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He Q, Zhu X, Fang F. Enhancing visual perceptual learning using transcranial electrical stimulation: Transcranial alternating current stimulation outperforms both transcranial direct current and random noise stimulation. J Vis 2023; 23:2. [PMID: 38054934 PMCID: PMC10702794 DOI: 10.1167/jov.23.14.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/23/2023] [Indexed: 12/07/2023] Open
Abstract
Diverse strategies can be employed to enhance visual skills, including visual perceptual learning (VPL) and transcranial electrical stimulation (tES). Combining VPL and tES is a popular method that holds promise for producing significant improvements in visual acuity within a short time frame. However, there is still a lack of comprehensive evaluation regarding the effects of combining different types of tES and VPL on enhancing visual function, especially with a larger sample size. In the present study, we recruited four groups of subjects (26 subjects each) to learn an orientation discrimination task with five daily training sessions. During training, the occipital region of each subject was stimulated by one type of tES-anodal transcranial direct current stimulation (tDCS), alternating current stimulation (tACS) at 10 Hz, high-frequency random noise stimulation (tRNS), and sham tACS-while the subject performed the training task. We found that, compared with the sham stimulation, both the high-frequency tRNS and the 10-Hz tACS facilitated VPL efficiently in terms of learning rate and performance improvement, but there was little modulatory effect in the anodal tDCS condition. Remarkably, the 10-Hz tACS condition exhibited superior modulatory effects compared with the tRNS condition, demonstrating the strongest modulation among the most commonly used tES types for further enhancing vision when combined with VPL. Our results suggest that alpha oscillations play a vital role in VPL. Our study provides a practical guide for vision rehabilitation.
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Affiliation(s)
- Qing He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Xinyi Zhu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Fang Fang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
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Leitner MC, Ladek AM, Hutzler F, Reitsamer H, Hawelka S. Placebo effect after visual restitution training: no eye-tracking controlled perimetric improvement after visual border stimulation in late subacute and chronic visual field defects after stroke. Front Neurol 2023; 14:1114718. [PMID: 37456634 PMCID: PMC10339290 DOI: 10.3389/fneur.2023.1114718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction A significant number of Restitution Training (RT) paradigms claim to ameliorate visual field loss after stroke by re-activating neuronal connections in the residual visual cortex due to repeated bright light-stimulation at the border of the blind and intact fields. However, the effectiveness of RT has been considered controversial both in science and clinical practice for years. The main points of the controversy are (1) the reliability of perimetric results which may be affected by compensatory eye movements and (2) heterogeneous samples consisting of patients with visual field defects and/or visuospatial neglect. Methods By means of our newly developed and validated Virtual Reality goggles Salzburg Visual Field Trainer (SVFT) 16 stroke patients performed RT on a regular basis for 5 months. By means of our newly developed and validated Eye Tracking Based Visual Field Analysis (EFA), we conducted a first-time full eye-movement-controlled perimetric pre-post intervention study. Additionally, patients subjectively rated the size of their intact visual field. Results Analysis showed that patients' mean self-assessment of their subjective visual field size indicated statistically significant improvement while, in contrast, objective eye tracking controlled perimetric results revealed no statistically significant effect. Discussion Bright-light detection RT at the blind-field border solely induced a placebo effect and did not lead to training-induced neuroplasticity in the visual cortex of the type needed to ameliorate the visual field size of stroke patients.
