Transcranial Direct Current Stimulation Modulates Neuronal Activity and Learning in Pilot Training

Modulation of human frontal midline theta by neurofeedback: A systematic review and quantitative meta-analysis

Human brain activity consists of different frequency bands associated with varying functions. Oscillatory activity of frontal brain regions in the theta range (4-8 Hz) is linked to cognitive processing and can be modulated by neurofeedback - a technique where participants receive real-time feedback about their brain activity and learn to modulate it. However, criticism of this technique evolved, and high heterogeneity of study designs complicates a valid evaluation of its effectiveness. This meta-analysis provides the first systematic overview over studies attempting to modulate frontal midline theta with neurofeedback in healthy human participants. Out of 1261 articles screened, 14 studies were eligible for systematic review and 11 for quantitative meta-analyses. Studies were evaluated following the DIAD model and the PRISMA guidelines. A significant across-study effect of medium size (Hedges' g = .66; 95%-CI [-0.62, 1.73]) with substantial between-study heterogeneity (Q(16) = 167.43, p < .001) was observed and subanalysis revealed effective frontal midline theta upregulation. We discuss moderators of effect sizes and provide guidelines for future research in this dynamic field.

Neurovascular coupling in the attention during visual working memory processes

Focusing attention in visual working memory (vWM) depends on the ability to filter distractors and expand the scope of targets. Although many properties of attention processes in vWM have been well documented, it remains unclear how the mechanisms of neurovascular coupling (NVC) function during attention processes in vWM. Here, we show simultaneous multimodal data that reveal the similar temporal and spatial features of attention processes during vWM. These similarities lead to common NVC outcomes across individuals. When filtering out distractors, the electroencephalography (EEG)-informed NVC displayed broader engagement across the frontoparietal network. A negative correlation may exist between behavioral metrics and EEG-informed NVC strength related to attention control. On a dynamic basis, NVC features exhibited higher discriminatory power in predicting behavior than other features alone. These results underscore how multimodal approaches can advance our understanding of the role of attention in vWM, and how NVC fluctuations are associated with actual behavior.

Impact of twice-a-day transcranial direct current stimulation intervention on cognitive function and motor cortex plasticity in patients with Alzheimer's disease

Background

Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer's disease (AD), and some studies suggest a close relationship between cognition and plasticity. However, the clinical benefits of transcranial direct current stimulation (tDCS) in patients still need to be evaluated.

Aims

This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity.

Methods

124 patients with AD were randomly assigned to active tDCS (n=63) or sham tDCS (n=61). The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks (5 days per week, 2 days off). The Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog) were used for cognition evaluation at baseline, week 2 and week 6. The cortical plasticity was represented by motor-evoked potential (MEP) measured with an electromyogram.

Results

The results showed that multiple courses of active tDCS can improve the cognitive functions of patients with AD, especially in the memory domain (word recall, recall of test instructions and word recognition). In addition, the damaged MEP level was enhanced following active treatment. In the active tDCS group, the improvements in ADAS-Cog total and subitem (word recall and word recognition) scores were negatively correlated with the enhancement of MEP.

Conclusions

Our research indicates for the first time that twice-a-day tDCS may improve the cognitive function of patients with AD. This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity, which warrants mechanistic investigations of the relationship between cognition and plasticity in the future.

Trial registration number

ChiCTR1900021067.

Simultaneous fMRI and tDCS for Enhancing Training of Flight Tasks

There is a gap in our understanding of how best to apply transcranial direct-current stimulation (tDCS) to enhance learning in complex, realistic, and multifocus tasks such as aviation. Our goal is to assess the effects of tDCS and feedback training on task performance, brain activity, and connectivity using functional magnetic resonance imaging (fMRI). Experienced glider pilots were recruited to perform a one-day, three-run flight-simulator task involving varying difficulty conditions and a secondary auditory task, mimicking real flight requirements. The stimulation group (versus sham) received 1.5 mA high-definition HD-tDCS to the right dorsolateral prefrontal cortex (DLPFC) for 30 min during the training. Whole-brain fMRI was collected before, during, and after stimulation. Active stimulation improved piloting performance both during and post-training, particularly in novice pilots. The fMRI revealed a number of tDCS-induced effects on brain activation, including an increase in the left cerebellum and bilateral basal ganglia for the most difficult conditions, an increase in DLPFC activation and connectivity to the cerebellum during stimulation, and an inhibition in the secondary task-related auditory cortex and Broca's area. Here, we show that stimulation increases activity and connectivity in flight-related brain areas, particularly in novices, and increases the brain's ability to focus on flying and ignore distractors. These findings can guide applied neurostimulation in real pilot training to enhance skill acquisition and can be applied widely in other complex perceptual-motor real-world tasks.

Training augmentation using additive sensory noise in a lunar rover navigation task

Background

The uncertain environments of future space missions means that astronauts will need to acquire new skills rapidly; thus, a non-invasive method to enhance learning of complex tasks is desirable. Stochastic resonance (SR) is a phenomenon where adding noise improves the throughput of a weak signal. SR has been shown to improve perception and cognitive performance in certain individuals. However, the learning of operational tasks and behavioral health effects of repeated noise exposure aimed to elicit SR are unknown.

Objective

We evaluated the long-term impacts and acceptability of repeated auditory white noise (AWN) and/or noisy galvanic vestibular stimulation (nGVS) on operational learning and behavioral health.

Methods

Subjects (n = 24) participated in a time longitudinal experiment to access learning and behavioral health. Subjects were assigned to one of our four treatments: sham, AWN (55 dB SPL), nGVS (0.5 mA), and their combination to create a multi-modal SR (MMSR) condition. To assess the effects of additive noise on learning, these treatments were administered continuously during a lunar rover simulation in virtual reality. To assess behavioral health, subjects completed daily, subjective questionnaires related to their mood, sleep, stress, and their perceived acceptance of noise stimulation.

