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Sharma G, Chitturi V, Sharma VK, Kathrotia R, Barde P, Parmar N, Sharma M, Singh RD. Innovative strategies for managing hallucinations by exploring effects of tDCS on source monitoring abilities. Sci Rep 2024; 14:16569. [PMID: 39019949 PMCID: PMC11254933 DOI: 10.1038/s41598-024-67279-0] [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: 03/02/2024] [Accepted: 07/09/2024] [Indexed: 07/19/2024] Open
Abstract
This randomised, crossover, sham-controlled study explored the neural basis of source-monitoring, a crucial cognitive process implicated in schizophrenia. Left superior temporal gyrus (STG) and dorsolateral prefrontal cortex (DLPFC) were the key focus areas. Thirty participants without neurological or psychological disorders underwent offline sham and active tDCS sessions with specific electrode montage targeting the left STG and DLPFC. Source-monitoring tasks, reality monitoring (Hear-Imagine), internal source-monitoring (Say-Imagine), and external source monitoring (Virtual-Real) were administered. Paired t-test and estimation statistics was performed with Graphpad version 10.1.0. The Benjamini-Hochberg procedure was employed to control the false discovery rate in multiple hypothesis testing. A significant improvement in internal source monitoring tasks (p = 0.001, Cohen's d = 0.97) was observed, but reality monitoring tasks demonstrated moderate improvement (p = 0.02, Cohen's d = 0.44). The study provides insights into the neural mechanisms of source monitoring in healthy individuals and proposes tDCS as a therapeutic intervention, laying the foundation for future studies to refine tDCS protocols and develop individualized approaches to address source monitoring deficits in schizophrenia.
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Affiliation(s)
- Gaurav Sharma
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Vinay Chitturi
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Vivek Kumar Sharma
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Rajesh Kathrotia
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Pradip Barde
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Naresh Parmar
- Department of Physiology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Medhavi Sharma
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rajkot, Gujarat, India
| | - Ragini D Singh
- Department of Biochemistry, All India Institute of Medical Sciences, Rajkot, Gujarat, India.
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Mattioli F, Maglianella V, D'Antonio S, Trimarco E, Caligiore D. Non-invasive brain stimulation for patients and healthy subjects: Current challenges and future perspectives. J Neurol Sci 2024; 456:122825. [PMID: 38103417 DOI: 10.1016/j.jns.2023.122825] [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: 07/06/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
Non-invasive brain stimulation (NIBS) techniques have a rich historical background, yet their utilization has witnessed significant growth only recently. These techniques encompass transcranial electrical stimulation and transcranial magnetic stimulation, which were initially employed in neuroscience to explore the intricate relationship between the brain and behaviour. However, they are increasingly finding application in research contexts as a means to address various neurological, psychiatric, and neurodegenerative disorders. This article aims to fulfill two primary objectives. Firstly, it seeks to showcase the current state of the art in the clinical application of NIBS, highlighting how it can improve and complement existing treatments. Secondly, it provides a comprehensive overview of the utilization of NIBS in augmenting the brain function of healthy individuals, thereby enhancing their performance. Furthermore, the article delves into the points of convergence and divergence between these two techniques. It also addresses the existing challenges and future prospects associated with NIBS from ethical and research standpoints.
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Affiliation(s)
- Francesco Mattioli
- AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, 00199 Rome, Italy; School of Computing, Electronics and Mathematics, University of Plymouth, Drake Circus, Plymouth PL4 8AA, United Kingdom
| | - Valerio Maglianella
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Sara D'Antonio
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Emiliano Trimarco
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Daniele Caligiore
- AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, 00199 Rome, Italy; Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy.
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3
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Sehatpour P, Kreither J, Lopez-Calderon J, Shastry AM, De Baun HM, Martinez A, Javitt DC. Network-level mechanisms underlying effects of transcranial direct current stimulation (tDCS) on visuomotor learning in schizophrenia. Transl Psychiatry 2023; 13:360. [PMID: 37993420 PMCID: PMC10665365 DOI: 10.1038/s41398-023-02656-3] [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: 03/23/2023] [Revised: 10/24/2023] [Accepted: 11/07/2023] [Indexed: 11/24/2023] Open
Abstract
Motor learning is a fundamental skill to our daily lives. Dysfunction in motor performance in schizophrenia (Sz) has been associated with poor social and functional outcomes. Transcranial direct current stimulation (tDCS), a non-invasive electrical brain stimulation approach, can influence underlying brain function with potential for improving motor learning in Sz. We used a well-established Serial Reaction Time Task (SRTT) to study motor learning, in combination with simultaneous tDCS and EEG recording, to investigate mechanisms of motor and procedural learning deficits in Sz, and to develop refined non-invasive brain stimulation approaches to improve neurocognitive dysfunction. We recruited 27 individuals with Sz and 21 healthy controls (HC). Individuals performed the SRTT task as they received sham and active tDCS with simultaneous EEG recording. Reaction time (RT), neuropsychological, and measures of global functioning were assessed. SRTT performance was significantly impaired in Sz and showed significant correlations with motor-related and working memory measures as well as global function. Source-space time-frequency decomposition of EEG showed beta-band coherence across supplementary-motor, primary-motor and visual cortex forming a network involved in SRTT performance. Motor-cathodal and visual-cathodal stimulations resulted in significant modulation in coherence particularly across the motor-visual nodes of the network accompanied by significant improvement in motor learning in both controls and patients. Here, we confirm earlier reports of SRTT impairment in Sz and demonstrate significant reversal of the deficits with tDCS. The findings support continued development of tDCS for enhancement of plasticity-based interventions in Sz, as well as source-space EEG analytic approaches for evaluating underlying neural mechanisms.
