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Wüst LN, Antonenko D, Malinowski R, Khakimova L, Grittner U, Obermayer K, Ladenbauer J, Flöel A. Interrelations and functional roles of key oscillatory activities during daytime sleep in older adults. J Sleep Res 2024; 33:e13981. [PMID: 37488062 DOI: 10.1111/jsr.13981] [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: 09/16/2022] [Revised: 05/24/2023] [Accepted: 06/13/2023] [Indexed: 07/26/2023]
Abstract
Certain neurophysiological characteristics of sleep, in particular slow oscillations (SOs), sleep spindles, and their temporal coupling, have been well characterised and associated with human memory abilities. Delta waves, which are somewhat higher in frequency and lower in amplitude compared to SOs, and their interaction with spindles have only recently been found to play a critical role in memory processing of rodents, through a competitive interaction between SO-spindle and delta-spindle coupling. However, human studies that comprehensively address delta wave interactions with spindles and SOs, as well as their functional role for memory are still lacking. Electroencephalographic data were acquired across three naps of 33 healthy older human participants (17 female) to investigate delta-spindle coupling and the interplay between delta- and SO-related activity. Additionally, we determined intra-individual stability of coupling measures and their potential link to the ability to form novel memories in a verbal memory task. Our results revealed weaker delta-spindle compared to SO-spindle coupling. Contrary to our initial hypothesis, we found no evidence for an opposing dependency between SO- and delta-related activities during non-rapid eye movement sleep. Moreover, the ratio between SO- and delta-nested spindles rather than SO-spindle and delta-spindle coupling measures by themselves predicted the ability to form novel memories best. In conclusion, our results do not confirm previous findings in rodents on competitive interactions between delta activity and SO-spindle coupling in older adults. However, they support the hypothesis that SO, delta wave, and spindle activity should be jointly considered when aiming to link sleep physiology and memory formation.
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Affiliation(s)
- Larissa N Wüst
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland
- Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Robert Malinowski
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Liliia Khakimova
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin, Berlin, Germany
| | - Klaus Obermayer
- Fakultät IV and Bernstein Center for Computational Neuroscience, Technische Universität Berlin, Berlin, Germany
| | - Julia Ladenbauer
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Greifswald, Greifswald, Germany
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2
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Wang Y, Monai H. Transcranial direct current stimulation alters cerebrospinal fluid-interstitial fluid exchange in mouse brain. Brain Stimul 2024; 17:620-632. [PMID: 38688399 DOI: 10.1016/j.brs.2024.04.009] [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: 01/22/2024] [Revised: 03/28/2024] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has gained prominence recently. Clinical studies have explored tDCS as an adjunct to neurologic disease rehabilitation, with evidence suggesting its potential in modulating brain clearance mechanisms. The glymphatic system, a proposed brain waste clearance system, posits that cerebrospinal fluid-interstitial fluid (CSF-ISF) exchange aids in efficient metabolic waste removal. While some studies have linked tDCS to astrocytic inositol trisphosphate (IP3)/Ca2+ signaling, the impact of tDCS on CSF-ISF exchange dynamics remains unclear. HYPOTHESIS tDCS influences the dynamics of CSF-ISF exchange through astrocytic IP3/Ca2+ signaling. METHODS In this study, we administered tDCS (0.1 mA for 10 min) to C57BL/6N mice anesthetized with ketamine-xylazine (KX). The anode was positioned on the cranial bone above the cortex, and the cathode was inserted into the neck. Following tDCS, we directly assessed brain fluid dynamics by injecting biotinylated dextran amine (BDA) as a CSF tracer into the cisterna magna (CM). The brain was then extracted after either 30 or 60 min and fixed. After 24 h, the sectioned brain slices were stained with Alexa 594-conjugated streptavidin (SA) to visualize BDA using immunohistochemistry. We conducted Electroencephalography (EEG) recordings and aquaporin 4 (AQP4)/CD31 immunostaining to investigate the underlying mechanisms of tDCS. Additionally, we monitored the efflux of Evans blue, injected into the cisterna magna, using cervical lymph node imaging. Some experiments were subsequently repeated with inositol trisphosphate receptor type 2 (IP3R2) knockout (KO) mice. RESULTS Post-tDCS, we observed an increased CSF tracer influx, indicating a modulation of CSF-ISF exchange by tDCS. Additionally, tDCS appeared to enhance the brain's metabolic waste efflux. EEG recordings showed an increase in delta wave post-tDCS. But no significant change in AQP4 expression was detected 30 min post-tDCS. Besides, we found no alteration in CSF-ISF exchange and delta wave activity in IP3R2 KO mice after tDCS. CONCLUSION Our findings suggest that tDCS augments the glymphatic system's influx and efflux. Through astrocytic IP3/Ca2+ signaling, tDCS was found to modify the delta wave, which correlates positively with brain clearance. This study underscores the potential of tDCS in modulating brain metabolic waste clearance.
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Affiliation(s)
- Yan Wang
- Graduate School of Humanities and Sciences, Ochanomizu University, Ohtsuka, Bunkyo-ku, Tokyo, 112-8610, Japan
| | - Hiromu Monai
- Graduate School of Humanities and Sciences, Ochanomizu University, Ohtsuka, Bunkyo-ku, Tokyo, 112-8610, Japan.
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Park KS, Choi SH, Yoon H. Modulation of sleep using noninvasive stimulations during sleep. Biomed Eng Lett 2023; 13:329-341. [PMID: 37519871 PMCID: PMC10382438 DOI: 10.1007/s13534-023-00298-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/06/2023] [Accepted: 06/18/2023] [Indexed: 08/01/2023] Open
Abstract
Among the various sleep modulation methods for improving sleep, three methods using noninvasive stimulation during sleep have been reviewed and summarized. The first method involves noninvasive direct brain stimulation to induce a current directly in the brain cortex. Electrically or magnetically applied stimulations trigger electrical events such as slow oscillations or sleep spindles, which can also be recorded by an electroencephalogram. The second method involves sensory stimulation during sleep, which provides stimulation through the sensory pathway to invoke equivalent brain activity like direct brain stimulation. Olfactory, vestibular, and auditory stimulation methods have been used, resulting in several sleep-modulating effects, which are characteristic and depend on the experimental paradigm. The third method is to modulate sleep by shifting the autonomic balance affecting sleep homeostasis. To strengthen parasympathetic dominance, stimulation was applied to decrease heart rate by synchronizing the heart rhythm. These noninvasive stimulation methods can strengthen slow-wave sleep, consolidate declarative or procedural memory, and modify sleep macrostructure. These stimulation methods provide evidence and possibility for sleep modulation in our daily life as an alternative method for the treatment of disturbed sleep and enhancing sleep quality and performance beyond the average level.
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Affiliation(s)
- Kwang Suk Park
- Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, 03080 Korea
| | - Sang Ho Choi
- School of Computer and Information Engineering, Kwangwoon University, Seoul, 01897 Korea
| | - Heenam Yoon
- Department of Human-Centered Artificial Intelligence, Sangmyung University, Seoul, 03016 Korea
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4
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Demirlek C, Bora E. Sleep-dependent memory consolidation in schizophrenia: A systematic review and meta-analysis. Schizophr Res 2023; 254:146-154. [PMID: 36889181 DOI: 10.1016/j.schres.2023.02.028] [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: 05/16/2022] [Revised: 02/06/2023] [Accepted: 02/27/2023] [Indexed: 03/10/2023]
Abstract
Sleep disturbances and cognitive impairment are both persistent and common features of schizophrenia. Accumulating evidence indicates that sleep-dependent memory consolidation might be impaired in patients with schizophrenia compared to healthy controls. The current systematic review was performed in accordance with PRISMA guidelines. A random-effects model was used to calculate effect sizes (Hedge's g). In the quantitative review, three separate meta-analyses were conducted for procedural memory in healthy controls, schizophrenia, and comparison between healthy controls and schizophrenia. Additionally, separate meta-analyses were conducted for the studies using finger tapping motor sequence task, as it is the most commonly used task. The current systematic review included 14 studies including 304 patients with schizophrenia and 209 healthy controls. The random-effects model analyses for sleep-dependent procedural memory consolidation resulted in a small effect size in schizophrenia (g = 0.26), a large effect size in healthy controls (g = 0.98), a moderate effect size in healthy controls vs schizophrenia (g = 0.64). For the studies using finger tapping motor sequence task, meta-analyses resulted in a small effect size in schizophrenia (g = 0.19), a large effect size in healthy controls (g = 1.07), a moderate effect size in healthy controls vs schizophrenia (g = 0.70). In the qualitative review, there was also impaired sleep-dependent declarative memory consolidation in schizophrenia compared to healthy controls. Current findings support that sleep improves memory consolidation in healthy adults, but there is a deficit in sleep-dependent memory consolidation in people with schizophrenia. Future studies investigating sleep-dependent consolidation of different memory subtypes with polysomnography in different stages of psychotic disorders are needed.
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Affiliation(s)
- Cemal Demirlek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey.
| | - Emre Bora
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, Dokuz Eylul University Medical School, Izmir, Turkey; Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia
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5
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Multisession Anodal Transcranial Direct Current Stimulation Enhances Adult Hippocampal Neurogenesis and Context Discrimination in Mice. J Neurosci 2023; 43:635-646. [PMID: 36639896 PMCID: PMC9888513 DOI: 10.1523/jneurosci.1476-22.2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/27/2022] [Accepted: 12/04/2022] [Indexed: 12/14/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is a promising noninvasive neuromodulatory treatment option for multiple neurologic and psychiatric disorders, but its mechanism of action is still poorly understood. Adult hippocampal neurogenesis (AHN) continues throughout life and is crucial for preserving several aspects of hippocampal-dependent cognitive functions. Nevertheless, the contribution of AHN in the neuromodulatory effects of tDCS remains unexplored. Here, we sought to investigate whether multisession anodal tDCS may modulate AHN and its associated cognitive functions. Multisession anodal tDCS were applied on the skull over the hippocampus of adult male mice for 20 min at 0.25 mA once daily for 10 d totally. We found that multisession anodal tDCS enhances AHN by increasing the proliferation, differentiation and survival of neural stem/progenitor cells (NSPCs). In addition, tDCS treatment increased cell cycle reentry and reduced cell cycle exit of NSPCs. The tDCS-treated mice exhibited a reduced GABAergic inhibitory tone in the dentate gyrus compared with sham-treated mice. The effect of tDCS on the proliferation of NSPCs was blocked by pharmacological restoration of GABAB receptor-mediated inhibition. Functionally, multisession anodal tDCS enhances performance on a contextual fear discrimination task, and this enhancement was prevented by blocking AHN using the DNA alkylating agent temozolomide (TMZ). Our results emphasize an important role for AHN in mediating the beneficial effects of tDCS on cognitive functions that substantially broadens the mechanistic understanding of tDCS beyond its well-described in hippocampal synaptic plasticity.SIGNIFICANCE STATEMENT Transcranial direct current stimulation (tDCS) has been shown to effectively enhance cognitive functions in healthy and pathologic conditions. However, the mechanisms underlying its effects are largely unknown and need to be better understood to enable its optimal clinical use. This study shows that multisession anodal tDCS enhances adult hippocampal neurogenesis (AHN) and therefore contributes to enhance context discrimination in mice. Our results also show that the effect of tDCS on AHN is associated with reduced GABAergic inhibition in the dentate gyrus. Our study uncovers a novel mechanism of anodal tDCS to elicit cognitive-enhancing effects and may have the potential to improve cognitive decline associated with normal aging and neurodegenerative disorders.