Results

We found that subjects learned the lunar rover task over time, as shown by significantly lower power required for the rover to complete traverses (p < 0.005) and increased object identification accuracy in the environment (p = 0.05), but this was not influenced by additive SR noise (p = 0.58). We found no influence of noise on mood or stress following stimulation (p > 0.09). We found marginally significant longitudinal effects of noise on behavioral health (p = 0.06) as measured by strain and sleep. We found slight differences in stimulation acceptability between treatment groups, and notably nGVS was found to be more distracting than sham (p = 0.006).

Conclusion

Our results suggest that repeatedly administering sensory noise does not improve long-term operational learning performance or affect behavioral health. We also find that repetitive noise administration is acceptable in this context. While additive noise does not improve performance in this paradigm, if it were used for other contexts, it appears acceptable without negative longitudinal effects.

The immediate effects of iTBS on the muscle activation pattern under challenging balance conditions in the patients with chronic low back pain: A preliminary study

Background

The patients with chronic low back pain (CLBP) showed impaired postural control, especially in challenging postural task. The dorsolateral prefrontal cortex (DLPFC) is reported to involve in the complex balance task, which required considerable attentional control. The effect of intermittent theta burst stimulation (iTBS) over the DLPFC to the capacity of postural control of CLBP patients is still unknown.

Methods

Participants diagnosed with CLBP received a single-session iTBS over the left DLPFC. All the participants completed the postural control tasks of single-leg (left/right) standing before and after iTBS. The activation changes of the DLPFC and M1 before and after iTBS were recorded by functional near-infrared spectroscopy (fNIRS). The activation pattern of the trunk [transversus abdominis (TrA), superficial lumbar multifidus (SLM)] and leg [tibialis anterior (TA), gastrocnemius medialis (GM)] muscles including root mean square (RMS) and co-contraction index (CCI) during single-leg standing were measured by surface electromyography (sEMG) before and after the intervention. The paired t-test was used to test the difference before and after iTBS. Pearson correlation analyses were performed to test the relationship between the oxyhemoglobin concentration and sEMG outcome variables (RMS and CCI).

Results

Overall, 20 participants were recruited. In the right-leg standing condition, compared with before iTBS, the CCI of the right TrA/SLM was significantly decreased (t = −2.172, p = 0.043), and the RMS of the right GM was significantly increased (t = 4.024, p = 0.001) after iTBS. The activation of the left DLPFC (t = 2.783, p = 0.012) and left M1 (t = 2.752, p = 0.013) were significantly decreased and the relationship between the left DLPFC and M1 was significant after iTBS (r = 0.575, p = 0.014). Correlation analysis showed the hemoglobin concentration of M1 was negatively correlated with the RMS of the right GM (r = −0.659, p = 0.03) and positively correlated between CCI of the right TrA/SLM (r = 0.503, p = 0.047) after iTBS. There was no significant difference in the brain or muscle activation change in the left leg-standing condition between before and after iTBS.

Conclusion

Intermittent theta burst stimulation over the left DLPFC seems to be able to improve the muscle activation pattern during postural control ability in challenging postural task, which would provide a new approach to the treatment of CLBP.

Differential Effects of Transcranial Static Magnetic Stimulation Over Left and Right Dorsolateral Prefrontal Cortex on Brain Oscillatory Responses During a Working Memory Task

Transcranial static magnetic stimulation (tSMS) is known to influence behavioral and neural activities. However, although the left and right dorsolateral prefrontal cortex (DLPFC) are associated with different cognitive functions, there remains a lack of knowledge on a difference in the effects of tSMS on cognitive performance and related brain activity between left and right DLPFC stimulations. To address this knowledge gap, we examined how differently tSMS over the left and right DLPFC altered working memory performance and electroencephalographic oscillatory responses using a 2-back task, in which subjects monitor a sequence of stimuli and decide whether a presented stimulus matches the stimulus presented two trials previously. Fourteen healthy adults (five females) performed the 2-back task before, during (20 min after the start of stimulation), immediately after, and 15 min after three different stimulation conditions: tSMS over the left DLPFC, tSMS over the right DLPFC, and sham stimulation. Our preliminary results revealed that while tSMS over the left and right DLPFC impaired working memory performance to a similar extent, the impacts of tSMS on brain oscillatory responses were different between the left and right DLPFC stimulations. Specifically, tSMS over the left DLPFC increased the event-related synchronization in beta band whereas tSMS over the right DLPFC did not show such an effect. These findings support evidence that the left and right DLPFC play different roles in working memory and suggest that the neural mechanism underlying the impairment of working memory by tSMS can be different between left and right DLPFC stimulations.

Non-invasive transcranial electrical brain stimulation guided by functional near-infrared spectroscopy for targeted neuromodulation: A review

One of the primary goals in cognitive neuroscience is to understand the neural mechanisms on which cognition is based. Researchers are trying to find how cognitive mechanisms are related to oscillations generated due to brain activity. The research focused on this topic has been considerably aided by developing non-invasive brain stimulation techniques. The dynamics of brain networks and the resultant behavior can be affected by non-invasive brain stimulation techniques, which make their use a focus of interest in many experiments and clinical fields. One essential non-invasive brain stimulation technique is transcranial electrical stimulation (tES), subdivided into transcranial direct and alternating current stimulation. tES has recently become more well-known because of the effective results achieved in treating chronic conditions. In addition, there has been exceptional progress in the interpretation and feasibility of tES techniques. Summarizing the beneficial effects of tES, this article provides an updated depiction of what has been accomplished to date, brief history, and the open questions that need to be addressed in the future. An essential issue in the field of tES is stimulation duration. This review briefly covers the stimulation durations that have been utilized in the field while monitoring the brain using functional-near infrared spectroscopy-based brain imaging.