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Affiliation(s)
- Pejman Sehatpour
- Division of Experimental Therapeutics, Columbia University Irving Medical Center, New York, NY, USA.
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
| | - Johanna Kreither
- PIA Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas, Facultad de Psicología, and Laboratorio de Neurofisiología, Escuela de Medicina, Universidad de Talca, Talca, Chile
| | | | - Adithya M Shastry
- Division of Experimental Therapeutics, Columbia University Irving Medical Center, New York, NY, USA
| | - Heloise M De Baun
- Division of Experimental Therapeutics, Columbia University Irving Medical Center, New York, NY, USA
| | - Antigona Martinez
- Division of Experimental Therapeutics, Columbia University Irving Medical Center, New York, NY, USA
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Daniel C Javitt
- Division of Experimental Therapeutics, Columbia University Irving Medical Center, New York, NY, USA.
- Schizophrenia Research Division, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA.
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Javitt D, Sehatpour P, Kreither J, Lopez-Calderon J, Shastry A, De-Baun H, Martinez A. Network-level mechanisms underlying effects of transcranial direct current stimulation (tDCS) on visuomotor learning impairments in schizophrenia. RESEARCH SQUARE 2023:rs.3.rs-2711867. [PMID: 37066410 PMCID: PMC10104242 DOI: 10.21203/rs.3.rs-2711867/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
Motor learning is a fundamental skill to our daily lives. Dysfunction in motor performance in schizophrenia (Sz) is associated with poor social and functional outcomes, but nevertheless remains understudied relative to other neurocognitive domains. Moreover, transcranial direct current stimulation (tDCS) can influence underlying brain function in Sz and may be especially useful in enhancing local cortical plasticity, but underlying neural mechanisms remain incompletely understood. Here, we evaluated performance of Sz individuals on the Serial Reaction Time Task (SRTT), which has been extensively used in prior tDCS research, in combination with concurrent tDCS and EEG source localization first to evaluate the integrity of visuomotor learning in Sz relative to other cognitive domains and second to investigate underlying neural mechanisms. Twenty-seven individuals with Sz and 21 healthy controls (HC) performed the SRTT task as they received sham or active tDCS and simultaneous EEG recording. Measures of motor, neuropsychological and global functioning were also assessed. Impaired SRTT performance correlated significantly with deficits in motor performance, working memory, and global functioning. Time-frequency ("Beamformer") EEG source localization showed beta-band coherence across supplementary-motor, primary-motor and visual cortex regions, with reduced visuomotor coherence in Sz relative to HC. Cathodal tDCS targeting both visual and motor regions resulted in significant modulation in coherence particularly across the motor-visual nodes of the network accompanied by significant improvement in motor learning in both controls and patients. Overall, these findings demonstrate the utility of the SRTT to study mechanisms of visuomotor impairment in Sz and demonstrate significant tDCS effects on both learning and connectivity when applied over either visual or motor regions. The findings support continued study of dysfunctional dorsal-stream visual connectivity and motor plasticity as components of cognitive impairment in Sz, of local tDCS administration for enhancement of plasticity, and of source-space EEG-based biomarkers for evaluation of underlying neural mechanisms.
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Affiliation(s)
- Daniel Javitt
- Columbia University Medical Center/Nathan Kline Institute
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Mondino M, Janin D, Galvao F, Brunelin J. High-Frequency Transcranial Random Noise Stimulation for Auditory Hallucinations of Schizophrenia: A Case Series. Biomedicines 2022; 10:2698. [PMID: 36359217 PMCID: PMC9687535 DOI: 10.3390/biomedicines10112698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/26/2022] [Accepted: 10/18/2022] [Indexed: 09/19/2023] Open
Abstract
Transcranial electrical stimulation has been proposed as a noninvasive therapeutic approach for reducing treatment-resistant symptoms of schizophrenia-in particular, auditory hallucinations. However, the high variability observed in the clinical response leaves much room to optimize the stimulation parameters and strengthen its benefits. We proposed to investigate the effects of high-frequency transcranial random noise stimulation (hf-tRNS), which is supposed to induce larger effects than conventional direct current stimulation. Here, we present an initial case series of ten patients with schizophrenia who underwent 10 sessions of 20 min hf-tRNS (2 mA, 100-500 Hz, 1 mA offset), with the anode placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients showed a significant reduction in auditory hallucinations after the hf-tRNS sessions (-36.1 +/- 21.8%, p = 0.0059). In this preliminary, open-label study conducted in ten patients with treatment-resistant symptoms of schizophrenia, frontotemporal hf-tRNS was shown to induce a substantial improvement in auditory hallucinations. Additional sham-controlled studies are needed to further evaluate hf-tRNS as a treatment for schizophrenia.
