifying discourse: Anodal tDCS of the primary motor cortex selectively reduces action appraisal in naturalistic narratives. Cortex 2020; 132:460-472. [PMID: 32950239 PMCID: PMC7655702 DOI: 10.1016/j.cortex.2020.08.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/08/2020] [Accepted: 08/05/2020] [Indexed: 12/13/2022]
Abstract
Non-invasive stimulation of the primary motor cortex (M1) modulates processing of decontextualized action words and sentences (i.e., verbal units denoting bodily motion). This suggests that language comprehension hinges on brain circuits mediating the bodily experiences evoked by verbal material. Yet, despite its relevance to constrain mechanistic language models, such a finding fails to reveal whether and how relevant circuits operate in the face of full-blown, everyday texts. Using a novel naturalistic discourse paradigm, we examined whether direct modulation of M1 excitability influences the grasping of narrated actions. Following random group assignment, participants received anodal transcranial direct current stimulation over the left M1, or sham stimulation of the same area, or anodal stimulation of the left ventrolateral prefrontal cortex. Immediately afterwards, they listened to action-laden and neutral stories and answered questions on information realized by verbs (denoting action and non-action processes) and circumstances (conveying locative or temporal details). Anodal stimulation of the left M1 selectively decreased outcomes on action-relative to non-action information -a pattern that discriminated between stimulated and sham participants with 74% accuracy. This result was particular to M1 and held irrespective of the subjects' working memory and vocabulary skills, further attesting to its specificity. Our findings suggest that offline modulation of motor-network excitability might lead to transient unavailability of putative resources needed to evoke actions in naturalistic texts, opening promising avenues for the language embodiment framework.
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Affiliation(s)
- Agustina Birba
- Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Francesca Vitale
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Tenerife, Spain
| | - Iván Padrón
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Tenerife, Spain
| | - Martín Dottori
- Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Manuel de Vega
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, Tenerife, Spain
| | - Máximo Zimerman
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina
| | - Lucas Sedeño
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Agustín Ibáñez
- Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile; Universidad Autónoma del Caribe, Barranquilla, Colombia; Global Brain Health Institute, University of California, San Francisco, United States
| | - Adolfo M García
- Universidad de San Andrés, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Global Brain Health Institute, University of California, San Francisco, United States; Faculty of Education, National University of Cuyo, Mendoza, Argentina; Departamento de Lingüística y Literatura, Facultad de Humanidades, Universidad de Santiago de Chile, Santiago, Chile.
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Pilloni G, Choi C, Shaw MT, Coghe G, Krupp L, Moffat M, Cocco E, Pau M, Charvet L. Walking in multiple sclerosis improves with tDCS: a randomized, double-blind, sham-controlled study. Ann Clin Transl Neurol 2020; 7:2310-2319. [PMID: 33080122 PMCID: PMC7664269 DOI: 10.1002/acn3.51224] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/21/2020] [Accepted: 09/27/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To evaluate whether multiple sessions of transcranial direct current stimulation (tDCS) applied to the primary motor (M1) cortex paired with aerobic exercise can improve walking functions in multiple sclerosis (MS). METHODS MS participants were recruited for a double-blind, parallel-arm, randomized, sham-controlled trial and assigned to 10 sessions (5 d/wk for 2 weeks) of either active or sham tDCS paired with unloaded cycling for 20 minutes. Stimulation was administered over the left M1 cortex (2.5 mA; anode over C3/cathode over FP2). Gait spatiotemporal parameters were assessed using a wearable inertial sensor (10-meter and 2-minute walking tests). Measurements were collected at baseline, end of tDCS intervention, and 4-week postintervention to test for duration of any benefits. RESULTS A total of 15 participants completed the study, nine in the active and six in the sham condition. The active and sham groups were matched according to gender (50% vs. 40% female), neurologic disability (median EDSS 5.5 vs. 5), and age (mean 52.1 ± 12.9 vs. 53.7 ± 9.8 years). The active group had a significantly greater increase in gait speed (0.87 vs. 1.20 m/s, p < 0.001) and distance covered during the 2-minute walking test (118.53 vs. 133.06 m, p < 0.001) at intervention end compared to baseline. At 4-week follow-up, these improvements were maintained (baseline vs. follow-up: gait speed 0.87 vs. 1.18 m/s, p < 0.001; distance traveled 118.53 vs. 143.82 m, p < 0.001). INTERPRETATION Multiple sessions of tDCS paired with aerobic exercise lead to cumulative and persisting improvements in walking and endurance in patients with MS.