Transcranial Electrical Stimulation Offers the Possibility of Improving Teamwork Among Military Pilots: A Review

Effective teamwork among military pilots is key to successful mission completion. The underlying neural mechanism of teamwork is thought to be inter-brain synchronization (IBS). IBS could also be explained as an incidental phenomenon of cooperative behavior, but the causality between IBS and cooperative behavior could be clarified by directly producing IBS through extra external stimuli applied to functional brain regions. As a non-invasive technology for altering brain function, transcranial electrical stimulation might have the potential to explore whether top-down enhancement of the synchronization of multiple brains can change cooperative behavioral performance among members of a team. This review focuses on the characteristic features of teamwork among military pilots and variations in neuroimaging obtained by hyper-scanning. Furthermore, we discuss the possibility that transcranial electrical stimulation could be used to improve teamwork among military pilots, try to provide a feasible design for doing so, and emphasize crucial aspects to be addressed by future research.

Potential of Transcranial Direct Current Stimulation in Alzheimer's Disease: Optimizing Trials Toward Clinical Use

Transcranial direct current stimulation (tDCS) is a safe and well-tolerated noninvasive method for stimulating the brain that is rapidly developing into a treatment method for various neurological and psychiatric conditions. In particular, there is growing evidence of a therapeutic role for tDCS in ameliorating or delaying the cognitive decline in Alzheimer's disease (AD). We provide a brief overview of the current development and application status of tDCS as a nonpharmacological therapeutic method for AD and mild cognitive impairment (MCI), summarize the levels of evidence, and identify the improvements needed for clinical applications. We also suggest future directions for large-scale controlled clinical trials of tDCS in AD and MCI, and emphasize the necessity of identifying the mechanistic targets to facilitate clinical applications.

Viewing neurovascular coupling through the lens of combined EEG-fNIRS: A systematic review of current methods

Neurovascular coupling is a key physiological mechanism that occurs in the healthy human brain, and understanding this process has implications for understanding the aging and neuropsychiatric populations. Combined electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) has emerged as a promising, noninvasive tool for probing neurovascular interactions in humans. However, the utility of this approach critically depends on the methodological quality used for multimodal integration. Despite a growing number of combined EEG-fNIRS applications reported in recent years, the methodological rigor of past studies remains unclear, limiting the accurate interpretation of reported findings and hindering the translational application of this multimodal approach. To fill this knowledge gap, we critically evaluated various methodological aspects of previous combined EEG-fNIRS studies performed in healthy individuals. A literature search was conducted using PubMed and PsycINFO on June 28, 2021. Studies involving concurrent EEG and fNIRS measurements in awake and healthy individuals were selected. After screening and eligibility assessment, 96 studies were included in the methodological evaluation. Specifically, we critically reviewed various aspects of participant sampling, experimental design, signal acquisition, data preprocessing, outcome selection, data analysis, and results presentation reported in these studies. Altogether, we identified several notable strengths and limitations of the existing EEG-fNIRS literature. In light of these limitations and the features of combined EEG-fNIRS, recommendations are made to improve and standardize research practices to facilitate the use of combined EEG-fNIRS when studying healthy neurovascular coupling processes and alterations in neurovascular coupling among various populations.

Neuroadaptive Training via fNIRS in Flight Simulators

Training to master a new skill often takes a lot of time, effort, and financial resources, particularly when the desired skill is complex, time sensitive, or high pressure where lives may be at risk. Professions such as aircraft pilots, surgeons, and other mission-critical operators that fall under this umbrella require extensive domain-specific dedicated training to enable learners to meet real-world demands. In this study, we describe a novel neuroadaptive training protocol to enhance learning speed and efficiency using a neuroimaging-based cognitive workload measurement system in a flight simulator. We used functional near-infrared spectroscopy (fNIRS), which is a wearable, mobile, non-invasive neuroimaging modality that can capture localized hemodynamic response and has been used extensively to monitor the anterior prefrontal cortex to estimate cognitive workload. The training protocol included four sessions over 2 weeks and utilized realistic piloting tasks with up to nine levels of difficulty. Learners started at the lowest level and their progress adapted based on either behavioral performance and fNIRS measures combined (neuroadaptive) or performance measures alone (control). Participants in the neuroadaptive group were found to have significantly more efficient training, reaching higher levels of difficulty or significantly improved performance depending on the task, and showing consistent patterns of hemodynamic-derived workload in the dorsolateral prefrontal cortex. The results of this study suggest that a neuroadaptive personalized training protocol using non-invasive neuroimaging is able to enhance learning of new tasks. Finally, we outline here potential avenues for further optimization of this fNIRS based neuroadaptive training approach. As fNIRS mobile neuroimaging is becoming more practical and accessible, the approaches developed here can be applied in the real world in scale.

Characterization of Bimanual Cyclical Tasks from Single-trial EEG-fNIRS Measurements

Robot-assisted bimanual training is promising to improve motor function and cortical reorganization for hemiparetic stroke patients. Closing the rehabilitation training loop with neurofeedback can help refine training protocols in time for better engagements and outcomes. However, due to the low signal-to- noise ratio (SNR) and non-stationary properties of neural signals, reliable characterization of bimanual training-induced neural activities from single-trial measurement is challenging. In this study, ten human participants were recruited conducting robot-assisted bimanual cyclical tasks (in-phase, 90° out-of-phase, and anti-phase) when concurrent electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) were recorded. A unified EEG-fNIRS bimodal signal processing framework was proposed to characterize neural activities induced by three types of bimanual cyclical tasks. In this framework, novel artifact removal methods were used to improve the SNR and the task-related component analysis (TRCA) was introduced to increase the reproducibility of EEG-fNIRS bimodal features. The optimized features were transformed into low-dimensional indicators to reliably characterize bimanual training-induced neural activation. The SVM classification results of three bimanual cyclical tasks revealed a good discrimination ability of EEG-fNIRS bimodal indicators (90.1%), which was higher than that using EEG (74.8%) or fNIRS (82.2%) alone, supporting the proposed method as a feasible technique to characterize neural activities during robot-assisted bimanual training.