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Affiliation(s)
- Marine Mondino
- Pôle Est, Centre Hospitalier Le Vinatier, F-69500 Bron, France
- PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, F-69000 Lyon, France
- University Lyon 1, F-69100 Villeurbanne, France
| | - Delphine Janin
- Pôle Est, Centre Hospitalier Le Vinatier, F-69500 Bron, France
- PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, F-69000 Lyon, France
- University Lyon 1, F-69100 Villeurbanne, France
| | - Filipe Galvao
- Pôle Est, Centre Hospitalier Le Vinatier, F-69500 Bron, France
| | - Jérôme Brunelin
- Pôle Est, Centre Hospitalier Le Vinatier, F-69500 Bron, France
- PSYR2 Team, Lyon Neuroscience Research Center, INSERM U1028, CNRS UMR5292, F-69000 Lyon, France
- University Lyon 1, F-69100 Villeurbanne, France
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Adjunctive tDCS for treatment-refractory auditory hallucinations in schizophrenia: A meta-analysis of randomized, double-blinded, sham-controlled studies. Asian J Psychiatr 2022; 73:103100. [PMID: 35430496 DOI: 10.1016/j.ajp.2022.103100] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/14/2022] [Accepted: 04/02/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Treatment-refractory auditory hallucinations (TRAH) in schizophrenia often do not improve with pharmacotherapy. We performed a meta-analysis of randomized, double-blind, sham-controlled clinical trials (RCTs) that systematically examined the therapeutic effects and tolerability of adjunctive active versus sham active transcranial direct current stimulation (tDCS) for auditory hallucinations as measured by the Auditory Hallucination Rating Scale (AHRS) in schizophrenia patients with TRAH. METHODS Relevant data were extracted, checked and analyzed using the Review Manager, Version 5.3 by three independent investigators. RESULTS Eight double-blind RCTs covering 329 schizophrenia patients (168 in active tDCS group, 161 in sham tDCS group) were included. Although no advantage of active tDCS on auditory hallucinations [7 RCTs, n = 224; standardized mean difference (SMD): - 0.33 (95% confidence interval (CI): - 0.71, 0.05), P = 0.09; I2 = 46%] was found compared to sham, subgroup analyses revealed that active tDCS with twice-daily stimulation [6 RCTs, n = 198; SMD: - 0.42 (95%CI: -0.82, -0.02), P = 0.04; I2 = 44%] and active tDCS with ≥ 10 stimulation sessions [6 RCTs, n = 198; SMD: - 0.42 (95%CI: -0.82, -0.02), P = 0.04; I2 = 44%] showed a significantly better therapeutic effect than sham in improving auditory hallucinations symptoms. Meta-analyses of total psychopathology and discontinuation due to any reason were not significantly different between the active and sham tDCS groups. CONCLUSION This meta-analysis demonstrated that the effects of tDCS for auditory hallucinations symptoms were influenced by the tDCS parameters. Twice-daily stimulation and ≥ 10 stimulation sessions may be needed to improve auditory hallucinations symptoms in schizophrenia with TRAH.
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Brunelin J, Mondino M, Haesebaert J, Attal J, Benoit M, Chupin M, Dollfus S, El-Hage W, Galvao F, Jardri R, Llorca PM, Magaud L, Plaze M, Schott-Pethelaz AM, Suaud-Chagny MF, Szekely D, Fakra E, Poulet E. Examining transcranial random noise stimulation as an add-on treatment for persistent symptoms in schizophrenia (STIM'Zo): a study protocol for a multicentre, double-blind, randomized sham-controlled clinical trial. Trials 2021; 22:964. [PMID: 34963486 PMCID: PMC8715588 DOI: 10.1186/s13063-021-05928-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Background One out of three patients with schizophrenia failed to respond adequately to antipsychotics and continue to experience debilitating symptoms such as auditory hallucinations and negative symptoms. The development of additional therapeutic approaches for these persistent symptoms constitutes a major goal for patients. Here, we develop a randomized-controlled trial testing the efficacy of high-frequency transcranial random noise stimulation (hf-tRNS) for the treatment of resistant/persistent symptoms of schizophrenia in patients with various profiles of symptoms, cognitive deficits and illness duration. We also aim to investigate the biological and cognitive effects of hf-tRNS and to identify the predictors of clinical response. Methods In a randomized, double-blind, 2-arm parallel-group, controlled, multicentre study, 144 patients with schizophrenia and persistent symptoms despite the prescription of at least one antipsychotic treatment will be randomly allocated to receive either active (n = 72) or sham (n = 72) hf-tRNS. hf-tRNS (100–500 Hz) will be delivered for 20 min with a current intensity of 2 mA and a 1-mA offset twice a day on 5 consecutive weekdays. The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left temporoparietal junction. Patients’ symptoms will be assessed prior to hf-tRNS (baseline), after the 10 sessions, and at 1-, 3- and 6-month follow-up. The primary outcome will be the number of responders defined as a reduction of at least 25% from the baseline scores on the Positive and Negative Syndrome Scale (PANSS) after the 10 sessions. Secondary outcomes will include brain activity and connectivity, source monitoring performances, social cognition, other clinical (including auditory hallucinations) and biological variables, and attitude toward treatment. Discussion The results of this trial will constitute a first step toward establishing the usefulness of hf-tRNS in schizophrenia whatever the stage of the illness and the level of treatment resistance. We hypothesize a long-lasting effect of active hf-tRNS on the severity of schizophrenia symptoms as compared to sham. This trial will also have implications for the use of hf-tRNS as a preventive intervention of relapse in patients with schizophrenia. Trial registration ClinicalTrials.gov NCT02744989. Prospectively registered on 20 April 2016
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Affiliation(s)
- Jerome Brunelin
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France. .,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France. .,Lyon 1 University, F-69000, Villeurbanne, France. .,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.