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Affiliation(s)
- Michael Christian Leitner
- Salzburg University of Applied Sciences, Salzburg, Austria
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Anja-Maria Ladek
- Research Program for Experimental Ophthalmology and Glaucoma Research, Department of Ophthalmology and Optometry, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Ophthalmology and Optometry, SALK, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Florian Hutzler
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
| | - Herbert Reitsamer
- Research Program for Experimental Ophthalmology and Glaucoma Research, Department of Ophthalmology and Optometry, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
- Department of Ophthalmology and Optometry, SALK, University Hospital of the Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Hawelka
- Centre for Cognitive Neuroscience (CCNS), University of Salzburg, Salzburg, Austria
- Department of Psychology, University of Salzburg, Salzburg, Austria
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Contò F, Tyler S, Paletta P, Battelli L. The role of the parietal lobe in task-irrelevant suppression during learning. Brain Stimul 2023; 16:715-723. [PMID: 37062348 DOI: 10.1016/j.brs.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 04/07/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Attention optimizes the selection of visual information, while suppressing irrelevant visual input through cortical mechanisms that are still unclear. We set to investigate these processes using an attention task with an embedded to-be-ignored interfering visual input. OBJECTIVE We delivered electrical stimulation to attention-related brain areas to modulate these facilitatory/inhibitory attentional mechanisms. We asked whether overtly training on a task while being covertly exposed to visual features from a visually identical but different task tested at baseline might influence post-training performance on the baseline task. METHODS In Experiment one, at baseline subjects performed an orientation discrimination (OD) task using a pair of gratings presented at individual's psychophysical threshold. We then trained participants over three-day separate sessions on a temporal order judgment task (TOJ), using the exact same gratings but presented with different time offsets. On the last post-training session we re-tested OD. We coupled training with transcranial random noise stimulation (tRNS) over the parietal cortex, the human middle temporal area or sham, in three separate groups. In Experiment two, subjects performed the same OD task at baseline and post-training, while tRNS was delivered at rest during the same sessions and stimulation conditions as in Experiment one. RESULTS Results showed that tRNS over parietal cortex facilitated learning of the trained TOJ task. Moreover, we found a detrimental effect on the untrained OD task when subjects received parietal tRNS coupled with training (Experiment one), but a benefit on OD when subjects received stimulation while at rest (Experiment two). CONCLUSIONS These results clearly indicate that task-irrelevant information is actively suppressed during learning, and that this prioritization mechanism of selection likely resides in the parietal cortex.
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Affiliation(s)
- F Contò
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, Corso Bettini 31, 38068, Rovereto (TN), Italy.
| | - S Tyler
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, Corso Bettini 31, 38068, Rovereto (TN), Italy; Butte College, Oroville, CA, 95965, USA
| | - P Paletta
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, Corso Bettini 31, 38068, Rovereto (TN), Italy
| | - L Battelli
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, Corso Bettini 31, 38068, Rovereto (TN), Italy; Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, 02215, USA; Department of Psychology, Harvard University, Cambridge, MA, 01238, 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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He Q, Yang XY, Zhao D, Fang F. Enhancement of visual perception by combining transcranial electrical stimulation and visual perceptual training. MEDICAL REVIEW (BERLIN, GERMANY) 2022; 2:271-284. [PMID: 37724187 PMCID: PMC10388778 DOI: 10.1515/mr-2022-0010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 06/16/2022] [Indexed: 09/20/2023]
Abstract
The visual system remains highly malleable even after its maturity or impairment. Our visual function can be enhanced through many ways, such as transcranial electrical stimulation (tES) and visual perceptual learning (VPL). TES can change visual function rapidly, but its modulation effect is short-lived and unstable. By contrast, VPL can lead to a substantial and long-lasting improvement in visual function, but extensive training is typically required. Theoretically, visual function could be further improved in a shorter time frame by combining tES and VPL than by solely using tES or VPL. Vision enhancement by combining these two methods concurrently is both theoretically and practically significant. In this review, we firstly introduced the basic concept and possible mechanisms of VPL and tES; then we reviewed the current research progress of visual enhancement using the combination of two methods in both general and clinical population; finally, we discussed the limitations and future directions in this field. Our review provides a guide for future research and application of vision enhancement and restoration by combining VPL and tES.
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Affiliation(s)
- Qing He
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Xin-Yue Yang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
| | - Daiqing Zhao
- Department of Psychology, The Pennsylvania State University, University Park, State College, PA, USA
| | - Fang Fang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
- Key Laboratory of Machine Perception, Ministry of Education, Peking University, Beijing, China
- IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China
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Contò F, Edwards G, Tyler S, Parrott D, Grossman E, Battelli L. Attention network modulation via tRNS correlates with attention gain. eLife 2021; 10:e63782. [PMID: 34826292 PMCID: PMC8626087 DOI: 10.7554/elife.63782] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 11/05/2021] [Indexed: 12/21/2022] Open
Abstract
Transcranial random noise stimulation (tRNS) can enhance vision in the healthy and diseased brain. Yet, the impact of multi-day tRNS on large-scale cortical networks is still unknown. We investigated the impact of tRNS coupled with behavioral training on resting-state functional connectivity and attention. We trained human subjects for 4 consecutive days on two attention tasks, while receiving tRNS over the intraparietal sulci, the middle temporal areas, or Sham stimulation. We measured resting-state functional connectivity of nodes of the dorsal and ventral attention network (DVAN) before and after training. We found a strong behavioral improvement and increased connectivity within the DVAN after parietal stimulation only. Crucially, behavioral improvement positively correlated with connectivity measures. We conclude changes in connectivity are a marker for the enduring effect of tRNS upon behavior. Our results suggest that tRNS has strong potential to augment cognitive capacity in healthy individuals and promote recovery in the neurological population.
