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Santander T, Leslie S, Li LJ, Skinner HE, Simonson JM, Sweeney P, Deen KP, Miller MB, Brunye TT. Towards optimized methodological parameters for maximizing the behavioral effects of transcranial direct current stimulation. Front Hum Neurosci 2024; 18:1305446. [PMID: 39015825 PMCID: PMC11250584 DOI: 10.3389/fnhum.2024.1305446] [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: 10/01/2023] [Accepted: 06/12/2024] [Indexed: 07/18/2024] Open
Abstract
Introduction Transcranial direct current stimulation (tDCS) administers low-intensity direct current electrical stimulation to brain regions via electrodes arranged on the surface of the scalp. The core promise of tDCS is its ability to modulate brain activity and affect performance on diverse cognitive functions (affording causal inferences regarding regional brain activity and behavior), but the optimal methodological parameters for maximizing behavioral effects remain to be elucidated. Here we sought to examine the effects of 10 stimulation and experimental design factors across a series of five cognitive domains: motor performance, visual search, working memory, vigilance, and response inhibition. The objective was to identify a set of optimal parameter settings that consistently and reliably maximized the behavioral effects of tDCS within each cognitive domain. Methods We surveyed tDCS effects on these various cognitive functions in healthy young adults, ultimately resulting in 721 effects across 106 published reports. Hierarchical Bayesian meta-regression models were fit to characterize how (and to what extent) these design parameters differentially predict the likelihood of positive/negative behavioral outcomes. Results Consistent with many previous meta-analyses of tDCS effects, extensive variability was observed across tasks and measured outcomes. Consequently, most design parameters did not confer consistent advantages or disadvantages to behavioral effects-a domain-general model suggested an advantage to using within-subjects designs (versus between-subjects) and the tendency for cathodal stimulation (relative to anodal stimulation) to produce reduced behavioral effects, but these associations were scarcely-evident in domain-specific models. Discussion These findings highlight the urgent need for tDCS studies to more systematically probe the effects of these parameters on behavior to fulfill the promise of identifying causal links between brain function and cognition.
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Affiliation(s)
- Tyler Santander
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Sara Leslie
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Luna J. Li
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Henri E. Skinner
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Jessica M. Simonson
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Patrick Sweeney
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Kaitlyn P. Deen
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Michael B. Miller
- Institute for Collaborative Biotechnologies, University of California, Santa Barbara, Santa Barbara, CA, United States
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, Santa Barbara, CA, United States
| | - Tad T. Brunye
- U. S. Army DEVCOM Soldier Center, Natick, MA, United States
- Center for Applied Brain and Cognitive Sciences, Tufts University, Medford, MA, United States
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ul-ain Q, Ilyas S, Ali H, Ali I, Ullah R, Arshad H, Khalid S, Azim ME, Liu T, Wang J. Exploring the Differential Effects of Transcranial Direct Current Stimulation: A Comparative Analysis of Motor Cortex and Cerebellar Stimulation. Heliyon 2024; 10:e26838. [PMID: 38515670 PMCID: PMC10955213 DOI: 10.1016/j.heliyon.2024.e26838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 02/07/2024] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
Background Transcranial Direct Current Stimulation (tDCS) is a non-invasive brain stimulation technique. Constant electric current is passed through the patient's scalp with the aim of modulating cortical excitability. Stroke is a cerebrovascular disease characterized by hemorrhage or cerebral ischemia. This systematic review and meta-analysis are aimed at comparing the efficacy of motor cortex stimulation with that of cerebellar stimulation by using transcranial direct current stimulation. Method Google Scholar, PubMed, EMBASE, Cochrane CENTRAL, and Physiotherapy Evidence Database (Pedro) databases were searched for studies. The extracted qualitative data was synthesized systematically. Cochrane RevMan software was used to conduct a meta-analysis of quantitative data. The fixed effects mean difference of the collected data was calculated at a 95% confidence interval (CI) for the changes in balance and side effects. Results This research included 10 articles with seven studies assessing changes in balance (outcome measured in CoP and FMA scores) and side effects (tingling and itching were the most prevalent). There was no significant difference between the efficacy levels of m1-tDCS versus ctDCS (P = 0.18), m1-tDCS versus sham (P = 0.92), and ctDCS versus sham (P = 0.19). Itching and tingling sensation were the most common and were significantly prevalent in sham interventions (P < 0.00001). Conclusion We found that motor cortex and cerebellar stimulations are both effective in improving motor function in stroke patients. There are no adverse effects to using the interventions besides mild itching and tingling experienced during the stimulation.
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Affiliation(s)
- Qurat ul-ain
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
- National Engineering Research Center for Healthcare Devices Guangzhou, Guangdong, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi'an, Shaanxi, PR China
| | - Saad Ilyas
- Faculty of Computing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Hamid Ali
- Department of Biosciences, COMSATS University Islamabad, Pakistan
| | - Ijaz Ali
- Centre for Applied Mathematics and Bioinformatics, Gulf University for Science and Technology, Hawally, Kuwait
| | - Riaz Ullah
- Department of Pharmacognosy, College of Pharmacy King Saud University, Riyadh, Saudi Arabia
| | - Hafsah Arshad
- Department of Physiotherapy and Rehabilitation, Ibadat International University, Islamabad, Pakistan
| | - Sana Khalid
- Department of Physiotherapy and Rehabilitation, Foundation University Islamabad, Pakistan
| | - Muhammad Ehab Azim
- Department of Physiotherapy and Rehabilitation, Foundation University Islamabad, Pakistan
| | - Tian Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
- National Engineering Research Center for Healthcare Devices Guangzhou, Guangdong, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi'an, Shaanxi, PR China
| | - Jue Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an, PR China
- National Engineering Research Center for Healthcare Devices Guangzhou, Guangdong, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi'an, Shaanxi, PR China
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Zhang F, Han Y, Wang H, Li Y, Tang D. Effects of transcranial direct current stimulation on motor learning in healthy elderly individuals: a systematic review and meta-analysis. Somatosens Mot Res 2024:1-11. [PMID: 38319133 DOI: 10.1080/08990220.2024.2310851] [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: 07/19/2022] [Accepted: 01/02/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is widely used in motor recovery. Nevertheless, whether tDCS improves motor learning in healthy older adults is still controversial. This review aims to investigate the effectiveness of tDCS on motor learning in healthy elderly individuals. METHODS The PubMed, Cochrane Library, Web of Science and Embase databases were initially searched from inception to December 5, 2022. The standard mean difference (SMD) with the corresponding 95% confidence intervals (CIs) were analysed via random-effect models. RESULTS Compared with the sham group, no significant effects were found regarding improvement in motor learning based on the speed or accuracy of the task and reaction time for the tDCS intervention group. After subgroup analysis, a significant effect was found for improved motor learning based on reaction time in the primary motor cortex (M1)-cerebellar group. CONCLUSIONS This review revealed that tDCS had no significant effect on improving the speed or accuracy of motor learning in healthy elderly adults. However, it has a significant effect on improving the motor learning ability based on the reaction time of the task (mainly referring to the tDCS stimulation position of M1 and cerebellar), although the results have obvious heterogeneity and uncertainty.
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Affiliation(s)
- Fusheng Zhang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
- School of Physical Education, Zhaotong University, Zhaotong, China
| | - Yanbai Han
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Hongli Wang
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Yong Li
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Dingyu Tang
- School of Physical Education, Zhaotong University, Zhaotong, China
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Pezzetta R, Gambarota F, Tarantino V, Devita M, Cattaneo Z, Arcara G, Mapelli D, Masina F. A meta-analysis of non-invasive brain stimulation (NIBS) effects on cerebellar-associated cognitive processes. Neurosci Biobehav Rev 2024; 157:105509. [PMID: 38101590 DOI: 10.1016/j.neubiorev.2023.105509] [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: 09/05/2023] [Revised: 11/28/2023] [Accepted: 12/10/2023] [Indexed: 12/17/2023]
Abstract
Non-invasive brain stimulation (NIBS) techniques, including transcranial magnetic stimulation (TMS) and transcranial electrical stimulation (tES), have provided valuable insights into the role of the cerebellum in cognitive processes. However, replicating findings from studies involving cerebellar stimulation poses challenges. This meta-analysis investigates the impact of NIBS on cognitive processes associated with the cerebellum. We conducted a systematic search and analyzed 66 studies and 91 experiments involving healthy adults who underwent either TMS or transcranial direct current stimulation (tDCS) targeting the cerebellum. The results indicate that anodal tDCS applied to the medial cerebellum enhances cognitive performance. In contrast, high-frequency TMS disrupts cognitive performance when targeting the lateral cerebellar hemispheres or when employed in online protocols. Similarly, low-frequency TMS and continuous theta burst stimulation (cTBS) diminish performance in offline protocols. Moreover, high-frequency TMS impairs accuracy. By identifying consistent effects and moderators of modulation, this meta-analysis contributes to improving the replicability of studies using NIBS on the cerebellum and provides guidance for future research aimed at developing effective NIBS interventions targeting the cerebellum.