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Abstract
Over the past few decades, the importance of sleep has become increasingly recognized for many physiologic functions, including cognition. Many studies have reported the deleterious effect of sleep loss or sleep disruption on cognitive performance. Beyond ensuring adequate sleep quality and duration, discovering methods to enhance sleep to augment its restorative effects is important to improve learning in many populations, such as the military, students, age-related cognitive decline, and cognitive disorders.
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Affiliation(s)
- Roneil G Malkani
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 525, Chicago, IL 60611, USA; Jesse Brown Veterans Affairs Medical Center, Chicago, IL 60612, USA.
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, 710 North Lake Shore Drive, Suite 520, Chicago, IL 60611, USA
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7
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Sahu M, Tripathi R, Jha NK, Jha SK, Ambasta RK, Kumar P. Cross talk mechanism of disturbed sleep patterns in neurological and psychological disorders. Neurosci Biobehav Rev 2022; 140:104767. [PMID: 35811007 DOI: 10.1016/j.neubiorev.2022.104767] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/25/2022]
Abstract
The incidence and prevalence of sleep disorders continue to increase in the elderly populace, particularly those suffering from neurodegenerative and neuropsychiatric disorders. This not only affects the quality of life but also accelerates the progression of the disease. There are many reasons behind sleep disturbances in such patients, for instance, medication use, nocturia, obesity, environmental factors, nocturnal motor disturbances and depressive symptoms. This review focuses on the mechanism and effects of sleep dysfunction in neurodegenerative and neuropsychiatric disorders. Wherein we discuss disturbed circadian rhythm, signaling cascade and regulation of genes during sleep deprivation. Moreover, we explain the perturbation in brainwaves during disturbed sleep and the ocular perspective of neurodegenerative and neuropsychiatric manifestations in sleep disorders. Further, as the pharmacological approach is often futile and carries side effects, therefore, the non-pharmacological approach opens newer possibilities to treat these disorders and widens the landscape of treatment options for patients.
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Affiliation(s)
- Mehar Sahu
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Rahul Tripathi
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET) Sharda University, UP, India.
| | - Rashmi K Ambasta
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India
| | - Pravir Kumar
- Molecular Neuroscience and Functional Genomics Laboratory, Delhi Technological University (Formerly Delhi College of Engineering), Delhi, India.
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8
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Weinhold SL, Lechinger J, Timm N, Hansen A, Ngo HVV, Göder R. Auditory stimulation in-phase with slow oscillations to enhance overnight memory consolidation in patients with schizophrenia? J Sleep Res 2022; 31:e13636. [PMID: 35686351 DOI: 10.1111/jsr.13636] [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: 09/25/2021] [Revised: 03/24/2022] [Accepted: 04/27/2022] [Indexed: 11/27/2022]
Abstract
Sleep-dependent memory consolidation is disturbed in patients with schizophrenia, who furthermore show reductions in sleep spindles and probably also in delta power during sleep. The memory dysfunction in these patients is one of the strongest markers for worse long-term functional outcome. However, therapeutic interventions to normalise memory functions, e.g., with medication, still do not exist. Against this backdrop, we investigated to what extent a non-invasive approach enhancing sleep with real-time auditory stimulation in-phase with slow oscillations might affect overnight memory consolidation in patients with schizophrenia. To this end, we examined 18 patients with stably medicated schizophrenia in a double-blinded sham-controlled design. Memory performance was assessed by a verbal (word list) and a non-verbal (complex figure) declarative memory task. In comparison to a sham condition without auditory stimuli, we found that in patients with schizophrenia, auditory stimulation evokes an electrophysiological response similar to that in healthy participants leading to an increase in slow wave and temporally coupled sleep spindle activity during stimulation. Despite this finding, patients did not show any beneficial effect on the overnight change in memory performance by stimulation. Although the stimulation in our study did not improve the patient's memory, the electrophysiological response gives hope that auditory stimulation could enable us to provide better treatment for sleep-related detriments in these patients in the future.
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Affiliation(s)
- Sara Lena Weinhold
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Julia Lechinger
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Nele Timm
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Anja Hansen
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy (ZIP), University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
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9
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Antal A, Luber B, Brem AK, Bikson M, Brunoni AR, Cohen Kadosh R, Dubljević V, Fecteau S, Ferreri F, Flöel A, Hallett M, Hamilton RH, Herrmann CS, Lavidor M, Loo C, Lustenberger C, Machado S, Miniussi C, Moliadze V, Nitsche MA, Rossi S, Rossini PM, Santarnecchi E, Seeck M, Thut G, Turi Z, Ugawa Y, Venkatasubramanian G, Wenderoth N, Wexler A, Ziemann U, Paulus W. Non-invasive brain stimulation and neuroenhancement. Clin Neurophysiol Pract 2022; 7:146-165. [PMID: 35734582 PMCID: PMC9207555 DOI: 10.1016/j.cnp.2022.05.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 04/19/2022] [Accepted: 05/18/2022] [Indexed: 12/15/2022] Open
Abstract
Attempts to enhance human memory and learning ability have a long tradition in science. This topic has recently gained substantial attention because of the increasing percentage of older individuals worldwide and the predicted rise of age-associated cognitive decline in brain functions. Transcranial brain stimulation methods, such as transcranial magnetic (TMS) and transcranial electric (tES) stimulation, have been extensively used in an effort to improve cognitive functions in humans. Here we summarize the available data on low-intensity tES for this purpose, in comparison to repetitive TMS and some pharmacological agents, such as caffeine and nicotine. There is no single area in the brain stimulation field in which only positive outcomes have been reported. For self-directed tES devices, how to restrict variability with regard to efficacy is an essential aspect of device design and function. As with any technique, reproducible outcomes depend on the equipment and how well this is matched to the experience and skill of the operator. For self-administered non-invasive brain stimulation, this requires device designs that rigorously incorporate human operator factors. The wide parameter space of non-invasive brain stimulation, including dose (e.g., duration, intensity (current density), number of repetitions), inclusion/exclusion (e.g., subject's age), and homeostatic effects, administration of tasks before and during stimulation, and, most importantly, placebo or nocebo effects, have to be taken into account. The outcomes of stimulation are expected to depend on these parameters and should be strictly controlled. The consensus among experts is that low-intensity tES is safe as long as tested and accepted protocols (including, for example, dose, inclusion/exclusion) are followed and devices are used which follow established engineering risk-management procedures. Devices and protocols that allow stimulation outside these parameters cannot claim to be "safe" where they are applying stimulation beyond that examined in published studies that also investigated potential side effects. Brain stimulation devices marketed for consumer use are distinct from medical devices because they do not make medical claims and are therefore not necessarily subject to the same level of regulation as medical devices (i.e., by government agencies tasked with regulating medical devices). Manufacturers must follow ethical and best practices in marketing tES stimulators, including not misleading users by referencing effects from human trials using devices and protocols not similar to theirs.
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Key Words
- AD, Alzheimer’s Disease
- BDNF, brain derived neurotrophic factor
- Cognitive enhancement
- DARPA, Defense Advanced Research Projects Agency
- DIY stimulation
- DIY, Do-It-Yourself
- DLPFC, dorsolateral prefrontal cortex
- EEG, electroencephalography
- EMG, electromyography
- FCC, Federal Communications Commission
- FDA, (U.S.) Food and Drug Administration
- Home-stimulation
- IFCN, International Federation of Clinical Neurophysiology
- LTD, long-term depression
- LTP, long-term potentiation
- MCI, mild cognitive impairment
- MDD, Medical Device Directive
- MDR, Medical Device Regulation
- MEP, motor evoked potential
- MRI, magnetic resonance imaging
- NIBS, noninvasive brain stimulation
- Neuroenhancement
- OTC, Over-The-Counter
- PAS, paired associative stimulation
- PET, positron emission tomography
- PPC, posterior parietal cortex
- QPS, quadripulse stimulation
- RMT, resting motor threshold
- SAE, serious adverse event
- SMA, supplementary motor cortex
- TBS, theta-burst stimulation
- TMS, transcranial magnetic stimulation
- Transcranial brain stimulation
- rTMS, repetitive transcranial magnetic stimulation
- tACS
- tACS, transcranial alternating current stimulation
- tDCS
- tDCS, transcranial direct current stimulation
- tES, transcranial electric stimulation
- tRNS, transcranial random noise stimulation
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Affiliation(s)
- Andrea Antal
- Department of Neurology, University Medical Center, Göttingen, Germany
| | - Bruce Luber
- Noninvasive Neuromodulation Unit, Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Anna-Katharine Brem
- University Hospital of Old Age Psychiatry, University of Bern, Bern, Switzerland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Marom Bikson
- Biomedical Engineering at the City College of New York (CCNY) of the City University of New York (CUNY), NY, USA
| | - Andre R. Brunoni
- Departamento de Clínica Médica e de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
- Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford GU2 7XH, UK
| | - Veljko Dubljević
- Science, Technology and Society Program, College of Humanities and Social Sciences, North Carolina State University, Raleigh, NC, USA
| | - Shirley Fecteau
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, CERVO Brain Research Centre, Centre intégré universitaire en santé et services sociaux de la Capitale-Nationale, Quebec City, Quebec, Canada
| | - Florinda Ferreri
- Unit of Neurology, Unit of Clinical Neurophysiology, Study Center of Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Padua, Italy
- Department of Clinical Neurophysiology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, 17475 Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, 17475 Greifswald, Germany
| | - Mark Hallett
- Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Roy H. Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Christoph S. Herrmann
- Experimental Psychology Lab, Department of Psychology, Carl von Ossietzky Universität, Oldenburg, Germany
| | - Michal Lavidor
- Department of Psychology and the Gonda Brain Research Center, Bar Ilan University, Israel
| | - Collen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales; The George Institute; Sydney, Australia
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
| | - Sergio Machado
- Department of Sports Methods and Techniques, Federal University of Santa Maria, Santa Maria, Brazil
- Laboratory of Physical Activity Neuroscience, Neurodiversity Institute, Queimados-RJ, Brazil
| | - Carlo Miniussi
- Center for Mind/Brain Sciences – CIMeC and Centre for Medical Sciences - CISMed, University of Trento, Rovereto, Italy
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Michael A Nitsche
- Department Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors at TU, Dortmund, Germany
- Dept. Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Simone Rossi
- Siena Brain Investigation and Neuromodulation Lab (Si-BIN Lab), Unit of Neurology and Clinical Neurophysiology, Department of Medicine, Surgery and Neuroscience, University of Siena, Italy
| | - Paolo M. Rossini
- Department of Neuroscience and Neurorehabilitation, Brain Connectivity Lab, IRCCS-San Raffaele-Pisana, Rome, Italy
| | - Emiliano Santarnecchi
- Precision Neuroscience and Neuromodulation Program, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Margitta Seeck
- Department of Clinical Neurosciences, Hôpitaux Universitaires de Genève, Switzerland
| | - Gregor Thut
- Centre for Cognitive Neuroimaging, School of Psychology and Neuroscience, EEG & Epolepsy Unit, University of Glasgow, United Kingdom
| | - Zsolt Turi
- Department of Neuroanatomy, Institute of Anatomy and Cell Biology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Yoshikazu Ugawa
- Department of Human Neurophysiology, Fukushima Medical University, Fukushima, Japan
| | | | - Nicole Wenderoth
- Neural Control of Movement Lab, Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence And Technological Enterprise (CREATE), Singapore
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ulf Ziemann
- Department of Neurology and Stroke, University of Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Germany
| | - Walter Paulus
- Department of of Neurology, Ludwig Maximilians University Munich, Germany
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10
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Munz M, Ahlich S, Nietzschmann A, Prehn-Kristensen A, Göder R. Improving recovery during sleep in depression: A pilot study with slow oscillating transcranial direct current stimulation. Psychiatry Res 2021; 301:113989. [PMID: 34022658 DOI: 10.1016/j.psychres.2021.113989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/03/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Manuel Munz
- Central Outpatient Department, Center for Integrative Psychiatry, School of Medicine, Christian Albrecht University Kiel, Germany.