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Affiliation(s)
- Giuseppina Pilloni
- Department of Neurology, NYU Langone Health, New York, NY, USA.,Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Claire Choi
- Department of Medicine, SUNY Downstate, New York, NY, USA
| | - Michael T Shaw
- Department of Psychology, Binghamton University, New York, NY, USA
| | - Giancarlo Coghe
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Lauren Krupp
- Department of Neurology, NYU Langone Health, New York, NY, USA
| | - Marilyn Moffat
- Department of Physical Therapy, New York University, New York, NY, USA
| | - Eleonora Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Massimiliano Pau
- Department of Mechanical, Chemical and Materials Engineering, University of Cagliari, Cagliari, Italy
| | - Leigh Charvet
- Department of Neurology, NYU Langone Health, New York, NY, USA
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Sandrini M, Manenti R, Sahin H, Cotelli M. Effects of transcranial electrical stimulation on episodic memory in physiological and pathological ageing. Ageing Res Rev 2020; 61:101065. [PMID: 32275953 DOI: 10.1016/j.arr.2020.101065] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/04/2020] [Accepted: 04/01/2020] [Indexed: 12/29/2022]
Abstract
Memory for personally-relevant past events (episodic memory) is critical for activities of daily living. Decline in this type of declarative long-term memory is a common characteristic of healthy ageing, a process accelerated in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Transcranial electrical stimulation (tES) has been used as a strategy to ameliorate episodic memory. Here, we critically review studies investigating whether tES may improve episodic memory in physiological and pathological ageing. Most of the studies suggest that tES over the prefrontal or temporoparietal cortices can have a positive effect on episodic memory, but the transfer to improvement of execution of daily living activities is still unknown. Further work is needed to better understand the mechanisms underlying the effects of stimulation, combine tES with neuroimaging and optimizing the dosing of stimulation. Future studies should also investigate the optimal timing of stimulation and the combination with medications to induce long-lasting beneficial effects in pathological ageing. More open science efforts should be done to improve rigor and reliability of tES in ageing research.
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Griskova-Bulanova I, Sveistyte K, Bjekic J. Neuromodulation of Gamma-Range Auditory Steady-State Responses: A Scoping Review of Brain Stimulation Studies. Front Syst Neurosci 2020; 14:41. [PMID: 32714158 PMCID: PMC7344212 DOI: 10.3389/fnsys.2020.00041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/02/2020] [Indexed: 11/29/2022] Open
Abstract
Neural oscillations represent a fundamental mechanism that enables coordinated action during normal brain functioning. Auditory steady-state responses (ASSRs) are used to test the ability to generate gamma-range activity. Different non-invasive brain stimulation (NIBS) techniques have the potential to modulate neural activation patterns that are aberrant in a variety of neuropsychiatric disorders. Here, we summarize the current state of knowledge on how different methods of NIBS (transcranial altering current stimulation—tACS, transcranial direct current stimulation—tDCS, transcranial random noise stimulation—tRNS, paired associative stimulation—PAS, repetitive transcranial magnetic stimulation—rTMS) affect the gamma-range ASSRs in both healthy and clinical populations. We show that the current research has been far from systematic and methodologically heterogeneous. Nevertheless, some brain stimulation techniques, especially tACS and rTMS show strong potential for further exploration. We outline the main findings and provide directions for further research into neuromodulation of ASSRs as a promising biomarker of different psychopathological conditions such as schizophrenia, bipolar disorder, attention deficit hyperactivity disorder (ADHD), autism.