| | - Marine Mondino
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | - Julie Haesebaert
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | | | | | - Marie Chupin
- Paris Brain Institute - Institut du Cerveau (ICM), Inserm U 1127, CNRS UMR 7225, Sorbonne Université, F-75013, Paris, France.,CATI Multicenter Neuroimaging Platform, F-75000, Paris, France
| | | | - Wissam El-Hage
- CHRU de Tours, CIC 1415, INSERM, Tours; UMR 1253, iBrain, Université de Tours, INSERM, F-37044, Tours, France
| | - Filipe Galvao
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France
| | - Renaud Jardri
- University in Lille, INSERM U1172, CHU Lille, Lille Neuroscience & Cognition Research Centre, Plasticity & SubjectivitY (PSY) team, CURE Platform, Lille, France
| | | | - Laurent Magaud
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France
| | - Marion Plaze
- GHU PARIS Psychiatrie & Neurosciences, site Sainte-Anne, Service Hospitalo-Universitaire, F-75014, Paris, France.,Université de Paris, F-75005, Paris, France
| | - Anne Marie Schott-Pethelaz
- Hospices Civils de Lyon, Pôle Santé Publique, Service Recherche et Epidémiologie Cliniques, F-69003, Lyon, France.,Research on Healthcare Performance RESHAPE, INSERM U1290, Université Claude Bernard Lyon 1, Villeurbanne, France
| | - Marie-Françoise Suaud-Chagny
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France
| | | | - Eric Fakra
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,CHU de Saint Etienne, F-42000, Saint Etienne, France
| | - Emmanuel Poulet
- Centre Hospitalier Le Vinatier, PSYR2 team, Bat 416 - 1st floor; 95 boulevard Pinel, 69678, F-69500, Bron cedex, France.,INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center, PSYR2 Team, F-69000, Lyon, France.,Lyon 1 University, F-69000, Villeurbanne, France.,Université Jean Monnet Saint Etienne, F-42000, Saint Etienne, France.,Psychiatric emergency service, Hospices civils de Lyon, F-69005, Lyon, France
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Blay M, Adam O, Bation R, Galvao F, Brunelin J, Mondino M. Improvement of Insight with Non-Invasive Brain Stimulation in Patients with Schizophrenia: A Systematic Review. J Clin Med 2021; 11:jcm11010040. [PMID: 35011780 PMCID: PMC8745271 DOI: 10.3390/jcm11010040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/10/2021] [Accepted: 12/21/2021] [Indexed: 12/13/2022] Open
Abstract
Patients with schizophrenia are often unaware of their condition and the consequences of their illness. This lack of insight results in impaired functioning, treatment non-adherence and poor prognosis. Here, we aimed to investigate the effects of non-invasive brain stimulation (NIBS) on two forms of insight, clinical and cognitive, in patients with schizophrenia. We conducted a systematic review of the literature registered in the PROSPERO database (CRD42020220323) according to PRISMA guidelines. The literature search was conducted in Medline and Web of Science databases based on studies published up until October 2020 that included pre-NIBS and post-NIBS measurements of clinical and/or cognitive insight in adults with schizophrenia. A total of 14 studies were finally included, and their methodological quality was assessed by using the QualSyst tool. Despite the lack of well-conducted large randomized-controlled studies using insight as the primary outcome, the available findings provide preliminary evidence that NIBS can improve clinical insight in patients with schizophrenia, with a majority of studies using transcranial direct current stimulation with a left frontotemporal montage. Further studies should investigate the effect of NIBS on insight as a primary outcome and how these effects on insight could translate into clinical and functional benefits in patients with schizophrenia.
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Affiliation(s)
- Martin Blay
- Centre Hospitalier le Vinatier, F-69500 Bron, France; (M.B.); (O.A.); (F.G.); (J.B.)
- Université Lyon 1, Lyon University, F-69100 Villeurbanne, France;
| | - Ondine Adam
- Centre Hospitalier le Vinatier, F-69500 Bron, France; (M.B.); (O.A.); (F.G.); (J.B.)
- Université Lyon 1, Lyon University, F-69100 Villeurbanne, France;
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, F-69000 Lyon, France
| | - Rémy Bation
- Université Lyon 1, Lyon University, F-69100 Villeurbanne, France;
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, F-69000 Lyon, France
- Psychiatric Unit, Wertheimer Neurologic Hospital, F-69500 Bron, France
| | - Filipe Galvao
- Centre Hospitalier le Vinatier, F-69500 Bron, France; (M.B.); (O.A.); (F.G.); (J.B.)
| | - Jérôme Brunelin
- Centre Hospitalier le Vinatier, F-69500 Bron, France; (M.B.); (O.A.); (F.G.); (J.B.)
- Université Lyon 1, Lyon University, F-69100 Villeurbanne, France;
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, F-69000 Lyon, France
| | - Marine Mondino
- Centre Hospitalier le Vinatier, F-69500 Bron, France; (M.B.); (O.A.); (F.G.); (J.B.)