| | - Sarah Ahlich
- Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian Albrecht University Kiel, Germany
| | - Anna Nietzschmann
- Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian Albrecht University Kiel, Germany
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian Albrecht University Kiel, Germany
| | - Robert Göder
- Department of Psychiatry and Psychotherapy, Center for Integrative Psychiatry, School of Medicine, Christian Albrecht University Kiel, Germany
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11
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Johnson BP, Cohen LG, Westlake KP. The Intersection of Offline Learning and Rehabilitation. Front Hum Neurosci 2021; 15:667574. [PMID: 33967725 PMCID: PMC8098688 DOI: 10.3389/fnhum.2021.667574] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 03/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Brian P Johnson
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, United States.,Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Kelly P Westlake
- Department of Physical Therapy and Rehabilitation Science, School of Medicine, University of Maryland, Baltimore, MD, United States
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12
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Cordone S, Scarpelli S, Alfonsi V, De Gennaro L, Gorgoni M. Sleep-Based Interventions in Alzheimer's Disease: Promising Approaches from Prevention to Treatment along the Disease Trajectory. Pharmaceuticals (Basel) 2021; 14:ph14040383. [PMID: 33921870 PMCID: PMC8073746 DOI: 10.3390/ph14040383] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
The multifactorial nature of Alzheimer’s disease (AD) has led scientific researchers to focus on the modifiable and treatable risk factors of AD. Sleep fits into this context, given the bidirectional relationship with AD confirmed by several studies over the last years. Sleep disorders appear at an early stage of AD and continue throughout the entire course of the pathology. Specifically, sleep abnormalities, such as more fragmented sleep, increase in time of awakenings, worsening of sleep quality and primary sleep disorders raise with the severity and progression of AD. Intervening on sleep, therefore, means acting both with prevention strategies in the pre-clinical phase and with treatments during the course of the disease. This review explores sleep disturbances in the different stages of AD, starting from the pre-clinical stage. Particular attention is given to the empirical evidence investigating obstructive sleep apnea (OSA) disorder and the mechanisms overlapping and sharing with AD. Next, we discuss sleep-based intervention strategies in the healthy elderly population, mild cognitive impairment (MCI) and AD patients. We mention interventions related to behavioral strategies, combination therapies, and bright light therapy, leaving extensive space for new and raising evidence on continuous positive air pressure (CPAP) treatment effectiveness. Finally, we clarify the role of NREM sleep across the AD trajectory and consider the most recent studies based on the promising results of NREM sleep enhancement, which use innovative experimental designs and techniques.
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Affiliation(s)
- Susanna Cordone
- UniCamillus, Saint Camillus International University of Health Sciences, 00131 Rome, Italy;
| | - Serena Scarpelli
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
| | | | - Luigi De Gennaro
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Correspondence:
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
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13
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Luckhardt C, Schütz M, Mühlherr A, Mössinger H, Boxhoorn S, Dempfle A, Salvador R, Ruffini G, Pereira HC, Castelo-Branco M, Latinus M, Bonnet-Brilhault F, Siemann J, Siniatchkin M, Ecker C, Freitag CM. Phase-IIa randomized, double-blind, sham-controlled, parallel group trial on anodal transcranial direct current stimulation (tDCS) over the left and right tempo-parietal junction in autism spectrum disorder-StimAT: study protocol for a clinical trial. Trials 2021; 22:248. [PMID: 33823927 PMCID: PMC8025356 DOI: 10.1186/s13063-021-05172-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 03/06/2021] [Indexed: 01/01/2023] Open
Abstract
Background Autism spectrum disorder (ASD) is characterized by impaired social communication and interaction, and stereotyped, repetitive behaviour and sensory interests. To date, there is no effective medication that can improve social communication and interaction in ASD, and effect sizes of behaviour-based psychotherapy remain in the low to medium range. Consequently, there is a clear need for new treatment options. ASD is associated with altered activation and connectivity patterns in brain areas which process social information. Transcranial direct current stimulation (tDCS) is a technique that applies a weak electrical current to the brain in order to modulate neural excitability and alter connectivity. Combined with specific cognitive tasks, it allows to facilitate and consolidate the respective training effects. Therefore, application of tDCS in brain areas relevant to social cognition in combination with a specific cognitive training is a promising treatment approach for ASD. Methods A phase-IIa pilot randomized, double-blind, sham-controlled, parallel-group clinical study is presented, which aims at investigating if 10 days of 20-min multi-channel tDCS stimulation of the bilateral tempo-parietal junction (TPJ) at 2.0 mA in combination with a computer-based cognitive training on perspective taking, intention and emotion understanding, can improve social cognitive abilities in children and adolescents with ASD. The main objectives are to describe the change in parent-rated social responsiveness from baseline (within 1 week before first stimulation) to post-intervention (within 7 days after last stimulation) and to monitor safety and tolerability of the intervention. Secondary objectives include the evaluation of change in parent-rated social responsiveness at follow-up (4 weeks after end of intervention), change in other ASD core symptoms and psychopathology, social cognitive abilities and neural functioning post-intervention and at follow-up in order to explore underlying neural and cognitive mechanisms. Discussion If shown, positive results regarding change in parent-rated social cognition and favourable safety and tolerability of the intervention will confirm tDCS as a promising treatment for ASD core-symptoms. This may be a first step in establishing a new and cost-efficient intervention for individuals with ASD. Trial registration The trial is registered with the German Clinical Trials Register (DRKS), DRKS00014732. Registered on 15 August 2018. Protocol version This study protocol refers to protocol version 1.2 from 24 May 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05172-1.
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Affiliation(s)
- Christina Luckhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany.
| | - Magdalena Schütz
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
| | - Andreas Mühlherr
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
| | - Hannah Mössinger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
| | - Sara Boxhoorn
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics (IMIS), Kiel University, Brunswiker Str. 10, 24105, Kiel, Germany
| | - Ricardo Salvador
- Neuroelectrics SLU, Av. Tibidabo 47 Bis, 08035, Barcelona, Spain
| | - Giulio Ruffini
- Neuroelectrics SLU, Av. Tibidabo 47 Bis, 08035, Barcelona, Spain
| | - Helena C Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Faculty of Medicine, Academic Clinical Centre, University of Coimbra (UC), Paco das Escolas, 3001 451, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), ICNAS, Faculty of Medicine, Academic Clinical Centre, University of Coimbra (UC), Paco das Escolas, 3001 451, Coimbra, Portugal
| | - Marianne Latinus
- UMR 1253, iBrain, Université de Tours, Inserm, Centre de Pédopsychiatrie, CHRU Bretonneau, 2 bd Tonnellé, 37044, Tours Cedex 9, France
| | - Frédérique Bonnet-Brilhault
- UMR 1253, iBrain, Université de Tours, Inserm, Centre de Pédopsychiatrie, CHRU Bretonneau, 2 bd Tonnellé, 37044, Tours Cedex 9, France.,Centre Hospitalier Universitaire de Tours (CHUT), Centre Universitaire de Pédopsychiatrie, UMR930 INSERM / Equipe autism, CHRU Tours / Hôpital Bretonneau, 2 Bd Tonnellé, 37044, Tours Cedex 9, France
| | - Julia Siemann
- Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, EvKB, Remterweg 13a, 33617, Bielefeld, Germany
| | - Michael Siniatchkin
- Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital Bethel, EvKB, Remterweg 13a, 33617, Bielefeld, Germany
| | - Christine Ecker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
| | - Christine M Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Deutschordenstr.50, 60528, Frankfurt, Germany
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14
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Orlov ND, Sanderson J, Muqtadir SA, Kalpakidou AK, Michalopoulou PG, Lu J, Shergill SS. The effect of training intensity on implicit learning rates in schizophrenia. Sci Rep 2021; 11:6511. [PMID: 33753755 PMCID: PMC7985318 DOI: 10.1038/s41598-021-85686-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 02/12/2021] [Indexed: 11/12/2022] Open
Abstract
Cognitive impairments in learning and memory are core symptoms of schizophrenia, associated with reduced self-reported quality of life. The most effective treatment of cognitive impairments is drill and practice cognitive training. Still, to date no study has investigated the effect of varying the frequency of training on cognitive outcomes. Here we utilized a verbal memory based language learning task, tapping into implicit cognitive processes, to investigate the role of training intensity on learning rates in individuals with schizophrenia. Data from 47 participants across two studies was utilized, one with a daily training regimen over 5 days and the other with a more intensive schedule of 5 sessions delivered over 2 days. The primary outcome measure was the change in implicit learning performance across five sessions, quantified with the Matthews Correlation Coefficient (MCC). Participants in the daily training group showed improved performance compared to the intensive group only at session 4. This is the first study to show that implicit learning rates are influenced by training intensity, with daily sessions outperforming a more intensive regimen; a period of consolidation overnight may be necessary to optimize cognitive training for individuals with schizophrenia.
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Affiliation(s)
- Natasza D Orlov
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.
- Harvard Medical School, Athinoula Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, USA.
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
- Precision Brain Imaging Lab, Department of Neuroscience, Medical University of South Carolina, Charleston, USA.
| | - Jessica Sanderson
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Syed Ali Muqtadir
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- Lahore University of Management Sciences, Lahore, Pakistan
| | - Anastasia K Kalpakidou
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- Marie Curie Palliative Care Research Department, University College London, London, UK
| | - Panayiota G Michalopoulou
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
| | - Sukhi S Shergill
- Cognition Imaging Schizophrenia Lab, Department of Psychosis Studies, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
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15
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Haller N, Hasan A, Padberg F, Strube W, da Costa Lane Valiengo L, Brunoni AR, Brunelin J, Palm U. [Transcranial electrical brain stimulation methods for treatment of negative symptoms in schizophrenia]. DER NERVENARZT 2021; 93:41-50. [PMID: 33492411 PMCID: PMC8763819 DOI: 10.1007/s00115-021-01065-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 11/24/2022]
Abstract
Über die letzten Jahre entwickelten sich Neuromodulationsverfahren zu einer dritten Säule neben Pharmakotherapie und Psychotherapie in der Behandlung psychischer Erkrankungen. Besonders in der Behandlung von Menschen mit einer Schizophrenie könnten Hirnstimulationsverfahren eine Alternative oder Ergänzung zu den etablierten Therapiestrategien darstellen. Die meist vorhandenen Positivsymptome können zumeist mit Antipsychotika adäquat behandelt werden. Gerade bei Patienten mit Schizophrenie besitzen jedoch Negativsymptome einen überdauernden Krankheitswert und beeinflussen den Verlauf durch globale Antriebsverarmung und beeinträchtigte Kognition im alltäglichen Leben negativ. Dieser Übersichtsartikel stellt eine Zusammenfassung über die verschiedenen nichtinvasiven Hirnstimulationsverfahren transkranielle Gleichstromstimulation (transcranial direct current stimulation, tDCS), Wechselstromstimulation (transcranial alternating current stimulation, tACS) sowie Rauschstromstimulation (transcranial random noise stimulation, tRNS) zur Behandlung der Negativsymptomatik bei Schizophrenie dar. Die neuen transkraniellen Hirnstimulationsverfahren könnten dabei helfen, gestörte neuronale Vernetzungen wieder herzustellen und die Konnektivität vor allem der dorsolateralen präfrontalen Anteile des Kortex zu verbessern. Einige Studien weisen auf eine Verbesserung der Negativsymptome durch Behandlung mit tDCS, tACS bzw. tRNS hin und könnten so neue Therapiemöglichkeiten in der Behandlung der Schizophrenie darstellen.
