Transcranial direct current stimulation to enhance athletic performance outcome in experienced bodybuilders

Does a single session of transcranial direct current stimulation enhance both physical and psychological performance in national- or international-level athletes? A systematic review

Some studies showed that a single session of transcranial direct current stimulation (tDCS) has the potential of modulating motor performance in healthy and athletes. To our knowledge, previously published systematic reviews have neither comprehensively investigated the effects of tDCS on athletic performance in both physical and psychological parameters nor investigated the effects of tDCS on high-level athletes. We examined all available research testing a single session of tDCS on strength, endurance, sport-specific performance, emotional states and cognitive performance for better application in competition and pre-competition trainings of national- or international-level athletes. A systematic search was conducted in PubMed, Web of Science, EBSCO, Embase, and Scopus up until to June 2023. Studies were eligible when participants had sports experience at a minimum of state and national level competitions, underwent a single session of tDCS without additional interventions, and received either sham tDCS or no interventions in the control groups. A total of 20 experimental studies (224 participants) were included from 18 articles. The results showed that a single tDCS session improved both physical and psychological parameters in 12 out of the 18 studies. Of these, six refer to the application of tDCS on the motor system (motor cortex, premotor cortex, cerebellum), five on dorsolateral prefrontal cortex and two on temporal cortex. The most sensitive to tDCS are strength, endurance, and emotional states, improved in 67%, 75%, and 75% of studies, respectively. Less than half of the studies showed improvement in sport-specific tasks (40%) and cognitive performance (33%). We suggest that tDCS is an effective tool that can be applied to competition and pre-competition training to improve athletic performance in national- or international-level athletes. Further research would explore various parameters (type of sports, brain regions, stimulation protocol, athlete level, and test tasks) and neural mechanistic studies in improving efficacy of tDCS interventions. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022326989, identifier CRD42022326989.

The impact of cerebellar transcranial direct current stimulation on isometric bench press performance in trained athletes

Athletic development centers on optimizing performance, including technical skills and fundamental motor abilities such as strength and speed. Parameters such as maximum contraction force and rate of force development, influence athletic success, although performance gains become harder to achieve as athletic abilities increase. Non-invasive transcranial direct current stimulation of the cerebellum (CB-tDCS) has been used successfully to increase force production in novices, although the potential effects in athletes remain unexplored. The present study examined the effects of CB-tDCS on maximum isometric voluntary contraction force (MVCiso) and isometric rate of force development (RFDiso) during a bench press task in well-trained athletes. 21 healthy, male, strength-trained athletes participated in a randomized, sham-controlled, double-blinded crossover design. Each participant completed the isometric bench press (iBP) task on two separate days, with at least 5 days between sessions, while receiving either CB-tDCS or sham stimulation. Electromyography (EMG) recordings of three muscles involved in iBP were acquired bilaterally to uncover differences in neuromuscular activation and agonist-antagonist co-contraction between conditions. Contrary to our hypothesis, no significant differences in MVCiso and RFDiso were observed between CB-tDCS and sham conditions. Furthermore, no tDCS-induced differences in neuromuscular activation or agonist-antagonist co-contraction were revealed. Here, we argue that the effects of CB-tDCS on force production appear to depend on the individual's training status. Future research should study individual differences in tDCS responses between athletes and novices, as well as the potential of high-definition tDCS for precise brain region targeting to potentially enhance motor performance in athletic populations.

The effect of transcranial direct current stimulation on rating of perceived exertion: A systematic review of the literature

The rating of perceived exertion (RPE) is a widely used method for monitoring the load during training, as it provides insight into the subjective intensity of effort experienced during exercises. Considering the role of brain in monitoring and perception of the effort, several studies explored the effect of transcranial direct current stimulation (tDCS) on RPE in different populations. The aim of current study is to review the studies that investigated the effect of tDCS on RPE in three groups including healthy untrained people, physically active persons, and athletes. Nine databases were searched for papers assessing the effect of tDCS on RPE. The data from the included studies were extracted and methodological quality was examined using the risk of bias 2 (ROB2) tool. Thirty-three studies met the inclusion criteria. According to the meta-analysis, active a-tDCS significantly decreased the RPE compared to the sham stimulation. The a-tDCS could decrease the RPE when it was applied over M1 or DLPF. Regarding the measurement tool, Borg's scale 6-20 and OMNI scale could show an improvement in RPE scale. A-tDCS is a promising technique that can decrease the RPE. M1 and DLPFC are suggested as the target area of stimulation. From the tools that measure the RPE, Borg's RPE 6-20 and OMNI scale could better show the effect of a-tDCS.

