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Wu PJ, Huang CH, Lee SY, Chang AYW, Wang WC, Lin CCK. The distinct and potentially conflicting effects of tDCS and tRNS on brain connectivity, cortical inhibition, and visuospatial memory. Front Hum Neurosci 2024; 18:1415904. [PMID: 38873654 PMCID: PMC11169625 DOI: 10.3389/fnhum.2024.1415904] [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: 04/11/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
Noninvasive brain stimulation (NIBS) techniques, including transcranial direct current stimulation (tDCS) and transcranial random noise stimulation (tRNS), are emerging as promising tools for enhancing cognitive functions by modulating brain activity and enhancing cognitive functions. Despite their potential, the specific and combined effects of tDCS and tRNS on brain functions, especially regarding functional connectivity, cortical inhibition, and memory performance, are not well-understood. This study aims to explore the distinct and combined impacts of tDCS and tRNS on these neural and cognitive parameters. Using a within-subject design, ten participants underwent four stimulation conditions: sham, tDCS, tRNS, and combined tDCS + tRNS. We assessed the impact on resting-state functional connectivity, cortical inhibition via Cortical Silent Period (CSP), and visuospatial memory performance using the Corsi Block-tapping Test (CBT). Our results indicate that while tDCS appears to induce brain lateralization, tRNS has more generalized and dispersive effects. Interestingly, the combined application of tDCS and tRNS did not amplify these effects but rather suggested a non-synergistic interaction, possibly due to divergent mechanistic pathways, as observed across fMRI, CSP, and CBT measures. These findings illuminate the complex interplay between tDCS and tRNS, highlighting their non-additive effects when used concurrently and underscoring the necessity for further research to optimize their application for cognitive enhancement.
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Affiliation(s)
- Pei-Jung Wu
- Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chih-Hsu Huang
- Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shuenn-Yuh Lee
- Department of Electrical Engineering, National Cheng Kung University, Tainan, Taiwan
| | - Alice Y. W. Chang
- Department of Physiology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wen-Chi Wang
- Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chou-Ching K. Lin
- Department of Neurology, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Dakwar-Kawar O, Mairon N, Hochman S, Berger I, Cohen Kadosh R, Nahum M. Transcranial random noise stimulation combined with cognitive training for treating ADHD: a randomized, sham-controlled clinical trial. Transl Psychiatry 2023; 13:271. [PMID: 37528107 PMCID: PMC10394047 DOI: 10.1038/s41398-023-02547-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 06/26/2023] [Accepted: 06/26/2023] [Indexed: 08/03/2023] Open
Abstract
Non-invasive brain stimulation has been suggested as a potential treatment for improving symptomology and cognitive deficits in Attention-Deficit/Hyperactivity Disorder (ADHD), the most common childhood neurodevelopmental disorder. Here, we examined whether a novel form of stimulation, high-frequency transcranial random noise stimulation (tRNS), applied with cognitive training (CT), may impact symptoms and neural oscillations in children with ADHD. We conducted a randomized, double-blind, sham-controlled trial in 23 unmedicated children with ADHD, who received either tRNS over the right inferior frontal gyrus (rIFG) and left dorsolateral prefrontal cortex (lDLPFC) or sham stimulation for 2 weeks, combined with CT. tRNS + CT yielded significant clinical improvements (reduced parent-reported ADHD rating-scale scores) following treatment, compared to the control intervention. These improvements did not change significantly at a 3-week follow-up. Moreover, resting state (RS)-EEG periodic beta bandwidth of the extracted peaks was reduced in the experimental compared to control group immediately following treatment, with further reduction at follow-up. A lower aperiodic exponent, which reflects a higher cortical excitation/inhibition (E/I) balance and has been related to cognitive improvement, was seen in the experimental compared to control group. This replicates previous tRNS findings in adults without ADHD but was significant only when using a directional hypothesis. The experimental group further exhibited longer sleep onset latencies and more wake-up times following treatment compared to the control group. No significant group differences were seen in executive functions, nor in reported adverse events. We conclude that tRNS + CT has a lasting clinical effect on ADHD symptoms and on beta activity. These results provide a preliminary direction towards a novel intervention in pediatric ADHD.