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Affiliation(s)
- Nikolas Haller
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Alkomiet Hasan
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland.,Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universität Augsburg, Medizinische Fakultät, BKH Augsburg, Augsburg, Deutschland
| | - Frank Padberg
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland
| | - Wolfgang Strube
- Klinik für Psychiatrie, Psychotherapie und Psychosomatik, Universität Augsburg, Medizinische Fakultät, BKH Augsburg, Augsburg, Deutschland
| | - Leandro da Costa Lane Valiengo
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasilien
| | - Andre R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brasilien
| | - Jerome Brunelin
- CH le Vinatier, INSERM U 1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en neuroscience de Lyon, Université de Lyon, Lyon, Frankreich
| | - Ulrich Palm
- Klinik für Psychiatrie und Psychotherapie, Klinikum der Universität München, München, Deutschland. .,Medical Park Chiemseeblick, Rasthausstr. 25, 83233, Bernau-Felden, Deutschland.
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16
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Fehér KD, Wunderlin M, Maier JG, Hertenstein E, Schneider CL, Mikutta C, Züst MA, Klöppel S, Nissen C. Shaping the slow waves of sleep: A systematic and integrative review of sleep slow wave modulation in humans using non-invasive brain stimulation. Sleep Med Rev 2021; 58:101438. [PMID: 33582581 DOI: 10.1016/j.smrv.2021.101438] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 10/14/2020] [Accepted: 11/10/2020] [Indexed: 01/19/2023]
Abstract
The experimental study of electroencephalographic slow wave sleep (SWS) stretches over more than half a century and has corroborated its importance for basic physiological processes, such as brain plasticity, metabolism and immune system functioning. Alterations of SWS in aging or pathological conditions suggest that modulating SWS might constitute a window for clinically relevant interventions. This work provides a systematic and integrative review of SWS modulation through non-invasive brain stimulation in humans. A literature search using PubMed, conducted in May 2020, identified 3220 studies, of which 82 fulfilled inclusion criteria. Three approaches have been adopted to modulate the macro- and microstructure of SWS, namely auditory, transcranial electrical and transcranial magnetic stimulation. Our current knowledge about the modulatory mechanisms, the space of stimulation parameters and the physiological and behavioral effects are reported and evaluated. The integration of findings suggests that sleep slow wave modulation bears the potential to promote our understanding of the functions of SWS and to develop new treatments for conditions of disrupted SWS.
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Affiliation(s)
- Kristoffer D Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Marina Wunderlin
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Jonathan G Maier
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Carlotta L Schneider
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christian Mikutta
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland; Privatklinik Meiringen, Meiringen, Switzerland
| | - Marc A Züst
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Switzerland.
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17
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Voysey ZJ, Barker RA, Lazar AS. The Treatment of Sleep Dysfunction in Neurodegenerative Disorders. Neurotherapeutics 2021; 18:202-216. [PMID: 33179197 PMCID: PMC8116411 DOI: 10.1007/s13311-020-00959-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 12/13/2022] Open
Abstract
Sleep dysfunction is highly prevalent across the spectrum of neurodegenerative conditions and is a key determinant of quality of life for both patients and their families. Mounting recent evidence also suggests that such dysfunction exacerbates cognitive and affective clinical features of neurodegeneration, as well as disease progression through acceleration of pathogenic processes. Effective assessment and treatment of sleep dysfunction in neurodegeneration is therefore of paramount importance; yet robust therapeutic guidelines are lacking, owing in part to a historical paucity of effective treatments and trials. Here, we review the common sleep abnormalities evident in neurodegenerative disease states and evaluate the latest evidence for traditional and emerging interventions, both pharmacological and nonpharmacological. Interventions considered include conservative measures, targeted treatments of specific clinical sleep pathologies, established sedating and alerting agents, melatonin, and orexin antagonists, as well as bright light therapy, behavioral measures, and slow-wave sleep augmentation techniques. We conclude by providing a suggested framework for treatment based on contemporary evidence and highlight areas that may emerge as major therapeutic advances in the near future.
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Affiliation(s)
- Zanna J Voysey
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair, University of Cambridge, Cambridge, CB2 0PY, UK
| | - Roger A Barker
- Department of Clinical Neurosciences, John van Geest Centre for Brain Repair and WT-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, CB2 0PY, UK
| | - Alpar S Lazar
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, NR4 7TJ, UK.
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18
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Azarpaikan A, Torbati HRT, Sohrabi M, Boostani R, Ghoshoni M. Timing-Dependent Priming Effects of Anodal tDCS on Two-Hand Coordination. J PSYCHOPHYSIOL 2020. [DOI: 10.1027/0269-8803/a000250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The aim of study was to investigate the interaction of time of applying anodal transcranial direct current stimulation (tDCS) with motor learning using a two-hand coordination (THC) task. Sixty-four healthy participants were tested under four stimulation conditions: anodal tDCS a head of the motor task, anodal tDCS during the motor task, anodal tDCS following the motor task, and sham tDCS. Transcranial direct current stimulation (tDCS) stimulation was applied on cerebellum by using a weak direct current (15 min) of 1.5 mA generated by a battery and regulated by the drive stimulator. The results show that on-line learning increased in the anodal tDCS-during group ( p = .039). The anodal tDCS-after group relied more on off-line learning ( p = .05). The during-tDCS and after-tDCS groups achieved greater improvements in speed/accuracy than the before-tDCS and sham-tDCS groups. The cerebellar tDCS may play a significant role to speed up motor skill acquisition and improve motor skill accuracy.
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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, Iran
| | - Majid Ghoshoni
- Department of Medicine Engineering, Faculty of Engineering, Azad University of Mashhad, Iran
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19
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Non-Invasive Brain Stimulation Does Not Improve Working Memory in Schizophrenia: A Meta-Analysis of Randomised Controlled Trials. Neuropsychol Rev 2020; 31:115-138. [PMID: 32918254 DOI: 10.1007/s11065-020-09454-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
Poor working memory functioning is commonly found in schizophrenia. A number of studies have now tested whether non-invasive brain stimulation can improve this aspect of cognitive functioning. This report used meta-analysis to synthesise the results of these studies to examine whether transcranial electrical stimulation (tES) or repetitive transcranial magnetic stimulation (rTMS) can improve working memory in schizophrenia. The studies included in this meta-analysis were sham-controlled, randomised controlled trials that utilised either tES or rTMS to treat working memory problems in schizophrenia. A total of 22 studies were included in the review. Nine studies administered rTMS and 13 administered tES. Meta-analysis revealed that compared to sham/placebo stimulation, neither TMS nor tES significantly improved working memory. This was found when working memory was measured with respect to the accuracy on working memory tasks (TMS studies: Hedges' g = 0.112, CI95: -0.082, 0.305, p = .257; tES studies Hedges' g = 0.080, CI95: -0.117, 0.277, p = .427) or the speed working memory tasks were completed (rTMS studies: Hedges' g = 0.233, CI95: -0.212, 0.678, p = .305; tES studies Hedges' g = -0.016, CI95: -0.204, 0.173, p = .871). For tES studies, meta-regression analysis found that studies with a larger number of stimulation sessions were associated with larger treatment effects. This association was not found for TMS studies. At present, rTMS and tES is not associated with a reliable improvement in working memory for individuals with schizophrenia.
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20
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Manoach DS, Mylonas D, Baxter B. Targeting sleep oscillations to improve memory in schizophrenia. Schizophr Res 2020; 221:63-70. [PMID: 32014359 PMCID: PMC7316628 DOI: 10.1016/j.schres.2020.01.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/06/2020] [Accepted: 01/09/2020] [Indexed: 12/26/2022]
Abstract
Although schizophrenia is defined by waking phenomena, a growing literature documents a deficit in sleep spindles, a defining oscillation of stage 2 non-rapid eye movement sleep. Compelling evidence supports an important role for spindles in cognition, and particularly memory. In schizophrenia, although the spindle deficit correlates with impaired sleep-dependent memory consolidation, recent clinical trials find that increasing spindles does not improve memory. This may reflect that sleep-dependent memory consolidation relies not on spindles alone, but also on their precise temporal coordination with cortical slow oscillations and hippocampal sharp-wave ripples. Consequently, interventions to improve memory in schizophrenia must not only increase spindles, but also preserve or enhance slow oscillations, hippocampal ripples and their temporal relations. Because hippocampal ripples and the activity of the thalamic spindle generator are difficult to measure noninvasively, screening potential interventions requires complementary animal and human studies. In this review we (i) propose that sleep oscillations are novel pathophysiological targets for therapy to improve cognition in schizophrenia; (ii) summarize our understanding of how these oscillations interact to consolidate memory; (iii) suggest that a systems neuroscience strategy is essential to selecting and evaluating effective treatments, and illustrate this with findings from clinical trials; and (iv) selectively review the interventional literature relevant to sleep and cognition, covering both pharmacological and noninvasive brain stimulation approaches. We conclude that coordinated sleep oscillations are promising targets for improving cognition in schizophrenia and that effective therapies will need to preserve or enhance sleep oscillatory dynamics and restore function at the network level.
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Affiliation(s)
- Dara S Manoach
- Department of Psychiatry Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA.
| | - Dimitrios Mylonas
- Department of Psychiatry Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Bryan Baxter
- Department of Psychiatry Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
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21
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Fröhlich F, Lustenberger C. Neuromodulation of sleep rhythms in schizophrenia: Towards the rational design of non-invasive brain stimulation. Schizophr Res 2020; 221:71-80. [PMID: 32354662 PMCID: PMC7316586 DOI: 10.1016/j.schres.2020.04.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/01/2020] [Accepted: 04/03/2020] [Indexed: 02/01/2023]
Abstract
Brain function critically depends on oscillatory synchronization of neuronal populations both during wake and sleep. Originally, neural oscillations have been discounted as an epiphenomenon. More recently, specific deficits in the structure of brain oscillations have been linked to psychiatric diseases. For example, schizophrenia is hallmarked by abnormalities in different brain oscillations. Key sleep rhythms during NEM sleep such as sleep spindles, which are implicated in memory consolidation and are related to cognitive functions, are strongly diminished in these patients compared to healthy controls. To date, it remains unclear whether these reductions in sleep oscillations are causal for the functional impairments observed in schizophrenia. The application of non-invasive brain stimulation permits the causal examination of brain network dynamics and will help to establish the causal association of sleep oscillations and symptoms of schizophrenia. To accomplish this, stimulation paradigms that selectively engage specific network targets such as sleep spindles or slow waves are needed. We propose that the successful development and application of these non-invasive brain stimulation approaches will require rational design that takes network dynamics and neuroanatomical information into account. The purpose of this article is to prepare the grounds for the next steps towards such rational design of non-invasive stimulation, with a special focus on electrical and auditory stimulation. First, we briefly summarize the deficits in network dynamics during sleep in schizophrenia. Then, we discuss today's and tomorrow's non-invasive brain stimulation modalities to engage these network targets.
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Affiliation(s)
- Flavio Fröhlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Caroline Lustenberger
- Neural Control of Movement Lab, Institute of Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland.