- Université Lyon 1, Lyon University, F-69100 Villeurbanne, France;
- INSERM U1028, CNRS UMR5292, PSYR2 Team, Lyon Neuroscience Research Center, F-69000 Lyon, France
- Correspondence:
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Kusztrits I, Marquardt L, Hugdahl K, Hirnstein M. Transcranial direct current stimulation (tDCS) enhances internal source monitoring abilities in healthy participants. PLoS One 2021; 16:e0257010. [PMID: 34529676 PMCID: PMC8445448 DOI: 10.1371/journal.pone.0257010] [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: 11/23/2020] [Accepted: 08/20/2021] [Indexed: 11/18/2022] Open
Abstract
Source monitoring refers to the ability to identify the origin of a memory, for example, whether you remember saying something or thinking about it, and confusions of these sources have been associated with the experience of auditory verbal hallucinations (AVHs). Both AVHs and source confusions are reported to originate from dysfunctional brain activations in the prefrontal cortex (PFC) and the superior temporal gyrus (STG); specifically, it is assumed that a hypoactive PFC and a hyperactive STG gives rise to AVHs and source confusions. We set out to test this assumption by trying to mimic this hypertemporal/hypofrontal model in healthy individuals with transcranial direct current stimulation (tDCS): the inhibitory cathode was placed over the left PFC and the excitatory anode over the left dorsolateral STG. Participants completed a reality monitoring task (distinguishing between external and internal memory sources) and an internal source monitoring task (distinguishing between two or more internal memory sources) in two separate experiments (offline vs. online tDCS). In the offline experiment (n = 34), both source monitoring tasks were completed after tDCS stimulation, and in the online experiment (n = 27) source monitoring tasks were completed while simultaneously being stimulated with tDCS. We found that internal source monitoring abilities were significantly enhanced during active online tDCS, while reality monitoring abilities were unaffected by stimulation in both experiments. We speculate, based on combining the present findings with previous studies, that there might be different brain areas involved in reality and internal source monitoring. While internal source monitoring seems to involve speech production areas, specifically Broca’s area, as suggested in the present study, reality monitoring seems to rely more on the STG and DLPFC, as shown in other studies of the field.
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Affiliation(s)
- Isabella Kusztrits
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Norwegian Centre for Mental Health Disorders Research, University of Bergen and Haukeland University Hospital, Bergen, Norway
- * E-mail:
| | - Lynn Marquardt
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Norwegian Centre for Mental Health Disorders Research, University of Bergen and Haukeland University Hospital, Bergen, Norway
| | - Kenneth Hugdahl
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Norwegian Centre for Mental Health Disorders Research, University of Bergen and Haukeland University Hospital, Bergen, Norway
- Department of Radiology, Haukeland University Hospital, Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Marco Hirnstein
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- NORMENT Norwegian Centre for Mental Health Disorders Research, University of Bergen and Haukeland University Hospital, Bergen, Norway
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Frontotemporal Transcranial Direct Current Stimulation Decreases Serum Mature Brain-Derived Neurotrophic Factor in Schizophrenia. Brain Sci 2021; 11:brainsci11050662. [PMID: 34069556 PMCID: PMC8160668 DOI: 10.3390/brainsci11050662] [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: 04/08/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/13/2022] Open
Abstract
Although transcranial direct current stimulation (tDCS) shows promise as a treatment for auditory verbal hallucinations in patients with schizophrenia, mechanisms through which tDCS may induce beneficial effects remain unclear. Evidence points to the involvement of neuronal plasticity mechanisms that are underpinned, amongst others, by brain-derived neurotrophic factor (BDNF) in its two main forms: pro and mature peptides. Here, we aimed to investigate whether tDCS modulates neural plasticity by measuring the acute effects of tDCS on peripheral mature BDNF levels in patients with schizophrenia. Blood samples were collected in 24 patients with schizophrenia before and after they received a single session of either active (20 min, 2 mA, n = 13) or sham (n = 11) frontotemporal tDCS with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. We compared the tDCS-induced changes in serum mature BDNF (mBDNF) levels adjusted for baseline values between the two groups. The results showed that active tDCS was associated with a significantly larger decrease in mBDNF levels (mean −20% ± standard deviation 14) than sham tDCS (−8% ± 21) (F = 5.387; p = 0.030; η2 = 0.205). Thus, mature BDNF may be involved in the beneficial effects of frontotemporal tDCS observed in patients with schizophrenia.