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Affiliation(s)
- Ornella Dakwar-Kawar
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Noam Mairon
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Itai Berger
- Pediatric Neurology Unit, Assuta-Ashdod University Hospital and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- School of Social Work and Social Welfare, Hebrew University of Jerusalem, Jerusalem, Israel
| | | | - Mor Nahum
- School of Occupational Therapy, Hebrew University of Jerusalem, Jerusalem, Israel.
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Sethi A, Pascual-Leone A, Santarnecchi E, Almalki G, Krishnan C. Transcranial random noise stimulation to augment hand function in individuals with moderate-to-severe stroke: A pilot randomized clinical trial. Restor Neurol Neurosci 2023; 41:193-202. [PMID: 38306067 DOI: 10.3233/rnn-231314] [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] [Indexed: 02/03/2024]
Abstract
Background Interventions to recover upper extremity (UE) function after moderate-to-severe stroke are limited. Transcranial random noise stimulation (tRNS) is an emerging non-invasive technique to improve neuronal plasticity and may potentially augment functional outcomes when combined with existing interventions, such as functional electrical stimulation (FES). Objective The objective of this study was to investigate the feasibility and preliminary efficacy of combined tRNS and FES-facilitated task practice to improve UE impairment and function after moderate-to-severe stroke. Methods Fourteen individuals with UE weakness were randomized into one of two groups: 1) tRNS with FES-facilitated task practice, or 2) sham-tRNS with FES-facilitated task practice. Both groups involved 18 intervention sessions (3 per week for 6 weeks). tRNS was delivered at 2 mA current between 100-500 Hz for the first 30 minutes of FES-facilitated task practice. We evaluated the number of sessions completed, adverse effects, participant satisfaction, and intervention fidelity between the two therapists. UE impairment (Fugl-Meyer Upper Extremity, FMUE), function (Wolf Motor Function Test, WMFT), participation (Stroke Impact Scale hand score, SIS-H), and grip strength were assessed at baseline, within 1 week and 3 months after completing the intervention. Results All participants completed the 18 intervention sessions. Participants reported minimal adverse effects (mild tingling in head). The two trained therapists demonstrated 93% adherence and 96% competency with the intervention protocol. FMUE and SIS-H improved significantly more in the tRNS group than in the sham-tRNS group at both timepoints (p≤0.05), and the differences observed exceeded the clinically meaningful differences for these scores. The WMFT and paretic hand grip strength improved in both groups after the intervention (p≤0.05), with no significant between group differences. Conclusion Our findings show for the first time that combining tRNS and FES-facilitated task practice is a feasible and promising approach to improve UE impairment and function after moderate-to-severe stroke.
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Affiliation(s)
- Amit Sethi
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alvaro Pascual-Leone
- Department of Neurology, Harvard Medical School Boston, MA, USA
- Marcus Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
| | - Emiliano Santarnecchi
- Precision Neuroscience & Neuromodulation Program, Network Control Laboratory, Gordon Center for Medical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ghaleb Almalki
- Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA, USA
| | - Chandramouli Krishnan
- Director of NeuRRo Lab, Department of Physical Medicine and Rehabilitation, Michigan Medicine, Ann Arbor, MI, USA
- Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
- School of Kinesiology, University of Michigan, Ann Arbor, MI, USA
- Department of Robotics, University of Michigan, Ann Arbor, MI, USA
- Department of Physical Therapy, University of Michigan, Flint, MI, USA
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Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. Neurosci Biobehav Rev 2022; 138:104702. [PMID: 35595071 DOI: 10.1016/j.neubiorev.2022.104702] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/12/2022] [Accepted: 05/13/2022] [Indexed: 12/22/2022]
Abstract
Van der Groen, O., Potok, W., Wenderoth, N., Edwards, G., Mattingley, J.B. and Edwards, D. Using noise for the better: The effects of transcranial random noise stimulation on the brain and behavior. NEUROSCI BIOBEHAV REV X (X) XXX-XXX 2021.- Transcranial random noise stimulation (tRNS) is a non-invasive electrical brain stimulation method that is increasingly employed in studies of human brain function and behavior, in health and disease. tRNS is effective in modulating perception acutely and can improve learning. By contrast, its effectiveness for modulating higher cognitive processes is variable. Prolonged stimulation with tRNS, either as one longer application, or multiple shorter applications, may engage plasticity mechanisms that can result in long-term benefits. Here we provide an overview of the current understanding of the effects of tRNS on the brain and behavior and provide some specific recommendations for future research.
