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Zhang N, Nitsche MA, Miao Y, Xiong Z, Vicario CM, Qi F. Transcranial Direct-Current Stimulation Over the Primary Motor Cortex and Cerebellum Improves Balance and Shooting Accuracy in Elite Ice Hockey Players. Int J Sports Physiol Perform 2024; 19:1107-1114. [PMID: 39179224 DOI: 10.1123/ijspp.2024-0041] [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: 02/01/2024] [Revised: 05/25/2024] [Accepted: 06/05/2024] [Indexed: 08/26/2024]
Abstract
PURPOSE To investigate the effects of transcranial direct-current stimulation (tDCS) applied over the primary motor cortex (M1) and cerebellum on balance control and shooting accuracy in elite ice hockey players. METHODS Twenty-one elite ice hockey players underwent anodal tDCS over the M1 (a-tDCSM1), anodal tDCS over the cerebellum (a-tDCSCB), concurrent dual-site anodal tDCS over the M1 and the cerebellum (a-tDCSM1+CB), and sham stimulation (tDCSSHAM). Before and after receiving tDCS (2 mA for 15 min), participants completed an ice hockey shooting-accuracy test, Pro-Kin balance test (includes stance test and proprioceptive assessment), and Y-balance test in randomized order. RESULTS For static balance performance, the ellipse area in the 2-legged stance with eyes open and the 1-legged stance with the dominant leg significantly improved following a-tDCSM1, a-tDCSCB, and concurrent dual-site a-tDCSM1+CB, compared with tDCSSHAM (all P < .05, Cohen d = 0.64-1.06). In dynamic balance performance, the average trace error of the proprioceptive assessment and the composite score of the Y-balance test with the dominant leg significantly improved following a-tDCSM1 and concurrent dual-site a-tDCSM1+CB (all P < .05, Cohen d = 0.77-1.00). For the ice hockey shooting-accuracy test, shooting-accuracy while standing on the unstable platform significantly increased following a-tDCSM1 (P = .010, Cohen d = 0.81) and a-tDCSCB (P = .010, Cohen d = 0.92) compared with tDCSSHAM. CONCLUSION tDCS could potentially be a valuable tool in enhancing static and dynamic balance and shooting accuracy on unstable platforms in elite ice hockey players.
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Affiliation(s)
- Na Zhang
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, Bielefeld, Germany
| | - Yu Miao
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
| | - Zheng Xiong
- China Ice Sports College, Beijing Sport University, Beijing, BJ, China
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Fengxue Qi
- Sports Coaching College, Beijing Sport University, Beijing, BJ, China
- Sports, Exercise and Brain Sciences Laboratory, Beijing Sport University, Beijing, BJ, China
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Claaß LV, Hedrich A, Reinelt J, Sehm B, Villringer A, Schlagenhauf F, Kaminski J. Influence of noninvasive brain stimulation on connectivity and local activation: a combined tDCS and fMRI study. Eur Arch Psychiatry Clin Neurosci 2024; 274:827-835. [PMID: 37597023 PMCID: PMC11127864 DOI: 10.1007/s00406-023-01666-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 07/31/2023] [Indexed: 08/21/2023]
Abstract
The effect of transcranial direct current stimulation (tDCS) on neurobiological mechanisms underlying executive function in the human brain remains elusive. This study aims at examining the effect of anodal and cathodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) in comparison with sham stimulation on resting-state connectivity as well as functional activation and working memory performance. We hypothesized perturbed fronto-parietal resting-state connectivity during stimulation and altered working memory performance combined with modified functional working memory-related activation. We applied tDCS with 1 mA for 21 min over the DLPFC inside an fMRI scanner. During stimulation, resting-state fMRI was acquired and task-dependent fMRI during working memory task performance was acquired directly after stimulation. N = 36 healthy subjects were studied in a within-subject design with three different experimental conditions (anodal, cathodal and sham) in a double-blind design. Seed-based functional connectivity analyses and dynamic causal modeling were conducted for the resting-state fMRI data. We found a significant stimulation by region interaction in the seed-based ROI-to-ROI resting-state connectivity, but no effect on effective connectivity. We also did not find an effect of stimulation on task-dependent signal alterations in working memory activation in our regions of interest and no effect on working memory performance parameters. We found effects on measures of seed-based resting-state connectivity, while measures of effective connectivity and task-based connectivity did not show any stimulation effect. We could not replicate previous findings of tDCS stimulation effects on behavioral outcomes. We critically discuss possible methodological limitations and implications for future studies.
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Affiliation(s)
- Luise Victoria Claaß
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Annika Hedrich
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Janis Reinelt
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Day Clinic for Cognitive Neurology, University Hospital at the University of Leipzig, Liebigstraße 16, 04103, Leipzig, Germany
- Berlin School of Mind and Brain, MindBrainBody Institute, Humboldt-Universität zu Berlin, Unter den Linden 6, 10999, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Jakob Kaminski
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany.
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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Willmot N, Leow LA, Filmer HL, Dux PE. Exploring the intra-individual reliability of tDCS: A registered report. Cortex 2024; 173:61-79. [PMID: 38382128 DOI: 10.1016/j.cortex.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 02/23/2024]
Abstract
Transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has become an important tool for the study of in-vivo brain function due to its modulatory effects. Over the past two decades, interest in the influence of tDCS on behaviour has increased markedly, resulting in a large body of literature spanning multiple domains. However, the effect of tDCS on human performance often varies, bringing into question the reliability of this approach. While reviews and meta-analyses highlight the contributions of methodological inconsistencies and individual differences, no published studies have directly tested the intra-individual reliability of tDCS effects on behaviour. Here, we conducted a large scale, double-blinded, sham-controlled registered report to assess the reliability of two single-session low-dose tDCS montages, previously found to impact response selection and motor learning operations, across two separate time periods. Our planned analysis found no evidence for either protocol being effective nor reliable. Post-hoc explorative analyses found evidence that tDCS influenced motor learning, but not response selection learning. In addition, the reliability of motor learning performance across trials was shown to be disrupted by tDCS. These findings are amongst the first to shed light specifically on the intra-individual reliability of tDCS effects on behaviour and provide valuable information to the field.