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11
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Mondino M, Fonteneau C, Simon L, Dondé C, Haesebaert F, Poulet E, Brunelin J. Advancing clinical response characterization to frontotemporal transcranial direct current stimulation with electric field distribution in patients with schizophrenia and auditory hallucinations: a pilot study. Eur Arch Psychiatry Clin Neurosci 2021; 271:85-92. [PMID: 32533249 DOI: 10.1007/s00406-020-01149-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 05/29/2020] [Indexed: 12/25/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been proposed as a therapeutic option for treatment-resistant auditory verbal hallucinations (AVH) in schizophrenia. In such cases, repeated sessions of tDCS are delivered with the anode over the left prefrontal cortex and the cathode over the left temporoparietal junction. Despite promising findings, the clinical response to tDCS is highly heterogeneous among patients. Here, we explored baseline differences between responders and nonresponders to frontotemporal tDCS using electric field modeling. We hypothesized that responders would display different tDCS-induced electric field strength in the brain areas involved in AVH compared to nonresponders.Using baseline structural MRI scans of 17 patients with schizophrenia and daily AVH who received 10 sessions of active frontotemporal tDCS, we constructed individual realistic whole brain models estimating electric field strength. Electric field maps were compared between responders (n = 6) and nonresponders to tDCS (n = 11) using an independent two-sample t test. Clinical response was defined as at least a 50% decrease of AVH 1 month after the last tDCS session.Results from the electric field map comparison showed that responders to tDCS displayed higher electric field strength in the left transverse temporal gyrus at baseline compared to nonresponders (T = 2.37; p = 0.016; 32 voxels).These preliminary findings suggested that the strength of the tDCS-induced electric field reaching the left transverse temporal gyrus could play an important role in the response to frontotemporal tDCS. In addition, this work suggests the interest of using electric field modeling to individualize tDCS and increase response rate.
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Affiliation(s)
- Marine Mondino
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clara Fonteneau
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Louis Simon
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Clément Dondé
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Frédéric Haesebaert
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
| | - Emmanuel Poulet
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France
- Centre Hospitalier Le Vinatier, Bron, France
- Emergency Psychiatry Unit, Edouard Herriot Hospital, Lyon University Hospital, Lyon, France
| | - Jerome Brunelin
- INSERM, U1028; CNRS, UMR5292; Lyon Neuroscience Research Center; PSYR2 Team, 95 bd pinel, F-69000, Lyon, France.
- Lyon University, Université Lyon 1, UCBL, 69000, Villeurbanne, France.
- Centre Hospitalier Le Vinatier, Bron, France.
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12
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Dondé C, Brunelin J, Micoulaud-Franchi JA, Maruani J, Lejoyeux M, Polosan M, Geoffroy PA. The Effects of Transcranial Electrical Stimulation of the Brain on Sleep: A Systematic Review. Front Psychiatry 2021; 12:646569. [PMID: 34163380 PMCID: PMC8215269 DOI: 10.3389/fpsyt.2021.646569] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 04/19/2021] [Indexed: 01/23/2023] Open
Abstract
Transcranial Electrical Stimulation (tES) is a promising non-invasive brain modulation tool. Over the past years, there have been several attempts to modulate sleep with tES-based approaches in both the healthy and pathological brains. However, data about the impact on measurable aspects of sleep remain scattered between studies, which prevent us from drawing firm conclusions. We conducted a systematic review of studies that explored the impact of tES on neurophysiological sleep oscillations, sleep patterns measured objectively with polysomnography, and subjective psychometric assessments of sleep in both healthy and clinical samples. We searched four main electronic databases to identify studies until February 2020. Forty studies were selected including 511 healthy participants and 452 patients. tES can modify endogenous brain oscillations during sleep. Results concerning changes in sleep patterns are conflicting, whereas subjective assessments show clear improvements after tES. Possible stimulation-induced mechanisms within specific cortico-subcortical sleep structures and networks are discussed. Although these findings cannot be directly transferred to the clinical practice and sleep-enhancing devices development for healthy populations, they might help to pave the way for future researches in these areas. PROSPERO registration number 178910.
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Affiliation(s)
- Clément Dondé
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Jerome Brunelin
- INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, PSY-R2 Team, Lyon, France.,Lyon University, Lyon, France.,Centre Hospitalier le Vinatier, Batiment 416, Bron, France
| | - Jean-Arthur Micoulaud-Franchi
- University Sleep Clinic, Services of Functional Exploration of the Nervous System, University Hospital of Bordeaux, Bordeaux, France.,USR CNRS 3413 SANPSY, University Hospital Pellegrin, University of Bordeaux, Bordeaux, France
| | - Julia Maruani
- Département de Psychiatrie et de Médecine Addictologique, Hôpital Fernand Widal, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France.,Université de Paris, Paris, France.,INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie, Paris, France
| | - Michel Lejoyeux
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France
| | - Mircea Polosan
- University Grenoble Alpes, Grenoble, France.,U1216 INSERM, Grenoble Institut of Neuroscience, La Tronche, France.,Psychiatry Department, CHU Grenoble Alpes, Grenoble, France
| | - Pierre A Geoffroy
- Paris Diderot University-Paris VII, 5 Rue Thomas Mann, Paris, France.,University Hospital Bichat-Claude Bernard, 46 rue Henri Huchard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
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13
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Straube B, van Kemenade BM, Kircher T, Schülke R. Transcranial direct current stimulation improves action-outcome monitoring in schizophrenia spectrum disorder. Brain Commun 2020; 2:fcaa151. [PMID: 33543133 PMCID: PMC7850031 DOI: 10.1093/braincomms/fcaa151] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 08/05/2020] [Accepted: 08/13/2020] [Indexed: 12/22/2022] Open
Abstract