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Kostova R, Cecere R, Thut G, Uhlhaas PJ. Targeting cognition in schizophrenia through transcranial direct current stimulation: A systematic review and perspective. Schizophr Res 2020; 220:300-310. [PMID: 32204971 DOI: 10.1016/j.schres.2020.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 01/03/2023]
Abstract
Cognitive deficits are a fundamental feature of schizophrenia for which currently no effective treatments exist. This paper examines the possibility to use transcranial direct current stimulation (tDCS) to target cognitive deficits in schizophrenia as evidence from studies in healthy participants suggests that tDCS may improve cognitive functions and associated neural processes. We carried out a systematic review with the following search terms: 'tDCS', 'electric brain stimulation', 'schizophrenia', 'cognitive', 'cognition' until March 2019. 659 records were identified initially, 612 of which were excluded after abstract screening. The remaining 47 articles were assessed for eligibility based on our criteria and 26 studies were excluded. In addition, we compared several variables, such as online vs. offline-stimulation protocols, stimulation type and intensity on mediating positive vs. negative study outcomes. The majority of studies (n = 21) identified significant behavioural and neural effects on a range of cognitive functions (versus n = 11 with null results), including working memory, attention and social cognition. However, we could not identify tDCS parameters (electrode montage, stimulation protocol, type and intensity) that clearly mediated effects on cognitive deficits. There is preliminary evidence for the possibility that tDCS may improve cognitive deficits in schizophrenia. We discuss the rationale and strength of evidence for using tDCS for targeting cognitive deficits in schizophrenia as well as methodological issues and potential mechanisms of action.
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Affiliation(s)
- R Kostova
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - R Cecere
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - G Thut
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK; Department of Child and Adolescent Psychiatry, Charite Universitätsmedizin Berlin, Berlin, Germany.
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23
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Salfi F, D'Atri A, Tempesta D, De Gennaro L, Ferrara M. Boosting Slow Oscillations during Sleep to Improve Memory Function in Elderly People: A Review of the Literature. Brain Sci 2020; 10:E300. [PMID: 32429181 PMCID: PMC7287854 DOI: 10.3390/brainsci10050300] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 05/11/2020] [Accepted: 05/13/2020] [Indexed: 02/05/2023] Open
Abstract
Sleep represents a crucial time window for the consolidation of memory traces. In this view, some brain rhythms play a pivotal role, first of all the sleep slow waves. In particular, the neocortical slow oscillations (SOs), in coordination with the hippocampal ripples and the thalamocortical spindles, support the long-term storage of the declarative memories. The aging brain is characterized by a disruption of this complex system with outcomes on the related cognitive functions. In recent years, the advancement of the comprehension of the sleep-dependent memory consolidation mechanisms has encouraged the development of techniques of SO enhancement during sleep to induce cognitive benefits. In this review, we focused on the studies reporting on the application of acoustic or electric stimulation procedures in order to improve sleep-dependent memory consolidation in older subjects. Although the current literature is limited and presents inconsistencies, there is promising evidence supporting the perspective to non-invasively manipulate the sleeping brain electrophysiology to improve cognition in the elderly, also shedding light on the mechanisms underlying the sleep-memory relations during healthy and pathological aging.
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Affiliation(s)
- Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Aurora D'Atri
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy
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24
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Abstract
Given the critical role of sleep, particularly sleep slow oscillations, sleep spindles, and hippocampal sharp wave ripples, in memory consolidation, sleep enhancement represents a key opportunity to improve cognitive performance. Techniques such as transcranial electrical and magnetic stimulation and acoustic stimulation can enhance slow oscillations and sleep spindles and potentially improve memory. Targeted memory reactivation in sleep may enhance or stabilize memory consolidation. Each technique has technical considerations that may limit its broader clinical application. Therefore, neurostimulation to enhance sleep quality, in particular sleep slow oscillations, has the potential for improving sleep-related memory consolidation in healthy and clinical populations.
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Affiliation(s)
- Roneil G Malkani
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine. 710 North Lake Shore Drive, Suite 525, Chicago, IL 60611, USA.
| | - Phyllis C Zee
- Division of Sleep Medicine, Department of Neurology, Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine. 710 North Lake Shore Drive, Suite 520, Chicago, IL 60611, USA
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Feld GB, Born J. Neurochemical mechanisms for memory processing during sleep: basic findings in humans and neuropsychiatric implications. Neuropsychopharmacology 2020; 45:31-44. [PMID: 31443105 PMCID: PMC6879745 DOI: 10.1038/s41386-019-0490-9] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/17/2019] [Accepted: 07/22/2019] [Indexed: 12/14/2022]
Abstract
Sleep is essential for memory formation. Active systems consolidation maintains that memory traces that are initially stored in a transient store such as the hippocampus are gradually redistributed towards more permanent storage sites such as the cortex during sleep replay. The complementary synaptic homeostasis theory posits that weak memory traces are erased during sleep through a competitive down-selection mechanism, ensuring the brain's capability to learn new information. We discuss evidence from neuropharmacological experiments in humans to show how major neurotransmitters and neuromodulators are implicated in these memory processes. As to the major excitatory neurotransmitter glutamate that plays a prominent role in inducing synaptic consolidation, we show that these processes, while strengthening cortical memory traces during sleep, are insufficient to explain the consolidation of hippocampus-dependent declarative memories. In the inhibitory GABAergic system, we will offer insights how drugs may alter the intricate interplay of sleep oscillations that have been identified to be crucial for strengthening memories during sleep. Regarding the dopaminergic reward system, we will show how it is engaged during sleep replay, but that dopaminergic neuromodulation likely plays a side role for enhancing relevant memories during sleep. Also, we briefly go into basic evidence on acetylcholine and cortisol whose low tone during slow wave sleep (SWS) is crucial in supporting hippocampal-to-neocortical memory transmission. Finally, we will outline how these insights can be used to improve treatment of neuropsychiatric disorders focusing mainly on anxiety disorders, depression, and addiction that are strongly related to memory processing.
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Affiliation(s)
- Gordon B Feld
- Department of Clinical Psychology, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
- Department of Addiction Behavior and Addiction Medicine, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
- Centre for Integrative Neuroscience, University of Tübingen, Tübingen, Germany
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Noninvasive Brain Stimulation Enhances Memory Acquisition and Is Associated with Synaptoneurosome Modification in the Rat Hippocampus. eNeuro 2019; 6:ENEURO.0311-19.2019. [PMID: 31699891 PMCID: PMC6900464 DOI: 10.1523/eneuro.0311-19.2019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 10/15/2019] [Accepted: 10/31/2019] [Indexed: 01/11/2023] Open
Abstract
Transcranial direct-current stimulation (tDCS) is a non-invasive brain stimulation approach previously shown to enhance memory acquisition, but more studies are needed to elucidate the underlying mechanisms. Here, we examined the effects of anodal tDCS (0.25 mA for 30 min) on the memory performance of male Sprague Dawley rats in the passive avoidance test (PAT) and the associated modifications to the hippocampal proteomes. Results indicate anodal tDCS applied before the acquisition period significantly enhanced memory performance in the PAT. Following PAT, synaptoneurosomes were biochemically purified from the hippocampi of tDCS-treated or sham-treated rats and individual protein abundances were determined by bottom-up liquid chromatography mass spectrometry analysis. Proteomic analysis identified 184 differentially expressed hippocampal proteins when comparing the sham to the tDCS before memory acquisition treatment group. Ingenuity pathway analysis (IPA) showed anodal tDCS before memory acquisition significantly enhanced pathways associated with memory, cognition, learning, transmission, neuritogenesis, and long-term potentiation (LTP). IPA identified significant upstream regulators including bdnf, shank3, and gsk3b. Protein-protein interaction (PPI) and protein sequence similarity (PSS) networks show that glutamate receptor pathways, ion channel activity, memory, learning, cognition, and long-term memory were significantly associated with anodal tDCS. Centrality measures from both networks identified key proteins including dlg, shank, grin, and gria that were significantly modified by tDCS applied before the acquisition period. Together, our results provide descriptive molecular evidence that anodal tDCS enhances memory performance in the PAT by modifying hippocampal synaptic plasticity related proteins.
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27
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Bueno-Lopez A, Eggert T, Dorn H, Danker-Hopfe H. Slow oscillatory transcranial direct current stimulation (so-tDCS) during slow wave sleep has no effects on declarative memory in healthy young subjects. Brain Stimul 2019; 12:948-958. [DOI: 10.1016/j.brs.2019.02.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 02/13/2019] [Accepted: 02/15/2019] [Indexed: 12/14/2022] Open
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28
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Preobrazhenskaya IS, Fantalis D, Abdyshova SA, Kindarova AA. Non-drug therapies for cognitive impairment. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2019. [DOI: 10.14412/2074-2711-2019-3s-68-77] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The review considers basic methods for non-drug correction of cognitive disorders, as well as a combined approach, including the use of drugs and cognitive-motor training in the rehabilitation of patients with impaired cognitive functions. The authors present their own data on the efficiency of non-drug therapies in patients with Alzheimer’s disease.
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Affiliation(s)
- I. S. Preobrazhenskaya
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - D. Fantalis
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - S. A. Abdyshova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - A. A. Kindarova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
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29
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Cellini N, Shimizu RE, Connolly PM, Armstrong DM, Hernandez LT, Polakiewicz AG, Estrada R, Aguilar-Simon M, Weisend MP, Mednick SC, Simons SB. Short Duration Repetitive Transcranial Electrical Stimulation During Sleep Enhances Declarative Memory of Facts. Front Hum Neurosci 2019; 13:123. [PMID: 31031612 PMCID: PMC6474382 DOI: 10.3389/fnhum.2019.00123] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/22/2019] [Indexed: 11/13/2022] Open
Abstract
Transcranial electrical stimulation (tES) during sleep has been shown to successfully modulate memory consolidation. Here, we tested the effect of short duration repetitive tES (SDR-tES) during a daytime nap on the consolidation of declarative memory of facts in healthy individuals. We use a previously described approach to deliver the stimulation at regular intervals during non-rapid eye movement (NREM) sleep, specifically stage NREM2 and NREM3. Similar to previous studies using tES, we find enhanced memory performance compared to sham both after sleep and 48 h later. We also observed an increase in the proportion of time spent in NREM3 sleep and SDR-tES boosted the overall rate of slow oscillations (SOs) during NREM2/NREM3 sleep. Retrospective investigation of brain activity immediately preceding stimulation suggests that increases in the SO rate are more likely when stimulation is delivered during quiescent and asynchronous periods of activity in contrast to other closed-loop approaches which target phasic stimulation during ongoing SOs.
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Affiliation(s)
- Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy
- Department of Cognitive Science, University of California, Irvine, Irvine, CA, United States
| | | | | | | | - Lexus T. Hernandez
- Department of Cognitive Science, University of California, Irvine, Irvine, CA, United States
| | | | | | | | | | - Sara C. Mednick
- Department of Cognitive Science, University of California, Irvine, Irvine, CA, United States
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30
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Johnson BP, Shipper AG, Westlake KP. Systematic Review Investigating the Effects of Nonpharmacological Interventions During Sleep to Enhance Physical Rehabilitation Outcomes in People With Neurological Diagnoses. Neurorehabil Neural Repair 2019; 33:345-354. [PMID: 30938225 DOI: 10.1177/1545968319840288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Conduct a systematic review of nonpharmacological interventions applied during sleep to enhance physical rehabilitation outcomes of individuals with a neurological diagnosis. DATA SOURCES Three online databases were searched for original research. STUDY SELECTION Intervention studies were included that used outcome measures of impairment, activity, and/or participation. DATA EXTRACTION Two reviewers independently screened 2287 titles and abstracts, reviewed 101 full texts, extracted data, and assessed study quality and risk of bias for 9 included studies. DATA SYNTHESIS All included studies were randomized controlled trials involving continuous positive airway pressure (CPAP) with inpatient individuals with stroke and sleep apnea. Several studies also included long-term outpatient follow-ups. Results in terms of outcomes based on impairment, activity, and participation were mixed. However, several studies found that the use of CPAP following stroke and sleep apnea during early stroke recovery had benefits relative to no CPAP. CONCLUSIONS The only nonpharmacological intervention to be administered during sleep in a neurological population to improve physical rehabilitation outcomes was found to be CPAP. This review was complicated by the variety of outcome measures used, lack of physical rehabilitation description, and CPAP compliance. In general, participants who had acceptable to good CPAP compliance saw the largest improvements in physical rehabilitation outcomes. Several other promising methods of brain stimulation during sleep are discussed.