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Caulfield KA, Indahlastari A, Nissim NR, Lopez JW, Fleischmann HH, Woods AJ, George MS. Electric Field Strength From Prefrontal Transcranial Direct Current Stimulation Determines Degree of Working Memory Response: A Potential Application of Reverse-Calculation Modeling? Neuromodulation 2022; 25:578-587. [PMID: 35670064 DOI: 10.1111/ner.13342] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) for working memory is an enticing treatment, but there is mixed evidence to date. OBJECTIVES We tested the effects of electric field strength from uniform 2 mA dosing on working memory change from prestimulation to poststimulation. Second, we statistically evaluated a reverse-calculation method of individualizing tDCS dose and its effect on normalizing electric field at the cortex. MATERIALS AND METHODS We performed electric field modeling on a data set of 28 healthy older adults (15 women, mean age = 73.7, SD = 7.3) who received ten sessions of active 2 mA tDCS (N = 14) or sham tDCS (N = 14) applied over bilateral dorsolateral prefrontal cortices (DLPFC) in a triple-blind design. We evaluated the relationship between electric field strength and working memory change on an N-back task in conditions of above-median, high electric field from active 2 mA (N = 7), below-median, low electric field from active 2 mA (N = 7), and sham (N = 14) at regions of interest (ROI) at the left and right DLPFC. We then determined the individualized reverse-calculation dose to produce the group average electric field and measured the electric field variance between uniform 2 mA doses vs individualized reverse-calculation doses at the same ROIs. RESULTS Working memory improvements from pre- to post-tDCS were significant for the above-median electric field from active 2 mA condition at the left DLPFC (mixed ANOVA, p = 0.013). Furthermore, reverse-calculation modeling significantly reduced electric field variance at both ROIs (Levene's test; p < 0.001). CONCLUSIONS Higher electric fields at the left DLPFC from uniform 2 mA doses appear to drive working memory improvements from tDCS. Individualized doses from reverse-calculation modeling significantly reduce electric field variance at the cortex. Taken together, using reverse-calculation modeling to produce the same, high electric fields at the cortex across participants may produce more effective future tDCS treatments for working memory.
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Affiliation(s)
- Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - James W Lopez
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Holly H Fleischmann
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Mark S George
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Chenot Q, Hamery C, Lepron E, Besson P, De Boissezon X, Perrey S, Scannella S. Performance after training in a complex cognitive task is enhanced by high-definition transcranial random noise stimulation. Sci Rep 2022; 12:4618. [PMID: 35301388 PMCID: PMC8931133 DOI: 10.1038/s41598-022-08545-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/28/2022] [Indexed: 11/10/2022] Open
Abstract
Interest for neuromodulation, and transcranial random noise stimulation (tRNS) in particular, is growing. It concerns patients rehabilitation, but also healthy people who want or need to improve their cognitive and learning abilities. However, there is no consensus yet regarding the efficacy of tRNS on learning and performing a complex task. In particular, the most effective electrode montage is yet to be determined. Here, we examined the effect of two different tRNS montages on learning rate, short- and long-term performance in a video game (Space Fortress) that engages multiple cognitive abilities. Sixty-one participants were randomly assigned to one of three groups (sham vs. simple-definition tRNS vs. high-definition tRNS) in a double-blind protocol. Their performance on the Space Fortress task was monitored during a 15-day experiment with baseline (day 1), stimulation (day 2 to 4), short- (day 5) and long-term (day 15) evaluations. Our results show that the high-definition tRNS group improved more on the long term than simple-definition tRNS group, tended to learn faster and had better performance retention compared to both simple-definition tRNS and sham groups. This study is the first to report that high-definition tRNS is more effective than conventional simple-definition tRNS to enhance performance in a complex task.