Functional near-infrared spectroscopy as a potential objective evaluation technique in neurocognitive disorders after traumatic brain injury

Most patients with neurocognitive disorders after traumatic brain injury (TBI) show executive dysfunction, in which the pre-frontal cortex (PFC) plays an important role. However, less objective evaluation technique could be used to assess the executive dysfunction in these patients. Functional near-infrared spectroscopy (fNIRS), which is a non-invasive technique, has been widely used in the study of psychiatric disorders, cognitive dysfunction, etc. The present study aimed to explore whether fNIRS could be a technique to assess the damage degree of executive function in patients with neurocognitive disorders after TBI by using the Stroop and N-back tasks in PFC areas. We enrolled 37 patients with neurocognitive disorders after TBI and 60 healthy controls. A 22-channel fNIRS device was used to record HbO during Stroop, 1-back and 2-back tasks. The results showed that patients made significantly more errors and had longer response times than healthy controls. There were statistically significant differences in HbO level variation in bilateral frontopolar, bilateral inferior frontal gyrus and left middle temporal gyrus during Stroop color word consistency tasks and in left frontopolar during Stroop color word inconsistency tasks. During 2-back tasks, there were also statistically significant differences in HbO level variation in bilateral frontopolar, bilateral inferior frontal gyrus, bilateral dorsolateral pre-frontal cortex. According to brain activation maps, the patients exhibited lower but more widespread activation during the 2-back and Stroop color word consistency tasks. The fNIRS could identify executive dysfunction in patients with neurocognitive disorders after TBI by detecting HbO levels, which suggested that fNIRS could be a potential objective evaluation technique in neurocognitive disorders after TBI.

Neuromodulatory effects of HD-tACS/tDCS on the prefrontal cortex: A resting-state fNIRS-EEG study

Transcranial direct and alternating current stimulation (tDCS and tACS, respectively) can modulate human brain dynamics and cognition. However, these modalities have not been compared using multiple imaging techniques concurrently. In this study, 15 participants participated in an experiment involving two sessions with a gap of 10 d. In the first and second sessions, tACS and tDCS were administered to the participants. The anode for tDCS was positioned at point FpZ, and four cathodes were positioned over the left and right prefrontal cortices (PFCs) to target the frontal regions simultaneously. tDCS was administered with 1 mA current. tACS was supplied with a current of 1 mA (zero-to-peak value) at 10 Hz frequency. Stimulation was applied concomitantly with functional near-infrared spectroscopy and electroencephalography acquisitions in the resting-state. The statistical test showed significant alteration (p < 0.001) in the mean hemodynamic responses during and after tDCS and tACS periods. Between-group comparison revealed a significantly less (p < 0.001) change in the mean hemodynamic response caused by tACS compared with tDCS. As hypothesized, we successfully increased the hemodynamics in both left and right PFCs using tDCS and tACS. Moreover, a significant increase in alpha-band power (p < 0.01) and low beta band power (p < 0.05) due to tACS was observed after the stimulation period. Although tDCS is not frequency-specific, it increased but not significantly (p > 0.05) the powers of most bands including delta, theta, alpha, low beta, high beta, and gamma. These findings suggest that both hemispheres can be targeted and that both tACS and tDCS are equally effective in high-definition configurations, which may be of clinical relevance.

Cognitive Telerehabilitation with Transcranial Direct Current Stimulation Improves Cognitive and Emotional Functioning Following a Traumatic Brain Injury: A Case Study

OBJECTIVE

Cognitive deficits following a traumatic brain injury (TBI) are a leading cause of disability in young adults and there is a critical need for novel approaches to improve cognitive outcomes in TBI survivors. Transcranial direct current stimulation (tDCS) paired with cognitive remediation has emerged as a viable, cost-effective, noninvasive approach for treating cognitive impairments in a wide variety of neurological conditions. Here, we report the first case study utilizing remotely supervised tDCS (RS-tDCS) protocol paired with cognitive remediation in a 29-year-old man with persisting cognitive and emotional sequelae following TBI.

METHOD

Neuropsychological measures were administered before and after the patient completed 20 daily sessions of RS-tDCS (2.0 mA × 20 minutes, left anodal dorsolateral prefrontal cortex montage). During the daily stimulation period, he completed adaptive cognitive training. All treatment procedures were delivered at home and monitored in real time via videoconference with a study technician.

RESULTS

Following 20 RS-tDCS and cognitive training sessions, he had significant improvements (>1 SD) on tests of attention and working memory, semantic fluency, and information processing speed. Mood was also improved.

CONCLUSIONS

This is the first demonstration of at-home telerehabilitation with RS-tDCS and cognitive training to improve cognitive outcomes following TBI.

Prefrontal high definition cathodal tDCS modulates executive functions only when coupled with moderate aerobic exercise in healthy persons

Transcranial direct current stimulation (tDCS) is a promising tool to enhance cognitive performance. However, its effectiveness has not yet been unequivocally shown. Thus, here we tested whether coupling tDCS with a bout of aerobic exercise (AE) is more effective in modulating cognitive functions than tDCS or AE alone. One hundred twenty-two healthy participants were assigned to five randomized controlled crossover experiments. Two multimodal target experiments (EXP-4: anodal vs. sham tDCS during AE; EXP-5: cathodal vs. sham tDCS during AE) investigated whether anodal (a-tDCS) or cathodal tDCS (c-tDCS) applied during AE over the left dorsolateral prefrontal cortex (left DLPFC) affects executive functioning (inhibition ability). In three unimodal control experiments, the participants were either stimulated (EXP-1: anodal vs. sham tDCS, EXP-2: cathodal vs. sham tDCS) or did AE (EXP-3: AE vs. active control). Participants performed an Eriksen flanker task during ergometer cycling at moderate intensity (in EXP. 3-5). Only c-tDCS during AE had a significant adverse effect on the inhibition task, with decreased accuracy. This outcome provides preliminary evidence that c-tDCS during AE over the left DLPFC might effectively modulate inhibition performance compared to c-tDCS alone. However, more systematic research is needed in the future.