Evaluation of Transcranial Direct Current Stimulation in Motor Function and Neural Rehabilitation

ABSTRACT

Transcranial direct current stimulation (tDCS) is used in neuromodulation to regulate the excitability of the cerebral cortex and induce neural plasticity. It was initially used to rehabilitate patients with neurological diseases. However, with the increasing number of studies involving healthy individuals, this technology is currently used in the field of sports as well. The administration of tDCS to the cerebral cortex, especially over the primary motor cortex (M1), has been found to improve muscle strength, enhance endurance, and promote motor skills in humans. This study mainly summarizes the effects of tDCS on motor function, mainly involving motor promotion of tDCS in healthy athletes and nonathletes, and in patients diagnosed with neurological diseases. The tDCS is a promising and effective tool used to promote motor function by regulating cortical excitability. However, no consensus is available regarding individually appropriate models of tDCS.

The Synergetic Effect of Plyometric Compound Exercises and Transcranial Direct Current Stimulation on Balance and Physical Function

This study aimed to investigate the effects of plyometric compound exercises and Transcranial Direct Current Stimulation (tDCS) on balance and body function in healthy adults. Forty-five students enrolled at Noryangjin Y Academy in Seoul who met the research criteria were equally and randomly divided into the following groups: the Experimental Group I, Experimental Group II, and Control Group. Experimental Groups I and II received tDCS and sham tDCS for 20 min, respectively; both groups performed plyometric compound exercises for 30 min twice weekly for four weeks. The Control Group received sham tDCS for 20 min twice weekly for four weeks. Tests such as the static balance test (Functional Reach Test, FRT), dynamic balance test (Y-Balance Test, Y-BT), power test (vertical jump test and long jump test), and agility test (t-test and side-step test) were conducted on the day of the experiment, before and after the intervention. Experimental Groups I and II significantly improved in static balance, dynamic balance, power, and agility (p < 0.001), whereas the Control Group did not. Experimental Group I showed greater effects on static balance, dynamic balance, power, and agility than Experimental Group II and the Control Group (p < 0.001). In conclusion, plyometric compound exercises + tDCS intervention can be effective for an ordinary person who trains balance and body functions (power and agility); in particular, to improve exercise performance.

Increased Cerebellar Gray Matter Volume in Athletes: A Voxel-Wise Coordinate-Based Meta-Analysis

Purpose: The purpose of this systematic review and meta-analysis study was to investigate distinct brain structural characteristics in athletes as compared with those in non-athletes by quantifying regional gray matter (GM) volume changes using voxel-based morphometry analysis based on a whole-brain approach. Methods: The systematic literature search was conducted from November 1, 2020 to October 18, 2021 via the two search engines including the PubMed and Web of Science. We included 13 studies that reported GM volume data in 229 athletes as compared 219 non-athletes based on the whole-brain analysis with specific three-dimensional coordinates in a standard stereotactic space. Thus, we performed a coordinate-based meta-analysis using the seed-based d mapping via permutation of subject images methods. Result: The coordinate-based meta-analysis reported that the athletes significantly reveal greater regional GM volume across right cerebellar lobules IV-V and Brodmann area 37 regions than those in the non-athletes with minimal levels of heterogeneity and publication bias between the included studies. The subgroup analyses show that greater GM volume for athletes in closed-skill sports appeared across the right cerebellar hemispheric lobules VIII and the right cingulum than those for non-athletes. Conclusion: These cumulative findings from multiple brain imaging studies suggest potential brain plasticity evidence in the athletes who experienced extensive motor training.

Evaluating cognitive impairment in the early stages of Parkinson's disease using the Cambridge brain sciences-cognitive platform

BACKGROUND

Non-motor symptoms (NMS) such as cognitive impairment are among common presentations in patients with Parkinson's disease (PD). In parallel with motor symptoms, these impediments can affect PD patients' quality of life. However, cognitive impairment has received less attention in early PD. On the other hand, the relationship between olfactory symptoms and cognitive impairment is unclear in early PD. Considering the importance of accurate and timely assessment of cognitive function in PD patients using readily available/validated tests, this study has employed the Cambridge Brain Sciences-Cognitive Platform (CBS-CP) as a computer-based tool to assess cognitive presentations in early PD patients.

METHODS

Thirty-four eligible males and females were assigned to PD and healthy controls (HCs). The cognitive performance was assessed using CBS-CP and Mini-Mental State Examination (MMSE), and olfactory function was measured through the standardized olfactory Quick Smell test (QST).

RESULTS

PD patients had poorer performance in all CBS-CP tasks, including short-term memory, attention, and reasoning domains than HCs. Meanwhile, the verbal domain task scores showed no significant difference between groups. PD MMSE results were in the normal range (mean=26.96), although there was a significant difference between the PD and HCs groups (P = 0.000). Our results revealed no correlation between cognitive impairment and olfactory function in PD patients.

CONCLUSION

Given the widely studied features of CBS-CP and its reliability across published evidence, CBS-CP appears to be a suitable measurement to evaluate cognitive impairment in early PD with normal MMSE scores. It seems cognitive and olfactory impairments are independent in early PD.

DATA AVAILABILITY STATEMENT

The datasets generated during the current study are available from the corresponding author upon reasonable request.