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Affiliation(s)
| | - Kristina Sveistyte
- School of Life Sciences, University of Nottingham, Nottingham, United Kingdom
| | - Jovana Bjekic
- Human Neuroscience Group, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
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Belopasova AV, Dobrynina LA, Kadykov AS, Berdnikovich ES, Bergelson TM, Tsypushtanova MM. [Noninvasive brain stimulation in the rehabilitation of patients with post-stroke aphasia]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:23-28. [PMID: 32307426 DOI: 10.17116/jnevro202012003223] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Over the past decade, non-invasive brain stimulation, in particular transcranial stimulation by direct electric current (TES), has been increasingly included in the array of methods used for rehabilitation of patients with post-stroke impairments (motor, speech, cognitive). Development of stimulation protocols with determination of the zones of exposure, as well as better understanding of the patterns of restoration of functional systems, became possible due to basic research using functional MRI paradigm. However, the complexity of the organization of the speech system, the variety of forms of aphasia that occur when it is damaged, the individual variability of neuroplastic processes, motivated a search for optimal stimulation protocols that contribute to the personification of the rehabilitation process. Portability, low cost of equipment, a good safety and tolerance profile, as well as a proven effect on neuroplasticity processes, are the undoubted advantages of TES-therapy. There is reason to believe that further study and clinical testing of this technique will turn it into the promising tool for enhancing the effectiveness of classical speech therapy approaches in patients with post-stroke aphasia.
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Affiliation(s)
| | | | - A S Kadykov
- Research Center of Neurology, Moscow, Russia
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de Sousa AVC, Grittner U, Rujescu D, Külzow N, Flöel A. Impact of 3-Day Combined Anodal Transcranial Direct Current Stimulation-Visuospatial Training on Object-Location Memory in Healthy Older Adults and Patients with Mild Cognitive Impairment. J Alzheimers Dis 2020; 75:223-244. [PMID: 32280093 PMCID: PMC7306891 DOI: 10.3233/jad-191234] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Associative object-location memory (OLM) is known to decline even in normal aging, and this process is accelerated in patients with mild cognitive impairment (MCI). Given the lack of curative treatment for Alzheimer's disease, activating cognitive resources during its preclinical phase might prevent progression to dementia. OBJECTIVE To evaluate the effects of anodal transcranial direct current stimulation (atDCS) combined with an associative episodic memory training on OLM in MCI patients and in healthy elderly (HE). METHODS In a single-blind cross-over design, 16 MCI patients and 32 HE underwent a 3-day visuospatial OLM training paired with either 20 min or 30 s (sham) atDCS (1 mA, right temporoparietal cortex). Effects on immediate (training success) and long-term memory (1-month) were investigated by conducting Mixed Model analyses. In addition, the impact of combined intervention on within-session (online) and on between-session (offline) performance were explored. RESULTS OLM training+atDCS enhanced training success only in MCI patients, but not HE (difference n.s.). Relative performance gain was similar in MCI patients compared to HE under atDCS. No beneficial effect was found after 1-month. Exploratory analyses suggested a positive impact on online, but a negative effect on offline performance in MCI patients. In both groups, exploratory post-hoc analyses indicated an association between initially low-performers and greater benefit from atDCS. CONCLUSION Cognitive training in MCI may be enhanced by atDCS, but further delineation of the impact of current brain state, as well as temporal characteristics of multi-session atDCS-training application, may be needed to induce longer-lasting effects.