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Affiliation(s)
- Nicholas Willmot
- Department of Defence, Edinburgh, SA, Australia; School of Psychology, The University of Queensland, St Lucia, QLD, Australia.
| | - Li-Ann Leow
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Hannah L Filmer
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
| | - Paul E Dux
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia
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Klírová M, Adamová A, Biačková N, Laskov O, Renková V, Stuchlíková Z, Odnohová K, Novák T. Transcranial direct current stimulation (tDCS) in the treatment of neuropsychiatric symptoms of long COVID. Sci Rep 2024; 14:2193. [PMID: 38272997 PMCID: PMC10810850 DOI: 10.1038/s41598-024-52763-4] [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: 10/09/2023] [Accepted: 01/23/2024] [Indexed: 01/27/2024] Open
Abstract
The study aimed to assess the efficacy of transcranial direct current stimulation (tDCS) in the treatment of neuropsychiatric (NP) symptoms of the post-acute sequelae of SARS-CoV-2 infection (PASC), known as the long COVID. A double-blind, randomized, sham-controlled study compared the efficacy and safety of prefrontal cortex active tDCS to sham-tDCS in treating NP-PASC. Patients diagnosed with NP-PASC, with a Fatigue Impact Scale (FIS) score ≥ 40, were eligible for the study. Twenty tDCS sessions were administered within four weeks, with continuous, end-of-treatment, and follow-up measurements. The primary outcome was a change in the FIS at the end-of-treatment, analyzed in the intention-to-treat population. Data from 33 patients assigned to active (n = 16) or sham-tDCS (n = 17) were analyzed. After the treatment, a decrease in the FIS score was more pronounced in the sham than in the active group, yet the intergroup difference was insignificant (11.7 [95% CI -11.1 to 34.5], p = 0.6). Furthermore, no significant intergroup differences were observed regarding anxiety, depression, quality of life, and cognitive performance. The small cohort sample, differences in baseline FIS scores between groups (non-stratified randomization), or chosen stimulation parameters may have influenced our findings. However, it might also be possible that the expected mechanism of action of tDCS is insufficient to treat these conditions.
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Affiliation(s)
- Monika Klírová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic.
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.
| | - Andrea Adamová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nina Biačková
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olga Laskov
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Renková
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | | | - Karolína Odnohová
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
| | - Tomáš Novák
- National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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Kim T, Salazar Fajardo JC, Jang H, Lee J, Kim Y, Kim G, Kim D. Effect of optimized transcranial direct current stimulation on motor cortex activation in patients with sub-acute or chronic stroke: a study protocol for a single-blinded cross-over randomized control trial. Front Neurosci 2023; 17:1328727. [PMID: 38192515 PMCID: PMC10773722 DOI: 10.3389/fnins.2023.1328727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/07/2023] [Indexed: 01/10/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) has shown positive but inconsistent results in stroke rehabilitation. This could be attributed to inter-individual variations in brain characteristics and stroke lesions, which limit the use of a single tDCS protocol for all post-stroke patients. Optimizing the electrode location in tDCS for each individual using magnetic resonance imaging (MRI) to generate three-dimensional computer models and calculate the electric field (E-field) induced by tDCS at a specific target point in the primary motor cortex may help reduce these inconsistencies. In stroke rehabilitation, locating the optimal position that generates a high E-field in a target area can influence motor recovery. Therefore, this study was designed to determine the effect of personalized tDCS electrode positions on hand-knob activation in post-stroke patients. Method This is a crossover study with a sample size of 50 participants, who will be randomly assigned to one of six groups and will receive one session of either optimized-active, conventional-active, or sham tDCS, with 24 h between sessions. The tDCS parameters will be 1 mA (5 × 5 cm electrodes) for 20 min. The motor-evoked potential (MEP) will be recorded before and after each session over the target area (motor cortex hand-knob) and the MEP hotspot. The MEP amplitude at the target location will be the primary outcome. Discussion We hypothesize that the optimized-active tDCS session would show a greater increase in MEP amplitude over the target area in patients with subacute and chronic stroke than conventional and sham tDCS sessions.Clinical trial registration: https://cris.nih.go.kr, identifier KCT0007536.
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Affiliation(s)
- TaeYeong Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | | | - Hanna Jang
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
| | - Juwon Lee
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon-si, Republic of Korea
| | - Yeonkyung Kim
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon-si, Republic of Korea
| | - Gowun Kim
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon-si, Republic of Korea
| | - Donghyeon Kim
- Research Institute, Neurophet Inc., Seoul, Republic of Korea
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Popyvanova A, Pomelova E, Bredikhin D, Koriakina M, Shestakova A, Blagovechtchenski E. Transspinal Direct Current Electrical Stimulation Selectively Affects the Excitability of the Corticospinal System, Depending on the Intensity but Not Motor Skills. Life (Basel) 2023; 13:2353. [PMID: 38137954 PMCID: PMC10744344 DOI: 10.3390/life13122353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023] Open
Abstract
Transspinal direct current stimulation (tsDCS) is a non-invasive technique used to modulate spinal cord activity. However, the effects and mechanisms of this stimulation are currently not comprehensively known. This study aimed to estimate the effect of different intensities of tsDCS applied at the level of cervical enlargement of the spinal cord (C7-Th1 segments) on the excitability of the corticospinal system (CSS) and the correction of motor skills in healthy subjects. The effect of tsDCS was estimated by the motor-evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) in the primary motor cortex (M1). The study involved 54 healthy adults aged 22 ± 4 years. The application of 11 min anodal tsDCS at the level of the cervical spine C7-Th1 with a current intensity of 2.5 mA did not change the MEP amplitude of the upper limb muscles, in contrast to the data that we previously obtained with a current intensity of 1.5 mA. We also found no difference in the effect of 2.5 mA stimulation on motor skill correction in healthy subjects in the nine-hole peg test (9-HPT) and the serial reaction time task (SRT) as with 1.5 mA stimulation. Our data show that an increase in the intensity of stimulation does not lead to an increase in the effects but rather reduces the effects of stimulation. These results provide information about the optimally appropriate stimulation current intensities to induce CSS excitability and the ability of tsDCS to influence motor skills in healthy adults.