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Affiliation(s)
| | - Filippo Gambarota
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Vincenza Tarantino
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Italy
| | - Maria Devita
- Department of General Psychology, University of Padova, Padova, Italy; Geriatrics Unit, Department of Medicine, University of Padova, Padova, Italy.
| | - Zaira Cattaneo
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | | | - Daniela Mapelli
- Department of General Psychology, University of Padova, Padova, Italy
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Qurat-ul-ain, Ahmad Z, Ilyas S, Ishtiaq S, Tariq I, Nawaz Malik A, Liu T, Wang J. Comparison of a single session of tDCS on cerebellum vs. motor cortex in stroke patients: a randomized sham-controlled trial. Ann Med 2023; 55:2252439. [PMID: 38100750 PMCID: PMC10732189 DOI: 10.1080/07853890.2023.2252439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 08/20/2023] [Indexed: 12/17/2023] Open
Abstract
OBJECTIVE The purpose of this study was to determine whether a single session of trans-cranial direct current stimulation (tDCS) of the cerebellum and M1 has any advantages over one another or sham stimulation in terms of balance, gait and lower limb function. METHODS A total of 66 patients who had experienced their first ever stroke were recruited into three groups for this double-blinded, parallel, randomized, sham-controlled trial: cerebellar stimulation group (CbSG), M1 stimulation group (MSG) and sham stimulation group (SSG). A single session of anodal tDCS with an intensity of 2 mA for a duration of 20 min was administered in addition to gait and balance training based on virtual reality using an Xbox 360 with Kinect. Balance, gait, cognition and risk of fall were assessed using outcome measures before intervention (T0), immediately after intervention (T1) and an hour after intervention (T2). RESULTS Across group analysis of all outcome measures showed statistically non-significant results (p > .05) except for Six Minute Walk Test (p value T0 = .003, p value T1 = .025, p value T2 = .016). The training effect difference showed a significant difference in balance, gait and cognition, as well as cerebral and cerebellar stimulation, in comparison to sham stimulation (p < .05). The risk of falls remained unaffected by any stimulation (p > .05). CONCLUSIONS In addition to Xbox Kinect-based rehabilitation training, a single session of anodal tDCS to the M1 or cerebellum may be beneficial for improving lower limb function, balance and gait performance.
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Affiliation(s)
- Qurat-ul-ain
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
| | - Zafran Ahmad
- Department of Logistics Engineering, Kunming University of Science & Technology, Kunming, China
| | - Saad Ilyas
- Faculty of Computing, Capital University of Science and Technology, Islamabad, Pakistan
- Department of Computing, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Summaiya Ishtiaq
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Iqbal Tariq
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation & Allied Health Sciences, Riphah College of Rehabilitation & Allied Health Sciences, Islamabad, Pakistan
| | - Tian Liu
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
| | - Jue Wang
- School of Life Science and Technology, The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, Xi’an Jiaotong University, Xi’an, PR China
- National Engineering Research Center for Healthcare Devices, Guangzhou, PR China
- The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs, Xi’an, PR China
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Vandendoorent B, Nackaerts E, Zoetewei D, Hulzinga F, Gilat M, Orban de Xivry JJ, Nieuwboer A. Effect of transcranial direct current stimulation on learning in older adults with and without Parkinson's disease: A systematic review with meta-analysis. Brain Cogn 2023; 171:106073. [PMID: 37611344 DOI: 10.1016/j.bandc.2023.106073] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/26/2023] [Accepted: 07/31/2023] [Indexed: 08/25/2023]
Abstract
Older adults with and without Parkinson's disease show impaired retention after training of motor or cognitive skills. This systematic review with meta-analysis aims to investigate whether adding transcranial direct current stimulation (tDCS) to motor or cognitive training versus placebo boosts motor sequence and working memory training. The effects of interest were estimated between three time points, i.e. pre-training, post-training and follow-up. This review was conducted according to the PRISMA guidelines (PROSPERO: CRD42022348885). Electronic databases were searched from conception to March 2023. Following initial screening, 24 studies were eligible for inclusion in the qualitative synthesis and 20 could be included in the meta-analysis, of which 5 studies concerned motor sequence learning (total n = 186) and 15 working memory training (total n = 650). Results were pooled using an inverse variance random effects meta-analysis. The findings showed no statistically significant additional effects of tDCS over placebo on motor sequence learning outcomes. However, there was a strong trend showing that tDCS boosted working memory training, although methodological limitations and some heterogeneity were also apparent. In conclusion, the present findings do not support wide implementation of tDCS as an add-on to motor sequence training at the moment, but the promising results on cognitive training warrant further investigations.
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Affiliation(s)
- Britt Vandendoorent
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
| | - Evelien Nackaerts
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Demi Zoetewei
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Femke Hulzinga
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Moran Gilat
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jean-Jacques Orban de Xivry
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, KU Leuven, Leuven, Belgium
| | - Alice Nieuwboer
- Neuromotor Rehabilitation Research Group, Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
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Ehsani F, Hafez Yousefi MS, Jafarzadeh A, Zoghi M, Jaberzadeh S. Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sci 2023; 13:1381. [PMID: 37891750 PMCID: PMC10605034 DOI: 10.3390/brainsci13101381] [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: 08/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Mohaddeseh Sadat Hafez Yousefi
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 5166614711, Iran
| | - Abbas Jafarzadeh
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Victoria, Ballarat, VIC 3350, Australia;
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
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de Albuquerque LL, Pantovic M, Clingo M, Fischer K, Jalene S, Landers M, Mari Z, Poston B. A Single Application of Cerebellar Transcranial Direct Current Stimulation Fails to Enhance Motor Skill Acquisition in Parkinson's Disease: A Pilot Study. Biomedicines 2023; 11:2219. [PMID: 37626716 PMCID: PMC10452618 DOI: 10.3390/biomedicines11082219] [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: 06/13/2023] [Revised: 08/01/2023] [Accepted: 08/04/2023] [Indexed: 08/27/2023] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder that leads to numerous impairments in motor function that compromise the ability to perform activities of daily living. Practical and effective adjunct therapies are needed to complement current treatment approaches in PD. Transcranial direct current stimulation applied to the cerebellum (c-tDCS) can increase motor skill in young and older adults. Because the cerebellum is involved in PD pathology, c-tDCS application during motor practice could potentially enhance motor skill in PD. The primary purpose was to examine the influence of c-tDCS on motor skill acquisition in a complex, visuomotor isometric precision grip task (PGT) in PD in the OFF-medication state. The secondary purpose was to determine the influence of c-tDCS on transfer of motor skill in PD. The study utilized a double-blind, SHAM-controlled, within-subjects design. A total of 16 participants completed a c-tDCS condition and a SHAM condition in two experimental sessions separated by a 7-day washout period. Each session involved practice of the PGT concurrent with either c-tDCS or SHAM. Additionally, motor transfer tasks were quantified before and after the practice and stimulation period. The force error in the PGT was not significantly different between the c-tDCS and SHAM conditions. Similarly, transfer task performance was not significantly different between the c-tDCS and SHAM conditions. These findings indicate that a single session of c-tDCS does not elicit acute improvements in motor skill acquisition or transfer in hand and arm tasks in PD while participants are off medications.
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Affiliation(s)
- Lidio Lima de Albuquerque
- School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC 28403, USA;
| | - Milan Pantovic
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Mitchell Clingo
- School of Medicine, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Katherine Fischer
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Sharon Jalene
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
| | - Merrill Landers
- Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Zoltan Mari
- Movement Disorders Program, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV 89106, USA;
| | - Brach Poston
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA; (M.P.); (K.F.); (S.J.)