Patients with schizophrenia spectrum disorder often demonstrate impairments in action-outcome monitoring. Passivity phenomena and hallucinations, in particular, have been related to impairments of efference copy-based predictions which are relevant for the monitoring of outcomes produced by voluntary action. Frontal transcranial direct current stimulation has been shown to improve action-outcome monitoring in healthy subjects. However, whether transcranial direct current stimulation can improve action monitoring in patients with schizophrenia spectrum disorder remains unknown. We investigated whether transcranial direct current stimulation can improve the detection of temporal action-outcome discrepancies in patients with schizophrenia spectrum disorder. On 4 separate days, we applied sham or left cathodal/right anodal transcranial direct current stimulation in a randomized order to frontal (F3/F4), parietal (CP3/CP4) and frontoparietal (F3/CP4) areas of 19 patients with schizophrenia spectrum disorder and 26 healthy control subjects. Action-outcome monitoring was assessed subsequent to 10 min of sham/transcranial direct current stimulation (1.5 mA). After a self-generated (active) or externally generated (passive) key press, subjects were presented with a visual outcome (a dot on the screen), which was presented after various delays (0-417 ms). Participants had to detect delays between the key press and the visual consequence. Symptom subgroups were explored based on the presence or absence of symptoms related to a paranoid-hallucinatory syndrome. In general, delay-detection performance was impaired in the schizophrenia spectrum disorder compared to the healthy control group. Interaction analyses showed group-specific (schizophrenia spectrum disorder versus healthy control group) and symptom-specific (with/without relevant paranoid-hallucinatory symptoms) transcranial direct current stimulation effects. Post hoc tests revealed that frontal transcranial direct current stimulation improved the detection of long delays in active conditions and reduced the proportion of false alarms in undelayed trials of the passive condition in patients. The patients with no or few paranoid-hallucinatory symptoms benefited especially from frontal transcranial direct current stimulation in active conditions, while improvement in the patients with paranoid-hallucinatory symptoms was predominantly reflected in reduced false alarm rates in passive conditions. These data provide some first evidence for the potential utility of transcranial direct current stimulation in improving efference copy mechanisms and action-outcome monitoring in schizophrenia spectrum disorder. Current data indicate that improving efference copy-related processes can be especially effective in patients with no or few positive symptoms, while intersensory matching (i.e. task-relevant in passive conditions) could be more susceptible to improvement in patients with paranoid-hallucinatory symptoms.
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Affiliation(s)
- Benjamin Straube
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Bianca M van Kemenade
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Rasmus Schülke
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
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14
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Chhabra H, Bose A, Shivakumar V, Agarwal SM, Sreeraj VS, Shenoy S, Hazari N, Dinakaran D, Parlikar R, Koparde V, Ramesh V, Biswal J, Murugaraja V, Gowda SM, Chand PK, Sivakumar PT, Kalmady SV, Narayanaswamy JC, Murthy P, Girimaji SC, Venkatasubramanian G. Tolerance of transcranial direct current stimulation in psychiatric disorders: An analysis of 2000+ sessions. Psychiatry Res 2020; 284:112744. [PMID: 31955053 DOI: 10.1016/j.psychres.2020.112744] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/05/2019] [Accepted: 01/01/2020] [Indexed: 12/29/2022]
Abstract
Transcranial direct current stimulation (tDCS), a non-invasive, neuromodulatory technique, is being increasingly applied to several psychiatric disorders. In this study, we describe the side-effect profile of repeated tDCS sessions (N = 2005) that were administered to 171 patients (156 adults and 15 adolescents) with different psychiatric disorders [schizophrenia [N = 109], obsessive-compulsive disorder [N = 28], alcohol dependence syndrome [N = 13], mild cognitive impairment [N = 10], depression [N = 6], dementia [N = 2] and other disorders [N = 3]]. tDCS was administered at a constant current strength of 2 mA with additional ramp-up and ramp-down phase of 20 s each at the beginning and end of the session, respectively. Other tDCS protocol parameters were: schizophrenia and obsessive-compulsive disorder: 5-days of twice-daily 20-min sessions with an inter-session interval of 3-h; Mild cognitive impairment/dementia and alcohol dependence syndrome: at least 5-days of once-daily 20-min session; Depression: 10-days of once-daily 30 min session. At the end of each tDCS session, any adverse event observed by the administrator and/or reported by the patient was systematically assessed using a comprehensive questionnaire. The commonly reported adverse events during tDCS included burning sensations (16.2%), skin redness (12.3%), scalp pain (10.1%), itching (6.7%), and tingling (6.3%). Most of the adverse events were noted to be mild, transient and well-tolerated. In summary, our observations suggest that tDCS is a safe mode for therapeutic non-invasive neuromodulation in psychiatric disorders in adults as well as the adolescent population.
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Affiliation(s)
- Harleen Chhabra
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Anushree Bose
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Venkataram Shivakumar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sri Mahavir Agarwal
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vanteemar S Sreeraj
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sonia Shenoy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Nandita Hazari
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Damodharan Dinakaran
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Rujuta Parlikar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vinayak Koparde
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Vinutha Ramesh
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Jitendriya Biswal
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Venkatachalam Murugaraja
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Shayanth Manche Gowda
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Prabhat K Chand
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Palanimuthu T Sivakumar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Sunil V Kalmady
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Janardhanan C Narayanaswamy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Pratima Murthy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India; Centre for Addiction Medicine, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Satish C Girimaji
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India
| | - Ganesan Venkatasubramanian
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore 560029, India.