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Affiliation(s)
| | | | | | | | | | - Evgeny Blagovechtchenski
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, 101000 Moscow, Russia; (A.P.); (E.P.); (D.B.); (M.K.); (A.S.)
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7
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Müller D, Habel U, Brodkin ES, Clemens B, Weidler C. HD-tDCS induced changes in resting-state functional connectivity: Insights from EF modeling. Brain Stimul 2023; 16:1722-1732. [PMID: 38008154 DOI: 10.1016/j.brs.2023.11.012] [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: 08/25/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND High-definition transcranial direct current stimulation (HD-tDCS) holds promise for therapeutic use in psychiatric disorders. One obstacle for the implementation into clinical practice is response variability. One way to tackle this obstacle is the use of Individualized head models. OBJECTIVE This study investigated the variability of HD-tDCS induced electric fields (EFs) and its impact on resting-state functional connectivity (rsFC) during different time windows. METHODS In this randomized, double-blind, and sham controlled study, seventy healthy males underwent 20 min of 1.5 mA HD-tDCS on the right inferior frontal gyrus (rIFG) while undergoing resting-state functional magnetic resonance imaging (rs-fMRI). Individual head models and EF simulations were created from anatomical images. The effects of HD-tDCS on rsFC were assessed using a seed-to-voxel analysis. A subgroup analysis explored the relationship between EF magnitude and rsFC during different stimulation time windows. RESULTS Results highlighted significant variability in HD-tDCS-induced EFs. Compared to the sham group, the active group showed increased rsFC between the rIFG and the left prefrontal cortex, during and after stimulation. During active stimulation, EF magnitude correlated positively with rsFC between the rIFG and the left hippocampus initially, and negatively during the subsequent period. CONCLUSION This study indicated an HD-tDCS induced increase of rsFC between left and right prefrontal areas. Furthermore, an interaction between the magnitude and the duration of HD-tDCS on rsFC was observed. Due to the high EF variability that was apparent, these findings highlight the need for individualized HD-tDCS protocols and the creation of head models to optimize effects and reduce response heterogeneity.
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Affiliation(s)
- Dario Müller
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany.
| | - Ute Habel
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany; JARA-BRAIN Institute Brain Structure-Function Relationships, Research Center Jülich and RWTH Aachen, Germany; Institute of Neuroscience and Medicine 10, Research Center Jülich, 52438, Jülich, Germany
| | - Edward S Brodkin
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, 3535 Market Street, Suite 3080, Philadelphia, PA, 19104-3309, USA
| | - Benjamin Clemens
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Carmen Weidler
- Department of Psychiatry, Psychotherapy and Psychosomatics, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany
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Xiao S, Shen B, Zhang C, Xu Z, Li J, Fu W, Jin J. Effects of tDCS on Foot Biomechanics: A Narrative Review and Clinical Applications. Bioengineering (Basel) 2023; 10:1029. [PMID: 37760131 PMCID: PMC10525503 DOI: 10.3390/bioengineering10091029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/13/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
In recent years, neuro-biomechanical enhancement techniques, such as transcranial direct current stimulation (tDCS), have been widely used to improve human physical performance, including foot biomechanical characteristics. This review aims to summarize research on the effects of tDCS on foot biomechanics and its clinical applications, and further analyze the underlying ergogenic mechanisms of tDCS. This review was performed for relevant papers until July 2023 in the following databases: Web of Science, PubMed, and EBSCO. The findings demonstrated that tDCS can improve foot biomechanical characteristics in healthy adults, including proprioception, muscle strength, reaction time, and joint range of motion. Additionally, tDCS can be effectively applied in the field of foot sports medicine; in particular, it can be combined with functional training to effectively improve foot biomechanical performance in individuals with chronic ankle instability (CAI). The possible mechanism is that tDCS may excite specific task-related neurons and regulate multiple neurons within the system, ultimately affecting foot biomechanical characteristics. However, the efficacy of tDCS applied to rehabilitate common musculoskeletal injuries (e.g., CAI and plantar fasciitis) still needs to be confirmed using a larger sample size. Future research should use multimodal neuroimaging technology to explore the intrinsic ergogenic mechanism of tDCS.
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Affiliation(s)
- Songlin Xiao
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Chuyi Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Zhen Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Jingjing Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Jing Jin
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
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Vergallito A, Varoli E, Pisoni A, Mattavelli G, Del Mauro L, Feroldi S, Vallar G, Romero Lauro LJ. State-dependent effectiveness of cathodal transcranial direct current stimulation on cortical excitability. Neuroimage 2023; 277:120242. [PMID: 37348625 DOI: 10.1016/j.neuroimage.2023.120242] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 06/09/2023] [Accepted: 06/20/2023] [Indexed: 06/24/2023] Open
Abstract
The extensive use of transcranial direct current stimulation (tDCS) in experimental and clinical settings does not correspond to an in-depth understanding of its underlying neurophysiological mechanisms. In previous studies, we employed an integrated system of Transcranial Magnetic Stimulation and Electroencephalography (TMS-EEG) to track the effect of tDCS on cortical excitability. At rest, anodal tDCS (a-tDCS) over the right Posterior Parietal Cortex (rPPC) elicits a widespread increase in cortical excitability. In contrast, cathodal tDCS (c-tDCS) fails to modulate cortical excitability, being indistinguishable from sham stimulation. Here we investigated whether an endogenous task-induced activation during stimulation might change this pattern, improving c-tDCS effectiveness in modulating cortical excitability. In Experiment 1, we tested whether performance in a Visuospatial Working Memory Task (VWMT) and a modified Posner Cueing Task (mPCT), involving rPPC, could be modulated by c-tDCS. Thirty-eight participants were involved in a two-session experiment receiving either c-tDCS or sham during tasks execution. In Experiment 2, we recruited sixteen novel participants who performed the same paradigm but underwent TMS-EEG recordings pre- and 10 min post- sham stimulation and c-tDCS. Behavioral results showed that c-tDCS significantly modulated mPCT performance compared to sham. At a neurophysiological level, c-tDCS significantly reduced cortical excitability in a frontoparietal network likely involved in task execution. Taken together, our results provide evidence of the state dependence of c-tDCS in modulating cortical excitability effectively. The conceptual and applicative implications are discussed.
