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Wang SC, Yokoyama JS, Tzeng NS, Tsai CF, Liu MN. Treatment resistant depression in elderly. PROGRESS IN BRAIN RESEARCH 2023; 281:25-53. [PMID: 37806715 DOI: 10.1016/bs.pbr.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Treatment refractory depression (TRD) in the elderly is a common psychiatric disorder with high comorbidity and mortality. Older adults with TRD often have complicated comorbidities and several predisposing risk factors, which may lead to neuropsychiatric dysfunction and poor response to treatment. Several hypotheses suggest the underlying mechanisms, including vascular, immunological, senescence, or abnormal protein deposition. Treatment strategies for TRD include optimization of current medication dose, augmentation, switching to an alternative agent or class, and combination of different antidepressant classes, as well as nonpharmacological adjuvant interventions such as biophysical stimulation and psychotherapy. In summary, treatment recommendations for TRD in the elderly favor a multimodal approach, combining pharmacological and nonpharmacological treatments.
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Affiliation(s)
- Sheng-Chiang Wang
- School of Medicine, National Defense Medical Center, Taipei, Taiwan; Department of Psychiatry, Tri-Service General Hospital Songshan Branch, National Defense Medical Center, Taipei, Taiwan; Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Jennifer S Yokoyama
- Memory and Aging Center, Department of Neurology, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States; Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, United States
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan; Student Counseling Center, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Mu-N Liu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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Tedla JS, Sangadala DR, Reddy RS, Gular K, Dixit S. High-definition trans cranial direct current stimulation and its effects on cognitive function: a systematic review. Cereb Cortex 2022; 33:6077-6089. [PMID: 36533541 DOI: 10.1093/cercor/bhac485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/14/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
Abstract
High-Definition Transcranial Direct Current Stimulation (HD-tDCS) is focal and improves higher mental functions. Due to the lack of published evidence, we conducted this review on the effect of HD-tDCS on cognitive functions in healthy and diseased individuals. We performed an electronic-data and gray-literature search to obtain the relevant studies for the review. The two distinct literature searches obtained a total of 468 studies. Out of these, a total of 12 studies were conducted on higher mental functions, and of these, two were on disordered consciousness, five were on memory, two were on speech, two were on cognition, and one was on execution. We submitted nine studies with control group to methodological quality assessment using the PEDro Scale. Remaining three studies underwent quality assessment by Quality Assessment Tool for Before-After (Pre-Post) Studies with No Control Group. We found that anodal HD-tDCS stimulation is significantly effective in treating disordered consciousness and improving memory, speech, cognition, and execution.
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Affiliation(s)
- Jaya Shanker Tedla
- King Khalid University Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, , Abha 61421, Kingdom of Saudi Arabia
| | - Devika Rani Sangadala
- King Khalid University Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, , Abha 61421, Kingdom of Saudi Arabia
| | - Ravi Shankar Reddy
- King Khalid University Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, , Abha 61421, Kingdom of Saudi Arabia
| | - Kumar Gular
- King Khalid University Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, , Abha 61421, Kingdom of Saudi Arabia
| | - Snehil Dixit
- King Khalid University Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, , Abha 61421, Kingdom of Saudi Arabia
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Rimmer RM, Costafreda SG, Mutz J, Joseph K, Brunoni AR, Loo CK, Padberg F, Palm U, Fu CH. Transcranial direct current stimulation effects in late life depression: A meta-analysis of individual participant data. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Ngan STJ, Chan LK, Chan WC, Lam LCW, Li WK, Lim K, Or E, Pang PF, Poon TK, Wong MCM, Wu YKA, Cheng PWC. High-definition transcranial direct current stimulation (HD-tDCS) as augmentation therapy in late-life depression (LLD) with suboptimal response to treatment-a study protocol for a double-blinded randomized sham-controlled trial. Trials 2022; 23:914. [PMID: 36307858 DOI: 10.1186/s13063-022-06855-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Late-life depression (LLD) has a poorer prognosis and higher relapse rate than younger adults, with up to one third of patients with LLD showing suboptimal response to antidepressant therapy. LLD has been associated with significant impairment in cognition and daily functioning. Few studies have evaluated the therapeutic effects of high-definition transcranial direct current stimulation (HD-tDCS) on depressive and cognitive symptoms of LLD. The current randomized controlled trial assesses the efficacy of HD-tDCS as an augmentation therapy with antidepressants compared to sham-control in subjects with LLD. METHODS Fifty-eight patients with LLD will be recruited and randomly assigned to the active HD-tDCS or sham HD-tDCS group. In both groups, patients will receive the active or sham intervention in addition to their pre-existing antidepressant therapy, for 2 weeks with 5 sessions per week, each lasting 30 min. The primary outcome measures will be the change of depressive symptoms, clinical response and the remission rate as measured with the Hamilton Depression Rating scale (HAMD-17) before and after the intervention, and at the 4th and 12th week after the completed intervention. Secondary outcome measures include cognitive symptoms, anxiety symptoms, daily functioning and adverse effects. DISCUSSION: Older adults with depression are associated with poorer outcomes or unsatisfactory responses to antidepressant therapy, and significant cognitive decline. Therefore, a new effective treatment option is needed. This randomized control trial aims at assessing the efficacy of HD-tDCS on ameliorating the depressive, cognitive and anxiety symptoms, and improving the daily functioning of subjects with LLD. TRIAL REGISTRATION ClinicalTrials.gov NCT05322863. Registered on 11 April 2022.
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Affiliation(s)
- Sze Ting Joanna Ngan
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Lap Kei Chan
- Department of Psychiatry, Kwai Chung Hospital, Kwai Chung, Hong Kong, Hong Kong
| | - Wai Chi Chan
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Tai Po Hospital, G/F, Multi-Centre, Tai Po, Hong Kong, Hong Kong
| | - Wan Kei Li
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Kelvin Lim
- Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Ego Or
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong
| | - Pui Fai Pang
- Department of Psychiatry, United Christian Hospital, Kwun Tong, Hong Kong, Hong Kong
| | - Ting Keung Poon
- Department of Psychiatry, Kowloon Hospital, Kadoorie Hill, Hong Kong, Hong Kong
| | - Mei Cheung Mimi Wong
- Department of Psychiatry, United Christian Hospital, Kwun Tong, Hong Kong, Hong Kong
| | - Ying King Anna Wu
- Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, Hong Kong
| | - Pak Wing Calvin Cheng
- New Clinical Building, Queen Mary Hospital, 2/F, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong, Hong Kong.
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Cheng YC, Kuo PH, Su MI, Huang WL. The efficacy of non-invasive, non-convulsive electrical neuromodulation on depression, anxiety and sleep disturbance: a systematic review and meta-analysis. Psychol Med 2022; 52:801-812. [PMID: 35105413 DOI: 10.1017/s0033291721005560] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The effects of non-invasive, non-convulsive electrical neuromodulation (NINCEN) on depression, anxiety and sleep disturbance are inconsistent in different studies. Previous meta-analyses on transcranial direct current stimulation (tDCS) and cerebral electrotherapy stimulation (CES) suggested that these methods are effective on depression. However, not all types of NINECN were included; results on anxiety and sleep disturbance were lacking and the influence of different populations and treatment parameters was not completely analyzed. We searched PubMed, Embase, PsycInfo, PsycArticles and CINAHL before March 2021 and included published randomized clinical trials of all types of NINCEN for symptoms of depression, anxiety and sleep in clinical and non-clinical populations. Data were pooled using a random-effects model. The main outcome was change in the severity of depressive symptoms after NINCEN treatment. A total of 58 studies on NINCEN were included in the meta-analysis. Active tDCS showed a significant effect on depressive symptoms (Hedges' g = 0.544), anxiety (Hedges' g = 0.667) and response rate (odds ratio = 1.9594) compared to sham control. CES also had a significant effect on depression (Hedges' g = 0.654) and anxiety (Hedges' g = 0.711). For all types of NINCEN, active stimulation was significantly effective on depression, anxiety, sleep efficiency, sleep latency, total sleep time, etc. Our results showed that tDCS has significant effects on both depression and anxiety and that these effects are robust for different populations and treatment parameters. The rational expectation of the tDCS effect is 'response' rather than 'remission'. CES also is effective for depression and anxiety, especially in patients with disorders of low severity.