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Affiliation(s)
- Federica Contò
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di TecnologiaRoveretoItaly
- Center for Mind/Brain Sciences, University of TrentoRoveretoItaly
| | - Grace Edwards
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di TecnologiaRoveretoItaly
- Department of Psychology, Harvard UniversityCambridgeUnited States
| | - Sarah Tyler
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di TecnologiaRoveretoItaly
- Butte CollegeOrovilleUnited States
| | - Danielle Parrott
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di TecnologiaRoveretoItaly
- Center for Mind/Brain Sciences, University of TrentoRoveretoItaly
| | - Emily Grossman
- Department of Cognitive Sciences, University of California, IrvineIrvineUnited States
| | - Lorella Battelli
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di TecnologiaRoveretoItaly
- Center for Mind/Brain Sciences, University of TrentoRoveretoItaly
- Department of Psychology, Harvard UniversityCambridgeUnited States
- Department of Neurology, Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel, Deaconess Medical Center, Harvard Medical SchoolBostonUnited States
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Ghin F, O'Hare L, Pavan A. Electrophysiological aftereffects of high-frequency transcranial random noise stimulation (hf-tRNS): an EEG investigation. Exp Brain Res 2021; 239:2399-2418. [PMID: 34105019 PMCID: PMC8354881 DOI: 10.1007/s00221-021-06142-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 05/24/2021] [Indexed: 12/02/2022]
Abstract
There is evidence that high-frequency transcranial random noise stimulation (hf-tRNS) is effective in improving behavioural performance in several visual tasks. However, so far there has been limited research into the spatial and temporal characteristics of hf-tRNS-induced facilitatory effects. In the present study, electroencephalogram (EEG) was used to investigate the spatial and temporal dynamics of cortical activity modulated by offline hf-tRNS on performance on a motion direction discrimination task. We used EEG to measure the amplitude of motion-related VEPs over the parieto-occipital cortex, as well as oscillatory power spectral density (PSD) at rest. A time-frequency decomposition analysis was also performed to investigate the shift in event-related spectral perturbation (ERSP) in response to the motion stimuli between the pre- and post-stimulation period. The results showed that the accuracy of the motion direction discrimination task was not modulated by offline hf-tRNS. Although the motion task was able to elicit motion-dependent VEP components (P1, N2, and P2), none of them showed any significant change between pre- and post-stimulation. We also found a time-dependent increase of the PSD in alpha and beta bands regardless of the stimulation protocol. Finally, time-frequency analysis showed a modulation of ERSP power in the hf-tRNS condition for gamma activity when compared to pre-stimulation periods and Sham stimulation. Overall, these results show that offline hf-tRNS may induce moderate aftereffects in brain oscillatory activity.
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Affiliation(s)
- Filippo Ghin
- School of Psychology, University of Lincoln, Brayford Wharf East, Lincoln, LN5 7AY, UK.
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, Fetscherstraße 74, Schubertstraße 42, 01309, Dresden, Germany.