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Affiliation(s)
- Angelica Vieira Cavalcanti de Sousa
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany
| | - Ulrike Grittner
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Stroke Research, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Dan Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatic, Martin-Luther-University Halle-Wittenberg, Germany
| | - Nadine Külzow
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany
- Kliniken Beelitz GmbH, Neurological Rehabilitation Clinic, Beelitz-Heilstätten, Germany
| | - Agnes Flöel
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Neurocure Cluster of Excellence, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Center for Stroke Research, Berlin, Germany
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Greifswald, Germany
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Eskandari Z, Dadashi M, Mostafavi H, Armani Kia A, Pirzeh R. Comparing the Efficacy of Anodal, Cathodal, and Sham Transcranial Direct Current Stimulation on Brain-Derived Neurotrophic Factor and Psychological Symptoms in Opioid-Addicted Patients. Basic Clin Neurosci 2019; 10:641-650. [PMID: 32477481 PMCID: PMC7253809 DOI: 10.32598/bcn.10.6.1710.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/10/2019] [Accepted: 08/31/2019] [Indexed: 12/22/2022] Open
Abstract
Introduction: Today, addiction to opioids is a serious problem all over the world. Unfortunately, the consumption of these drugs and the number of addicted people have drastically increased. This research aimed at comparing the efficacy of anodal, cathodal, and sham transcranial Direct Current Stimulation (tDCS) on the Brain-Derived Neurotrophic Factor (BDNF) and psychological symptoms in opioid-addicted patients. Methods: Thirty opioid-addicted patients were selected based on the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition, through the convenience sampling method. They were then randomly assigned to 3 groups (10 in each group). The subjects were evaluated before and after tDCS by their serum level of BDNF, desires for drug questionnaire, and depression anxiety stress scale. The data were analyzed by the Kolmogorov-Smirnov test, one-way analysis of variance, as well as the Bonferroni test. Results: Stimulating the Dorsolateral Prefrontal Cortex (DLPFC) led to a significant change in increasing the level of BDNF (P=0.031) and reducing the degree of depression (P=0.018), anxiety (P=0.001), stress (P=0.012), and decreased the level of craving (P=0.001) in opioid-addicted patients. There was no significant difference between active stimulation groups (anodal left/cathodal right and anodal right/cathodal left). The stimulation of the right DLPFC (group B) significantly increased BDNF in comparison with the sham group (sham tDCS) and decreased anxiety and craving. Nonetheless, no change was observed in depression and stress. The stimulation of the left DLPFC (group A) significantly reduced depression, anxiety, stress, and craving compared with the sham group, while there was no change in BDNF. Conclusion: In addition to the conventional treatments of opioid-addicted patients, tDCS is an effective complementary treatment.
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Affiliation(s)
- Zakaria Eskandari
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Dadashi
- Department of Clinical Psychology, Faculty of Medicine, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossin Mostafavi
- Department of Clinical Psychology, Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Alireza Armani Kia
- Department of Physiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Pirzeh
- Department of Physiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Asan AS, Gok S, Sahin M. Electric Fields Induced By Transcutaneous And Intracranial Current Injections In The Rat Brain. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2019; 2018:2252-2255. [PMID: 30440854 DOI: 10.1109/embc.2018.8512770] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
As a non-invasive brain stimulation technique, transcranial electrical stimulation (TES) and specifically the transcranial direct current stimulation (tDCS) has gained popularity in recent years for treatment of a wide variety of cognitive and neurological disorders. Recent studies have shown that TES can alter the motor cortex excitability. Animal studies to demonstrate the underlying mechanisms of TES are clearly lacking in literature. Clinical studies have agreed on the critical role of the current intensity and the montage of the electrodes for the treatment to be effective. In this study, we used a rat model for in vivo investigation of the vertical electrical (E) field distribution due to electrodes placed over the skin and through a craniotomy hole. A mono-phasic current pulse was used as a substitute for DC currents by taking advantage of primarily resistive properties of the brain tissue at low frequencies. The electrical potentials induced by the current pulses were recorded with penetrations at 0mm, 2mm, and 4mm away from the stimulation electrode. The results showed that the E-field was maximum immediately under the anodic electrode and decreased both in the vertical and horizontal directions rapidly by distance. The magnitude of the electric field varied from tens of mV/mm to a fraction of mV/mm by distance for a 100 μ A stimulus amplitude. The results also show that the E-field amplitudes and distribution strongly depend on whether the stimulus electrode is placed over the skin or into a craniotomy hole.