A dual-mode neurostimulation approach to enhance athletic performance outcome in experienced taekwondo practitioners

Transcranial Direct Current Stimulation (tDCS) is a growing empirical approach to improve athletic performance. Some recent studies have investigated the effects of transcutaneous spinal direct current stimulation (tsDCS) on the motor performance such as reaction time. TDCS and tsDCS can lead to alteration of the spontaneous neural activity, and the membrane potentials of motor neurons in cerebral cortex and spinal interneurons, respectively. Given the paucity of experimental studies on the non-invasive brain stimulation in the field of sports neuroscience, especially martial sports, the present study aimed at investigating the effects of neurostimulation in potentiating the motor and cognitive functions in experienced taekwondo practitioners. The study sample included 15 experienced male taekwondo players who received real or sham direct current stimulation on the primary motor cortex (M1) and the lumbar spinal segment (T12-L2) over two sessions, 72 h apart. Next, the performance of the participants was evaluated through a simulation of taekwondo exercise directly after the sham and real sessions. Moreover, a cognitive platform (CBS: Cambridge Brain Science) was used to investigate the participants' cognitive profile in each instance. Unlike sham stimulation, real tDCS was associated with improved selective attention and reaction time in both in the simulated task performance and cognitive examination. The concurrent cortical and trans-spinal tDCS was found to improve selective attention (31% performance improvement) (P < 0.0001) [EFFECT SIZE; 1.84]. and reduce reaction time (4.7% performance improvement) (P < 0.0001) [EFFECT SIZE; 0.02]. Meanwhile, the intervention failed to leave a significant change in cognitive functions evaluated through CBS (P > 0.05). As informed by our results, the present dual-mode neurostimulation could improve motor functions potentially through the effect of tsDCS over the spinal interneurons and tDCS over the primary motor cortex. Likewise, our findings suggested an improved performance in simulated taekwondo task after real- but not sham-stimulation. This study paves the way for designing neurostimulation protocols to improve the performance of professional athletes, namely martial art practitioners, including their accuracy and velocity of reactions. Such positive effects of neuostimulation in athletic performance as demonstrated in this research and similar reports are expected to enhance the athletes' success in professional competitions.

Effects of single session transcranial direct current stimulation on aerobic performance and one arm pull-down explosive force of professional rock climbers

Objective: To explore the effects of single-session transcranial direct current stimulation (tDCS) on aerobic performance and explosive force in the one-arm pull-down of long-term trained rock climbers. Method: Twenty athletes (twelve male and eight female) from the Rock Climbing Team of Hunan province (Hunan, China) were selected for a randomized double-blind crossover study. After baseline tests, All subjects visited laboratories twice to randomly receive either sham or a-tDCS at a current intensity of 2 mA for 20 min. The two visits were more than 72 h apart. Immediately after each stimulation, subjects completed a 9-min 3-level-load aerobic test and a one-arm pull-down test. Results: Differences in the heart rate immediately after 9-min incremental aerobic exercises revealed no statistical significance between each group (p > 0.05). However, the decrease in heart rate per unit time after exercise after real stimulation was significantly better than before stimulation (p < 0.05), and no statistical significance was observed between after sham stimulation and before stimulation (p > 0.05). One-arm pull-down explosive force on both sides after real stimulation was improved by a-tDCS compared with before stimulation, but with no significant difference (p > 0.05). Real stimulation was significantly improved, compared with sham stimulation on the right side (p < 0.05). Conclusion: Single-session tDCS could potentially benefit sports performance in professional athletes.

The influence of a single transcranial direct current stimulation session on physical fitness in healthy subjects: a systematic review

Physical fitness is of indisputable importance for both health, and sports. Currently, the brain is being increasingly recognized as a contributor to physical fitness. Hereby, transcranial direct current stimulation (tDCS), as an ergogenic aid, has gained scientific interest. The current PRISMA-adherent review aimed to examine the effect of tDCS on the three core components of physical fitness: muscle strength, -endurance and cardiopulmonary endurance. Randomized controlled- or cross-over trials evaluating the effect of a single tDCS session (vs. sham) in healthy individuals were included. Hereby, a wide array of tDCS-related factors (e.g., tDCS montage and dose) was taken into account. Thirty-five studies (540 participants) were included. Between-study heterogeneity in factors such as age, activity level, tDCS protocol, and outcome measures was large. The capacity of tDCS to improve physical fitness varied substantially across studies. Nevertheless, muscle endurance was most susceptible to improvements following anodal tDCS (AtDCS), with 69% of studies (n = 11) investigating this core component of physical fitness reporting positive effects. The primary motor cortex and dorsolateral prefrontal cortex were targeted the most, with positive results being reported on muscle and cardiopulmonary endurance. Finally, online tDCS seemed most beneficial, and no clear relationship between tDCS and dose-related parameters seemed present. These findings can contribute to optimizing tDCS interventions during the rehabilitation of patients with a variety of (chronic) diseases such as cardiovascular disease. Therefore, future studies should focus on further unraveling the potential of AtDCS on physical fitness and, more specifically, muscle endurance in both healthy subjects and patients suffering from (chronic) diseases. This study was registered in Prospero with the registration number CRD42021258529. "To enable PROSPERO to focus on COVID-19 registrations during the 2020 pandemic, this registration record was automatically published exactly as submitted. The PROSPERO team has not checked eligibility".