| | - Louise O'Hare
- School of Psychology, University of Lincoln, Brayford Wharf East, Lincoln, LN5 7AY, UK
- Division of Psychology, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ, UK
| | - Andrea Pavan
- School of Psychology, University of Lincoln, Brayford Wharf East, Lincoln, LN5 7AY, UK
- Department of Psychology, University of Bologna, Viale Berti Pichat, 5, 40127, Bologna, Italy
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On a Quantitative Approach to Clinical Neuroscience in Psychiatry: Lessons from the Kuramoto Model. Harv Rev Psychiatry 2021; 29:318-326. [PMID: 34049338 DOI: 10.1097/hrp.0000000000000301] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The human brain is a complex system comprising subregions that dynamically exchange information between its various parts through synchronization. These dynamic, complex interactions ultimately play a role in perception, emotion, cognition, and behavior, as well as in various maladaptive neurologic and psychiatric processes. It is therefore important to understand how brain dynamics might be implicated in these processes. Over the past few years, network neuroscience and computational neuroscience have highlighted the importance of measures such as metastability (a property whereby members of an oscillating system tend to linger at the edge of synchronicity without permanently becoming synchronized) in quantifying brain dynamics. Altered metastability has been implicated in various psychiatric illnesses, such as traumatic brain injury and Alzheimer's disease. Computational models, which range in complexity, have been used to assess how various parameters affect metastability, synchronization, and functional connectivity. These models, though limited, can act as heuristics in understanding brain dynamics. This article (aimed at the clinical psychiatrist who might not possess an extensive mathematical background) is intended to provide a brief and qualitative summary of studies that have used a specific, highly simplified computational model of coupled oscillators (Kuramoto model) for understanding brain dynamics-which might bear some relevance to clinical psychiatry.
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Edwards G, Contò F, Bucci LK, Battelli L. Controlling Brain State Prior to Stimulation of Parietal Cortex Prevents Deterioration of Sustained Attention. Cereb Cortex Commun 2020; 1:tgaa069. [PMID: 34296130 PMCID: PMC8152938 DOI: 10.1093/texcom/tgaa069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 08/25/2020] [Accepted: 09/19/2020] [Indexed: 11/13/2022] Open
Abstract
Sustained attention is a limited resource which declines during daily tasks. Such decay is exacerbated in clinical and aging populations. Inhibition of the intraparietal sulcus (IPS), using low-frequency repetitive transcranial magnetic stimulation (LF-rTMS), can lead to an upregulation of functional communication within the attention network. Attributed to functional compensation for the inhibited node, this boost lasts for tens of minutes poststimulation. Despite the neural change, no behavioral correlate has been found in healthy subjects, a necessary direct evidence of functional compensation. To understand the functional significance of neuromodulatory induced fluctuations on attention, we sought to boost the impact of LF-rTMS to impact behavior. We controlled brain state prior to LF-rTMS using high-frequency transcranial random noise stimulation (HF-tRNS), shown to increase and stabilize neuronal excitability. Using fMRI-guided stimulation protocols combining HF-tRNS and LF-rTMS, we tested the poststimulation impact on sustained attention with multiple object tracking (MOT). While attention deteriorated across time in control conditions, HF-tRNS followed by LF-rTMS doubled sustained attention capacity to 94 min. Multimethod stimulation was more effective when targeting right IPS, supporting specialized attention processing in the right hemisphere. Used in cognitive domains dependent on network-wide neural activity, this tool may cause lasting neural compensation useful for clinical rehabilitation.
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Affiliation(s)
- Grace Edwards
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, 38068 Rovereto, Italy
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA
| | - Federica Contò
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, 38068 Rovereto, Italy
- Center for Mind/Brain Sciences – CIMeC, University of Trento, 38122 Trento, Italy
| | - Loryn K Bucci
- Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Lorella Battelli
- Center for Neuroscience and Cognitive Systems@UniTn, Istituto Italiano di Tecnologia, 38068 Rovereto, Italy
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA
- Berenson-Allen Center for Noninvasive Brain Stimulation and Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