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Affiliation(s)
- Ying-Chih Cheng
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Department of Public Health and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Min-I Su
- Division of Cardiology, Department of Internal Medicine, Taitung MacKay Memorial Hospital, Taitung, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
| | - Wei-Lieh Huang
- Department of Psychiatry, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Cerebellar Research Center, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
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Veenakumari M, Goyal N, Kumar M, Kshitiz KK, Kumar P. Serum glial cell derived neurotrophic factor (GDNF) as a predictor of response to HD-tDCS in bipolar affective disorder. Asian J Psychiatr 2022; 68:102965. [PMID: 34952447 DOI: 10.1016/j.ajp.2021.102965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/30/2021] [Accepted: 12/14/2021] [Indexed: 12/24/2022]
Abstract
Serum glial cell line derived neurotrophic factor (GDNF) homeostasis within brain circuits represent target for focal neuromodulation techniques such as high-definition transcranial direct current stimulation (HD-tDCS). In current trial 37 inpatients with bipolar disorder (BD) received active (n = 18) or sham (n = 19) anodal HD-tDCS over right dorsolateral prefrontal cortex (DLPFC). Outcome measures evaluated by YMRS (p = 0.001, effect size=0.946), BPRS (p = 0.015, effect size=0.220) scales and serum GDNF (p = 0.003, effect size = 0.287) at baseline, before and after receiving HD-tDCS revealed significant improvement (active>sham) with modest effect size. However, the study findings are limited due to small sample size and shorter duration of follow-up.
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Affiliation(s)
- M Veenakumari
- Central Institute of Psychiatry, Ranchi 834006, Jharkhand, India.
| | - Nishant Goyal
- Central Institute of Psychiatry, Ranchi 834006, Jharkhand, India
| | - Mahesh Kumar
- Central Institute of Psychiatry, Ranchi 834006, Jharkhand, India
| | - K K Kshitiz
- Central Institute of Psychiatry, Ranchi 834006, Jharkhand, India
| | - Pramod Kumar
- Rajendra Institute of Medical Sciences, Ranchi 834009, Jharkhand, India
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De Bortoli E, Cabane J, Manera V, Gros A, Robert P. [Effects of HD-tDCS stimulation on apathy, depression and their speech parameters]. Encephale 2021; 48:484-485. [PMID: 34801231 DOI: 10.1016/j.encep.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 06/24/2021] [Accepted: 06/30/2021] [Indexed: 10/19/2022]
Affiliation(s)
- E De Bortoli
- Université Côté d'Azur, centre hospitalier universitaire de Nice, laboratoire CoBTeK, service clinique gériatrique du cerveau et du mouvement, 06000 Nice, France.
| | - J Cabane
- Université Côté d'Azur, centre hospitalier universitaire de Nice, laboratoire CoBTeK, service clinique gériatrique du cerveau et du mouvement, 06000 Nice, France
| | - V Manera
- Université Côté d'Azur, centre hospitalier universitaire de Nice, laboratoire CoBTeK, service clinique gériatrique du cerveau et du mouvement, 06000 Nice, France
| | - A Gros
- Université Côté d'Azur, centre hospitalier universitaire de Nice, laboratoire CoBTeK, service clinique gériatrique du cerveau et du mouvement, 06000 Nice, France
| | - P Robert
- Université Côté d'Azur, centre hospitalier universitaire de Nice, laboratoire CoBTeK, service clinique gériatrique du cerveau et du mouvement, 06000 Nice, France
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Wang P, Zhu M, Mo S, Li X, Wang J. The effect of somatosensory alpha transcranial alternating current stimulation on pain empathy is trait empathy and gender dependent. CNS Neurosci Ther 2021; 27:687-693. [PMID: 33739605 PMCID: PMC8111491 DOI: 10.1111/cns.13631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 12/30/2022] Open
Abstract
Background Pain empathy enables a person to experience and understand other's pain state by observing others in pain condition. Such prosocial ability is deficient in many psychopathological disorders. Somatosensory alpha suppression is considered as neural correlates of pain empathy and is hypothesized as a target for enhancement of pain empathy. Researches demonstrated that alpha suppression could be enhanced by transcranial alternating current stimulation (tACS) at alpha frequency non‐invasively. Aims We applied alpha tACS over the primary somatosensory cortex of healthy subjects to investigate whether alpha tACS is able to enhance the pain empathy performance. Results The results showed that there was no difference of pain empathy performance between alpha tACS and sham tACS either when tACS was applied during the task or before task. While in the alpha tACS group, the pain empathy performance was positively correlated with empathic concern of male subjects, the sub‐component of personal trait empathy. Conclusions Alpha tACS cannot alter the empathy performance overall, but the modulation effect of alpha tACS on pain empathy is dependent on the gender and trait empathy of subjects.