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Affiliation(s)
- Alessandra Vergallito
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy.
| | - Erica Varoli
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Alberto Pisoni
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy
| | - Giulia Mattavelli
- IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Pavia, Italy; Istituti Clinici Scientifici Maugeri IRCCS, Cognitive Neuroscience Laboratory of Pavia Institute, 27100, Italy
| | - Lilia Del Mauro
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Sarah Feroldi
- School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Vallar
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy; MiBTec - Mind and Behavior Technological Center, University of Milano-Bicocca, Milan, Italy
| | - Leonor J Romero Lauro
- Department of Psychology, University of Milano-Bicocca, Milano, Italy; NeuroMi, Milan Center for Neuroscience, Milano, Italy
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10
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Klees-Themens G, Théoret H. The effects of transcranial direct current stimulation on corticospinal excitability: A systematic review of nonsignificant findings. Eur J Neurosci 2023; 58:3074-3097. [PMID: 37407275 DOI: 10.1111/ejn.16073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 07/07/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that can modulate brain activity through the application of low-intensity electrical currents. Based on its reported effects on corticospinal excitability (CSE), tDCS has been used to study cognition in healthy individuals and reduce symptoms in a variety of clinical conditions. Despite its increasing popularity as a research and clinical tool, high interindividual variability has been reported in the response to protocols using transcranial magnetic stimulation (TMS) to assess tDCS-induced changes in CSE leading to several nonsignificant findings. In this systematic review, studies that reported no significant modulation of CSE following tDCS were identified from PubMed and Embase (Ovid) databases. Forty-three articles were identified where demographic, TMS and tDCS parameters were extracted. Overall, stimulation parameters, CSE measurements and participant characteristics were similar to those described in studies reporting positive results and were likewise heterogeneous between studies. Small sample sizes and inadequate blinding were notable features of the reviewed studies. This systematic review suggests that studies reporting nonsignificant findings do not markedly differ from those reporting significant modulation of CSE.
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Affiliation(s)
| | - Hugo Théoret
- Department of Psychology, Université de Montréal, Montreal, Québec, Canada
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Transcranial random noise stimulation over the left dorsolateral prefrontal cortex attenuates pain expectation and perception. Clin Neurophysiol 2023; 147:1-10. [PMID: 36608385 DOI: 10.1016/j.clinph.2022.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/04/2022] [Accepted: 12/14/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The dorsolateral prefrontal cortex (DLPFC) has been increasingly used as a neuromodulatory target in pain management. Transcranial random noise stimulation (tRNS) was shown to effectively elevate cortical excitability. Hence, this study aimed to characterize how tRNS over the left DLPFC affects pain expectation and perception, as well as the efficacy of conditioned-pain modulation (CPM) that reflects the function of the endogenous pain-inhibitory pathway. METHODS Using a randomized, double-blinded, and sham-controlled design, healthy participants were randomly recruited to receive tRNS with a direct current offset or sham stimulation. Their expectations and perceptions of painful electrocutaneous stimuli, as well as CPM efficacy were assessed before, immediately after, and 30 min after tRNS. RESULTS Compared with sham stimulation, perceived-pain ratings to the painful stimuli, and expected-pain ratings before painful stimuli, attenuated immediately after tRNS, whereas this analgesic effect was ineffective 30 min after tRNS. Importantly, the immediate analgesia induced by tRNS could be accounted for by tRNS effect on attenuating expected-pain ratings before certain painful stimuli. However, CPM efficacy was not significantly affected by tRNS. CONCLUSIONS These results demonstrate analgesia immediately after applying tRNS over the left DLPFC. SIGNIFICANCE This study provides evidence for analgesia of DLPFC-tRNS on an experimental pain model.
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Hsu G, Shereen AD, Cohen LG, Parra LC. Robust enhancement of motor sequence learning with 4 mA transcranial electric stimulation. Brain Stimul 2023; 16:56-67. [PMID: 36574814 PMCID: PMC10171179 DOI: 10.1016/j.brs.2022.12.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Motor learning experiments with transcranial direct current stimulation (tDCS) at 2 mA have produced mixed results. We hypothesize that tDCS boosts motor learning provided sufficiently high field intensity on the motor cortex. METHODS In a single-blinded design, 108 healthy participants received either anodal (N = 36) or cathodal (N = 36) tDCS at 4 mA total, or no stimulation (N = 36) while they practiced a 12-min sequence learning task. Anodal stimulation was delivered across four electrode pairs (1 mA each), with anodes above the right parietal lobe and cathodes above the right frontal lobe. Cathodal stimulation, with reversed polarities, served as an active control for sensation, while the no-stimulation condition established baseline performance. fMRI-localized targets on the primary motor cortex in 10 subjects were used in current flow models to optimize electrode placement for maximal field intensity. A single electrode montage was then selected for all participants. RESULTS We found a significant difference in performance with anodal vs. cathodal stimulation (Cohen's d = 0.71) and vs. no stimulation (d = 0.56). This effect persisted for at least 1 h, and subsequent learning for a new sequence and the opposite hand also improved. Sensation ratings were comparable in the active groups and did not exceed moderate levels. Current flow models suggest the new electrode montage can achieve stronger motor cortex polarization than alternative montages. CONCLUSION The present paradigm shows a medium to large effect size and is well-tolerated. It may serve as a go-to experiment for future studies on motor learning and tDCS.