Single-session anodal transcranial direct current stimulation to enhance sport-specific performance in athletes: A systematic review and meta-analysis

BACKGROUND

Transcranial direct current stimulation (tDCS) has emerged as a promising and feasible method to improve motor performance in healthy and clinical populations. However, the potential of tDCS to enhance sport-specific motor performance in athletes remains elusive.

OBJECTIVE

We aimed at analyzing the acute effects of a single anodal tDCS session on sport-specific motor performance changes in athletes compared to sham.

METHODS

A systematic review and meta-analysis was conducted in the electronic databases PubMed, Web of Science, and SPORTDiscus. The meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, two subgroup analyses were conducted (1) depending on the stimulated brain areas (primary motor cortex (M1), temporal cortex (TC), prefrontal cortex (PFC), cerebellum (CB)), and (2) studies clustered in subgroups according to different sports performance domains (endurance, strength, visuomotor skill).

RESULTS

A total number of 19 studies enrolling a sample size of 258 athletes were deemed eligible for inclusion. Across all included studies, a significant moderate standardized mean difference (SMD) favoring anodal tDCS to enhance sport-specific motor performance could be observed. Subgroup analysis depending on cortical target areas of tDCS indicated a significant moderate SMD in favor of anodal tDCS compared to sham for M1 stimulation.

CONCLUSION

A single anodal tDCS session can lead to performance enhancement in athletes in sport-specific motor tasks. Although no definitive conclusions can be drawn regarding the modes of action as a function of performance domain or stimulation site, these results imply intriguing possibilities concerning sports performance enhancement through anodal M1 stimulation.

Functional whole-brain mechanisms underlying effects of tDCS on athletic performance of male rowing athletes revealed by resting-state fMRI

Introduction

Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that applied to modulate brain activity and enhance motor recovery. However, the neurobiological substrates underlying the effects of tDCS on brain function remain poorly understood. This study aimed to investigate the central mechanisms of tDCS on improving the athletic performance of male rowing athletes.

Methods

Twelve right-handed male professional rowing athletes received tDCS over the left primary motor cortex while undergoing regular training. The resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired before and after tDCS. Measures of amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) were calculated and compared between baseline and follow-up, as well as topological measures including global and local efficiency of functional brain networks constructed by graph theoretical analysis.

Results

Male rowing athletes showed increased isokinetic muscle strength of the left knee and left shoulder after tDCS. Increased ALFF values were found in the right precentral gyrus of male rowing athletes after tDCS when compared with those before tDCS. In addition, male rowing athletes showed increased ReHo values in the left paracentral lobule following tDCS. Moreover, increased nodal global efficiency was identified in the left inferior frontal gyrus (opercular part) of male rowing athletes after tDCS.

Conclusion

The findings suggested that simultaneous tDCS-induced excitation over the primary motor cortex might potentially improve the overall athletic performance in male rowing athletes through the right precentral gyrus and left paracentral lobule, as well as left inferior frontal gyrus.

Effects of Preceding Transcranial Direct Current Stimulation on Movement Velocity and EMG Signal during the Back Squat Exercise

This study aimed to evaluate the effects of preceding anodal transcranial direct stimulation (a-tDCS) over the dorsolateral prefrontal cortex (DLPFC) during the back squat exercise on movement velocity and surface electromyographic (sEMG) activity. Thirteen healthy, well-trained, male firefighters (34.72 ± 3.33 years; 178 ± 7.61 cm; 76.85 ± 11.21 kg; 26.8 ± 4.2 kg·m−2; back squat 1-repetition maximum 141.5 ± 16.3 kg) completed this randomised double-blinded sham-controlled crossover study. After familiarisation and basal measurements, participants attended the laboratory on two occasions separated by 72 h to receive either Sham or a-tDCS (current intensity of 2 mA for 20 min). Immediately after stimulation, participants completed three sets of 12 repetitions (70% of 1-RM) with three minutes of recovery between sets monitored with a linear position transducer. The sEMG of the rectus femoris (RF) and vastus lateralis (VL) of both legs were recorded. No significant differences were observed between a-tDCS and Sham interventions on mean concentric velocity at any set (p > 0.05). Velocity loss and effort index were significantly higher (p < 0.05) in set 3 compared to set 1 only in the a-tDCS group. The right-leg RM and right-leg VL elicited the greatest muscle activation during set 1 after a-tDCS and Sham, respectively (p < 0.05). Our results revealed that a-tDCS over the DLPFC might impact movement velocity or fatigue tolerance in well-trained individuals. Notwithstanding, significant differences in dominant-leg muscle activity were found both in a-tDCS and Sham.