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Affiliation(s)
| | | | | | - Pierre Besson
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
| | - Xavier De Boissezon
- Toulouse Neuroimaging Center (ToNIC), Université de Toulouse, INSERM, Toulouse, France
- Department of Physical Medicine and Rehabilitation, University Hospital of Toulouse, Toulouse, France
| | - Stéphane Perrey
- EuroMov Digital Health in Motion, Univ Montpellier, IMT Mines Ales, Montpellier, France
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Haque ZZ, Samandra R, Mansouri FA. Neural substrate and underlying mechanisms of working memory: insights from brain stimulation studies. J Neurophysiol 2021; 125:2038-2053. [PMID: 33881914 DOI: 10.1152/jn.00041.2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
The concept of working memory refers to a collection of cognitive abilities and processes involved in the short-term storage of task-relevant information to guide the ongoing and upcoming behavior and therefore describes an important aspect of executive control of behavior for achieving goals. Deficits in working memory and related cognitive abilities have been observed in patients with brain damage or neuropsychological disorders and therefore it is important to better understand neural substrate and underlying mechanisms of working memory. Working memory relies on neural mechanisms that enable encoding, maintenance, and manipulation of stored information as well as integrating them with ongoing and future goals. Recently, a surge in brain stimulation studies have led to development of various noninvasive techniques for localized stimulation of prefrontal and other cortical regions in humans. These brain stimulation techniques can potentially be tailored to influence neural activities in particular brain regions and modulate cognitive functions and behavior. Combined use of brain stimulation with neuroimaging and electrophysiological recording have provided a great opportunity to monitor neural activity in various brain regions and noninvasively intervene and modulate cognitive functions in cognitive tasks. These studies have shed more light on the neural substrate and underlying mechanisms of working memory in humans. Here, we review findings and insight from these brain stimulation studies about the contribution of brain regions, and particularly prefrontal cortex, to working memory.
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Affiliation(s)
- Zakia Z Haque
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Ranshikha Samandra
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia
| | - Farshad Alizadeh Mansouri
- Cognitive Neuroscience Laboratory, Department of Physiology, Monash Biomedicine Discovery Institute, Monash University, Clayton, Victoria, Australia.,ARC Centre for Integrative Brain Function, Monash University, Clayton, Victoria, Australia
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Byrne EM, Ewbank MP, Gathercole SE, Holmes J. The effects of transcranial direct current stimulation on within- and cross-paradigm transfer following multi-session backward recall training. Brain Cogn 2020; 141:105552. [PMID: 32298870 PMCID: PMC7221346 DOI: 10.1016/j.bandc.2020.105552] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 12/02/2022]
Abstract
Randomised controlled trial combining backward recall memory training and tDCS. Systematic investigation into task features constraining training transfer. Measurement of potential benefits of tDCS for training and for transfer across tasks with varying degrees of overlap with training task. Training transfer is constrained by paradigm but not task materials. tDCS over left DLPFC (1 mA, 10 min) does not enhance training or transfer.
Transcranial direct current stimulation (tDCS) has been shown to enhance the efficacy and generalisation of working memory (WM) training, but there has been little systematic investigation into how coupling task-specific WM training with stimulation impacts more specifically on transfer to untrained tasks. This randomised controlled trial investigated the boundary conditions to transfer by testing firstly whether the benefits of training on backward digit recall (BDR) extend to untrained backward recall tasks and n-back tasks with different materials, and secondly which, if any, form of transfer is enhanced by tDCS. Forty-eight participants were allocated to one of three conditions: BDR training with anodal (10 min, 1 mA) or sham tDCS, or visual search training with sham tDCS, applied over the left dorsolateral prefrontal cortex. Transfer was assessed on within- (backward recall with digits, letters, and spatial locations) and cross-paradigm (n-back with digits and letters) transfer tests following three sessions of training and stimulation. On-task training gains were found, with transfer to other backward span but not n-back tasks. There was little evidence that tDCS enhanced on-task training or transfer. These findings indicate that training enhances paradigm-specific processes within WM, but that tDCS does not enhance these gains.
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Affiliation(s)
- Elizabeth M Byrne
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, University of Cambridge, Cambridge CB2 7EF, UK.
| | - Michael P Ewbank
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, University of Cambridge, Cambridge CB2 7EF, UK.
| | - Susan E Gathercole
- Department of Psychiatry, Douglas House, 18b Trumpington Road, University of Cambridge, Cambridge CB2 8AH, UK.
| | - Joni Holmes
- MRC Cognition and Brain Sciences Unit, 15 Chaucer Road, University of Cambridge, Cambridge CB2 7EF, UK.
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Schroeder PA, Dresler T, Bahnmueller J, Artemenko C, Cohen Kadosh R, Nuerk HC. Cognitive Enhancement of Numerical and Arithmetic Capabilities: a Mini-Review of Available Transcranial Electric Stimulation Studies. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-016-0006-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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