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Affiliation(s)
- Gavin Hsu
- Department of Biomedical Engineering, The City College of New York, The City University of New York, New York, NY, USA.
| | - A Duke Shereen
- Advanced Science Research Center at the Graduate Center of the City University of New York, USA
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Lucas C Parra
- Department of Biomedical Engineering, The City College of New York, The City University of New York, New York, NY, USA
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Ehrhardt SE, Ballard T, Wards Y, Mattingley JB, Dux PE, Filmer HL. tDCS augments decision-making efficiency in an intensity dependent manner: A training study. Neuropsychologia 2022; 176:108397. [DOI: 10.1016/j.neuropsychologia.2022.108397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/10/2022] [Accepted: 10/14/2022] [Indexed: 11/15/2022]
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Maudrich T, Ragert P, Perrey S, Kenville R. Single-session anodal transcranial direct current stimulation to enhance sport-specific performance in athletes: A systematic review and meta-analysis. Brain Stimul 2022; 15:1517-1529. [PMID: 36442774 DOI: 10.1016/j.brs.2022.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 10/13/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) has emerged as a promising and feasible method to improve motor performance in healthy and clinical populations. However, the potential of tDCS to enhance sport-specific motor performance in athletes remains elusive. OBJECTIVE We aimed at analyzing the acute effects of a single anodal tDCS session on sport-specific motor performance changes in athletes compared to sham. METHODS A systematic review and meta-analysis was conducted in the electronic databases PubMed, Web of Science, and SPORTDiscus. The meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, two subgroup analyses were conducted (1) depending on the stimulated brain areas (primary motor cortex (M1), temporal cortex (TC), prefrontal cortex (PFC), cerebellum (CB)), and (2) studies clustered in subgroups according to different sports performance domains (endurance, strength, visuomotor skill). RESULTS A total number of 19 studies enrolling a sample size of 258 athletes were deemed eligible for inclusion. Across all included studies, a significant moderate standardized mean difference (SMD) favoring anodal tDCS to enhance sport-specific motor performance could be observed. Subgroup analysis depending on cortical target areas of tDCS indicated a significant moderate SMD in favor of anodal tDCS compared to sham for M1 stimulation. CONCLUSION A single anodal tDCS session can lead to performance enhancement in athletes in sport-specific motor tasks. Although no definitive conclusions can be drawn regarding the modes of action as a function of performance domain or stimulation site, these results imply intriguing possibilities concerning sports performance enhancement through anodal M1 stimulation.
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Affiliation(s)
- Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
| | - Patrick Ragert
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Stéphane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Rouven Kenville
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany; Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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15
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Ramasawmy P, Khalid S, Petzke F, Antal A. Pain reduction in fibromyalgia syndrome through pairing transcranial direct current stimulation and mindfulness meditation: A randomized, double-blinded, sham-controlled pilot clinical trial. Front Med (Lausanne) 2022; 9:908133. [PMID: 36314032 PMCID: PMC9596988 DOI: 10.3389/fmed.2022.908133] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
Background This double-blinded, randomized and sham-controlled pilot clinical trial aimed to investigate the preliminary clinical efficacy and feasibility of combining mindfulness meditation (MM) and transcranial direct current stimulation (tDCS) for pain and associated symptoms in patients with fibromyalgia syndrome (FMS). Methods Included FMS patients (age: 33 to 70) were randomized to three different groups to receive either ten daily sessions of anodal tDCS over the left primary motor cortex paired with MM for 20 min (active + MM, n = 10), sham tDCS combined with MM (sham + MM, n = 10) or no intervention (NoT, n = 10). Patients in the bimodal therapy groups received a week of training in MM prior to the stimulation. Participants reported pain intensity, the primary outcome, by filling in a pain diary daily throughout the whole study. They were also evaluated for quality of life, pressure pain sensitivity, psychological wellbeing, sleep quality and sleep quantity. Assessments were performed at three time points (baseline, immediately after treatment and one-month follow-up). Results Participants in the active + MM group did not exhibit reduced pain intensity following the bimodal therapy compared to controls. Patients in active group demonstrated clinically meaningful and significantly higher quality of life following the therapeutic intervention than other groups. There was no significant difference among groups regarding pressure pain sensitivity, sleep parameters and psychological scales. The combined treatment was well tolerated among participants, with no serious adverse effects. Conclusion This study was the first to pair these two effective non-pharmacological therapies for pain management in FMS. In the light of an underpowered sample size, repetitive anodal tDCS combined with MM did not improve pain or FMS-associated symptoms. However, patients in the active + MM group reported higher quality of life than the control groups. Studies with more participants and longer follow-ups are required to confirm our findings. Clinical trial registration [www.drks.de], identifier [DRKS00023490].
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Affiliation(s)
- Perianen Ramasawmy
- Department of Neurology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Sarah Khalid
- Department of Neurology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Frank Petzke
- Department of Anesthesiology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany
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Razza LB, da Silva PHR, Busatto GF, Duran FLDS, Pereira J, De Smet S, Klein I, Zanão TA, Luethi MS, Baeken C, Vanderhasselt MA, Buchpiguel CA, Brunoni AR. Brain Perfusion Alterations Induced by Standalone and Combined Non-Invasive Brain Stimulation over the Dorsolateral Prefrontal Cortex. Biomedicines 2022; 10:2410. [PMID: 36289672 PMCID: PMC9598449 DOI: 10.3390/biomedicines10102410] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 11/17/2022] Open
Abstract
Non-invasive brain stimulation (NIBS) interventions are promising for the treatment of psychiatric disorders. Notwithstanding, the NIBS mechanisms of action over the dorsolateral prefrontal cortex (DLPFC), a hub that modulates affective and cognitive processes, have not been completely mapped. We aimed to investigate regional cerebral blood flow (rCBF) changes over the DLPFC and the subgenual anterior cingulate cortex (sgACC) of different NIBS protocols using Single-Photon Emission Computed Tomography (SPECT). A factorial, within-subjects, double-blinded study was performed. Twenty-three healthy subjects randomly underwent four sessions of NIBS applied once a week: transcranial direct current stimulation (tDCS), intermittent theta-burst stimulation (iTBS), combined tDCS + iTBS and placebo. The radiotracer 99m-Technetium-ethylene-cysteine-dimer was injected intravenously during the NIBS session, and SPECT neuroimages were acquired after the session. Results revealed that the combination of tDCS + iTBS increased right sgACC rCBF. Cathodal and anodal tDCS increased and decreased DLPFC rCBF, respectively, while iTBS showed no significant changes compared to the placebo. Our findings suggest that the combined protocol might optimize the activity in the right sgACC and encourage future trials with neuropsychiatric populations. Moreover, mechanistic studies to investigate the effects of tDCS and iTBS over the DLPFC are required.