Transcranial Direct Current Stimulation Does Not Affect Sprint Performance or the Horizontal Force-Velocity Profile

Purpose: The aim of this study was to explore the effects of transcranial direct current stimulation (tDCS) on sprint performance and the horizontal force-velocity (F-v) profile. Method: Thirty-two healthy subjects (25 men and 7 women; age = 21.8 ± 2.4 years) completed three sessions separated by 1 week following a double-blinded crossover design. Each session consisted of two maximal sprints of 30 meters that were performed after applying ANODAL, CATHODAL or SHAM tDCS over the left dorsolateral prefrontal cortex (DLPFC) for 15 minutes at 2 mA. The 30-m time and the horizontal F-v profile variables (theoretical maximal force [F₀], theoretical maximal velocity, Fv slope, maximal power [Pmax], decrease in the ratio of horizontal-to-resultant force, and maximal ratio of horizontal-to-resultant force) were compared between the tDCS conditions. Results: No significant differences between the tDCS conditions were observed for any variable (p range = 0.061 to 0.842). The magnitude of the differences was negligible for most of the comparisons (effect size [ES] < 0.20) with the only exception of P_max and F₀ which were greater for the ANODAL compared to the SHAM condition (both ES = 0.20). Conclusions: The application of tDCS over the DLPFC is not effective to increase non-fatigued sprint performance.

Brain Stimulation Over the Motion-Sensitive Midtemporal Area Reduces Deleterious Effects of Mental Fatigue on Perceptual-Cognitive Skills in Basketball Players

The objective of this study was to analyze the effect of anodal transcranial direct current stimulation (a-tDCS) over the motion-sensitive midtemporal area on perceptual-cognitive skills (visuomotor and basketball decision-making skills) in mentally fatigued basketball players. A total of 20 male basketball players were recruited. This was a randomized, double-blinded, and counterbalanced crossover study with two experimental conditions: a-tDCS and Sham. The participants completed the basketball decision-making task and visuomotor skill after performing a 60-min sport-based videogame task with anodal (i.e., a-tDCS) or placebo (Sham) stimulation over the motion-sensitive middle temporal area. Worse response time was observed in visuomotor skill for Sham than a-tDCS postexperiment (p < .05). There was no main condition effect for accuracy of visuomotor skill (p > .05). There was more impairment in accuracy and response time in basketball decision-making skills for the Sham condition than a-tDCS (p < .05). Notably, a-tDCS over the motion-sensitive middle temporal area removed the negative effects of mental fatigue on perceptual-cognitive skills.

Neuromuscular Fatigue Responses of Endurance- and Strength-Trained Athletes during Incremental Cycling Exercise

This study explored the development of neuromuscular fatigue responses during progressive cycling exercise. The sample comprised 32 participants aged 22.0 ± 0.54 years who were assigned into three groups: endurance-trained group (END, triathletes, n = 10), strength-trained group (STR, bodybuilders, n = 10) and control group (CG, recreationally active students, n = 12). The incremental cycling exercise was performed using a progressive protocol starting with a 3 min resting measurement and then 50 W workload with subsequent constant increments of 50 W every 3 min until 200 W. Surface electromyography (SEMG) of rectus femoris muscles was recorded during the final 30 s of each of the four workloads. During the final 15 s of each workload, participants rated their overall perception of effort using the 20-point rating of the perceived exertion (RPE) scale. Post hoc Tukey’s HSD testing showed significant differences between the END and STR groups in median frequency and mean power frequency across all workloads (p < 0.001 and p < 0.01, respectively). Athletes from the END group had significantly lower electromyogram amplitude responses than those from the STR (p = 0.0093) and CG groups (p = 0.0006). Increasing RPE points from 50 to 200 W were significantly higher in the STR than in the END group (p < 0.001). In conclusion, there is a significant variation in the neuromuscular fatigue profiles between athletes with different training backgrounds when a cycling exercise is applied. The approximately linear trends of the SEMG and RPE values of both groups of athletes with increasing workload support the increased skeletal muscle recruitment with perceived exertion or fatiguing effect.

Transcranial Direct Current Stimulation of Motor Cortex Enhances Spike Performances of Professional Female Volleyball Players

The purpose of this study was to investigate effects of brain excitability by transcranial direct current stimulation (tDCS) on spike performances of professional female volleyball players. Thirteen professional female volleyball players were recruited for participation. We performed a randomized single-blind, SHAM-stimulus controlled, and counter-balanced crossover design with two interventions in this study. An anodal tDCS current was applied over the primary motor cortex (M1) for 20 min at 2 mA. In the SHAM intervention, the current was first applied for 30 s, after which it was terminated. Exercise performance assessment which comprised spike performance (spike ball speed, spiking consistency), two vertical jumps (jump and reach: JaR, countermovement jump: CMJ), bench-press and back-squat one-repetition maximum (1RM) were tested pre- and post-intervention. Results indicated that spike ball speed and spiking consistency following tDCS were significantly higher than those after SHAM intervention (both p < 0.05). However, JaR and CMJ did not show any significant differences between tDCS and SHAM intervention groups (both p > 0.05). There was no significant difference in bench-press and back-squat 1RM between two groups either (both p > 0.05). These findings suggest that tDCS could be effective in enhancing motor coordination performances of professional female volleyball athletes.