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Cattagni T, Geiger M, Supiot A, de Mazancourt P, Pradon D, Zory R, Roche N. A single session of anodal transcranial direct current stimulation applied over the affected primary motor cortex does not alter gait parameters in chronic stroke survivors. Neurophysiol Clin 2019; 49:283-293. [DOI: 10.1016/j.neucli.2019.07.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 01/20/2023] Open
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Testing the role of cognitive inhibition in physical endurance using high-definition transcranial direct current stimulation over the prefrontal cortex. Hum Mov Sci 2019; 67:102507. [PMID: 31394308 DOI: 10.1016/j.humov.2019.102507] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 06/21/2019] [Accepted: 07/26/2019] [Indexed: 12/22/2022]
Abstract
The aim of this study was to clarify the role of the prefrontal cortex (PFC) in physical effort regulation. We hypothesized that the PFC would be progressively involved in physical endurance through the engagement of cognitive inhibition, which would be necessary to maintain effort by inhibiting fatigue-related cues. This hypothesis was examined using a double-blind, sham-controlled, within-subjects study (N = 20) using high-definition (HD) transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (dlPFC). Participants had to maintain a knee extensor contraction at 30% of their maximal force while simultaneously performing an Eriksen flanker task to evaluate their inhibition performance during the task. Anodal stimulation of the dlPFC influenced response to the cognitive task during exercise, as seen by slower response times and better accuracy. However, it did not lead to any measureable improvement in cognitive inhibition and did not influence endurance time. There was no correlation between cognitive inhibition and the maintenance of physical effort. This result does not indicate a relationship between cognitive inhibition and endurance performance. The contribution of the PFC in physical endurance could be explained through its involvement on decisional processes.
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Cardon E, Van Rompaey V, Jacquemin L, Mertens G, Vermeersch H, Joossen I, Beyers J, Vanderveken OM, Van de Heyning P, Topsakal V, Gilles A. Sequential dual-site High-Definition transcranial Direct Current Stimulation (HD-tDCS) treatment in chronic subjective tinnitus: study protocol of a double-blind, randomized, placebo-controlled trial. Trials 2019; 20:471. [PMID: 31370873 PMCID: PMC6676604 DOI: 10.1186/s13063-019-3594-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 07/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Chronic tinnitus is a highly prevalent symptom, with many patients reporting considerable effects of tinnitus on quality of life. No clear evidence-based treatment options are currently available. While counseling-based methods are valuable in some cases, they are not sufficiently effective for all tinnitus patients. Neuromodulation techniques such as high-definition transcranial direct current stimulation (HD-tDCS) are proposed to have positive effects on tinnitus severity but, to date, these effects have not been proven conclusively. The proposed trial will investigate the hypothesis that chronic tinnitus patients receiving HD-tDCS will report a positive effect on the impact of tinnitus on daily life, as compared to patients receiving sham stimulation. Methods This study proposes a randomized, double-blind, placebo-controlled trial with parallel group design. A total of 100 chronic tinnitus patients will be randomly allocated to an experimental group or a sham group, with allocation stratified according to gender and tinnitus severity. Patient and researcher will be blinded to the patient’s allocation. Patients will undergo six sessions of sequential dual-site HD-tDCS of the left temporal area and the right dorsolateral prefrontal cortex. Evaluations will take place at baseline, immediately following treatment, and at three and six months after the start of the therapy. The primary outcome measure is the change in Tinnitus Functional Index (TFI) score. Secondary outcome measures include audiological measurements, cortical auditory evoked potentials, the Repeatable Battery for the Assessment of Neuropsychological Status adjusted for hearing-impaired individuals (RBANS-H), and supplementary questionnaires probing tinnitus severity and additional symptoms. By use of a linear regression model, the effects of HD-tDCS compared to sham stimulation will be assessed. Discussion The objective of this study is to evaluate whether HD-tDCS can reduce the impact of tinnitus on daily life in chronic tinnitus patients. To date, published trials on the effects of HD-tDCS on tinnitus suffer from a lack of standardization and few randomized controlled trials exist. The proposed study will be the first adequately powered trial to investigate the effects of sequential dual-site HD-tDCS on tinnitus severity. Trial registration ClinicalTrials.gov, NCT03754127. Registered on 22 November 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3594-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- E Cardon
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.