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Affiliation(s)
- Lais Boralli Razza
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000 Ghent, Belgium
| | - Pedro Henrique Rodrigues da Silva
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Geraldo F. Busatto
- Laboratório de Neuroimagem em Psiquiatria (LIM-21), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovidio Pires de Campos 785, São Paulo 05403-000, Brazil
| | - Fábio Luis de Souza Duran
- Laboratório de Neuroimagem em Psiquiatria (LIM-21), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovidio Pires de Campos 785, São Paulo 05403-000, Brazil
| | - Juliana Pereira
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Stefanie De Smet
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000 Ghent, Belgium
| | - Izio Klein
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Tamires A. Zanão
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Matthias S. Luethi
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
| | - Chris Baeken
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000 Ghent, Belgium
- Department of Psychiatry (UZBrussel), Free University Brussels, 1090 Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
- Department of Experimental Clinical and Health Psychology, Ghent University, 9000 Ghent, Belgium
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Psychiatry and Medical Psychology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
- Ghent Experimental Psychiatry (GHEP) Lab, Ghent University, 9000 Ghent, Belgium
| | - Carlos Alberto Buchpiguel
- Divisão de Medicina Nuclear (LIM-43), Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 01246-904, Brazil
| | - André Russowsky Brunoni
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Departamento Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo 05403-010, Brazil
- Laboratório de Neuroimagem em Psiquiatria (LIM-21), Instituto de Psiquiatria, Faculdade de Medicina da Universidade de São Paulo, R. Dr. Ovidio Pires de Campos 785, São Paulo 05403-000, Brazil
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, Av. Prof Lineu Prestes 2565, São Paulo 05508-000, Brazil
- Hospital Universitário, Universidade de São Paulo, São Paulo 01246-904, Brazil
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17
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No robust online effects of transcranial direct current stimulation on corticospinal excitability. Brain Stimul 2022; 15:1254-1268. [PMID: 36084908 DOI: 10.1016/j.brs.2022.08.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been used for over twenty years to modulate cortical (particularly motor corticospinal) excitability both during (online) and outlasting (offline) the stimulation, with the former effects associated to the latter. However, tDCS effects are highly variable, partially because stimulation intensity is commonly not adjusted individually (in contrast to transcranial magnetic stimulation, TMS). In Experiment 1, we therefore explored an empirical approach of personalizing tDCS intensity for the primary motor cortex (M1) based on dose-response curves (DRCs), individually relating tDCS Intensity (in steps from 0.3 to 2.0 mA) and Polarity (anodal, cathodal) to the online modulation of concurrent TMS motor evoked potentials (MEP), assessing DRC reliability across two separate days. No robust DRCs could be observed, neither at the individual nor at the group level, with the only robust effect being a (paradoxical) MEP facilitation during cathodal tDCS at 2.0 mA, but no modulation at traditional intensities of or near 1 mA. In Experiment 2, we therefore attempted to replicate the classical bidirectional online MEP modulation during 1 mA tDCS that had been reported by several of the early seminal tDCS papers. We either closely recreated stimulation parameters and temporal protocol of these original studies (Experiment 2A) or slightly modernized them according to current standards (Experiment 2B). In neither experiment did we observed any significant online MEP modulation. We conclude that an empirical titration of individually effective tDCS intensities may not be feasible as online tDCS effects do not appear to be sufficiently robust.
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Huang YJ, Wang SM, Chen C, Chen CA, Wu CW, Chen JJ, Peng CW, Lin CW, Huang SW, Chen SC. High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial. Neurorehabil Neural Repair 2022; 36:645-654. [PMID: 36047662 DOI: 10.1177/15459683221121751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain. OBJECTIVE This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke. METHODS A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period. RESULTS Spasticity of shoulder adductor (P = .05), elbow extensor (P = .04), and thumb flexor (P < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes (P = .06-.26, ηp2 = 0.06-0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS. CONCLUSIONS Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov (ID: NCT04278105).