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Nikolin S, Alonzo A, Martin D, Gálvez V, Buten S, Taylor R, Goldstein J, Oxley C, Hadzi-Pavlovic D, Loo CK. Transcranial Random Noise Stimulation for the Acute Treatment of Depression: A Randomized Controlled Trial. Int J Neuropsychopharmacol 2020; 23:146-156. [PMID: 31899509 PMCID: PMC7171931 DOI: 10.1093/ijnp/pyz072] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 11/27/2019] [Accepted: 12/31/2019] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Transcranial electrical stimulation has broad potential as a treatment for depression. Transcranial random noise stimulation, which delivers randomly fluctuating current intensities, may have greater cortical excitatory effects compared with other forms of transcranial electrical stimulation. We therefore aimed to investigate the antidepressant efficacy of transcranial random noise stimulation. METHODS Depressed participants were randomly assigned by computer number generator to receive 20 sessions of either active or sham transcranial random noise stimulation over 4 weeks in a double-blinded, parallel group randomized-controlled trial. Transcranial random noise stimulation was delivered for 30 minutes with a direct current offset of 2 mA and a random noise range of 2 mA. Primary analyses assessed changes in depression severity using the Montgomery-Asperg Depression Rating Scale. Neuroplasticity, neuropsychological, and safety outcomes were analyzed as secondary measures. RESULTS Sixty-nine participants were randomized, of which 3 discontinued treatment early, leaving 66 (sham n = 34, active n = 32) for per-protocol analysis. Depression severity scores reduced in both groups (Montgomery-Asperg Depression Rating Scale reduction in sham = 7.0 [95% CI = 5.0-8.9]; and active = 5.2 [95% CI = 3.2-7.3]). However, there were no differences between active and sham groups in the reduction of depressive symptoms or the number of participants meeting response (sham = 14.7%; active = 3.1%) and remission criteria (sham = 5.9%; active = 0%). Erythema, paresthesia, fatigue, and dizziness/light-headedness occurred more frequently in the active transcranial random noise stimulation group. Neuroplasticity, neuropsychological, and acute cognitive effects were comparable between groups. CONCLUSION Our results do not support the use of transcranial random noise stimulation with the current stimulation parameters as a therapeutic intervention for the treatment of depression. CLINICAL TRIAL REGISTRATION AT CLINICALTRIALS gov/NCT01792414.
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Affiliation(s)
- Stevan Nikolin
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
| | - Angelo Alonzo
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
| | - Donel Martin
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
| | - Veronica Gálvez
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Mental Health Department, Parc Taulí University Hospital, Institut d’Investigació I Innovació Sanitària Parc Taulí (I3PT), Barcelona, Spain
| | - Sara Buten
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Prince of Wales Hospital, Sydney, Australia
| | - Rohan Taylor
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Concord Centre for Mental Health, Concord, Australia
| | | | - Cristal Oxley
- Department of Child and Adolescent Psychiatry, Michael Rutter Centre – South London and Maudsley NHS Foundation Trust, UK
| | | | - Colleen K Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
- St. George Hospital, Sydney, Australia
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Boosting Learning Efficacy with Noninvasive Brain Stimulation in Intact and Brain-Damaged Humans. J Neurosci 2019; 39:5551-5561. [PMID: 31133558 DOI: 10.1523/jneurosci.3248-18.2019] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/10/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022] Open
Abstract
Numerous behavioral studies have shown that visual function can improve with training, although perceptual refinements generally require weeks to months of training to attain. This, along with questions about long-term retention of learning, limits practical and clinical applications of many such paradigms. Here, we show for the first time in female and male human participants that just 10 d of visual training coupled with transcranial random noise stimulation (tRNS) over visual areas causes dramatic improvements in visual motion perception. Relative to control conditions and anodal stimulation, tRNS-enhanced learning was at least twice as fast, and, crucially, it persisted for 6 months after the end of training and stimulation. Notably, tRNS also boosted learning in patients with chronic cortical blindness, leading to recovery of motion processing in the blind field after just 10 d of training, a period too short to elicit enhancements with training alone. In sum, our results reveal a remarkable enhancement of the capacity for long-lasting plastic and restorative changes when a neuromodulatory intervention is coupled with visual training.SIGNIFICANCE STATEMENT Our work demonstrates that visual training coupled with brain stimulation can dramatically reduce the training period from months to weeks, and lead to fast improvement in neurotypical subjects and chronic cortically blind patients, indicating the potential of our procedure to help restore damaged visual abilities for currently untreatable visual dysfunctions. Together, these results indicate the critical role of early visual areas in perceptual learning and reveal its capacity for long-lasting plastic changes promoted by neuromodulatory intervention.