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9
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Chang Y, Peng D, Zhao Y, Chen X, Li J, Wu X, Liu P, Liu H. Transcranial direct current stimulation over left dorsolateral prefrontal cortex facilitates auditory-motor integration for vocal pitch regulation. Front Neurosci 2023; 17:1208581. [PMID: 37457017 PMCID: PMC10347532 DOI: 10.3389/fnins.2023.1208581] [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: 04/19/2023] [Accepted: 06/16/2023] [Indexed: 07/18/2023] Open
Abstract
Background A growing body of literature has implicated the left dorsolateral prefrontal cortex (DLPFC) in the online monitoring of vocal production through auditory feedback. Specifically, disruption of or damage to the left DLPFC leads to exaggerated compensatory vocal responses to altered auditory feedback. It is conceivable that enhancing the cortical excitability of the left DLPFC may produce inhibitory influences on vocal feedback control by reducing vocal compensations. Methods We used anodal transcranial direct current stimulation (a-tDCS) to modulate cortical excitability of the left DLPFC and examined its effects on auditory-motor integration for vocal pitch regulation. Seventeen healthy young adults vocalized vowel sounds while hearing their voice pseudo-randomly pitch-shifted by ±50 or ±200 cents, either during (online) or after (offline) receiving active or sham a-tDCS over the left DLPFC. Results Active a-tDCS over the left DLPFC led to significantly smaller peak magnitudes and shorter peak times of vocal compensations for pitch perturbations than sham stimulation. In addition, this effect was consistent regardless of the timing of a-tDCS (online or offline stimulation) and the size and direction of the pitch perturbation. Conclusion These findings provide the first causal evidence that a-tDCS over the left DLPFC can facilitate auditory-motor integration for compensatory adjustment to errors in vocal output. Reduced and accelerated vocal compensations caused by a-tDCS over left DLPFC support the hypothesis of a top-down neural mechanism that exerts inhibitory control over vocal motor behavior through auditory feedback.
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Affiliation(s)
- Yichen Chang
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Danhua Peng
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yan Zhao
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xi Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jingting Li
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiuqin Wu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Peng Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hanjun Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
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10
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Byczynski G, Vanneste S. Modulating motor learning with brain stimulation: Stage-specific perspectives for transcranial and transcutaneous delivery. Prog Neuropsychopharmacol Biol Psychiatry 2023; 125:110766. [PMID: 37044280 DOI: 10.1016/j.pnpbp.2023.110766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/22/2023] [Accepted: 04/09/2023] [Indexed: 04/14/2023]
Abstract
Brain stimulation has been used in motor learning studies with success in improving aspects of task learning, retention, and consolidation. Using a variety of motor tasks and stimulus parameters, researchers have produced an array of literature supporting the efficacy of brain stimulation to modulate motor task learning. We discuss the use of transcranial direct current stimulation, transcranial alternating current stimulation, and peripheral nerve stimulation to modulate motor learning. In a novel approach, we review literature of motor learning modulation in terms of learning stage, categorizing learning into acquisition, consolidation, and retention. We endeavour to provide a current perspective on the stage-specific mechanism behind modulation of motor task learning, to give insight into how electrical stimulation improves or hinders motor learning, and how mechanisms differ depending on learning stage. Offering a look into the effectiveness of peripheral nerve stimulation for motor learning, we include potential mechanisms and overlapping features with transcranial stimulation. We conclude by exploring how peripheral stimulation may contribute to the results of studies that employed brain stimulation intracranially.
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Affiliation(s)
- Gabriel Byczynski
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; Global Brain Health Institute, Trinity College Dublin, D02 PN40, Ireland
| | - Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; School of Psychology, Trinity College Institute for Neuroscience, School of Psychology, Trinity College Dublin, D02 PN40, Ireland; Global Brain Health Institute, Trinity College Dublin, D02 PN40, Ireland.
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11
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Qurat-ul-ain, Ahmad Z, Ishtiaq S, Ilyas S, Shahid I, Tariq I, Malik AN, Liu T, Wang J. Short term effects of anodal cerebellar vs. anodal cerebral transcranial direct current stimulation in stroke patients, a randomized control trial. Front Neurosci 2022; 16:1035558. [PMID: 36507323 PMCID: PMC9730515 DOI: 10.3389/fnins.2022.1035558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 10/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Balance and gait impairments are major motor deficits in stroke patients that require intensive neuro-rehabilitation. Anodal transcranial direct current stimulation is a neuro-modulatory technique recently used in stroke patients for balance and gait improvement. Majority of studies focusing on tDCS have assessed its effects on cerebral motor cortex and more recently cerebellum as well but to our best knowledge the comparison of stimulating these two regions in stroke patients is not investigated so far. Objective The current study aimed to compare the effect of anodal transcranial direct current stimulation on cerebellar and cerebral motor cortex M1 in stroke patients. Materials and methods This double-blinded, parallel, randomized, sham controlled trial included 66 patients with a first-ever ischemic stroke were recruited into three groups; Cerebellar stimulation group (CbSG), M1 Stimulation Group (MSG), and Sham stimulation group (SSG). A total of three sessions of anodal transcranial direct current stimulation were given on consecutive days in addition to non-immersive virtual reality using Xbox 360 with kinect. Anodal tDCS with an intensity of 2 mA was applied for a duration of 20 min. Primary outcome measures berg balance scale (BBS), timed up and go test (TUG), BESTest Balance Evaluation-Systems Test (BESTest) and secondary outcomes measures montreal cognitive assessment (MoCA), mini mental state examination (MMSE), Johns Hopkins Fall Risk Assessment Tool (JHFRAT), twenty five feet walk test (25FWT), six minute walk test (6MWT), and tDCS Adverse Effects was assessed before initiation of treatment (T0) and at the end of third session of stimulation (T1). Results The results of between group's analysis using mean difference showed a significant difference with p-value <0.05 for balance (BBS, TUG, BESTest), walking ability (6MWT, 25FWT), risk of fall (JHFRAT). Cognitive function did not show any significant change among the groups for MoCA with p-value >0.05 but MMSE was improved having significant p-value (p = 0.013). However, 6MWT and 25FWT showed non-significant results for both between group and within group analysis. In pairwise comparison both the cerebellar and cerebral stimulation groups showed Significant difference with p-value <0.05 in comparison to sham stimulation; BBS (cerebellar vs. sham p ≤ 0.001, cerebral vs. sham p = 0.011), TUG (cerebellar vs. sham p = 0.001, cerebral vs. sham p = 0.041), Bestest (cerebellar vs. sham p = 0.007, cerebral vs. sham p = 0.003). Whereas for JHFRAT only cerebellar stimulation in comparison to sham and motor cortex stimulation showed significant improvements (cerebellar vs. M1 p = 0.037, cerebellar vs. sham p = 0.037). MMSE showed significant improvement in M1 stimulation (M1 vs. cerebellar p = 0.036, M1 vs. sham p = 0.011). Conclusion Findings of the study suggest anodal tDCS stimulation of the cerebellum and cerebral motor cortex both improves gait, balance and risk of fall in stroke patients. However, both stimulation sites do not induce any notable improvement in cognitive function. Effects of both stimulation sites have similar effects on mobility in stroke patients.