Different paradigms of transcranial electrical stimulation improve motor function impairment and striatum tissue injuries in the collagenase-induced intracerebral hemorrhage rat model

Background

In the horizon of therapeutic restrictions in intracerebral hemorrhage (ICH), recently, non-invasive transcranial electrical stimulation (tES) has achieved considerable prosperities. Translational studies have postulated that transcranial direct current stimulation (tDCS) and the other types of tES remain potentially a novel therapeutic option to reverse or stabilize cognitive and motor impairments.

Objective

The aim of this study was to comparatively evaluate the effects of the four main paradigms of tES, including tDCS, transcranial alternating (tACS), pulsed (tPCS), and random noise (tRNS) stimulations on collagenase-induced sensorimotor impairments and striatum tissue damage in male rats.

Methods

To induce ICH, 0.5 μl of collagenase was injected into the right striatum of male Sprague Dawley rats. One day after surgery, tES, was applied to the animals for seven consecutive days. Motor functions were appraised by neurological deficit score, rotarod, and wire hanging tests on the day before surgery and postoperative days 3, 7, and 14. After behavioral tests, brain tissue was prepared appropriately to perform the stereological evaluations.

Results

The results indicated that the application of the four tES paradigms (tDCS, tACS, tRNS, and tPCS) significantly reversed motor disorders in collagenase-induced ICH groups. Further, the motor function improvement of tACS and tRNS receiving rats in wire-hanging and rotarod tests were higher than the other two tES receiving groups. Structural changes and stereological assessments also confirmed the results of behavioral functions.

Conclusion

Our findings suggest that in addition to tDCS application in the treatment of ICH, other tES paradigms, especially tACS and tRNS may be considered as add-on therapeutic strategies in stroke.

Transcranial direct current stimulation (tDCS) and sporting performance: A systematic review and meta-analysis of tDCS effects on physical endurance, muscular strength, and visuomotor skills

Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been linked with a range of physiological and cognitive enhancements relevant to sporting performance. As a number of positive and null findings have been reported in the literature, the present meta-analysis sought to synthesise results across endurance, strength, and visuomotor skill domains to investigate if tDCS improves any aspect of sporting performance. Online database searches in August 2020 identified 43 full-text studies which examined the acute effects of tDCS compared to sham/control conditions on physical endurance, muscular strength, and visuomotor skills in healthy adults. Meta-analysis indicated a small overall effect favouring tDCS stimulation over sham/control (standardized mean difference (SMD)=0.25, CI95%[0.14;0.36]). Effects on strength (SMD=0.31, CI95%[0.10;0.51]) and visuomotor (SMD=0.29, CI95%[0.00;0.57]) tasks were larger than endurance performance (SMD=0.18, CI95%[0.00;0.37]). Meta-regressions indicated effect sizes were not related to stimulation parameters, but other factors such as genetics, gender, and experience may modulate tDCS effects. The results suggest tDCS has the potential to be used as an ergogenic aid in conjunction with a specified training regime.

Simultaneous transcranial and transcutaneous spinal direct current stimulation to enhance athletic performance outcome in experienced boxers

Transcranial direct current stimulation (tDCS) is among the rapidly growing experimental approaches to enhance athletic performance. Likewise, novel investigations have recently addressed the effects of transcutaneous spinal Direct Current Stimulation (tsDCS) on motor functions such as reduced reaction time. The impact of tDCS, and tsDCS might be attributed to altered spontaneous neural activity and membrane potentials of cortical and corticomotoneuronal cells, respectively. Given the paucity of empirical research in non-invasive brain stimulation in sports neuroscience, especially in boxing, the present investigation studied the effects of neuromodulation on motor and cognitive functions of professional boxers. The study sample comprised 14 experienced male boxers who received random sequential real or sham direct current stimulation over the primary motor cortex (M1) and paraspinal region (corresponding to the hand area) in two sessions with a 72-h interval. Unlike sham stimulation, real stimulation improved selective attention and reaction time of the experienced boxers [enhanced selective attention (p < 0.0003), diminished right hand (p < 0.0001) and left hand reaction time (p < 0.0006)]. Meanwhile, the intervention left no impact on the participants' cognitive functions (p > 0.05). We demonstrated that simultaneous stimulation of the spinal cord and M1 can improve the performance of experienced boxers through neuromodulation. The present study design may be extended to examine the role of neurostimulation in other sport fields.

Effects of transcranial direct current stimulation on cognitive dysfunction in multiple sclerosis

BACKGROUND

Around 40%-70% of patients with multiple sclerosis (MS) may experience cognitive impairments during the course of their disease with detrimental effects on social and occupational activities. Transcranial direct current stimulation (tDCS has been investigated in pain, fatigue, and mood disorders related to MS, but to date, few studies have examined effects of tDCS on cognitive performance in MS.

OBJECTIVE

The current study aimed to investigate the effects of a multi-session tDCS protocol on cognitive performance and resting-state brain electrical activities in patients with MS.