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Del Felice A, Castiglia L, Formaggio E, Cattelan M, Scarpa B, Manganotti P, Tenconi E, Masiero S. Personalized transcranial alternating current stimulation (tACS) and physical therapy to treat motor and cognitive symptoms in Parkinson's disease: A randomized cross-over trial. Neuroimage Clin 2019; 22:101768. [PMID: 30921609 PMCID: PMC6439208 DOI: 10.1016/j.nicl.2019.101768] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/22/2019] [Accepted: 03/10/2019] [Indexed: 02/06/2023]
Abstract
Abnormal cortical oscillations are markers of Parkinson's Disease (PD). Transcranial alternating current stimulation (tACS) can modulate brain oscillations and possibly impact on behaviour. Mapping of cortical activity (prevalent oscillatory frequency and topographic scalp distribution) may provide a personalized neurotherapeutic target and guide non-invasive brain stimulation. This is a cross-over, double blinded, randomized trial. Electroencephalogram (EEG) from participants with PD referred to Specialist Clinic, University Hospital, were recorded. TACS frequency and electrode position were individually defined based on statistical comparison of EEG power spectra maps with normative data from our laboratory. Stimulation frequency was set according to the EEG band displaying higher power spectra (with beta excess on EEG map, tACS was set at 4 Hz; with theta excess, tACS was set at 30 Hz). Participants were randomized to tACS or random noise stimulation (RNS), 5 days/week for 2-weeks followed by ad hoc physical therapy. EEG, motor (Unified Parkinson's Disease Rating Scale-motor: UPDRS III), neuropsychological (frontal, executive and memory tests) performance and mood were measured before (T0), after (T1) and 4-weeks after treatment (T2). A linear model with random effects and Wilcoxon test were used to detect differences. Main results include a reduction of beta rhythm in theta-tACS vs. RNS group at T1 over right sensorimotor area (p = .014) and left parietal area (p = .010) and at T2 over right sensorimotor area (p = .004) and left frontal area (p = .039). Bradykinesia items improved at T1 (p = .002) and T2 (p = .047) compared to T0 in the tACS group. In the tACS group the Montréal Cognitive Assessment (MoCA) improved at T2 compared with T1 (p = .049). Individualized tACS in PD improves motor and cognitive performance. These changes are associated with a reduction of excessive fast EEG oscillations.
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Affiliation(s)
- Alessandra Del Felice
- Department of Neuroscience, Section of Rehabilitation, University of Padova, via Giustiniani 3, 35128 Padova, Italy.
| | - Leonora Castiglia
- Department of Neuroscience, Section of Rehabilitation, University of Padova, via Giustiniani 3, 35128 Padova, Italy.
| | - Emanuela Formaggio
- Department of Neuroscience, Section of Rehabilitation, University of Padova, via Giustiniani 3, 35128 Padova, Italy.
| | - Manuela Cattelan
- Department of Statistical Sciences, University of Padova, via C. Battisti 241, 35121 Padova, Italy.
| | - Bruno Scarpa
- Department of Statistical Sciences, University of Padova, via C. Battisti 241, 35121 Padova, Italy.
| | - Paolo Manganotti
- Neurology Section, Cattinara University Hospital, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy.
| | - Elena Tenconi
- Department of Neuroscience, Psychiatric Clinic, University of Padova, Via Giustiniani 3, 35128 Padova, Italy.
| | - Stefano Masiero
- Department of Neuroscience, Section of Rehabilitation, University of Padova, via Giustiniani 3, 35128 Padova, Italy.
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Howard CJ, Boulton H, Bedwell SA, Boatman CA, Roberts KL, Mitra S. Low-Frequency Repetitive Transcranial Magnetic Stimulation to Right Parietal Cortex Disrupts Perception of Briefly Presented Stimuli. Perception 2019; 48:346-355. [PMID: 30832537 DOI: 10.1177/0301006619834251] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Right parietal cortex has recently been linked to the temporal resolution of attention. We therefore sought to investigate whether disruption to right parietal cortex would affect attention to visual stimuli presented for brief durations. Participants performed a visual discrimination task before and after 10 minutes repetitive transcranial magnetic stimulation (1 Hz) to right or central parietal cortex as well as 20 minutes after the second block of trials. Participants reported the spatial frequency of a masked Gabor patch presented for a brief duration of 60, 120, or 240 ms. We calculated error magnitudes by comparing accuracy to a guessing model. We then compared error magnitudes to blocks with no stimulation, producing a measure of baselined performance. Baselined performance was poorer at longer stimulus durations after right parietal than central parietal stimulation, suggesting that right parietal cortex is involved in attention to briefly presented stimuli, particularly in situations where rapid accumulation of visual evidence is needed.
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