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Affiliation(s)
- Qurat-ul-ain
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China
| | - Zafran Ahmad
- School of Economics and Management, Yunnan University, Kunming, China
| | - Summaiya Ishtiaq
- Department of Rehabilitation Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Saad Ilyas
- Faculty of Computing, Capital University of Science and Technology, Islamabad, Pakistan
| | - Irum Shahid
- Institute of Physical Medical and Rehabilitation, Khyber Medical University, Peshawar, Pakistan
| | - Iqbal Tariq
- Faculty of Rehabilitation and Allied Health Sciences, Riphah College of Rehabilitation and Allied Health Sciences, Islamabad, Pakistan
| | - Arshad Nawaz Malik
- Faculty of Rehabilitation and Allied Health Sciences, Riphah College of Rehabilitation and Allied Health Sciences, Islamabad, Pakistan
| | - Tian Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China
| | - Jue Wang
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, China,National Engineering Research Center for Healthcare Devices Guangzhou, Guangzhou, Guangdong, China,The Key Laboratory of Neuro-informatics & Rehabilitation Engineering of Ministry of Civil Affairs Xi’an, Xi’an, Shaanxi, China,*Correspondence: Jue Wang,
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12
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Hu K, Wan R, Liu Y, Niu M, Guo J, Guo F. Effects of transcranial alternating current stimulation on motor performance and motor learning for healthy individuals: A systematic review and meta-analysis. Front Physiol 2022; 13:1064584. [PMID: 36467691 PMCID: PMC9715745 DOI: 10.3389/fphys.2022.1064584] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Accepted: 11/07/2022] [Indexed: 11/26/2023] Open
Abstract
Objective:Previous behavioral studies have reported the potential of transcranial alternating current stimulation in analyzing the causal relationship between neural activity and behavior. However, the efficacy of tACS on motor performance and learning in healthy individuals remains unclear. This systematic reviewexamines the effectiveness of tACS on motor performance and motor learning in healthy individuals. Methods: Literature was systematically searched through the Cochrane Library, PubMed, EMBASE, and Web of Science until 16 October 2022. Studies were eligible for review if they were randomized, parallel, or crossover experimental designs and reported the efficacy of tACS on motor performance and motor learning in healthy adults. Review Manager 5.3 was used to evaluate the methodological quality and analyze the combined effect. Results: Ten studies (270 participants) met all the inclusion criteria. The results showed that motor performance was not significantly greater than that with sham tACS stimulation [I2 = 44%, 95% CI (-0.01, 0.35), p = 0.06, standardized mean difference = 0.17], whereas motor learning ability improved significantly [I2 = 33%, 95% CI (-1.03, -0.31), p = 0.0002, SMD = -0.67]. Subgroup analysis found that gamma bend tACS could affect the changes in motor performance (I2 = 6%, 95% CI (0.05, 0.51), p = 0.02, SMD = 0.28), and online tACS did as well [I2 = 54%, 95% CI (0.12, 0.56), p = 0.002, SMD = 0.34]. Conclusion: The results showed that tACS effectively improves motor performance (gamma band and online mode) and motor learning in healthy individuals, which indicates that tACS may be a potential therapeutic tool to improve motor behavioral outcomes. However, further evidence is needed to support these promising results. Systematic Review Registration: PROSPERO, identifier CRD42022342884.
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Affiliation(s)
- Kun Hu
- College of Human Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Ruihan Wan
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, China
| | - Ying Liu
- Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Maolin Niu
- College of Human Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Jianrui Guo
- College of Human Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
| | - Feng Guo
- College of Human Kinesiology, Shenyang Sport University, Shenyang, Liaoning, China
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13
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Siew-Pin Leuk J, Yow KE, Zi-Xin Tan C, Hendy AM, Kar-Wing Tan M, Hock-Beng Ng T, Teo WP. A meta-analytical review of transcranial direct current stimulation parameters on upper limb motor learning in healthy older adults and people with Parkinson's disease. Rev Neurosci 2022; 34:325-348. [PMID: 36138560 DOI: 10.1515/revneuro-2022-0073] [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: 06/14/2022] [Accepted: 08/22/2022] [Indexed: 11/15/2022]
Abstract
Current literature lacks consolidated evidence for the impact of stimulation parameters on the effects of transcranial direct current stimulation (tDCS) in enhancing upper limb motor learning. Hence, we aim to synthesise available methodologies and results to guide future research on the usage of tDCS on upper limb motor learning, specifically in older adults and Parkinson's disease (PD). Thirty-two studies (Healthy older adults, N = 526, M = 67.25, SD = 4.30 years; PD, N = 216, M = 66.62, SD = 6.25 years) were included in the meta-analysis. All included studies consisted of active and sham protocols. Random effect meta-analyses were conducted for (i) subjects (healthy older adults and PD); (ii) intensity (1.0, 1.5, 2 mA); (iii) electrode montage (unilateral anodal, bilateral anodal, unilateral cathodal); (iv) stimulation site (cerebellum, frontal, motor, premotor, SMA, somatosensory); (v) protocol (online, offline). Significant tDCS effect on motor learning was reported for both populations, intensity 1.0 and 2.0 mA, unilateral anodal and cathodal stimulation, stimulation site of the motor and premotor cortex, and both online and offline protocols. Regression showed no significant relationship between tDCS effects and density. The efficacy of tDCS is also not affected by the number of sessions. However, studies that reported only single session tDCS found significant negative association between duration with motor learning outcomes. Our findings suggest that different stimulation parameters enhanced upper limb motor learning in older adults and PD. Future research should combine tDCS with neuroimaging techniques to help with optimisation of the stimulation parameters, considering the type of task and population.
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Affiliation(s)
- Jessie Siew-Pin Leuk
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
| | - Kai-En Yow
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
| | - Clenyce Zi-Xin Tan
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
| | - Ashlee M Hendy
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences (SENS), Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia
| | - Mika Kar-Wing Tan
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
| | - Tommy Hock-Beng Ng
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
| | - Wei-Peng Teo
- Physical Education and Sports Science (PESS) Academic Group, National Institute of Education, Nanyang Technological University, 1 Nanyang Walk, Singapore 637616, Singapore
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Ponce GV, Klaus J, Schutter DJLG. A Brief History of Cerebellar Neurostimulation. CEREBELLUM (LONDON, ENGLAND) 2022; 21:715-730. [PMID: 34403075 PMCID: PMC9325826 DOI: 10.1007/s12311-021-01310-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 12/28/2022]
Abstract
The first attempts at using electric stimulation to study human brain functions followed the experiments of Luigi Galvani and Giovanni Aldini on animal electricity during the eighteenth century. Since then, the cerebellum has been among the areas that have been studied by invasive and non-invasive forms of electrical and magnetic stimulation. During the nineteenth century, animal experiments were conducted to map the motor-related regions of cerebellar cortex by means of direct electric stimulation. As electric stimulation research on the cerebellum moved into the twentieth century, systematic research of electric cerebellar stimulation led to a better understanding of its effects and mechanism of action. In addition, the clinical potential of cerebellar stimulation in the treatment of motor diseases started to be explored. With the introduction of transcranial electric and magnetic stimulation, cerebellar research moved to non-invasive techniques. During the twenty-first century, following on groundbreaking research that linked the cerebellum to non-motor functions, non-invasive techniques have facilitated research into different aspects of cerebellar functioning. The present review provides a brief historical account of cerebellar neurostimulation and discusses current challenges and future direction in this field of research.
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Affiliation(s)
- Gustavo V Ponce
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584CS, Utrecht, The Netherlands
| | - Jana Klaus
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584CS, Utrecht, The Netherlands
| | - Dennis J L G Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584CS, Utrecht, The Netherlands.
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15
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Liu C, Xie Y, Hao Y, Zhang W, Yang L, Bu J, Wei Z, Wu H, Pescetelli N, Zhang X. Using multisession tDCS stimulation as an early intervention on memory bias processing in subthreshold depression. Psychophysiology 2022; 60:e14148. [PMID: 35819779 DOI: 10.1111/psyp.14148] [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] [Received: 01/07/2021] [Revised: 05/24/2022] [Accepted: 06/13/2022] [Indexed: 12/01/2022]
Abstract
Transcranial direct current stimulation (tDCS) as an intervention tool has gained promising results in major depression disorder. However, studies related to subthreshold depression's (SD) cognitive deficits and neuromodulation approaches for the treatment of SD are still rare. We adopted Beck's cognitive model of depression and tested the tDCS stimulation effects on attentional and memory deficits on SD. First, this was a single-blinded, randomized, sham-controlled clinical trial to determine a 13-day tDCS modulation effect on 49 SD (27: Stimulation; 22: Sham) and 17 healthy controls. Second, the intervention effects of the consecutive and single-session tDCS were compared. Furthermore, the attentional and memory biases were explored in SD. Anodal tDCS was administrated over left dorsolateral prefrontal cortex for 13 consecutive days. Attentional and memory bias were assessed through a modified Sternberg task and a dot-probe task on the 1st, 2nd, and 15th day while their EEG was being recorded. After the 13-day tDCS stimulation (not after single-session stimulation), we found reduced memory bias (Stimulation vs. Sham, p = .02, r2 = .09) and decreased mid-frontal alpha power (p < .01, r2 = .13). In contrast, tDCS did not affect any attentional related behavioral or neural indexes (all ps > .15). Finally, reduced depressive symptoms (e.g., BDI score) were found for both groups. The criteria of SD varied across studies; the efficacy of this protocol should be tested in elderly patients. Our study suggests memory bias of SD can be modulated by the multisession tDCS and alpha power could serve as a neural index for intervention.