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15
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Weickert TW, Salimuddin H, Lenroot RK, Bruggemann J, Loo C, Vercammen A, Kindler J, Weickert CS. Preliminary findings of four-week, task-based anodal prefrontal cortex transcranial direct current stimulation transferring to other cognitive improvements in schizophrenia. Psychiatry Res 2019; 280:112487. [PMID: 31376788 DOI: 10.1016/j.psychres.2019.112487] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/07/2023]
Abstract
Most transcranial Direct Current Stimulation (tDCS) trials of schizophrenia administer few sessions and do not assess transfer effects to other cognitive domains. In a randomized, double-blind, sham-controlled, parallel groups trial, we determined the extent to which 4-weeks of 2 mA tDCS at 20 min/day totalling 20 tDCS sessions administered during a spatial working memory test, with anodal right dorsolateral prefrontal cortex (DLPFC) and cathodal left tempo-parietal junction (TPJ) placement, as an adjunct to antipsychotics reduced auditory hallucinations and improved cognition in 12 outpatients with schizophrenia. Anodal tDCS significantly improved language-based working memory after 2 weeks and verbal fluency after 2 and 4 weeks. Thus, four weeks of tDCS appears to be safe and elicits transfer benefits to other prefrontal-dependent cognitive abilities in schizophrenia.
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Affiliation(s)
- T W Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
| | - H Salimuddin
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - R K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - J Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - C Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - A Vercammen
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Faculty of Natural Sciences, Imperial College London, London, UK
| | - J Kindler
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - C S Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
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16
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Huang J, Zhuo C, Xu Y, Lin X. Auditory verbal hallucination and the auditory network: From molecules to connectivity. Neuroscience 2019; 410:59-67. [PMID: 31082536 DOI: 10.1016/j.neuroscience.2019.04.051] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 04/24/2019] [Accepted: 04/26/2019] [Indexed: 12/20/2022]
Abstract
Auditory verbal hallucinations (AVHs) frequently occur across multiple psychiatric diseases especially in schizophrenia (SCZ) patients. Functional imaging studies have revealed the hyperactivity of the auditory cortex and disrupted auditory-verbal network activity underlying AVH etiology. This review will firstly summarize major findings from both human AVH patients and animal models, with focuses on the auditory cortex and associated cortical/sub-cortical areas. Besides mesoscale connectivity or activity data, structure and functions at synaptic level will be discussed, in conjunction with molecular mechanisms. We have summarized major findings for the pathogenesis of AVH in SCZ patients, with focuses in the auditory cortex and prefrontal cortex (PFC). Those discoveries provide explanations for AVH from different perspectives including inter-regional connectivity, local activity in specific areas, structure and functions of synapse, and potentially molecular targets. Due to the uniqueness of AVH in humans, full replica using animals seems impossible. However, we can still extract useful information from animal SCZ models based on the disruption of auditory pathway during AVH episodes. Therefore, we will further interpolate the synaptic structures and molecular targets, whose dysregulation in SCZ models may be highly related with AVH episodes. As the last part, implications for future development of treatment strategies will be discussed.
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Affiliation(s)
- Jianjie Huang
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
| | - Chuanjun Zhuo
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China; Department of Psychiatry, Institute of Mental Health, Jining University, Jining Shandong Province, 272191, China; Department of Psychiatric-Neuroimaging-Genetics and Comorbidity Laboratory (PNGC-Lab), Tianjin Mental Health Centre, Mental Health Teaching Hospital of Tianjin Medical University, Tianjin Anding Hospital, China, Tianjin, 300222, China; Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China; MDT Center for Cognitive Impairment and Sleep Disorders, First Hospital of Shanxi Medical University, Taiyuan, 030001, China.
| | - Yong Xu
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Xiaodong Lin
- Department of Psychiatric-Neuroimging-Genetics Laboratory(PNG-Lab), Wenzhou Seventh People's Hospital, Wenzhou, Zhejiang Province, 325000, China
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17
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Sreeraj VS, Dinakaran D, Parlikar R, Chhabra H, Selvaraj S, Shivakumar V, Bose A, Narayanaswamy JC, Venkatasubramanian G. High-definition transcranial direct current simulation (HD-tDCS) for persistent auditory hallucinations in schizophrenia. Asian J Psychiatr 2018; 37:46-50. [PMID: 30110662 DOI: 10.1016/j.ajp.2018.08.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 08/07/2018] [Accepted: 08/08/2018] [Indexed: 01/11/2023]
Abstract
Conventional transcranial Direct Current Stimulation (tDCS) has been reported to alleviate persistent auditory hallucinations (AH) in schizophrenia as an add-on intervention. High-Definition tDCS (HD-tDCS), an optimized form of tDCS, has the potential for more focalized neuromodulation. In this study, add-on HD-tDCS (5 days twice daily session with 2-mA cathodal current on left temporo-parietal junction) using 4 × 1 ring montage significantly reduced persistent AH (t = 3.6;p < 0.01) in schizophrenia patients (N = 19). Add-on HD-tDCS has promising potential to treat persisting AH in schizophrenia. This needs further systematic research.
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Affiliation(s)
- Vanteemar S Sreeraj
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Damodharan Dinakaran
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Rujuta Parlikar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Harleen Chhabra
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Sowmya Selvaraj
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Venkataram Shivakumar
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Anushree Bose
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Janardhanan C Narayanaswamy
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Ganesan Venkatasubramanian
- WISER Neuromodulation Program, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India.
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