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Affiliation(s)
- Yi-Jing Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Shun-Min Wang
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chieh Chen
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei
| | - Chien-An Chen
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chun-Wei Wu
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei
| | - Jia-Jin Chen
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei.,International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei.,School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei
| | - Che-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan.,Medical Device Innovation Center, National Cheng Kung University, Tainan.,Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan.,Institute of Medical Informatics, College of Electrical Engineering and Computer Science, National Cheng Kung University, Tainan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
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De Laet C, Herman B, Riga A, Bihin B, Regnier M, Leeuwerck M, Raymackers JM, Vandermeeren Y. Bimanual motor skill learning after stroke: Combining robotics and anodal tDCS over the undamaged hemisphere: An exploratory study. Front Neurol 2022; 13:882225. [PMID: 36061986 PMCID: PMC9433746 DOI: 10.3389/fneur.2022.882225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSince a stroke can impair bimanual activities, enhancing bimanual cooperation through motor skill learning may improve neurorehabilitation. Therefore, robotics and neuromodulation with transcranial direct current stimulation (tDCS) are promising approaches. To date, tDCS has failed to enhance bimanual motor control after stroke possibly because it was not integrating the hypothesis that the undamaged hemisphere becomes the major poststroke hub for bimanual control.ObjectiveWe tested the following hypotheses: (I) In patients with chronic hemiparetic stroke training on a robotic device, anodal tDCS applied over the primary motor cortex of the undamaged hemisphere enhances bimanual motor skill learning compared to sham tDCS. (II) The severity of impairment correlates with the effect of tDCS on bimanual motor skill learning. (III) Bimanual motor skill learning is less efficient in patients than in healthy individuals (HI).MethodsA total of 17 patients with chronic hemiparetic stroke and 7 healthy individuals learned a complex bimanual cooperation skill on the REAplan® neurorehabilitation robot. The bimanual speed/accuracy trade-off (biSAT), bimanual coordination (biCo), and bimanual force (biFOP) scores were computed for each performance. In patients, real/sham tDCS was applied in a crossover, randomized, double-blind approach.ResultsCompared to sham, real tDCS did not enhance bimanual motor skill learning, retention, or generalization in patients, and no correlation with impairment was noted. The healthy individuals performed better than patients on bimanual motor skill learning, but generalization was similar in both groups.ConclusionA short motor skill learning session with a robotic device resulted in the retention and generalization of a complex skill involving bimanual cooperation. The tDCS strategy that would best enhance bimanual motor skill learning after stroke remains unknown.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT02308852, identifier: NCT02308852.
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Affiliation(s)
- Chloë De Laet
- Stroke Unit/NeuroModulation Unit (NeMU), Department of Neurology, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
| | - Benoît Herman
- Louvain Bionics, UCLouvain, Louvain-la-Neuve, Belgium
- Materials and Civil Engineering (iMMC), Institute of Mechanics, UCLouvain, Louvain-la-Neuve, Belgium
| | - Audrey Riga
- Stroke Unit/NeuroModulation Unit (NeMU), Department of Neurology, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
- Louvain Bionics, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Division (NEUR), Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
| | - Benoît Bihin
- Scientific Support Unit, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
| | - Maxime Regnier
- Scientific Support Unit, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
| | - Maria Leeuwerck
- Department of Physical Medicine and Rehabilitation, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
| | - Jean-Marc Raymackers
- Department of Neurology and Neurosurgery, Clinique Saint-Pierre, Ottignies-Louvain-la-Neuve, Belgium
| | - Yves Vandermeeren
- Stroke Unit/NeuroModulation Unit (NeMU), Department of Neurology, CHU UCL Namur (Mont-Godinne), UCLouvain, Yvoir, Belgium
- Louvain Bionics, UCLouvain, Louvain-la-Neuve, Belgium
- Clinical Division (NEUR), Institute of NeuroScience (IoNS), UCLouvain, Brussels, Belgium
- *Correspondence: Yves Vandermeeren
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20
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Palimeris S, Ansari Y, Remaud A, Tremblay F, Corriveau H, Boudrias MH, Milot MH. Effect of a tailored upper extremity strength training intervention combined with direct current stimulation in chronic stroke survivors: A Randomized Controlled Trial. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:978257. [PMID: 36189037 PMCID: PMC9397935 DOI: 10.3389/fresc.2022.978257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 07/14/2022] [Indexed: 11/25/2022]
Abstract
Strengthening exercises are recommended for managing persisting upper limb (UL) weakness following a stroke. Yet, strengthening exercises often lead to variable gains because of their generic nature. For this randomized controlled trial (RCT), we aimed to determine whether tailoring strengthening exercises using a biomarker of corticospinal integrity, as reflected in the amplitude of motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS), could optimize training effects in the affected UL. A secondary aim was to determine whether applying anodal transcranial direct current stimulation (tDCS) could enhance exercise-induced training effects. For this multisite RCT, 90 adults at the chronic stage after stroke (>6 months) were recruited. Before training, participants underwent TMS to detect the presence of MEPs in the affected hand. The MEP amplitude was used to stratify participants into three training groups: (1) low-intensity, MEP <50 μV, (2) moderate-intensity, 50 μV < MEP < 120 μV, and (3) high-intensity, MEP>120 μV. Each group trained at a specific intensity based on the one-repetition maximum (1 RM): low-intensity, 35–50% 1RM; moderate-intensity, 50–65% 1RM; high-intensity, 70–85% 1RM. The strength training targeted the affected UL and was delivered 3X/week for four consecutive weeks. In each training group, participants were randomly assigned to receive either real or sham anodal tDCS (2 mA, 20 min) over the primary motor area of the affected hemisphere. Pre-/post-intervention, participants underwent a clinical evaluation of their UL to evaluate motor impairments (Fugl-Meyer Assessment), manual dexterity (Box and Blocks test) and grip strength. Post-intervention, all groups exhibited similar gains in terms of reduced impairments, improved dexterity, and grip strength, which was confirmed by multivariate and univariate analyses. However, no effect of interaction was found for tDCS or training group, indicating that tDCS had no significant impact on outcomes post-intervention. Collectively, these results indicate that adjusting training intensity based on the size of MEPs in the affected extremity provides a useful approach to optimize responses to strengthening exercises in chronic stroke survivors. Also, the lack of add-on effects of tDCS applied to the lesioned hemisphere on exercise-induced improvements in the affected UL raises questions about the relevance of combining such interventions in stroke.