Effects of Transcranial Direct Current Stimulation (tDCS) on Cognitive Performance and Cerebral Oxygen Hemodynamics: A Systematic Review

Background: There is increasing evidence to support the efficacy of transcranial direct current stimulation (tDCS) applications in cognitive augmentation and rehabilitation. Neuromodulation achieved with tDCS may further regulate regional cerebral perfusion affiliated through the neurovascular unit; however, components of cerebral perfusion decrease across aging. A novel neuroimaging approach, functional near-infrared spectroscopy (fNIRS), can aid in quantifying these regional perfusional changes. To date, the interaction of the effects of tDCS on cognitive performance across the lifespan and obtained fNIRS hemodynamic responses remain unknown.

Objective: This review aims to examine the effects of tDCS on cognitive performance and fNIRS hemodynamic responses within the context of cognitive aging.

Methods: Six databases were searched for studies. Quality appraisal and data extraction were conducted by two independent reviewers. Meta-analysis was carried out to determine overall and subgroup effect sizes.

Results: Eight studies met inclusion criteria. The overall effect size demonstrates that tDCS can alter cognitive performance and fNIRS signals, with aging being a potential intermediary in tDCS efficacy.

Conclusion: From the studies included, the effects of tDCS on cognitive performance and fNIRS metrics are most prominent in young healthy adults and appear to become less robust with increasing age. Given the small number of studies included in this review further investigation is recommended.

Within-session repeated transcranial direct current stimulation of the posterior parietal cortex enhances spatial working memory

Spatial working memory (SWM) is an essential cognitive ability that supports complex tasks, but its capacity is limited. Studies using transcranial direct current stimulation (tDCS) have shown potential benefits for SWM performance. Recent studies have shown that repeated short applications of tDCS affected corticospinal excitability. Moreover, neuroimaging studies have indicated that the pattern of neural activity measured in the posterior parietal cortex (PPC) tracks SWM ability. It is unknown whether repeated tDCS can enhance SWM and whether varied tDCS protocols (single 10 min tDCS, 10 min tDCS-5 min break-10 min tDCS, 10 min tDCS-20 min break-10 min tDCS) over the right PPC have different effects on SWM. The current study investigated whether offline single-session and repeated tDCS over the right PPC affects SWM updating, as measured by spatial 2-back and 3-back tasks. The results showed that stimulating the right PPC with repeated 10 min anodal tDCS significantly improved the response speed of the spatial 2-back task relative to single-session tDCS. Repeated 10 min tDCS with a longer interval (i.e. inter-stimulation interval of 20 min) enhanced the response speed of the spatial 3-back task. Altogether these findings provide causal evidence that suggests that the right PPC plays an important role in SWM. Furthermore, repeated tDCS with longer intervals may be a promising intervention for improving SWM-related function.

Functional Effects of Bilateral Dorsolateral Prefrontal Cortex Modulation During Sequential Decision-Making: A Functional Near-Infrared Spectroscopy Study With Offline Transcranial Direct Current Stimulation

The ability to learn sequential contingencies of actions for predicting future outcomes is indispensable for flexible behavior in many daily decision-making contexts. It remains open whether such ability may be enhanced by transcranial direct current stimulation (tDCS). The present study combined tDCS with functional near-infrared spectroscopy (fNIRS) to investigate potential tDCS-induced effects on sequential decision-making and the neural mechanisms underlying such modulations. Offline tDCS and sham stimulation were applied over the left and right dorsolateral prefrontal cortex (dlPFC) in young male adults (N = 29, mean age = 23.4 years, SD = 3.2) in a double-blind between-subject design using a three-state Markov decision task. The results showed (i) an enhanced dlPFC hemodynamic response during the acquisition of sequential state transitions that is consistent with the findings from a previous functional magnetic resonance imaging (fMRI) study; (ii) a tDCS-induced increase of the hemodynamic response in the dlPFC, but without accompanying performance-enhancing effects at the behavioral level; and (iii) a greater tDCS-induced upregulation of hemodynamic responses in the delayed reward condition that seems to be associated with faster decision speed. Taken together, these findings provide empirical evidence for fNIRS as a suitable method for investigating hemodynamic correlates of sequential decision-making as well as functional brain correlates underlying tDCS-induced modulation. Future research with larger sample sizes for carrying out subgroup analysis is necessary in order to decipher interindividual differences in tDCS-induced effects on sequential decision-making process at the behavioral and brain levels.

Effect of Repeated Anodal HD-tDCS on Executive Functions: Evidence From a Pilot and Single-Blinded fNIRS Study

Executive functions are of vital importance in the process of active cognition, which is thought to be associated with the dorsolateral prefrontal cortex (DLPFC). As a valid brain stimulation technology, high-definition transcranial direct current stimulation (HD-tDCS) has been used to optimize cognitive function in healthy adults. Substantial evidence indicates that short-term or single anodal tDCS sessions over the left DLPFC will enhance the performance of executive functions. However, the changes in performance and cortical activation of executive functions after modulation by repeated anodal HD-tDCS is as yet unexplored. This study aims to examine changes in three core components of executive functions (inhibitory control, working memory, and cognitive flexibility) produced by nine HD-tDCS sessions (1.5 mA, over left DLPFC, 20 min per session), and to use functional near-infrared spectroscopy (fNIRS) to bilaterally record DLPFC neural activity. A total of 43 participants were divided randomly into two study groups (anodal group vs. sham group) to complete nine interventions. Our results demonstrate that the enhancement of cognitive flexibility in the anodal group was significantly better than that in the sham group. Additionally, a Stroop effect-related decrease in oxygenated hemoglobin (HbO) concentration in the DLPFC was observed in the anodal group but not the sham group. In conclusion, our study found that repeated anodal HD-tDCS sessions can significantly promote cognitive flexibility, one of the core components of executive function, and that alterations in DLPFC activation can enhance our understanding of the neuroplastic modifications modulated by HD-tDCS.