METHODS

Twenty-four eligible MS patients were randomly assigned to real (anodal) or sham tDCS groups. Before and after 8 consecutive daily tDCS sessions over the left dorsolateral prefrontal cortex (DLPFC), patients' cognitive performance was assessed using the Cambridge Brain Sciences-Cognitive Platform (CBS-CP). Cortical electrical activity was also evaluated using quantitative electroencephalography (QEEG) analysis at baseline and after the intervention.

RESULTS

Compared to the sham condition, significant improvement in reasoning and executive functions of the patients in the real tDCS group was observed. Attention was also improved considerably but not statistically significantly following real tDCS. However, no significant changes in resting-state brain activities were observed after stimulation in either group.

CONCLUSION

Anodal tDCS over the left DLPFC appears to be a promising therapeutic option for cognitive dysfunction in patients with MS. Larger studies are required to confirm these findings and to investigate underlying neuronal mechanisms.

Effect of tDCS on well-being and autonomic function in professional male players after official soccer matches

This study aimed to examine the effect of transcranial direct current stimulation (tDCS) used as a recovery strategy, on heart rate (HR) measures and perceived well-being in 12 male professional soccer players. tDCS was applied in the days after official matches targeting the left dorsolateral prefrontal cortex (DLPFC) with 2 mA for 20 min (F3-F4 montage). Participants were randomly assigned to anodal tDCS (a-tDCS) or sham tDCS sessions. Players completed the Well-Being Questionnaire (WBQ) and performed the Submaximal Running Test (SRT) before and after tDCS. HR during exercise (HRex) was determined during the last 30 s of SRT. HR recovery (HRR) was recorded at 60 s after SRT. The HRR index was calculated from the absolute difference between HRex and HRR. A significant increase was observed for WBQ (effect of time; p<0.001; η_p²=0.417) with no effect for condition or interaction. A decrease in HRR (p = 0.014; η_p²=0.241), and an increase in HRR index were observed (p = 0.045; η_p²=0.168), with no effect for condition or interaction. No change for HRex was evident (p>0.05). These results suggest that a-tDCS over the DLPFC may have a positive effect on enhancing well-being and parasympathetic autonomic markers, which opens up a possibility for testing tDCS as a promising recovery-enhancing strategy targeting the brain in soccer players. The findings suggest that brain areas related to emotional and autonomic control might be involved in these changes with a possible interaction effect of tDCS by placebo-related effects, but more research is needed to verify this effect.

Transcranial Stimulation Improves Volume and Perceived Exertion but does not Change Power

This study aimed to analyze the acute effect of anodal transcranial direct current stimulation (a-tDCS) over the primary motor cortex (M1) on the volume, perceived exertion, and neuromuscular performance measurements in trained and untrained adults. Twenty-four male adults (12 trained and 12 untrained) participated in this single-blind, randomized, and sham-controlled study. The participants performed three back squat repetitions using the 15RM load with maximal concentric velocity to assess neuromuscular performance before tDCS and 30-min after resistance exercise. Next, they were randomly assigned to a-tDCS over M1 or the sham condition. Participants performed ten sets of parallel back squat with 15RM load and repetitions sustained to momentary muscular failure. The total number of repetitions was higher (p<0.05) and perceived exertion was lower (p<0.05) after a-tDCS in both groups. Peak power, velocity, and force decreased in both groups after the RE session (p<0.05), but with a higher rate in untrained individuals (p<0.05). No significant effect was found for peak power, peak velocity, and peak force (p>0.05). This study suggests that using a-tDCS may improve the total volume of repetitions and perceived exertion in trained and untrained individuals.

Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19

Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19. Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders. Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders. Results: Non-invasive neuromodulation may manage disorders associated with COVID-19 through four pathways: (1) Direct infection mitigation through the stimulation of regions involved in the regulation of systemic anti-inflammatory responses and/or autonomic responses and prevention of neuroinflammation and recovery of respiration; (2) Amelioration of COVID-19 symptoms of musculoskeletal pain and systemic fatigue; (3) Augmenting cognitive and physical rehabilitation following critical illness; and (4) Treating outbreak-related mental distress including neurological and psychiatric disorders exacerbated by surrounding psychosocial stressors related to COVID-19. The selection of the appropriate techniques will depend on the identified target treatment pathway. Conclusion: COVID-19 infection results in a myriad of acute and chronic symptoms, both directly associated with respiratory distress (e.g., rehabilitation) or of yet-to-be-determined etiology (e.g., fatigue). Non-invasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19.