| | - V Van Rompaey
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - L Jacquemin
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - G Mertens
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - H Vermeersch
- Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - I Joossen
- Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - J Beyers
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - O M Vanderveken
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - P Van de Heyning
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - V Topsakal
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| | - A Gilles
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, Campus Drie Eiken, Antwerp University, Antwerp, Belgium.,Department of Otorhinolaryngology - Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Department of Education, Health & Social Work, University College Ghent, Ghent, Belgium
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Davis SE, Smith GA. Transcranial Direct Current Stimulation Use in Warfighting: Benefits, Risks, and Future Prospects. Front Hum Neurosci 2019; 13:114. [PMID: 31105538 PMCID: PMC6499187 DOI: 10.3389/fnhum.2019.00114] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 03/14/2019] [Indexed: 12/26/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique which provides unique potential to directly improve human capability on a temporary, at needs, basis. The purpose of this paper is to consider the utility of tDCS through analysis of the potential risks and benefits in the context of defence service personnel. First, we look at the potential benefits, focusing primarily on warfighter survivability and enriching cognition quality in support of command and control. Second, we look at the potential detriments to tDCS military use, focusing on adverse effects, safety considerations, and risk. Third, we examine how the level of risk can be mitigated through military doctrine development focusing on safety parameters and exclusion criteria. Finally, we explore the future prospects of military tDCS use, particularly in terms of addressing gaps in the literature so that tDCS can be used ethically and efficaciously at the level of individual personnel.
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Affiliation(s)
- Steven E Davis
- Joint and Operational Analysis Division, Defence Science and Technology Group, Edinburgh, SA, Australia
| | - Glen A Smith
- Institute of Integrated and Intelligent Systems, Griffith University, Nathan, QLD, Australia
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Electrical stimulation induces neurite outgrowth in PC12m3 cells via the p38 mitogen-activated protein kinase pathway. Neurosci Lett 2019; 698:81-84. [DOI: 10.1016/j.neulet.2019.01.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 12/29/2018] [Accepted: 01/07/2019] [Indexed: 11/20/2022]
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Sivaramakrishnan A, Hombali AS, Shankar R, Fregni F, Thibaut A. Transcranial direct current stimulation (tDCS) for improving fatigue, motor function, and pain in people with multiple sclerosis. Hippokratia 2019. [DOI: 10.1002/14651858.cd013296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Anjali Sivaramakrishnan
- University of Illinois at Chicago; Graduate program in Rehabilitation Sciences; 1919 W. Taylor Street Chicago Illinois USA 60612
| | - Aditi S Hombali
- Institute of Mental Health; Department of Research; Block 7, Buangkok View, Buangkok Green Medical Park Singapore Singapore 539747
| | - Ravi Shankar
- Manipal University; Department of Statistics; Level 6, Health Sciences Library Building, Manipal University Udupi Karnataka India 576104
| | - Felipe Fregni
- Harvard Medical School; 79/96, 13th Street Charlestown Massachusetts USA 02129
| | - Aurore Thibaut
- Harvard Medical School; Department of Physical Medicine and Rehabilitation; 79/96, 13th Street Charlestown Massachusetts USA 02145
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Fuentes Calderón MA, Miralles AN, Pimienta MJ, Estella JMG, Ledesma MJS. Analysis of the Factors Related to the Effectiveness of Transcranial Current Stimulation in Upper Limb Motor Function Recovery after Stroke: a Systematic Review. J Med Syst 2019; 43:69. [PMID: 30737601 DOI: 10.1007/s10916-019-1193-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/30/2019] [Indexed: 02/08/2023]
Abstract