Causal Role of the Dorsolateral Prefrontal Cortex in Belief Updating under Uncertainty

Adaptive performance in uncertain environments depends on the ability to continuously update internal beliefs about environmental states. Recent correlative evidence suggests that a frontoparietal network including the dorsolateral prefrontal cortex (dlPFC) supports belief updating under uncertainty, but whether the dlPFC serves a "causal" role in this process is currently not clear. To elucidate its contribution, we leveraged transcranial direct current stimulation (tDCS) over the right dlPFC, while 91 participants performed an incentivized belief-updating task. Participants also underwent a psychosocial stress or control manipulation to investigate the role of stress, which is known to modulate dlPFC functioning. We observed enhanced monetary value updating after anodal tDCS when it was normatively expected from a Bayesian perspective. A model-based analysis indicates that this effect was driven by belief updating. However, we also observed enhanced non-normative value updating, which might have been driven instead by expectancy violation. Enhanced normative and non-normative value updating reflected increased vs. decreased Bayesian rationality, respectively. Furthermore, cortisol increases were associated with enhanced positive, but not with negative, value updating. The present study thereby sheds light on the causal role of the right dlPFC in the remarkable human ability to navigate uncertain environments by continuously updating prior knowledge following new evidence.

Converging Evidence That Neural Plasticity Underlies Transcranial Direct-Current Stimulation

It is not definitely known how direct-current stimulation causes its long-lasting effects. Here, we tested the hypothesis that the long time course of transcranial direct-current stimulation (tDCS) is because of the electrical field increasing the plasticity of the brain tissue. If this is the case, then we should see tDCS effects when humans need to encode information into long-term memory, but not at other times. We tested this hypothesis by delivering tDCS to the ventral visual stream of human participants during different tasks (i.e., recognition memory vs. visual search) and at different times during a memory task. We found that tDCS improved memory encoding, and the neural correlates thereof, but not retrieval. We also found that tDCS did not change the efficiency of information processing during visual search for a certain target object, a task that does not require the formation of new connections in the brain but instead relies on attention and object recognition mechanisms. Thus, our findings support the hypothesis that direct-current stimulation modulates brain activity by changing the underlying plasticity of the tissue.

Unskilled shooters improve both accuracy and grouping shot having as reference skilled shooters cortical area: An EEG and tDCS study

Transcranial direct current stimulation (tDCS) has been used as a non-invasive method for enhanced motor and cognitive abilities. However, no previous study has investigated if the tDCS application in unskilled shooters on cortical sites, selected based on the cortical activity of skilled shooters, improves the accuracy and shot grouping. Sixty participants were selected, which included 10 skilled shooters and 50 unskilled shooters. After we identified the right dorsolateral prefrontal cortex (DLPFC) as the area with the highest activity in skilled shooters, we applied anodal tDCS over the right DLPFC in the unskilled shooters under two conditions: sham-tDCS (placebo) and real-tDCS (anodal tDCS). We also analyzed electroencephalography. Our results indicated that anodal tDCS application enhanced the shot accuracy (p = 0.001). Furthermore, the beta power in the EEG recording was higher in the left DLPFC, left and right parietal cortex (p = 0,001) after applying anodal tDCS, while the low-gamma power was higher in the right DLPFC in sham-tDCS (p = 0.001) and right parietal cortex after anodal-tDCS (p = 0.001). Our findings indicate that anodal tDCS can improve accuracy and shot grouping when applied over the unskilled shooters' right DLPFC. Furthermore, beta and low-gamma bands are influenced by anodal tDCS over the right DLPFC, which may be predictive of skill improvement.

The Effects of Transcranial Electrical Stimulation on Human Motor Functions: A Comprehensive Review of Functional Neuroimaging Studies

Transcranial electrical stimulation (tES) is a promising tool to enhance human motor skills. However, the underlying physiological mechanisms are not fully understood. On the other hand, neuroimaging modalities provide powerful tools to map some of the neurophysiological biomarkers associated with tES. Here, a comprehensive review was undertaken to summarize the neuroimaging evidence of how tES affects human motor skills. A literature search has been done on the PubMed database, and 46 relative articles were selected. After reviewing these articles, we conclude that neuroimaging techniques are feasible to be coupled with tES and offer valuable information of cortical excitability, connectivity, and oscillations regarding the effects of tES on human motor behavior. The biomarkers derived from neuroimaging could also indicate the motor performance under tES conditions. This approach could advance the understanding of tES effects on motor skill and shed light on a new generation of adaptive stimulation models.

Anodal and cathodal tDCS modulate neural activity and selectively affect GABA and glutamate syntheses in the visual cortex of cats

KEY POINTS

The present study showed that anodal and cathodal transcranial direct current stimulation (tDCS) can respectively increase and decrease the amplitude of visually evoked field potentials in the stimulated visual cortex of cats, with the effect lasting for ∼60-70 min. We directly measured tDCS-induced changes in the concentration of inhibitory and excitatory neurotransmitters in the visual cortex using the enzyme-linked immunosorbent assay method and showed that anodal and cathodal tDCS can selectively decrease the concentration of GABA and glutamate in the stimulated cortical area. Anodal and cathodal tDCS can selectively inhibit the synthesis of GABA and glutamate by suppressing the expression of GABA- and glutamate-synthesizing enzymes, respectively.