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Affiliation(s)
- Brian P Johnson
- 1 University of Maryland School of Medicine, Baltimore, MD, USA
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31
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Abstract
There is overwhelming evidence that sleep is crucial for memory consolidation. Patients with schizophrenia and their unaffected relatives have a specific deficit in sleep spindles, a defining oscillation of non-rapid eye movement (NREM) Stage 2 sleep that, in coordination with other NREM oscillations, mediate memory consolidation. In schizophrenia, the spindle deficit correlates with impaired sleep-dependent memory consolidation, positive symptoms, and abnormal thalamocortical connectivity. These relations point to dysfunction of the thalamic reticular nucleus (TRN), which generates spindles, gates the relay of sensory information to the cortex, and modulates thalamocortical communication. Genetic studies are beginning to provide clues to possible neurodevelopmental origins of TRN-mediated thalamocortical circuit dysfunction and to identify novel targets for treating the related memory deficits and symptoms. By forging empirical links in causal chains from risk genes to thalamocortical circuit dysfunction, spindle deficits, memory impairment, symptoms, and diagnosis, future research can advance our mechanistic understanding, treatment, and prevention of schizophrenia.
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Affiliation(s)
- Dara S Manoach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts 02114, USA; .,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, Massachusetts 02129, USA
| | - Robert Stickgold
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215;
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Cellini N, Mednick SC. Stimulating the sleeping brain: Current approaches to modulating memory-related sleep physiology. J Neurosci Methods 2018; 316:125-136. [PMID: 30452977 DOI: 10.1016/j.jneumeth.2018.11.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 10/25/2018] [Accepted: 11/14/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND One of the most audacious proposals throughout the history of psychology was the potential ability to learn while we sleep. The idea penetrated culture via sci-fi movies and inspired the invention of devices that claimed to teach foreign languages, facts, and even quit smoking by simply listening to audiocassettes or other devices during sleep. However, the promises from this endeavor didn't stand up to experimental scrutiny, and the dream was shunned from the scientific community. Despite the historic evidence that the sleeping brain cannot learn new complex information (i.e., words, images, facts), a new wave of current interventions are demonstrating that sleep can be manipulated to strengthen recent memories. NEW METHOD Several recent approaches have been developed that play with the sleeping brain in order to modify ongoing memory processing. Here, we provide an overview of the available techniques to non-invasively modulate memory-related sleep physiology, including sensory, vestibular and electrical stimulation, as well as pharmacological approaches. RESULTS N/A. COMPARISON WITH EXISTING METHODS N/A. CONCLUSIONS Although the results are encouraging, suggesting that in general the sleeping brain may be optimized for better memory performance, the road to bring these techniques in free-living conditions is paved with unanswered questions and technical challenges that need to be carefully addressed.
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Affiliation(s)
- Nicola Cellini
- Department of General Psychology, University of Padova, Padova, Italy.
| | - Sara C Mednick
- Department of Cognitive Sciences, University of California, Irvine, United States
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33
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Lindenmayer JP, Kulsa MKC, Sultana T, Kaur A, Yang R, Ljuri I, Parker B, Khan A. Transcranial direct-current stimulation in ultra-treatment-resistant schizophrenia. Brain Stimul 2018; 12:54-61. [PMID: 30316742 DOI: 10.1016/j.brs.2018.10.002] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 09/28/2018] [Accepted: 10/01/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Transcranial direct-current stimulation (tDCS), a non-invasive neurostimulation treatment, has been reported in a number of sham-controlled studies to show significant improvements in treatment-resistant auditory hallucinations in schizophrenia patients, primarily in ambulatory and higher-functioning patients, but little is known of the effects of tDCS on hospitalized, low-functioning inpatients. OBJECTIVE/HYPOTHESIS The purpose of this study was to examine the efficacy and safety of tDCS for auditory hallucinations in hospitalized ultra-treatment-resistant schizophrenia (TRS) and to evaluate the effects of tDCS on cognitive functions. We hypothesized that treatment non-response reported in previous tDCS studies may have been due to the insufficient duration of direct-current stimulation. METHODS Inpatient participants with DSM-V schizophrenia, long-standing treatment-resistance, and auditory verbal hallucinations (AVH) participated in this 4-week sham-controlled, randomized trial. Assessments included the Positive and Negative Syndrome Scale (PANSS) and MATRICS Consensus Cognitive Battery (MCCB) at baseline and endpoint (at the end of Week 4), and the Auditory Hallucinations Rating Scale (AHRS) administered at baseline, endpoint, and weekly throughout the study. Participants were randomized to receive active vs. sham tDCS treatments twice daily for 4 weeks. RESULTS Twenty-eight participants were enrolled (tDCS, n = 15; control, n = 13) and 21 participants completed all 4 weeks of the trial. Results showed a significant reduction for the auditory hallucination total score (p ≤ 0.05). We found a 21.9% decrease in AHRS Total Score for the tDCS group and a 12.6% decrease in AHRS Total Score for the control group. Significant reductions in frequency, number of voices over time, length of auditory hallucinations, and overall psychopathology were also observed for the tDCS group. When assessing cognitive functioning, only Working Memory showed improvement for the tDCS group. CONCLUSION Although there was only a small improvement noted in auditory hallucination scores for the tDCS group, this improvement was meaningful when compared to no standard treatment of the control group. While this makes the interpretation of clinical significance debatable, it does confirm that tDCS combined with pharmacological intervention can provide clinical gains over pharmacological intervention alone. Therefore, tDCS treatment appears to be effective not only for ambulatory, higher-functioning patients, but also for patients with ultra-treatment-resistant schizophrenia.
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Affiliation(s)
- J P Lindenmayer
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; New York University School of Medicine, 550 First Avenue, New York, NY, 10016, USA.
| | - Mila Kirstie C Kulsa
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; Teachers College Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
| | - Tania Sultana
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Amandeep Kaur
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Ran Yang
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; Teachers College Columbia University, 525 West 120th Street, New York, NY, 10027, USA.
| | - Isidora Ljuri
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Benedicto Parker
- Manhattan Psychiatric Center, 600 East 125th Street Wards Island, New York, NY, 10035, USA; Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA.
| | - Anzalee Khan
- Nathan S. Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY, 10962, USA; NeuroCog Trials, 3211 Shannon Road #300, Durham, NC, 27707, USA.
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Gupta T, Dean DJ, Kelley NJ, Bernard JA, Ristanovic I, Mittal VA. Cerebellar Transcranial Direct Current Stimulation Improves Procedural Learning in Nonclinical Psychosis: A Double-Blind Crossover Study. Schizophr Bull 2018; 44:1373-1380. [PMID: 29301026 PMCID: PMC6192475 DOI: 10.1093/schbul/sbx179] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The present double-blind crossover study examines the effects of cerebellar transcranial direct current stimulation (tDCS) in controls and in an analogue population to psychosis: individuals reporting elevated symptoms of nonclinical psychosis (NCP). A total of 18 controls and 24 NCP individuals were randomized into conditions consisting of 25 minutes of anodal (active) or sham cerebellar tDCS. Following this, both groups completed a pursuit rotor task designed to measure procedural learning performance. Participants then returned 1-week later and received the corresponding condition (either active or sham) and repeated the pursuit rotor task. Results indicate that in the sham condition, control participants showed significantly greater rates of motor learning when compared with the NCP group. In the active condition, the NCP group exhibited significant improvements in the rate of motor learning and performed at a level that was comparable to controls; these data support the link between cerebellar dysfunction and motor learning. Taken together, tDCS may be a promising treatment mechanism for patient populations and a useful experimental approach in elucidating our understanding of psychosis.
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Affiliation(s)
- Tina Gupta
- Department of Psychology, Northwestern University, Evanston, IL,To whom correspondence should be addressed; Department of Psychology, Northwestern University, 2029 Sheridan Road, Evanston, IL 60208, US; tel: 847-467-5907, fax: 847-467-5707, e-mail:
| | - Derek J Dean
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO,Center for Neuroscience, University of Colorado Boulder, Boulder, CO
| | | | - Jessica A Bernard
- Department of Psychology, Texas A&M University, College Station, TX,Institute for Neuroscience, Texas A&M University, College Station, TX
| | | | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL,Department of Psychiatry, Northwestern University, Evanston, ILs,Institute of Policy Research, Northwestern University, Evanston, IL,Department of Medical Social Sciences, Northwestern University, Evanston, IL,Institute for Innovations in Developmental Sciences, Northwestern University, Evanston, IL
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35
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Rodriguez-Ugarte M, Ianez E, Ortiz M, Azorin JM. Novel tDCS montage favors lower limb motor imagery detection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:2170-2173. [PMID: 30440834 DOI: 10.1109/embc.2018.8512656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This work studies a novel transcranial direct current stimulation (tDCS) montage to improve a brain-machine interface (BMI) lower limb motor imagery detection. The tDCS montage is composed by two anodes and one cathode. One anode is located over the motor cortex and the other one over the cerebellum. Ten healthy subjects participated in this experiment. They were randomly separated into two groups: sham, which received a fake stimulation, and active tDCS, which received a real stimulation. Each subject was experimented on five consecutive days. Results pointed out that there was a significant difference $(p < 0 .05)$ in the classification accuracy between the sham and the active tDCS group. On each of the five days of the experiment the active tDCS group achieved better accuracy results than the sham group: 4%, 10%, 10%, 9% and 7% higher respectively.
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Wilckens KA, Ferrarelli F, Walker MP, Buysse DJ. Slow-Wave Activity Enhancement to Improve Cognition. Trends Neurosci 2018; 41:470-482. [PMID: 29628198 PMCID: PMC6015540 DOI: 10.1016/j.tins.2018.03.003] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 02/26/2018] [Accepted: 03/05/2018] [Indexed: 02/07/2023]
Abstract
Slow-wave activity (SWA), and its coupling with other sleep features, reorganizes cortical circuitry, supporting cognition. This raises the question: can cognition be improved through SWA enhancement? SWA enhancement techniques range from behavioral interventions (such as exercise), which have high feasibility but low specificity, to laboratory-based techniques (such as transcranial stimulation), which have high specificity but are less feasible for widespread use. In this review we describe the pathways through which SWA is enhanced. Pathways encompass enhanced neural activity, increased energy metabolism, and endocrine signaling during wakefulness; also direct enhancement during sleep. We evaluate the robustness and practicality of SWA-enhancement techniques, discuss approaches for determining a causal role of SWA on cognition, and present questions to clarify the mechanisms of SWA-dependent cognitive improvements.
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Affiliation(s)
- Kristine A Wilckens
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA.
| | - Fabio Ferrarelli
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Matthew P Walker
- University of California, Berkeley, Department of Psychology, CA, USA
| | - Daniel J Buysse
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
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Johnson JM, Durrant SJ. The effect of cathodal transcranial direct current stimulation during rapid eye-movement sleep on neutral and emotional memory. ROYAL SOCIETY OPEN SCIENCE 2018; 5:172353. [PMID: 30109059 PMCID: PMC6083708 DOI: 10.1098/rsos.172353] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 06/13/2018] [Indexed: 06/08/2023]
Abstract
Sleep-dependent memory consolidation has been extensively studied. Neutral declarative memories and serial reaction time task (SRTT) performance can benefit from slow-wave activity, characterized by less than 1 Hz frequency cortical slow oscillations (SO). Emotional memories can benefit from theta activity, characterized by 4-8 Hz frequency cortical oscillations. Applying transcranial direct current stimulation (tDCS) during sleep entrains specific frequencies to alter sleep architecture. When applying cathodal tDCS (CtDCS), neural inhibition or excitation may depend on the waveform at the applied frequency. A double dissociation was predicted, with CtDCS at SO frequency improving neutral declarative memory and SRTT performance, and theta frequency CtDCS inhibiting negative emotional memory. Participants completed three CtDCS conditions (Theta: 5 Hz, SO: 0.75 Hz and control: sham) and completed an SRTT and word recognition task pre- and post-sleep, comprising emotional and neutral words to assess memory. In line with predictions, CtDCS improved neutral declarative memory when applied at SO frequency. When applied at theta frequency, no negative emotional word memory impairment was found but a positive association was found between post-stimulation theta power and emotional word recognition. SRTT performance was also not altered by either CtDCS frequency. Future studies should investigate overnight theta CtDCS and examine the effects of CtDCS during and after stimulation.