Transcranial direct current stimulation is one of the non-invasive techniques whose main mechanism of action is based on its modulation of cortical excitability. The objective of this study is to analyze the variables (i.e, demographics, clinicals, stimulation parameters) that could influence into the responses during rehabilitation of the upper extremity in patients with stroke. Our systematic review has been performed by searching full-text articles published from January 2008 to December 2018 in Embase, Medline, PubMed and Cochrane Library databases. Studies with adult patients with ischemic or hemorrhagic stroke at any stage of evolution were included. We compared interventions with any type of transcranial direct current stimulation (anodal, cathodal or bihemispheric, also known as dual) regarding improvement of upper extremity motor function. We included 14 studies with 368 patients, of whom almost 89% have ischemic etiology and more than half are males. Most patients were considered subacute or chronic, while only two studies were selected with patients in the acute phase. Different methods of using transcranial direct current stimulation with several complementary therapies were identified, such as virtual reality, robot therapy, Occupational Therapy, Physiotherapy, Constraint Induced Movement Therapy or Peripheral Nerve Stimulation. In conclusion, there is not significant evidence due to heterogeneity of clinical data and therapies. Clinical studies with greater number of participants and protocols standardized could outline this assessment in future studies.
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Affiliation(s)
| | | | - Mauricio Jaramillo Pimienta
- Departament of Neurosurgery, Universitary Hospital of Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - Jesús María Gonçalves Estella
- Departament of Neurosurgery, Universitary Hospital of Salamanca, Paseo de San Vicente, 58-182, 37007, Salamanca, Spain
| | - María José Sánchez Ledesma
- Departament of Surgery, University of Salamanca, Alfonso X el Sabio s/n, 37007, Salamanca, Spain.,VisualMed Systems Group, University of Salamanca, Patio Escuelas 1, 37008, Salamanca, Spain
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Kenney-Jung DL, Blacker CJ, Camsari DD, Lee JC, Lewis CP. Transcranial Direct Current Stimulation: Mechanisms and Psychiatric Applications. Child Adolesc Psychiatr Clin N Am 2019; 28:53-60. [PMID: 30389076 DOI: 10.1016/j.chc.2018.07.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Transcranial direct current stimulation (tDCS) involves the application of weak electric current to the scalp. tDCS may influence brain functioning through effects on cortical excitability, neural plasticity, and learning. Evidence in adults suggests promising therapeutic applications for depression, and the adverse effect profile is generally mild. Early research indicates complex interactions between tDCS and concurrent cognitive and motor tasks. Further investigation is warranted to understand how tDCS impacts processes relevant to psychiatric conditions.
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Affiliation(s)
- Daniel L Kenney-Jung
- Department of Neurology, University of Minnesota, 420 Delaware Street SE, MMC 295, Minneapolis, MN 55455, USA
| | - Caren J Blacker
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Deniz Doruk Camsari
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
| | - Jonathan C Lee
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, 1001 Queen Street W, Toronto, ON M6J 1H4, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, Toronto, ON M5T 1R8, Canada
| | - Charles P Lewis
- Department of Psychiatry and Psychology, Division of Child and Adolescent Psychiatry, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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Yuan T, Yadollahpour A, Salgado-Ramírez J, Robles-Camarillo D, Ortega-Palacios R. Transcranial direct current stimulation for the treatment of tinnitus: a review of clinical trials and mechanisms of action. BMC Neurosci 2018; 19:66. [PMID: 30359234 PMCID: PMC6202858 DOI: 10.1186/s12868-018-0467-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 10/23/2018] [Indexed: 12/27/2022] Open
Abstract