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Affiliation(s)
- Peipei Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Minjia Zhu
- Department of Orthodontics, School of Stomatology, Capital Medical University, Beijing, China
| | - Shaohua Mo
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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Gao N, Zheng W, Murezati T, Gu W, Li X, Jin Z. GW117: A novel serotonin (5-HT 2C ) receptor antagonist and melatonin (MT 1 /MT 2 ) receptor agonist with potential antidepressant-like activity in rodents. CNS Neurosci Ther 2021; 27:702-713. [PMID: 33650297 PMCID: PMC8111499 DOI: 10.1111/cns.13630] [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] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 12/28/2022] Open
Abstract
Aims To evaluate the antidepressant‐like effect of compound GW117 in rodents using in vitro binding and uptake assays as well in vivo behavioral tests. Methods We investigated the target profile of GW117 using [35S]‐GTPγS and [3H]PIP binding. Using the forced swimming test and chronic unpredictable stress in rats, tail suspension test in mice and rats, and learned helplessness model in mice, we further revealed the antidepressant‐like and anxiolytic‐like effects of GW117. Results The current study suggests that GW117 displays serotonin 2C (5‐HT2C) receptor antagonist and melatonin type 1 and 2 (MT1/MT2) receptor agonist properties, as well as evident antidepressant and anxiolytic effects. Conclusion These data suggest that GW117 is probably a potent antidepressant.
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Affiliation(s)
- Nana Gao
- Department of Gastrointestinal Surgery and Clinical Nutrition, Beijing Shijitan Hospital,Captial Medical University, Beijing, China
| | - Wei Zheng
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Tiliwaerde Murezati
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Wei Gu
- Beijing Guangwei Pharmaceutical Technology Co., Ltd, Beijing, China
| | - Xiaorong Li
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Zengliang Jin
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
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High definition transcranial direct current stimulation (HD-tDCS): A systematic review on the treatment of neuropsychiatric disorders. Asian J Psychiatr 2021; 56:102542. [PMID: 33486461 DOI: 10.1016/j.ajp.2020.102542] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 12/14/2020] [Accepted: 12/28/2020] [Indexed: 12/15/2022]
Abstract
HD-tDCS (High-definition transcranial direct current stimulation) is a novel non-invasive brain stimulation (NIBS) technique based on the principle that when weak intensity electric currents are targeted on specific areas of the scalp, they cause underlying cortical stimulation. HD-tDCS shares its technical methodology with conventional tDCS (montage comprising of one anode and one cathode) except for a few modifications that are believed to have focal and longer-lasting neuromodulation effects. Although HD-tDCS is a recently available NIBS technique, impactful studies, case reports, and few controlled trials have been conducted in this context, facilitating an understanding of its neurobiological effects and the clinical translation of the same in health care set-up. The current article narratively reviews the mechanism of action of HD-tDCS, and it systematically examines the cognitive, clinical, and neurobiological effects of HD-tDCS in healthy volunteers as well as patients with neuropsychiatric conditions. Thus, this review attempts to explore the role of HD-tDCS in present-day practice and the future in the context of various neurological and psychiatric disorders.