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Affiliation(s)
- Chialun Liu
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Yunlu Xie
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Yaru Hao
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Wei Zhang
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Lizhuang Yang
- Anhui Province Key Laboratory of Medical Physics and Technology, Institute of health and medical technique, Hefei Institute of Physical Science, Chinese Academy of Science, Hefei, China
| | - Junjie Bu
- School of Biomedical Engineering, Research and Engineering Center of Biomedical Materials, Anhui Medical University, Hefei, China
| | - Zhengde Wei
- Hefei National Laboratory for Physical Sciences at the Microscale and School of Life Sciences, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China
| | - Haiyan Wu
- Centre for Cognitive and Brain Sciences (CCBS), University of Macau (UM), Macau, China
| | - Niccolo' Pescetelli
- Hybrid Collective Intelligence Group, Center for Humans and Machines, Max Planck Institute for Human Development, Berlin, Germany
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities & Social Science, University of Science & Technology of China, Hefei, China.,Department of Radiology, the First Affiliated Hospital of USTC, Hefei National Research Center for Physical Sciences at the Microscale and School of Life Science, Division of Life Science and Medicine, University of Science & Technology of China, Hefei, China.,Application Technology Center of Physical Therapy to Brain Disorders, Institute of Advanced Technology, University of Science & Technology of China, Hefei, China.,Biomedical Sciences and Health Laboratory of Anhui Province, University of Science & Technology of China, Hefei, China
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16
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Ehsani F, Mortezanejad M, Yosephi MH, Daniali S, Jaberzadeh S. The effects of concurrent M1 anodal tDCS and physical therapy interventions on function of ankle muscles in patients with stroke: a randomized, double-blinded sham-controlled trial study. Neurol Sci 2021; 43:1893-1901. [PMID: 34476629 DOI: 10.1007/s10072-021-05503-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 07/22/2021] [Indexed: 11/26/2022]
Abstract
One of the most common symptoms in stroke patients is spasticity. The aims were to investigate the effects of anodal trans-cranial direct current stimulation (a-tDCS) over the affected primary motor cortex (M1) on ankle plantar flexor spasticity and dorsiflexor muscle activity in stroke patients. The design of this study was a randomized sham-controlled clinical trial. Thirty-two participants with stroke were randomly assigned to three groups (experimental, sham, control groups). Participants in the experimental and sham groups received 10-session 20-min M1 a-tDCS concurrent with physical therapy (PT), while the control group only received 10-session PT. All groups were instructed to perform home stretching exercises and balance training. Berg Balance Scale (BBS), Modified Ashworth Scale (MAS) of plantar flexors, and EMG activity of lateral gastrocnemius (LG) and tibialis anterior (TA) were recorded during active and passive ankle dorsiflexion immediately and 1 month after interventions. A significant reduction was shown in MAS and EMG activity of LG during dorsiflexion, immediately and 1 month after intervention in the M1 a-tDCS group (p <0.001). BBS also significantly increased only in the M1 a-tDCS group (p <0.001). In addition, EMG activity of TA during active dorsiflexion increased immediately and 1 month after intervention in the M1 a-tDCS group (p <0.001). However, in the sham and control groups, EMG activity of TA increased immediately (p<0.001), while this was not maintained 1 month after intervention (p >0.05). PT concurrent with M1 a-tDCS can significantly prime lasting effects of decreasing LG spasticity, increasing TA muscle activity, and also balance in stroke patients.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran.
| | - Marzieh Mortezanejad
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohaddeseh Hafez Yosephi
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran
| | - Said Daniali
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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17
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Lee JH, Lee TL, Kang N. Transcranial direct current stimulation decreased cognition-related reaction time in older adults: A systematic review and meta-analysis. Ageing Res Rev 2021; 70:101377. [PMID: 34089900 DOI: 10.1016/j.arr.2021.101377] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/18/2021] [Accepted: 05/31/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND This systematic review and meta-analysis investigated the effects of transcranial direct current stimulation (tDCS) on the cognitive functions of healthy older adults by focusing on the changes in reaction time during cognitive tasks. METHOD A total of 31 studies qualified for this meta-analysis, and we acquired 36 comparisons from the included studies for data synthesis. The individual effect sizes were calculated by comparing the altered reaction time during the performance of a specific cognitive task between the active tDCS and sham groups. In two moderator variable analyses, we examined the potentially different effects of the tDCS protocols on the cognition-related reaction time based on the tDCS protocol used (i.e., online vs. offline tDCS) and the five cognitive domains: (a) perceptual-motor function, (b) learning and memory, (c) executive function / complex attention, (d) language, and (e) social cognition. Meta-regression analyses were conducted to estimate the relationship between demographic and tDCS parameter characteristics and the changes in reaction time. RESULTS The random-effects model meta-analysis revealed significant small effects of tDCS on cognition-related reaction time. Specifically, providing online tDCS significantly reduced the reaction time, and these patterns were observed during learning and memory and executive function / complex attention tasks. However, applying offline tDCS failed to find any significant reduction of reaction time across various cognitive tasks. The meta-regression analysis revealed that the effects of tDCS on the reaction time during the performance of cognitive tasks increased for the older people. CONCLUSIONS These findings suggest that providing online tDCS may effectively improve the ageing-induced reaction time related to specific cognitive functions of elderly people.
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Billeri L, Naro A. A narrative review on non-invasive stimulation of the cerebellum in neurological diseases. Neurol Sci 2021; 42:2191-2209. [PMID: 33759055 DOI: 10.1007/s10072-021-05187-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 03/15/2021] [Indexed: 12/26/2022]
Abstract
IMPORTANCE The cerebellum plays an important role in motor, cognitive, and affective functions owing to its dense interconnections with basal ganglia and cerebral cortex. This review aimed at summarizing the non-invasive cerebellar stimulation (NICS) approaches used to modulate cerebellar output and treat cerebellar dysfunction in the motor domain. OBSERVATION The utility of NICS in the treatment of cerebellar and non-cerebellar neurological diseases (including Parkinson's disease, dementia, cerebellar ataxia, and stroke) is discussed. NICS induces meaningful clinical effects from repeated sessions alone in both cerebellar and non-cerebellar diseases. However, there are no conclusive data on this issue and several concerns need to be still addressed before NICS could be considered a valuable, standard therapeutic tool. CONCLUSIONS AND RELEVANCE Even though some challenges must be overcome to adopt NICS in a wider clinical setting, this tool might become a useful strategy to help patients with lesions in the cerebellum and cerebral areas that are connected with the cerebellum whether one could enhance cerebellar activity with the intention of facilitating the cerebellum and the entire, related network, rather than attempting to facilitate a partially damaged cortical region or inhibiting the homologs' contralateral area. The different outcome of each approach would depend on the residual functional reserve of the cerebellum, which is confirmed as a critical element to be probed preliminary in order to define the best patient-tailored NICS.
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Affiliation(s)
- Luana Billeri
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS113, Ctr. Casazza, 98124, Messina, Italy
| | - Antonino Naro
- IRCCS Centro Neurolesi Bonino Pulejo, via Palermo, SS113, Ctr. Casazza, 98124, Messina, Italy.
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19
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Online and offline effects of transcranial alternating current stimulation of the primary motor cortex. Sci Rep 2021; 11:3854. [PMID: 33594133 PMCID: PMC7887242 DOI: 10.1038/s41598-021-83449-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 01/05/2021] [Indexed: 01/31/2023] Open
Abstract
Transcranial alternating current stimulation (tACS) is a non-invasive brain stimulation technique that allows interaction with endogenous cortical oscillatory rhythms by means of external sinusoidal potentials. The physiological mechanisms underlying tACS effects are still under debate. Whereas online (e.g., ongoing) tACS over the motor cortex induces robust state-, phase- and frequency-dependent effects on cortical excitability, the offline effects (i.e. after-effects) of tACS are less clear. Here, we explored online and offline effects of tACS in two single-blind, sham-controlled experiments. In both experiments we used neuronavigated transcranial magnetic stimulation (TMS) of the primary motor cortex (M1) as a probe to index changes of cortical excitability and delivered M1 tACS at 10 Hz (alpha), 20 Hz (beta) and sham (30 s of low-frequency transcranial random noise stimulation; tRNS). Corticospinal excitability was measured by single pulse TMS-induced motor evoked potentials (MEPs). tACS was delivered online in Experiment 1 and offline in Experiment 2. In Experiment 1, the increase of MEPs size was maximal with the 20 Hz stimulation, however in Experiment 2 neither the 10 Hz nor the 20 Hz stimulation induced tACS offline effects. These findings support the idea that tACS affects cortical excitability only during online application, at least when delivered on the scalp overlying M1, thereby contributing to the development of effective protocols that can be applied to clinical populations.