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Affiliation(s)
| | - Simon J. Durrant
- School of Psychology, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, UK
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Sheng J, Xie C, Fan DQ, Lei X, Yu J. High definition-transcranial direct current stimulation changes older adults' subjective sleep and corresponding resting-state functional connectivity. Int J Psychophysiol 2018; 129:1-8. [PMID: 29750977 DOI: 10.1016/j.ijpsycho.2018.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 05/03/2018] [Accepted: 05/07/2018] [Indexed: 12/18/2022]
Abstract
With advanced age, older adults show functional deterioration in sleep. Transcranial direct current stimulation (tDCS), a noninvasive brain stimulation, modulates individuals' behavioral performance in various cognitive domains. However, the modulation effect and neural mechanisms of tDCS on sleep, especially for the elderly population are not clear. Here, we aimed to investigate whether high-definition transcranial direct current stimulation (HD-tDCS) could modulate community-dwelling older adults' subjective sleep and whether these potential improvements are associated with the large-scale brain activity alterations recorded by functional magnetic resonance imaging. Thirty-one older adults were randomly allocated to the HD-tDCS group and the control group. HD-tDCS was applied for 25 min at 1.5 mA per day for two weeks. The anode electrode was placed over the left dorsolateral prefrontal cortex, surrounded by 4 cathodes at 7 cm radius. All participants completed sleep neuropsychological assessments and fMRI scans individually before and after intervention. Behaviorally, we observed a HD-tDCS-induced enhancement of older adults' sleep duration. On the aspect of the corresponding neural alterations, we observed that HD-tDCS decreased the functional connectivity between the default mode network (DMN) and subcortical network. More importantly, the decoupling connectivity of the DMN-subcortical network was correlated with the improvements of subjective sleep in the HD-tDCS group. Our findings add novel behavioral and neural evidences about tDCS-induced sleep improvement in community-dwelling older adults. With further development, tDCS may be used as an alternative treatment for sleep disorders and alleviate the dysfunction of brain networks induced by aging.
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Affiliation(s)
- Jing Sheng
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Chao Xie
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Dong-Qiong Fan
- Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Xu Lei
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Chongqing Collaborative Innovation Center for Brain Science, Chongqing 400715, China
| | - Jing Yu
- Faculty of Psychology, Southwest University, Chongqing 400715, China; Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing 100101, China; Chongqing Collaborative Innovation Center for Brain Science, Chongqing 400715, China.
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Koo PC, Mölle M, Marshall L. Efficacy of slow oscillatory‐transcranial direct current stimulation on
EEG
and memory – contribution of an inter‐individual factor. Eur J Neurosci 2018; 47:812-823. [DOI: 10.1111/ejn.13877] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 02/08/2018] [Accepted: 02/16/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Ping Chai Koo
- Institute of Experimental and Clinical Pharmacology and Toxicology University of Lübeck Ratzeburger Allee 160, Bldg 66 23562 Lübeck Germany
- Center of Brain, Behavior and Metabolism University of Lübeck Lübeck Germany
- Department of Psychiatry and Psychotherapy Rostock University Medical Centre Rostock Germany
| | - Matthias Mölle
- Center of Brain, Behavior and Metabolism University of Lübeck Lübeck Germany
| | - Lisa Marshall
- Institute of Experimental and Clinical Pharmacology and Toxicology University of Lübeck Ratzeburger Allee 160, Bldg 66 23562 Lübeck Germany
- Center of Brain, Behavior and Metabolism University of Lübeck Lübeck Germany
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Lunsford-Avery JR, Gonçalves BDSB, Brietzke E, Bressan RA, Gadelha A, Auerbach RP, Mittal VA. Adolescents at clinical-high risk for psychosis: Circadian rhythm disturbances predict worsened prognosis at 1-year follow-up. Schizophr Res 2017; 189:37-42. [PMID: 28169087 PMCID: PMC5544586 DOI: 10.1016/j.schres.2017.01.051] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/27/2017] [Accepted: 01/29/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Individuals with psychotic disorders experience disruptions to both the sleep and circadian components of the sleep/wake cycle. Recent evidence has supported a role of sleep disturbances in emerging psychosis. However, less is known about how circadian rhythm disruptions may relate to psychosis symptoms and prognosis for adolescents with clinical high-risk (CHR) syndromes. The present study examines circadian rest/activity rhythms in CHR and healthy control (HC) youth to clarify the relationships among circadian rhythm disturbance, psychosis symptoms, psychosocial functioning, and the longitudinal course of illness. METHODS Thirty-four CHR and 32 HC participants were administered a baseline evaluation, which included clinical interviews, 5days of actigraphy, and a sleep/activity diary. CHR (n=29) participants were re-administered clinical interviews at a 1-year follow-up assessment. RESULTS Relative to HC, CHR youth exhibited more fragmented circadian rhythms and later onset of nocturnal rest. Circadian disturbances (fragmented rhythms, low daily activity) were associated with increased psychotic symptom severity among CHR participants at baseline. Circadian disruptions (lower daily activity, rhythms that were more fragmented and/or desynchronized with the light/dark cycle) also predicted severity of psychosis symptoms and psychosocial impairment at 1-year follow-up among CHR youth. CONCLUSIONS Circadian rhythm disturbances may represent a potential vulnerability marker for emergence of psychosis, and thus, rest/activity rhythm stabilization has promise to inform early-identification and prevention/intervention strategies for CHR youth. Future studies with longer study designs are necessary to further examine circadian rhythms in the prodromal period and rates of conversion to psychosis among CHR teens.
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Affiliation(s)
- Jessica R Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| | | | - Elisa Brietzke
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo A Bressan
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Randy P Auerbach
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA; Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Vijay A Mittal
- Departments of Psychology, Psychiatry, and Medical Social Sciences and the Institute for Policy Research, Northwestern University, Evanston, IL, USA
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Demanuele C, Bartsch U, Baran B, Khan S, Vangel MG, Cox R, Hämäläinen M, Jones MW, Stickgold R, Manoach DS. Coordination of Slow Waves With Sleep Spindles Predicts Sleep-Dependent Memory Consolidation in Schizophrenia. Sleep 2017; 40:2739498. [PMID: 28364465 DOI: 10.1093/sleep/zsw013] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 01/21/2023] Open
Abstract
Study Objectives Schizophrenia patients have correlated deficits in sleep spindle density and sleep-dependent memory consolidation. In addition to spindle density, memory consolidation is thought to rely on the precise temporal coordination of spindles with slow waves (SWs). We investigated whether this coordination is intact in schizophrenia and its relation to motor procedural memory consolidation. Methods Twenty-one chronic medicated schizophrenia patients and 17 demographically matched healthy controls underwent two nights of polysomnography, with training on the finger tapping motor sequence task (MST) on the second night and testing the following morning. We detected SWs (0.5-4 Hz) and spindles during non-rapid eye movement (NREM) sleep. We measured SW-spindle phase-amplitude coupling and its relation with overnight improvement in MST performance. Results Patients did not differ from controls in the timing of SW-spindle coupling. In both the groups, spindles peaked during the SW upstate. For patients alone, the later in the SW upstate that spindles peaked and the more reliable this phase relationship, the greater the overnight MST improvement. Regression models that included both spindle density and SW-spindle coordination predicted overnight improvement significantly better than either parameter alone, suggesting that both contribute to memory consolidation. Conclusion Schizophrenia patients show intact spindle-SW temporal coordination, and these timing relationships, together with spindle density, predict sleep-dependent memory consolidation. These relations were seen only in patients suggesting that their memory is more dependent on optimal spindle-SW timing, possibly due to reduced spindle density. Interventions to improve memory may need to increase spindle density while preserving or enhancing the coordination of NREM oscillations.
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Affiliation(s)
- Charmaine Demanuele
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
| | - Ullrich Bartsch
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA.,School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
| | - Bengi Baran
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
| | - Sheraz Khan
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
| | - Mark G Vangel
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
| | - Roy Cox
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
| | - Matti Hämäläinen
- Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
| | - Matthew W Jones
- School of Physiology and Pharmacology, University of Bristol, Bristol, United Kingdom
| | - Robert Stickgold
- Harvard Medical School, Boston, MA.,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA
| | - Dara S Manoach
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA.,Athinoula A. Martinos Center for Biomedical Imaging, Charlestown, MA.,Harvard Medical School, Boston, MA
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42
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Wu YJ, Lin CC, Yeh CM, Chien ME, Tsao MC, Tseng P, Huang CW, Hsu KS. Repeated transcranial direct current stimulation improves cognitive dysfunction and synaptic plasticity deficit in the prefrontal cortex of streptozotocin-induced diabetic rats. Brain Stimul 2017; 10:1079-1087. [PMID: 28870510 DOI: 10.1016/j.brs.2017.08.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 07/22/2017] [Accepted: 08/22/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Cognitive dysfunction is commonly observed in diabetic patients. We have previously reported that anodal transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex can facilitate visuospatial working memory in diabetic patients with concomitant diabetic peripheral neuropathy and mild cognitive impairment, but the underlying mechanisms remain unclear. OBJECTIVE We investigated the cellular mechanisms underlying the effect of tDCS on cognitive decline in streptozotocin (STZ)-induced diabetic rats. METHODS STZ-induced diabetic rats were subjected to either repeated anodal tDCS or sham stimulation over the medial prefrontal cortex (mPFC). Spatial working memory performance in delayed nonmatch-to-place T maze task (DNMT), the induction of long-term potentiation (LTP) in the mPFC, and dendritic morphology of Golgi-stained pyramidal neurons in the mPFC were assessed. RESULTS Repeated applications of prefrontal anodal tDCS improved spatial working memory performance in DNMT and restored the impaired mPFC LTP of diabetic rats. The mPFC of tDCS-treated diabetic rats exhibited higher levels of brain-derived neurotrophic factor (BDNF) protein and N-Methyl-d-aspartate receptor (NMDAR) subunit mRNA and protein compared to sham stimulation group. Furthermore, anodal tDCS significantly increased dendritic spine density on the apical dendrites of mPFC layer V pyramidal cells in diabetic rats, whereas the complexity of basal and apical dendritic trees was unaltered. CONCLUSIONS Our findings suggest that repeated anodal tDCS may improve spatial working memory performance in streptozotocin-induced diabetic rats through augmentation of synaptic plasticity that requires BDNF secretion and transcription/translation of NMDARs in the mPFC, and support the therapeutic potential of tDCS for cognitive decline in diabetes mellitus patients.