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Affiliation(s)
- Stephania Palimeris
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
- BRAIN Lab, Jewish Rehabilitation Hospital, Laval, QC, Canada
- Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR) and CISSS-Laval, Montréal, QC, Canada
| | | | | | - François Tremblay
- Bruyère Research Institute, Ottawa, ON, Canada
- Faculty of Health Sciences, School of Rehabilitation Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Hélène Corriveau
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, École de réadaptation, Sherbrooke, QC, Canada
- Centre de recherche sur le vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
| | - Marie Hélène Boudrias
- Faculty of Medicine and Health Sciences, School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada
- BRAIN Lab, Jewish Rehabilitation Hospital, Laval, QC, Canada
- Montreal Center for Interdisciplinary Research in Rehabilitation (CRIR) and CISSS-Laval, Montréal, QC, Canada
| | - Marie Hélène Milot
- Faculté de médecine et des sciences de la santé, Université de Sherbrooke, École de réadaptation, Sherbrooke, QC, Canada
- Centre de recherche sur le vieillissement, CIUSSS de l'Estrie-CHUS, Sherbrooke, QC, Canada
- *Correspondence: Marie Hélène Milot
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21
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Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. Neurosci Biobehav Rev 2022; 138:104702. [PMID: 35595071 DOI: 10.1016/j.neubiorev.2022.104702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/12/2022] [Accepted: 05/13/2022] [Indexed: 12/22/2022]
Abstract
Van der Groen, O., Potok, W., Wenderoth, N., Edwards, G., Mattingley, J.B. and Edwards, D. Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. NEUROSCI BIOBEHAV REV X (X) XXX-XXX 2021.- Transcranial random noise stimulation (tRNS) is a non-invasive electrical brain stimulation method that is increasingly employed in studies of human brain function and behavior, in health and disease. tRNS is effective in modulating perception acutely and can improve learning. By contrast, its effectiveness for modulating higher cognitive processes is variable. Prolonged stimulation with tRNS, either as one longer application, or multiple shorter applications, may engage plasticity mechanisms that can result in long-term benefits. Here we provide an overview of the current understanding of the effects of tRNS on the brain and behavior and provide some specific recommendations for future research.
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22
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Fujiyama H, Tan J, Puri R, Hinder MR. Influence of tDCS over right inferior frontal gyrus and pre-supplementary motor area on perceptual decision-making and response inhibition: A healthy ageing perspective. Neurobiol Aging 2021; 109:11-21. [PMID: 34634749 DOI: 10.1016/j.neurobiolaging.2021.09.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 08/21/2021] [Accepted: 09/09/2021] [Indexed: 12/12/2022]
Abstract
A wide body of literature suggests that transcranial direct current stimulation (tDCS) administered over the prefrontal cortex can improve executive function - including decision-making and inhibitory control - in healthy young adults. However, the effects of tDCS in older adults are largely unknown. Here, using a double-blind, sham-controlled approach, changes in a combined perceptual decision-making and inhibitory control task were assessed before and after the application of tDCS (1 mA, 20 minute) targeting the right inferior frontal gyrus (rIFG) or pre-supplementary motor area (preSMA) in 42 young (18-34 years) and 41 older (60-80 years) healthy adults. Compared to sham stimulation, anodal tDCS over the preSMA improved decision-making speed for both age groups. Furthermore, the inhibitory control performance of older and younger adults was improved by preSMA and rIFG stimulation, respectively. This study provides evidence that tDCS can improve both perceptual decision-making and inhibitory control in healthy older adults, with the causal role of the preSMA and rIFG regions in cognitive control appearing to vary as a function of healthy ageing.
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Affiliation(s)
- Hakuei Fujiyama
- Psychology, Murdoch University, Western Australia, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Western Australia, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Western Australia, Australia.
| | - Jane Tan
- Action and Cognition Laboratory, Discipline of Psychology, Murdoch University, Perth, Australia
| | - Rohan Puri
- Sensorimotor Neuroscience and Ageing Research Group, School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Mark R Hinder
- Sensorimotor Neuroscience and Ageing Research Group, School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Hobart, Australia
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23
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Yao J, Li X, Zhang W, Lin X, Lyu X, Lou W, Peng W. Analgesia induced by anodal tDCS and high-frequency tRNS over the motor cortex: Immediate and sustained effects on pain perception. Brain Stimul 2021; 14:1174-1183. [PMID: 34371209 DOI: 10.1016/j.brs.2021.07.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/21/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Many studies have shown effects of anodal transcranial direct current stimulation (a-tDCS) and high-frequency transcranial random noise stimulation (tRNS) on elevating cortical excitability. Moreover, tRNS with a direct current (DC)-offset is more likely to lead to increases in cortical excitability than solely tRNS. While a-tDCS over primary motor cortex (M1) has been shown to attenuate pain perception, tRNS + DC-offset may prove as an effective means for pain relief. OBJECTIVE This study aimed to examine effects of a-tDCS and high-frequency tRNS + DC-offset over M1 on pain expectation and perception, and assess whether these effects could be influenced by the certainty of pain expectation. METHODS Using a double-blinded and sham-controlled design, 150 healthy participants were recruited to receive a single-session a-tDCS, high-frequency tRNS + DC-offset, or sham stimulation over M1. The expectation and perception of electrical stimulation in certain and uncertain contexts were assessed at baseline, immediately after, and 30 min after stimulation. RESULTS Compared with sham stimulation, a-tDCS induced immediate analgesic effects that were greater when the stimulation outcome was expected with uncertainty; tRNS induced immediate and sustained analgesic effects that were mediated by decreasing pain expectation. Nevertheless, we found no strong evidence for tRNS being more effective for attenuating pain than a-tDCS. CONCLUSIONS The analgesic effects of a-tDCS and tRNS showed different temporal courses, which could be related to the more sustained effectiveness of high-frequency tRNS + DC-offset in elevating cortical excitability. Moreover, expectations of pain intensity should be taken into consideration to maximize the benefits of neuromodulation.
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Affiliation(s)
- Junjie Yao
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaoyun Li
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Wenyun Zhang
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xinxin Lin
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Xiaohan Lyu
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China
| | - Wutao Lou
- Department of Biomedical Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Weiwei Peng
- School of Psychology, Shenzhen University, Shenzhen, Guangdong, China.
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24
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Zoghi M, Jaberzadeh S. Letter to the editor: Reducing seizure frequency in patients with refractory epilepsy with cathodal transcranial direct current stimulation. Brain Stimul 2021; 14:1091-1092. [PMID: 34333166 DOI: 10.1016/j.brs.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Maryam Zoghi
- Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
| | - Shapour Jaberzadeh
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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