Future Portrait of the Athletic Brain: Mechanistic Understanding of Human Sport Performance Via Animal Neurophysiology of Motor Behavior

Sport performances are often showcases of skilled motor control. Efforts to understand the neural processes subserving such movements may teach us about general principles of behavior, similarly to how studies on neurological patients have guided early work in cognitive neuroscience. While investigations on non-human animal models offer valuable information on the neural dynamics of skilled motor control that is still difficult to obtain from humans, sport sciences have paid relatively little attention to these mechanisms. Similarly, knowledge emerging from the study of sport performance could inspire innovative experiments in animal neurophysiology, but the latter has been only partially applied. Here, we advocate that fostering interactions between these two seemingly distant fields, i.e., animal neurophysiology and sport sciences, may lead to mutual benefits. For instance, recording and manipulating the activity from neurons of behaving animals offer a unique viewpoint on the computations for motor control, with potentially untapped relevance for motor skills development in athletes. To stimulate such transdisciplinary dialog, in the present article, we also discuss steps for the reverse translation of sport sciences findings to animal models and the evaluation of comparability between animal models of a given sport and athletes. In the final section of the article, we envision that some approaches developed for animal neurophysiology could translate to sport sciences anytime soon (e.g., advanced tracking methods) or in the future (e.g., novel brain stimulation techniques) and could be used to monitor and manipulate motor skills, with implications for human performance extending well beyond sport.

Ergogenic Effects of Bihemispheric Transcranial Direct Current Stimulation on Fitness: a Randomized Cross-over Trial

Several types of routines and methods have been experimented to gain neuromuscular advantages, in terms of exercise performance, in athletes and fitness enthusiasts. The aim of the present study was to evaluate the impact of biemispheric transcranial direct current stimulation on physical fitness indicators of healthy, physically active, men. In a randomized, single-blinded, crossover fashion, seventeen subjects (age: 30.9 ± 6.5 years, BMI: 24.8±3.1 kg/m2) underwent either stimulation or sham, prior to: vertical jump, sit & reach, and endurance running tests. Mixed repeated measures anova revealed a large main effect of stimulation for any of the three physical fitness measures. Stimulation determined increases of lower limb power (+ 5%), sit & reach amplitude (+ 9%) and endurance running capacity (+ 12%) with respect to sham condition (0.16<ηp2 < 0.41; p<0.05). Ratings-of-perceived-exertion, recorded at the end of each test session, did not change across all performances. However, in the stimulated-endurance protocol, an average lower rate-of-perceived-exertion at iso-time was inferred. A portable transcranial direct current stimulation headset could be a valuable ergogenic resource for individuals seeking to improve physical fitness in daily life or in athletic training.

Non-Invasive Brain Stimulation: Augmenting the Training and Performance Potential in Esports Players

During the last two decades, esports, a highly competitive sporting activity, has gained increasing popularity. Both performance and competition in esports require players to have fine motor skills and physical and cognitive abilities in controlling and manipulating digital activities in a virtual environment. While strategies for building and improving skills and abilities are crucial for successful gaming performance, few effective training approaches exist in the fast-growing area of competitive esports. In this paper, we describe a non-invasive brain stimulation (NIBS) approach and highlight the relevance and potential areas for research while being cognizant of various technical, safety, and ethical issues related to NIBS when applied to esports.

Different Effects of 2 mA and 4 mA Transcranial Direct Current Stimulation on Muscle Activity and Torque in a Maximal Isokinetic Fatigue Task

Studies investigating the effects of transcranial direct current stimulation (tDCS) on fatigue and muscle activity have elicited measurable improvements using stimulation intensities ≤2 mA and submaximal effort tasks. The purpose of this study was to determine the effects of 2 mA and 4 mA anodal tDCS over the primary motor cortex (M1) on performance fatigability and electromyographic (EMG) activity of the leg muscles during a maximal isokinetic task in healthy young adults. A double-blind, randomized, sham-controlled crossover study design was applied. Twenty-seven active young adults completed four sessions, each spaced by 5-8 days. During session 1, dominance was verified with isokinetic strength testing, and subjects were familiarized with the fatigue task (FT). The FT protocol included 40 continuous maximum isokinetic contractions of the knee extensors and flexors (120°/s, concentric/concentric). During Sessions 2-4, tDCS was applied for 20 min with one of three randomly assigned intensities (sham, 2 mA or 4 mA) and the FT was repeated. The anode and cathode of the tDCS device were placed over C3 and the contralateral supraorbital area, respectively. A wireless EMG system collected muscle activity during the FT. The 2 mA tDCS condition had significantly less torque (65.9 ± 32.7 Nm) during the FT than both the sham (68.4 ± 33.9 Nm, p < 0.001) and 4 mA conditions (68.4 ± 33.9 Nm, p = 0.001). Furthermore, the 2 mA condition (33.8 ± 11.7%) had significantly less EMG activity during the FT than both the sham (39.7 ± 10.6%, p < 0.001) and 4 mA conditions (40.5 ± 13.4%, p = 0.001). Contrary to previous submaximal isometric fatigue investigations, the 2 mA tDCS condition significantly reduced torque production and EMG activity of the leg extensors during a maximal isokinetic FT compared with the sham and 4 mA conditions. Also, torque production and EMG activity in the 4 mA condition were not significantly different from sham. Thus, the effects of tDCS, and the underlying mechanisms, might not be the same for different tasks and warrants more investigation.