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Affiliation(s)
- Yi-Jen Wu
- Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chou-Ching Lin
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Che-Ming Yeh
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Miao-Er Chien
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Chung Tsao
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Philip Tseng
- Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan; TMU Research Center for Brain and Consciousness, Taipei Medical University, Taipei, Taiwan; Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chin-Wei Huang
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kuei-Sen Hsu
- Department of Pharmacology, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Gould RW, Grannan MD, Gunter BW, Ball J, Bubser M, Bridges TM, Wess J, Wood MW, Brandon NJ, Duggan ME, Niswender CM, Lindsley CW, Conn PJ, Jones CK. Cognitive enhancement and antipsychotic-like activity following repeated dosing with the selective M 4 PAM VU0467154. Neuropharmacology 2017; 128:492-502. [PMID: 28729220 DOI: 10.1016/j.neuropharm.2017.07.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/06/2017] [Accepted: 07/14/2017] [Indexed: 01/22/2023]
Abstract
Although selective activation of the M1 muscarinic acetylcholine receptor (mAChR) subtype has been shown to improve cognitive function in animal models of neuropsychiatric disorders, recent evidence suggests that enhancing M4 mAChR function can also improve memory performance. Positive allosteric modulators (PAMs) targeting the M4 mAChR subtype have shown therapeutic potential for the treatment of multiple symptoms observed in schizophrenia, including positive and cognitive symptoms when assessed in acute preclinical dosing paradigms. Since the cholinergic system has been implicated in multiple stages of learning and memory, we evaluated the effects of repeated dosing with the highly selective M4 PAM VU0467154 on either acquisition and/or consolidation of learning and memory when dosed alone or after pharmacologic challenge with the N-methyl-d-aspartate subtype of glutamate receptors (NMDAR) antagonist MK-801. MK-801 challenge represents a well-documented preclinical model of NMDAR hypofunction that is thought to underlie some of the positive and cognitive symptoms observed in schizophrenia. In wildtype mice, 10-day, once-daily dosing of VU0467154 either prior to, or immediately after daily testing enhanced the rate of learning in a touchscreen visual pairwise discrimination task; these effects were absent in M4 mAChR knockout mice. Following a similar 10-day, once-daily dosing regimen of VU0467154, we also observed 1) improved acquisition of memory in a cue-mediated conditioned freezing paradigm, 2) attenuation of MK-801-induced disruptions in the acquisition of memory in a context-mediated conditioned freezing paradigm and 3) reversal of MK-801-induced hyperlocomotion. Comparable efficacy and plasma and brain concentrations of VU0467154 were observed after repeated dosing as those previously reported with an acute, single dose administration of this M4 PAM. Together, these studies are the first to demonstrate that cognitive enhancing and antipsychotic-like activity are not subject to the development of tolerance following repeated dosing with a selective M4 PAM in mice and further suggest that activation of M4 mAChRs may modulate both acquisition and consolidation of memory functions.
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Affiliation(s)
- Robert W Gould
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Michael D Grannan
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Barak W Gunter
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Jacob Ball
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA
| | - Michael Bubser
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Thomas M Bridges
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA
| | - Jurgen Wess
- Laboratory of Bioorganic Chemistry, NIDDK, National Institutes of Health, Bethesda, MD 20892, USA
| | - Michael W Wood
- AstraZeneca, Neuroscience, Innovative Medicines & Early Development, Waltham, MA 02451, USA
| | - Nicholas J Brandon
- AstraZeneca, Neuroscience, Innovative Medicines & Early Development, Waltham, MA 02451, USA
| | - Mark E Duggan
- AstraZeneca, Neuroscience, Innovative Medicines & Early Development, Waltham, MA 02451, USA
| | - Colleen M Niswender
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Kennedy Center, Nashville, TN 37232, USA
| | - Craig W Lindsley
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA; Department of Chemistry, Vanderbilt University, Nashville, TN 37232, USA
| | - P Jeffrey Conn
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Kennedy Center, Nashville, TN 37232, USA
| | - Carrie K Jones
- Department of Pharmacology, Vanderbilt University, Nashville, TN 37232, USA; Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, TN 37232, USA.
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45
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Wilhelm I, Groch S, Preiss A, Walitza S, Huber R. Widespread reduction in sleep spindle activity in socially anxious children and adolescents. J Psychiatr Res 2017; 88:47-55. [PMID: 28086128 DOI: 10.1016/j.jpsychires.2016.12.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 12/21/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022]
Abstract
Social anxiety disorder (SAD) is one of the most prevalent psychiatric diseases typically emerging during childhood and adolescence. Biological vulnerabilities such as a protracted maturation of prefrontal cortex functioning together with heightened reactivity of the limbic system leading to increased emotional reactivity are discussed as factors contributing to the emergence and maintenance of SAD. Sleep slow wave activity (SWA, 0.75-4.5 Hz) and sleep spindle activity (9-16 Hz) reflect processes of brain maturation and emotion regulation. We used high-density electroencephalography to characterize sleep SWA and spindle activity and their relationship to emotional reactivity in children and adolescents suffering from SAD and healthy controls (HC). Subjectively rated arousal was assessed using an emotional picture-word association task. SWA did not differ between socially anxious and healthy participants. We found a widespread reduction in fast spindle activity (13-16 Hz) in SAD patients compared to HC. SAD patients rated negative stimuli to be more arousing and these arousal ratings were negatively correlated with fast spindle activity. These results suggest electrophysiological alterations that are evident at an early stage of psychopathology and that are closely linked to one core symptom of anxiety disorders such as increased emotional reactivity. The role of disturbed GABAergic neurotransmission is discussed as an underlying factor.
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Affiliation(s)
- Ines Wilhelm
- University Children's Hospital Zürich, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zürich, Switzerland; Department of Experimental Psychopathology and Psychotherapy, University of Zürich, Switzerland
| | - Sabine Groch
- University Children's Hospital Zürich, Switzerland
| | - Andrea Preiss
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Switzerland
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Switzerland
| | - Reto Huber
- University Children's Hospital Zürich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Switzerland.
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Mervis JE, Capizzi RJ, Boroda E, MacDonald AW. Transcranial Direct Current Stimulation over the Dorsolateral Prefrontal Cortex in Schizophrenia: A Quantitative Review of Cognitive Outcomes. Front Hum Neurosci 2017; 11:44. [PMID: 28210217 PMCID: PMC5288642 DOI: 10.3389/fnhum.2017.00044] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 01/20/2017] [Indexed: 11/13/2022] Open
Abstract
Cognitive deficits are a core and disabling feature of psychotic disorders, specifically schizophrenia. Current treatments for impaired cognition in schizophrenia remain insufficient. Recent research suggests transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex can potentiate cognitive improvements in healthy individuals and those with psychiatric conditions, such as schizophrenia. However, this burgeoning literature has not been quantitatively evaluated. Through a literature search and quantitative review, we identified 194 papers on tDCS, psychosis, and cognition. Selection criteria included pre/post design and sham control to achieve specific sham-adjusted effect sizes. The 6 retained studies all address schizophrenia populations and include single and repeated stimulation, as well as within and between subject designs. Small positive effects were found for anodal stimulation on behavioral measures of attention and working memory, with tentative findings for cognitive ability and memory. Cathodal stimulation yielded a small positive effect on behaviorally measured cognitive ability. Neurophysiological measures of attention showed a small to medium down-modulation effect for anodal stimulation. Implications of these findings and guidelines for future research are discussed. As revealed by this report, due to the paucity of data available, much remains unknown regarding the clinical efficacy of tDCS in schizophrenia.
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Affiliation(s)
- Joshua E Mervis
- Department of Psychology, University of Minnesota Minneapolis, MN, USA
| | - Riley J Capizzi
- Department of Psychology, University of Minnesota Minneapolis, MN, USA
| | - Elias Boroda
- Department of Neuroscience, University of Minnesota Minneapolis, MN, USA
| | - Angus W MacDonald
- Department of Psychology, University of MinnesotaMinneapolis, MN, USA; Department of Psychiatry, University of Minnesota Medical SchoolMinneapolis, MN, USA
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47
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Reduced sleep spindle activity point to a TRN-MD thalamus-PFC circuit dysfunction in schizophrenia. Schizophr Res 2017; 180:36-43. [PMID: 27269670 PMCID: PMC5423439 DOI: 10.1016/j.schres.2016.05.023] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 11/23/2022]
Abstract
Sleep disturbances have been reliably reported in patients with schizophrenia, thus suggesting that abnormal sleep may represent a core feature of this disorder. Traditional electroencephalographic studies investigating sleep architecture have found reduced deep non-rapid eye movement (NREM) sleep, or slow wave sleep (SWS), and increased REM density. However, these findings have been inconsistently observed, and have not survived meta-analysis. By contrast, several recent EEG studies exploring brain activity during sleep have established marked deficits in sleep spindles in schizophrenia, including first-episode and early-onset patients, compared to both healthy and psychiatric comparison subjects. Spindles are waxing and waning, 12-16Hz NREM sleep oscillations that are generated within the thalamus by the thalamic reticular nucleus (TRN), and are then synchronized and sustained in the cortex. While the functional role of sleep spindles still needs to be fully established, increasing evidence has shown that sleep spindles are implicated in learning and memory, including sleep dependent memory consolidation, and spindle parameters have been associated to general cognitive ability and IQ. In this article we will review the EEG studies demonstrating sleep spindle deficits in patients with schizophrenia, and show that spindle deficits can predict their reduced cognitive performance. We will then present data indicating that spindle impairments point to a TRN-MD thalamus-prefrontal cortex circuit deficit, and discuss about the possible molecular mechanisms underlying thalamo-cortical sleep spindle abnormalities in schizophrenia.
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Sleep-Related Interventions to Improve Psychotherapy. COGNITIVE NEUROSCIENCE OF MEMORY CONSOLIDATION 2017. [DOI: 10.1007/978-3-319-45066-7_23] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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Manoach DS, Pan JQ, Purcell SM, Stickgold R. Reduced Sleep Spindles in Schizophrenia: A Treatable Endophenotype That Links Risk Genes to Impaired Cognition? Biol Psychiatry 2016; 80:599-608. [PMID: 26602589 PMCID: PMC4833702 DOI: 10.1016/j.biopsych.2015.10.003] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/18/2015] [Accepted: 10/05/2015] [Indexed: 11/26/2022]
Abstract
Although schizophrenia (SZ) is defined by waking phenomena, abnormal sleep is a common feature. In particular, there is accumulating evidence of a sleep spindle deficit. Sleep spindles, a defining thalamocortical oscillation of non-rapid eye movement stage 2 sleep, correlate with IQ and are thought to promote long-term potentiation and enhance memory consolidation. We review evidence that reduced spindle activity in SZ is an endophenotype that impairs sleep-dependent memory consolidation, contributes to symptoms, and is a novel treatment biomarker. Studies showing that spindles can be pharmacologically enhanced in SZ and that increasing spindles improves memory in healthy individuals suggest that treating spindle deficits in patients with SZ may improve cognition. Spindle activity is highly heritable, and recent large-scale genome-wide association studies have identified SZ risk genes that may contribute to spindle deficits and illuminate their mechanisms. For example, the SZ risk gene CACNA1I encodes a calcium channel that is abundantly expressed in the thalamic spindle generator and plays a critical role in spindle activity based on a mouse knockout. Future genetic studies of animals and humans can delineate the role of this and other genes in spindles. Such cross-disciplinary research, by forging empirical links in causal chains from risk genes to proteins and cellular functions to endophenotypes, cognitive impairments, symptoms, and diagnosis, has the potential to advance the mechanistic understanding, treatment, and prevention of SZ. This review highlights the importance of deficient sleep-dependent memory consolidation among the cognitive deficits of SZ and implicates reduced sleep spindles as a potentially treatable mechanism.
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Affiliation(s)
- Dara S. Manoach
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA,Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129, USA,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Jen Q. Pan
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA
| | - Shaun M. Purcell
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02215, USA,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA,Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Robert Stickgold
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts 02142, USA,Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA 02215 Harvard Medical School, Boston, MA, 02215
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