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Lu H, Li J, Zhang L, Chan SSM, Lam LCW. Dynamic changes of region-specific cortical features and scalp-to-cortex distance: implications for transcranial current stimulation modeling. J Neuroeng Rehabil 2021; 18:2. [PMID: 33397402 PMCID: PMC7784346 DOI: 10.1186/s12984-020-00764-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 09/22/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Transcranial current stimulation in rehabilitation is a fast-growing field featured with computational and biophysical modeling. Cortical features and scalp-to-cortex distance (SCD) are key variables for determining the strength and distribution of the electric field, yet longitudinal studies able to capture these dynamic changes are missing. We sought to investigate and quantify the ageing effect on the morphometry and SCD of left primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC) in normal ageing adults and mild cognitive impairment (MCI) converters. METHODS Baseline, 1-year and 3-year follow-up structural magnetic resonance imaging scans from normal ageing adults (n = 32), and MCI converters (n = 22) were drawn from the Open Access Series of Imaging Studies. We quantified the changes of the cortical features and SCDs of left M1 and DLPFC, including grey matter volume, white matter volume, cortical thickness, and folding. Head model was developed to simulate the impact of SCD on the electric field induced by transcranial current stimulation. RESULTS Pronounced ageing effect was found on the SCD of left DLPFC in MCI converters. The SCD change of left DLPFC from baseline to 3-year follow-up demonstrated better performance to discriminate MCI converters from normal ageing adults than the other morphometric measures. The strength of electric field was consequently decreased with SCD in MCI converters. CONCLUSION Ageing has a prominent, but differential effect on the region-specific SCD and cortical features in older adults with cognitive impairments. Our findings suggest that SCD, cortical thickness, and folding of the targeted regions could be used as valuable imaging markers when conducting transcranial brain stimulation in individuals with brain atrophy.
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Affiliation(s)
- Hanna Lu
- Department of Psychiatry, Multi-Centre, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, G/F China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Li
- Department of Psychiatry, Multi-Centre, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, G/F China
| | - Li Zhang
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Sandra Sau Man Chan
- Department of Psychiatry, Multi-Centre, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, G/F China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Multi-Centre, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, G/F China
| | - for the Open Access Series of Imaging Studies
- Department of Psychiatry, Multi-Centre, The Chinese University of Hong Kong, Tai Po Hospital, Hong Kong SAR, G/F China
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Mechanical and Automation Engineering, The Chinese University of Hong Kong, Hong Kong SAR, China
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12
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Wong HL, Chan WC, Wong YL, Wong SN, Yung HY, Wong SMC, Cheng PWC. High-definition transcranial direct current stimulation-An open-label pilot intervention in alleviating depressive symptoms and cognitive deficits in late-life depression. CNS Neurosci Ther 2019; 25:1244-1253. [PMID: 31657152 PMCID: PMC6834921 DOI: 10.1111/cns.13253] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/12/2019] [Accepted: 10/14/2019] [Indexed: 12/31/2022] Open
Abstract
The efficacy of high-definition transcranial direct current stimulation (HD-tDCS) in late-life depression (LLD) remains unknown due to limited research on its therapeutic effects on the hallmarks of LLD-the depressive and cognitive symptoms. The present open-label pilot study aimed to examine the effectiveness of HD-tDCS as an augmentation therapy with antidepressants in improving the depressive and cognitive symptoms for LLD. Significant improvements were hypothesized in the depressive, cognitive, and daily functioning outcomes over time. A total of 15 subjects with LLD (13 females, mean age = 73.27 ± 6.25) received five consecutive daily sessions of 20-minute active HD-tDCS interventions weekly for 2 weeks, with a 2 mA anodal stimulation over F3 and cathodal stimulation over FC1, AF3, F7, and FC5. Depressive symptoms and cognitive and daily functioning were assessed across five assessment timepoints. The results revealed that the HD-tDCS was effective in reducing the depressive severity and the remission rates, with a sustained effect at both the 1-month and 3-month follow-up. Pre-post improvements were seen in the overall cognitive functioning and in verbal fluency, but not in executive functioning. Our pilot study provides a preliminary result of HD-tDCS in LLD, which was a safe and effective treatment in alleviating depressive symptoms, with mild cognitive improvements observed. Further larger scale randomized controlled trials are needed to confirm this result.
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Affiliation(s)
- Hau-Lam Wong
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Wai Chi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong
| | - Yiu-Lung Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Sze-Nga Wong
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
| | - Hui-Yan Yung
- Department of Psychiatry, Queen Mary Hospital, Hong Kong
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