ABSTRACT

Transcranial direct current stimulation (tDCS) evokes long-lasting neuronal excitability in the target brain region. The underlying neural mechanisms remain poorly understood. The present study examined tDCS-induced alterations in neuronal activities, as well as the concentration and synthesis of GABA and glutamate (GLU), in area 21a (A21a) of cat visual cortex. Our analysis showed that anodal and cathodal tDCS respectively enhanced and suppressed neuronal activities in A21a, as indicated by a significantly increased and decreased amplitude of visually evoked field potentials (VEPs). The tDCS-induced effect lasted for ∼60-70 min. By contrast, sham tDCS had no significant impact on the VEPs in A21a. On the other hand, the concentration of GABA, but not that of GLU, in A21a significantly decreased after anodal tDCS relative to sham tDCS, whereas the concentration of GLU, but not that of GABA, in A21a significantly decreased after cathodal tDCS relative to sham tDCS. Furthermore, the expression of GABA-synthesizing enzymes GAD65 and GAD67 in A21a significantly decreased in terms of both mRNA and protein concentrations after anodal tDCS relative to sham tDCS, whereas that of GLU-synthesizing enzyme glutaminase (GLS) did not change significantly after anodal tDCS. By contrast, both mRNA and protein concentrations of GLS in A21a significantly decreased after cathodal tDCS relative to sham tDCS, whereas those of GAD65/GAD67 showed no significant change after cathodal tDCS. Taken together, these results indicate that anodal and cathodal tDCS may selectively reduce GABA and GLU syntheses and thus respectively enhance and suppress neuronal excitability in the stimulated brain area.

Effects of Transcranial Direct Current Stimulation on Baseline and Slope of Prefrontal Cortex Hemodynamics During a Spatial Working Memory Task

Background: Transcranial direct current stimulation (tDCS) has been shown to be an inexpensive, safe, and effective way of augmenting a variety of cognitive abilities. Relatively recent advances in neuroimaging technology have provided the ability to measure brain activity concurrently during active brain stimulation rather than after stimulation. The effects on brain activity elicited by tDCS during active tDCS reported by initial studies have been somewhat conflicted and seemingly dependent on whether a behavioral improvement was observed. Objective: The current study set out to address questions regarding behavioral change, within and between-participant designs as well as differentiating the effects on hemodynamic amplitude and baseline during active tDCS stimulation. Methods: We tested the effects of transcranial direct current stimulation (tDCS) on anterior hemodynamics in prefrontal cortex during performance on a spatial memory task. Prefrontal cortex activity was measured with functional near infrared spectroscopy (fNIRS), a wearable and portable neuroimaging technique that utilizes near infrared light to measure cortical oxygenated and deoxygenated hemoglobin changes non-invasively. There were two groups, one group (n = 10) received only sham stimulation and the other group (n = 11) received sham followed by anodal stimulation to right ventral lateral prefrontal cortex. Results: Analyses revealed an increase in spatial memory performance following tDCS stimulation. This augmented performance was accompanied by changes to oxygenation (HbO-HbR) at the onset of the hemodynamic response in bilateral dorsolateral prefrontal cortex and left ventral medial prefrontal cortex. In these regions we also observed that stimulation improved neural processing efficiency, by reducing oxygenation and increasing performance from block to block. During and following tDCS stimulation, it was also observed that in bilateral dorsolateral prefrontal cortex the relationship between performance and oxygenation inverted, from a negative relationship to a positive relationship. Conclusion: The results suggest that tDCS is predominately a mechanism for changing neurons propensity for activity as opposed to their strength of activity. tDCS not only alters the efficiency of task relevant processing, but also the nature in which hemodynamic resources are used during augmented task performance.

Systematic review of combined functional near-infrared spectroscopy and transcranial direct-current stimulation studies

Significance: Combining transcranial direct-current stimulation (tDCS) with functional near-infrared spectroscopy (fNIRS) is a recent approach to exploring brain activation evoked by neurostimulation. Aim: To critically evaluate studies combining tDCS and fNIRS and provide a consolidated overview of cortical hemodynamic responses to neurostimulation. Approach: Key terms were searched in three databases (MEDLINE, EMBASE, and PsycINFO) with cross-referencing and works from Google Scholar also evaluated. All studies reporting on fNIRS-derived hemoglobin changes evoked by tDCS were included. Results: Literature searches revealed 474 articles, of which 28 were included for final review (22 in healthy individuals: 9 involving rest and 13 with tasks; 6 in the clinical setting). At rest, an overall increase in cortical activation was observed in fNIRS responses at the site of stimulation, with evidence suggesting nonstimulated brain regions are also similarly affected. Conversely, during tasks, reduced cortical activation was observed during online stimulation. Offline and poststimulation effects were less consistent, as is the impact on clinical populations and their symptom correlation. Conclusion: This review explores the methodological frameworks for fNIRS-tDCS evaluations and summarizes hemodynamic responses associated with tDCS in all populations. Our findings provide further evidence of the impact of tDCS on neuronal activation within functionally connected networks.

Utilizing Neurons for Digital Logic Circuits: A Molecular Communications Analysis

With the advancement of synthetic biology, several new tools have been conceptualized over the years as alternative treatments for current medical procedures. As part of this work, we investigate how synthetically engineered neurons can operate as digital logic gates that can be used towards bio-computing inside the brain and its impact on epileptic seizure-like behaviour. We quantify the accuracy of logic gates under high firing rates amid a network of neurons and by how much it can smooth out uncontrolled neuronal firings. To test the efficacy of our method, simulations composed of computational models of neurons connected in a structure that represents a logic gate are performed. Our simulations demonstrate the accuracy of performing the correct logic operation, and how specific properties such as the firing rate can play an important role in the accuracy. As part of the analysis, the mean squared error is used to quantify the quality of our proposed model and predict the accurate operation of a gate based on different sampling frequencies. As an application, the logic gates were used to smooth out epileptic seizure-like activity in a biological neuronal network, where the results demonstrated the effectiveness of reducing its mean firing rate. Our proposed system has the potential to be used in future approaches to treating neurological conditions in the brain.