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Nguemeni C, Stiehl A, Hiew S, Zeller D. No Impact of Cerebellar Anodal Transcranial Direct Current Stimulation at Three Different Timings on Motor Learning in a Sequential Finger-Tapping Task. Front Hum Neurosci 2021; 15:631517. [PMID: 33613217 PMCID: PMC7892471 DOI: 10.3389/fnhum.2021.631517] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 01/13/2021] [Indexed: 11/21/2022] Open
Abstract
Background: Recently, attention has grown toward cerebellar neuromodulation in motor learning using transcranial direct current stimulation (tDCS). An important point of discussion regarding this modulation is the optimal timing of tDCS, as this parameter could significantly influence the outcome. Hence, this study aimed to investigate the effects of the timing of cerebellar anodal tDCS (ca-tDCS) on motor learning using a sequential finger-tapping task (FTT). Methods: One hundred and twenty two healthy young, right-handed subjects (96 females) were randomized into four groups (Duringsham, Before, Duringreal, After). They performed 2 days of FTT with their non-dominant hand on a custom keyboard. The task consisted of 40 s of typing followed by 20 s rest. Each participant received ca-tDCS (2 mA, sponge electrodes of 25 cm2, 20 min) at the appropriate timing and performed 20 trials on the first day (T1, 20 min). On the following day, only 10 trials of FTT were performed without tDCS (T2, 10 min). Motor skill performance and retention were assessed. Results: All participants showed a time-dependent increase in learning. Motor performance was not different between groups at the end of T1 (p = 0.59). ca-tDCS did not facilitate the retention of the motor skill in the FTT at T2 (p = 0.27). Thus, our findings indicate an absence of the effect of ca-tDCS on motor performance or retention of the FTT independently from the timing of stimulation. Conclusion: The present results suggest that the outcome of ca-tDCS is highly dependent on the task and stimulation parameters. Future studies need to establish a clear basis for the successful and reproducible clinical application of ca-tDCS.
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Affiliation(s)
- Carine Nguemeni
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Annika Stiehl
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Shawn Hiew
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
| | - Daniel Zeller
- Department of Neurology, University Hospital of Würzburg, Würzburg, Germany
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21
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Hermsdorf F, Fricke C, Stockert A, Classen J, Rumpf JJ. Motor Performance But Neither Motor Learning Nor Motor Consolidation Are Impaired in Chronic Cerebellar Stroke Patients. THE CEREBELLUM 2020; 19:275-285. [PMID: 31997138 PMCID: PMC7082373 DOI: 10.1007/s12311-019-01097-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The capacity to acquire and retain new motor skills is essential for everyday behavior and a prerequisite to regain functional independence following impairments of motor function caused by brain damage, e.g., ischemic stroke. Learning a new motor skill requires repeated skill practice and passes through different online and offline learning stages that are mediated by specific dynamic interactions between distributed brain regions including the cerebellum. Motor sequence learning is an extensively studied paradigm of motor skill learning, yet the role of the cerebellum during online and offline stages remains controversial. Here, we studied patients with chronic cerebellar stroke and healthy control participants to further elucidate the role of the cerebellum during acquisition and consolidation of sequential motor skills. Motor learning was assessed by an ecologically valid explicit sequential finger tapping paradigm and retested after an interval of 8 h to assess consolidation. Compared to healthy controls, chronic cerebellar stroke patients displayed significantly lower motor sequence performance independent of whether the ipsilesional or contralesional hand was used for task execution. However, the ability to improve performance during training (i.e., online learning) and to consolidate training-induced skill formation was similar in patients and controls. Findings point to an essential role of the cerebellum in motor sequence production that cannot be compensated, while its role in online and offline motor sequence learning seems to be either negligible or amenable to compensatory mechanisms. This further suggests that residual functional impairments caused by cerebellar stroke may be mitigated even months later by additional skill training.
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Affiliation(s)
- Franz Hermsdorf
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Christopher Fricke
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Anika Stockert
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Joseph Classen
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany
| | - Jost-Julian Rumpf
- Department of Neurology, University of Leipzig, Liebigstr. 20, 04103, Leipzig, Germany.
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22
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Kumari N, Taylor D, Rashid U, Vandal AC, Smith PF, Signal N. Cerebellar transcranial direct current stimulation for learning a novel split-belt treadmill task: a randomised controlled trial. Sci Rep 2020; 10:11853. [PMID: 32678285 PMCID: PMC7366632 DOI: 10.1038/s41598-020-68825-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 06/30/2020] [Indexed: 11/09/2022] Open
Abstract
This study aimed to examine the effect of repeated anodal cerebellar transcranial direct current stimulation (ctDCS) on learning a split-belt treadmill task. Thirty healthy individuals randomly received three consecutive sessions of active or sham anodal ctDCS during split-belt treadmill training. Motor performance and strides to steady-state performance were evaluated before (baseline), during (adaptation), and after (de-adaptation) the intervention. The outcomes were measured one week later to assess absolute learning and during the intervention to evaluate cumulative, consecutive, and session-specific effects. Data were analysed using linear mixed-effects regression models. During adaptation, there was no significant difference in absolute learning between the groups (p > 0.05). During de-adaptation, a significant difference in absolute learning between the groups (p = 0.03) indicated slower de-adaptation with anodal ctDCS. Pre-planned secondary analysis revealed that anodal ctDCS significantly reduced the cumulative (p = 0.01) and consecutive-session effect (p = 0.01) on immediate adaptation. There were significant cumulative (p = 0.02) and session-specific effects (p = 0.003) on immediate de-adaptation. Repeated anodal ctDCS does not enhance motor learning measured during adaptation to a split-belt treadmill task. However, it influences the maintenance of learnt walking patterns, suggesting that it may be beneficial in maintaining therapeutic effects.
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Affiliation(s)
- Nitika Kumari
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.
| | - Denise Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
| | - Usman Rashid
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Alain C Vandal
- Department of Statistics, University of Auckland, Auckland, New Zealand
| | - Paul F Smith
- Department of Pharmacology and Toxicology, School of Biomedical Sciences, Brain Health Research Centre, University of Otago, Dunedin, New Zealand.,Brain Research New Zealand, Auckland, New Zealand
| | - Nada Signal
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
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23
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Morya E, Monte-Silva K, Bikson M, Esmaeilpour Z, Biazoli CE, Fonseca A, Bocci T, Farzan F, Chatterjee R, Hausdorff JM, da Silva Machado DG, Brunoni AR, Mezger E, Moscaleski LA, Pegado R, Sato JR, Caetano MS, Sá KN, Tanaka C, Li LM, Baptista AF, Okano AH. Beyond the target area: an integrative view of tDCS-induced motor cortex modulation in patients and athletes. J Neuroeng Rehabil 2019; 16:141. [PMID: 31730494 PMCID: PMC6858746 DOI: 10.1186/s12984-019-0581-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 08/19/2019] [Indexed: 02/07/2023] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) is a non-invasive technique used to modulate neural tissue. Neuromodulation apparently improves cognitive functions in several neurologic diseases treatment and sports performance. In this study, we present a comprehensive, integrative review of tDCS for motor rehabilitation and motor learning in healthy individuals, athletes and multiple neurologic and neuropsychiatric conditions. We also report on neuromodulation mechanisms, main applications, current knowledge including areas such as language, embodied cognition, functional and social aspects, and future directions. We present the use and perspectives of new developments in tDCS technology, namely high-definition tDCS (HD-tDCS) which promises to overcome one of the main tDCS limitation (i.e., low focality) and its application for neurological disease, pain relief, and motor learning/rehabilitation. Finally, we provided information regarding the Transcutaneous Spinal Direct Current Stimulation (tsDCS) in clinical applications, Cerebellar tDCS (ctDCS) and its influence on motor learning, and TMS combined with electroencephalography (EEG) as a tool to evaluate tDCS effects on brain function.