Background Tinnitus is the perception of sound in the absence of any external acoustic stimulation. Transcranial direct current stimulation (tDCS) has shown promising though heterogeneous therapeutic outcomes for tinnitus. The present study aims to review the recent advances in applications of tDCS for tinnitus treatment. In addition, the clinical efficacy and main mechanisms of action of tDCS on suppressing tinnitus are discussed. Methods The study was performed in accordance with the PRISMA guidelines. The databases of the PubMed (1980–2018), Embase (1980–2018), PsycINFO (1850–2018), CINAHL, Web of Science, BIOSIS Previews (1990–2018), Cambridge Scientific Abstracts (1990–2018), and google scholar (1980–2018) using the set search terms. The date of the most recent search was 20 May, 2018. The randomized controlled trials that have assessed at least one therapeutic outcome measured before and after tDCS intervention were included in the final analysis. Results Different tDCS protocols were used for tinnitus ranging single to repeated sessions (up to 10) consisting of daily single session of 15 to 20-min and current intensities ranging 1–2 mA. Dorsolateral prefrontal cortex (DLPFC) and auditory cortex are the main targets of stimulation. Both single and repeated sessions showed moderate to significant treatment effects on tinnitus symptoms. In addition to improvements in tinnitus symptoms, the tDCS interventions particularly bifrontal DLPFC showed beneficial outcomes on depression and anxiety comorbid with tinnitus. Heterogeneities in the type of tinnitus, tDCS devices, protocols, and site of stimulation made the systematic reviews of the literature difficult. However, the current evidence shows that tDCS can be developed as an adjunct or complementary treatment for intractable tinnitus. TDCS may be a safe and cost-effective treatment for tinnitus in the short-term application. Conclusions The current literature shows moderate to significant therapeutic efficacy of tDCS on tinnitus symptoms. Further randomized placebo-controlled double-blind trials with large sample sizes are needed to reach a definitive conclusion on the efficacy of tDCS for tinnitus. Future studies should further focus on developing efficient disease- and patient-specific protocols.
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Affiliation(s)
- Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Co-innovation Center of Neuroregeneration, Nantong University, Nantong, Jiangsu, China
| | - Ali Yadollahpour
- Department of Medical Physics, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Golestan Blvd, Ahvaz, 61357-33118, Iran.
| | - Julio Salgado-Ramírez
- Biomedical Engineering Department, Polytechnic University of Pachuca, Zempoala, Mexico
| | | | - Rocío Ortega-Palacios
- Biomedical Engineering Department, Polytechnic University of Pachuca, Zempoala, Mexico
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Anodal transcranial direct current stimulation prevents methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced neurotoxicity by modulating autophagy in an in vivo mouse model of Parkinson's disease. Sci Rep 2018; 8:15165. [PMID: 30310174 PMCID: PMC6181991 DOI: 10.1038/s41598-018-33515-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 09/28/2018] [Indexed: 12/22/2022] Open
Abstract
Parkinson's disease (PD) is a neurodegenerative disorder characterized by the accumulation of protein inclusions and the loss of dopaminergic neurons. Transcranial direct current stimulation (tDCS) is a non-invasive brain-stimulating technique that has demonstrated promising results in clinical studies of PD. Despite accumulating evidence indicating that tDCS exerts a protective effect, the mechanism underlying its activity remains unknown. In the present study, we first investigated the neuroprotective effect of tDCS in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced PD mouse model and then evaluated the effect of tDCS on the autophagy pathway. tDCS improved behavioral alterations, increased tyrosine hydroxylase protein levels and suppressed α-synuclein protein levels in MPTP-treated mice. MPTP-treated mice subjected to tDCS also had lower levels of autophagy-related proteins, such as microtubule-associated protein 1 light chain 3 and AMP-activated protein kinase, and higher levels of mechanistic target of rapamycin and p62. In addition, the protein levels of phosphoinositide 3-kinase and brain-derived neurotrophic factor were higher, and the levels of unc-51-like kinase 1 were lower in MPTP-treated mice subjected to tDCS. Our findings suggest that tDCS protected against MPTP-induced PD in a mouse model by modulating autophagy.
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