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Affiliation(s)
- Edgard Morya
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Rio Grande do Norte Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Kátia Monte-Silva
- Universidade Federal de Pernambuco, Recife, Pernambuco Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY USA
| | - Zeinab Esmaeilpour
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY USA
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Andre Fonseca
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Tommaso Bocci
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy
| | - Faranak Farzan
- School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia Canada
| | - Raaj Chatterjee
- School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia Canada
| | - Jeffrey M. Hausdorff
- Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Eva Mezger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Luciane Aparecida Moscaleski
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Rodrigo Pegado
- Graduate Program in Rehabilitation Science, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Marcelo Salvador Caetano
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Kátia Nunes Sá
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia Brazil
| | - Clarice Tanaka
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Laboratório de Investigações Médicas-54, Universidade de São Paulo, São Paulo, São Paulo Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Abrahão Fontes Baptista
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia Brazil
- Laboratório de Investigações Médicas-54, Universidade de São Paulo, São Paulo, São Paulo Brazil
| | - Alexandre Hideki Okano
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
- Graduate Program in Physical Education. State University of Londrina, Londrina, Paraná, Brazil
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24
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Patel R, Ashcroft J, Patel A, Ashrafian H, Woods AJ, Singh H, Darzi A, Leff DR. The Impact of Transcranial Direct Current Stimulation on Upper-Limb Motor Performance in Healthy Adults: A Systematic Review and Meta-Analysis. Front Neurosci 2019; 13:1213. [PMID: 31803003 PMCID: PMC6873898 DOI: 10.3389/fnins.2019.01213] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022] Open
Abstract
Background: Transcranial direct current stimulation (tDCS) has previously been reported to improve facets of upper limb motor performance such as accuracy and strength. However, the magnitude of motor performance improvement has not been reviewed by contemporaneous systematic review or meta-analysis of sham vs. active tDCS. Objective: To systematically review and meta-analyse the existing evidence regarding the benefits of tDCS on upper limb motor performance in healthy adults. Methods: A systematic search was conducted to obtain relevant articles from three databases (MEDLINE, EMBASE, and PsycINFO) yielding 3,200 abstracts. Following independent assessment by two reviewers, a total of 86 articles were included for review, of which 37 were deemed suitable for meta-analysis. Results: Meta-analyses were performed for four outcome measures, namely: reaction time (RT), execution time (ET), time to task failure (TTF), and force. Further qualitative review was performed for accuracy and error. Statistically significant improvements in RT (effect size −0.01; 95% CI −0.02 to 0.001, p = 0.03) and ET (effect size −0.03; 95% CI −0.05 to −0.01, p = 0.017) were demonstrated compared to sham. In exercise tasks, increased force (effect size 0.10; 95% CI 0.08 to 0.13, p < 0.001) and a trend towards improved TTF was also observed. Conclusions: This meta-analysis provides evidence attesting to the impact of tDCS on upper limb motor performance in healthy adults. Improved performance is demonstrable in reaction time, task completion time, elbow flexion tasks and accuracy. Considerable heterogeneity exists amongst the literature, further confirming the need for a standardised approach to reporting tDCS studies.
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Affiliation(s)
- Ronak Patel
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - James Ashcroft
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Ashish Patel
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Hutan Ashrafian
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Adam J Woods
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Harsimrat Singh
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Ara Darzi
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
| | - Daniel Richard Leff
- Department of Surgery & Cancer, Imperial College London, London, United Kingdom
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25
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Kumari N, Taylor D, Signal N. The Effect of Cerebellar Transcranial Direct Current Stimulation on Motor Learning: A Systematic Review of Randomized Controlled Trials. Front Hum Neurosci 2019; 13:328. [PMID: 31636552 PMCID: PMC6788395 DOI: 10.3389/fnhum.2019.00328] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Cerebellar transcranial direct current stimulation (ctDCS) appears to modulate motor performance in both adaptation and motor skill tasks; however, whether the gains are long-lasting is unclear. Objectives: This systematic review aims to evaluate the effect of ctDCS with respect to different time scales of motor learning. Methods: Ten electronic databases (CINAHL, MEDLINE, SPORT Discus, Scopus, Web of Science, Cochrane via OVID, Evidence-Based Reviews (EBM) via OVID, AMED: Allied and Complementary Medicine, PsycINFO, and PEDro) were systematically searched. Studies evaluating the effect of ctDCS compared to sham ctDCS on motor learning in healthy individuals were selected and reviewed. Two authors independently reviewed the quality of the included studies using the revised Cochrane's risk-of-bias tool. The results were extracted with respect to the time scale in which changes in motor performance were evaluated. Results: Seventeen randomized controlled trials met the eligibility criteria of which 65% of the studies had a “high” risk-of-bias, and 35% had “some concerns.” These studies included data from 629 healthy participants. Of the studies that evaluated the effect of anodal ctDCS during and immediately after the stimulation, four found enhanced, three found impaired, and ten found no effect on gains in motor performance. Of the studies that evaluated the effect of anodal ctDCS after a break of 24 h or more, seven found enhanced, two found impaired, and one found no effect on gains in motor performance. Of the studies that evaluated the effect of cathodal ctDCS across a range of time scales, five found impaired, one found enhanced, and five found no effect on gains in motor performance. Conclusions: In healthy individuals, anodal ctDCS appears to improve short to longer-term motor skill learning, whereas it appears to have no effect on gains in motor performance during and immediate after the stimulation. ctDCS may have potential to improve motor performance beyond the training period. The challenge of the motor task and its characteristics, and the stimulation parameters are likely to influence the effect of ctDCS on motor learning.
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Affiliation(s)
- Nitika Kumari
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Nada Signal
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
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26
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Jafarzadeh A, Ehsani F, Yosephi MH, Zoghi M, Jaberzadeh S. Concurrent postural training and M1 anodal transcranial direct current stimulation improve postural impairment in patients with chronic low back pain. J Clin Neurosci 2019; 68:224-234. [DOI: 10.1016/j.jocn.2019.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/05/2019] [Indexed: 11/24/2022]
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27
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van Dun K, Manto M. Non-invasive Cerebellar Stimulation: Moving Towards Clinical Applications for Cerebellar and Extra-Cerebellar Disorders. THE CEREBELLUM 2019; 17:259-263. [PMID: 29282616 DOI: 10.1007/s12311-017-0908-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The field of non-invasive stimulation of the cerebellum is quickly expanding. The anatomical structure of the cerebellum with a high density of neurons in the superficial layer, its electrical properties, and its participation in numerous closed-loop circuits involved in motor, cognitive, and affective operations both in children and in adults make of the cerebellum a target with very high potential for neuromodulation of both cerebellar and extra-cerebellar disorders, in neurology, psychiatry, and neurosurgery. A common research effort is required to extract the optimal parameters of stimulation and to identify how non-invasive stimulation of the cerebellum modifies cerebellar plasticity and functional connectivity in remote cortical and subcortical areas. A patient stratification should be considered.
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Affiliation(s)
- Kim van Dun
- Clinical and Experimental Neurolinguistics, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
| | - Mario Manto
- FNRS, ULB-Erasme, Brussels, Belgium
- Service des Neurosciences, Université de Mons, Mons, Belgium
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28
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Yosephi MH, Ehsani F, Zoghi M, Jaberzadeh S. Multi-session anodal tDCS enhances the effects of postural training on balance and postural stability in older adults with high fall risk: Primary motor cortex versus cerebellar stimulation. Brain Stimul 2018; 11:1239-1250. [DOI: 10.1016/j.brs.2018.07.044] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 06/25/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022] Open
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29
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Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulatory approach that is affordable, safe, and well tolerated. This review article summarizes the research and clinically relevant findings from meta-analyses and studies investigating the cognitive effects of tDCS in healthy and clinical populations. We recapitulate findings from recent studies where cognitive performance paired with tDCS was compared with performance under placebo (sham stimulation) in single sessions and longitudinal designs where cognitive effects were evaluated following repeated sessions. In summary, the tDCS literature currently indicates that the effects of tDCS on cognitive measures are less robust and less predictable compared with the more consistent effects on motor outcomes. There is also a notable difference in the consistency of single-session and longitudinal designs. In single-session tDCS designs, there are small effects amid high variability confounded by individual differences and potential sham stimulation effects. In contrast, longitudinal studies provide more consistent benefits in healthy and clinical populations, particularly when tDCS is paired with a concurrent task. Yet, these studies are few in number, thereby impeding design optimization. While there is good evidence that tDCS can modulate cognitive functioning and potentially produce longer-term benefits, a major challenge to widespread translation of tDCS is the absence of a complete mechanistic account for observed effects. Significant future work is needed to identify a priori responders from nonresponders for every cognitive task and tDCS protocol.
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30
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Carvalho S, French M, Thibaut A, Lima W, Simis M, Leite J, Fregni F. Median nerve stimulation induced motor learning in healthy adults: A study of timing of stimulation and type of learning. Eur J Neurosci 2018; 48:1667-1679. [PMID: 29885268 DOI: 10.1111/ejn.13990] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 05/23/2018] [Accepted: 05/29/2018] [Indexed: 01/08/2023]
Abstract
Median nerve stimulation (MNS) has been shown to change brain metaplasticity over the somatosensory networks, based on a bottom-up mechanism and may improve motor learning. This exploratory study aimed to test the effects of MNS on implicit and explicit motor learning as measured by the serial reaction time task (SRTT) using a double-blind, sham-controlled, randomized trial, in which participants were allocated to one of three groups: (a) online active MNS during acquisition, (b) offline active MNS during early consolidation and (c) sham MNS. SRTT was performed at baseline, during the training phase (acquisition period), and 30 min after training. We assessed the effects of MNS on explicit and implicit motor learning at the end of the training/acquisition period and at retest. The group receiving online MNS (during acquisition) showed a significantly higher learning index for the explicit sequences compared to the offline group (MNS during early consolidation) and the sham group. The offline group also showed a higher learning index as compared to sham. Additionally, participants receiving online MNS recalled the explicit sentence significantly more than the offline MNS and sham groups. MNS effects on motor learning have a specific effect on type of learning (explicit vs. implicit) and are dependent on timing of stimulation (during acquisition vs. early consolidation). More research is needed to understand and optimize the effects of peripheral electrical stimulation on motor learning. Taken together, our results show that MNS, especially when applied during the acquisition phase, is a promising tool to modulate motor leaning.
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Affiliation(s)
- Sandra Carvalho
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Neurotherapeutics and Experimental Psychopatology Group, Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
| | - Melanie French
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Aurore Thibaut
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Coma Science Group, GIGA-Consciousness, University and University Hospital of Liege, Liege, Belgium
| | - Wilrama Lima
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Marcel Simis
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, São Paulo, Brazil
| | - Jorge Leite
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
- Neurotherapeutics and Experimental Psychopatology Group, Psychological Neuroscience Laboratory, CIPsi, School of Psychology, University of Minho, Campus de Gualtar, Braga, Portugal
- Univ Portucalense, Portucalense Institute for Human Development - INPP, Oporto, Portugal
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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31
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Oldrati V, Schutter DJLG. Targeting the Human Cerebellum with Transcranial Direct Current Stimulation to Modulate Behavior: a Meta-Analysis. CEREBELLUM (LONDON, ENGLAND) 2018; 17:228-236. [PMID: 28786014 PMCID: PMC5849643 DOI: 10.1007/s12311-017-0877-2] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Transcranial direct current stimulation (tDCS) is increasingly used to study motor- and non-motor-related functions of the cerebellum. The aim of the present study was to quantitatively review available studies to estimate the efficacy of cerebellar tDCS in altering motor- and cognitive-related behavioral performance in healthy volunteers. The present meta-analysis included 32 sham-controlled studies. Results from random effects modeling of the cumulative effect size demonstrated that anodal and cathodal tDCS to the cerebellum were effective in changing performance. No evidence for polarity-dependent effects of cerebellar tDCS was found. Current findings establish the feasibility to target motor and non-motor-related cerebellar functions with tDCS, but arguably due to anatomical differences between the cerebellum and cerebral cortex, the polarity of tDCS is not predictive of the direction of the behavioral changes in healthy volunteers.
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Affiliation(s)
- Viola Oldrati
- Department of Brain and Behavioral Sciences, University of Pavia, Piazza A. Botta 6, 27100, Pavia, Italy
| | - Dennis J L G Schutter
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands.
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32
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Non-invasive Cerebellar Stimulation: a Promising Approach for Stroke Recovery? THE CEREBELLUM 2017; 17:359-371. [DOI: 10.1007/s12311-017-0906-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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33
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Archer DB, Kang N, Misra G, Marble S, Patten C, Coombes SA. Visual feedback alters force control and functional activity in the visuomotor network after stroke. NEUROIMAGE-CLINICAL 2017; 17:505-517. [PMID: 29201639 PMCID: PMC5700823 DOI: 10.1016/j.nicl.2017.11.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 11/09/2017] [Accepted: 11/13/2017] [Indexed: 11/27/2022]
Abstract
Modulating visual feedback may be a viable option to improve motor function after stroke, but the neurophysiological basis for this improvement is not clear. Visual gain can be manipulated by increasing or decreasing the spatial amplitude of an error signal. Here, we combined a unilateral visually guided grip force task with functional MRI to understand how changes in the gain of visual feedback alter brain activity in the chronic phase after stroke. Analyses focused on brain activation when force was produced by the most impaired hand of the stroke group as compared to the non-dominant hand of the control group. Our experiment produced three novel results. First, gain-related improvements in force control were associated with an increase in activity in many regions within the visuomotor network in both the stroke and control groups. These regions include the extrastriate visual cortex, inferior parietal lobule, ventral premotor cortex, cerebellum, and supplementary motor area. Second, the stroke group showed gain-related increases in activity in additional regions of lobules VI and VIIb of the ipsilateral cerebellum. Third, relative to the control group, the stroke group showed increased activity in the ipsilateral primary motor cortex, and activity in this region did not vary as a function of visual feedback gain. The visuomotor network, cerebellum, and ipsilateral primary motor cortex have each been targeted in rehabilitation interventions after stroke. Our observations provide new insight into the role these regions play in processing visual gain during a precisely controlled visuomotor task in the chronic phase after stroke.
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Affiliation(s)
- Derek B Archer
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Nyeonju Kang
- Division of Sport Science, Incheon National University, Incheon, South Korea
| | - Gaurav Misra
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Shannon Marble
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States
| | - Carolynn Patten
- Neural Control of Movement Lab, Department of Physical Therapy, University of Florida and Malcolm-Randall VA Medical Center, Gainesville, FL, United States
| | - Stephen A Coombes
- Laboratory for Rehabilitation Neuroscience, Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL, United States.
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Ehsani F, Samaei A, Zoghi M, Hedayati R, Jaberzadeh S. The effects of cerebellar transcranial direct current stimulation on static and dynamic postural stability in older individuals: a randomized double-blind sham-controlled study. Eur J Neurosci 2017; 46:2875-2884. [PMID: 28973782 DOI: 10.1111/ejn.13731] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 09/25/2017] [Accepted: 09/27/2017] [Indexed: 12/31/2022]
Abstract
The aging population is growing rapidly. Risk of falling is higher in older people compared to young adults due to several reasons including poor posture and balance. The main aim of this study was to investigate the effect of cerebellar anodal transcranial direct current stimulation (a-tDCS) on static and dynamic postural stability in older individuals. Twenty-nine older adults participated in this study and were randomly allocated to two groups of active a-tDCS (experimental; n = 14) or sham tDCS group (n = 15). Experimental group received cerebellar a-tDCS for 20 min with intensity of 1.5 mA. Anterior-posterior and medial-lateral postural stability indices (postural sway) in addition to Berg Balance Score were measured before and after the intervention. Postural sways in static and dynamic postural tasks were significantly decreased (P < 0.05) after cerebellar a-tDCS, in addition to Berg Balance Score that increased significantly in active cerebellar a-tDCS group (P < 0.05). However, there were no significant changes in postural stability indices or Berg Balance Score in sham group (P > 0.05). The findings indicated immediate effect of cerebellar a-tDCS on improvement of postural control and balance in older individuals.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, 3513138111, Iran
| | - Afshin Samaei
- Department of Internal Medicine, Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Vic., Australia
| | - Rozita Hedayati
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, 3513138111, Iran
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
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