Transcranial direct current stimulation: a roadmap for research, from mechanism of action to clinical implementation

Transcranial direct current stimulation (tDCS) is a promising method for altering the function of neural systems, cognition, and behavior. Evidence is emerging that it can also influence psychiatric symptomatology, including major depression and schizophrenia. However, there are many open questions regarding how the method might have such an effect, and uncertainties surrounding its influence on neural activity, and human cognition and functioning. In the present critical review, we identify key priorities for future research into major depression and schizophrenia, including studies of the mechanism(s) of action of tDCS at the neuronal and systems levels, the establishment of the cognitive impact of tDCS, as well as investigations of the potential clinical efficacy of tDCS. We highlight areas of progress in each of these domains, including data that appear to favor an effect of tDCS on neural oscillations rather than spiking, and findings that tDCS administration to the prefrontal cortex during task training may be an effective way to enhance behavioral performance. Finally, we provide suggestions for further empirical study that will elucidate the impact of tDCS on brain and behavior, and may pave the way for efficacious clinical treatments for psychiatric disorders.

The Effects of Transcranial Direct Current Stimulation (tDCS) on Working Memory Training in Healthy Young Adults

Working memory (WM) is a fundamental cognitive ability to support complex thought, but it is limited in capacity. WM training has shown the potential benefit for those in need of a higher WM ability. Many studies have shown the potential of transcranial direct current stimulation (tDCS) to transiently enhance WM performance by delivering a low current to the brain cortex of interest, via electrodes on the scalp. tDCS has also been revealed as a promising intervention to augment WM training in a few studies. However, those few tDCS-paired WM training studies, focused more on the effect of tDCS on WM enhancement and its transferability after training and paid less attention to the variation of cognitive performance during the training procedure. The current study attempted to explore the effect of tDCS on the variation of performance, during WM training, in healthy young adults. All the participants received WM training with the load-adaptive verbal N-back task, for 5 days. During the training procedure, active/sham anodal high-definition tDCS (HD-tDCS) was used to stimulate the left dorsolateral prefrontal cortex (DLPFC). To examine the training effect, pre- and post-tests were performed, respectively, 1 day before and after the training sessions. At the beginning of each training session, stable-load WM tasks were performed, to examine the performance variation during training. Compared to the sham stimulation, higher learning rates of performance metrics during the training procedure were found when WM training was combined with active anodal HD-tDCS. The performance improvements (post–pre) of the active group, were also found to be higher than those of the sham group and were transferred to a similar untrained WM task. Further analysis revealed a negative relationship between the training improvements and the baseline performance. These findings show the potential that tDCS may be leveraged as an intervention to facilitate WM training, for those in need of a higher WM ability.

A Review of Acute Aerobic Exercise and Transcranial Direct Current Stimulation Effects on Cognitive Functions and Their Potential Synergies

Today, several pharmaceutic and non-pharmaceutic approaches exist to treat psychiatric and neurological diseases. Because of the lack of treatment procedures that are medication free and without severe side effects, transcranial direct current stimulation (tDCS) and aerobic exercise (AE) have been tested to explore the potential for initiating and modulating neuroplasticity in the human brain. Both tDCS and AE could support cognition and behavior in the clinical and non-clinical context to improve the recovery process within neurological or psychiatric conditions or to increase performance. As these techniques still lack meaningful effects, although they provide multiple beneficial opportunities within disease and health applications, there is emerging interest to find improved tDCS and AE protocols. Since multimodal approaches could provoke synergetic effects, a few recent studies have begun to combine tDCS and AE within different settings such as in cognitive training in health or for treatment purposes within clinical settings, all of which show superior effects compared to single technique applications. The beneficial outcomes of both techniques depend on several parameters and the understanding of neural mechanisms that are not yet fully understood. Recent studies have begun to directly combine tDCS and AE within one session, although their interactions on the behavioral, neurophysiological and neurochemical levels are entirely unclear. Therefore, this review: (a) provides an overview of acute behavioral, neurophysiological, and neurochemical effects that both techniques provoke within only one single application in isolation; (b) gives an overview regarding the mechanistic pathways; and (c) discusses potential interactions and synergies between tDCS and AE that might be provoked when directly combining both techniques. From this literature review focusing primarily on the cognitive domain in term of specific executive functions (EFs; inhibition, updating, and switching), it is concluded that a direct combination of tDCS and AE provides multiple beneficial opportunities for synergistic effects. A combination could be useful within non-clinical settings in health and for treating several psychiatric and neurologic conditions. However, there is a lack of research and there are several possibly interacting moderating parameters that must be considered and more importantly must be systematically investigated in the future.

A pilot investigation on the effects of combination transcranial direct current stimulation and speed of processing cognitive remediation therapy on simulated driving behavior in older adults with HIV

Cognitive impairments seen in people living with HIV (PLWH) are associated with difficulties in everyday functioning, specifically driving. This study utilized speed of processing cognitive remediation therapy (SOP-CRT) with transcranial direct current stimulation (tDCS) to gauge the feasibility and impact on simulated driving. Thirty PLWH (M _age = 54.53, SD = 3.33) were randomly assigned to either: sham tDCS SOP-CRT or active tDCS SOP-CRT. Seven indicators of simulated driving performance and safety were obtained. Repeated measures ANOVAs controlling for driver's license status (valid and current license or expired/no license) revealed a large training effect on average driving speed. Participants who received active tDCS SOP-CRT showed a slower average driving speed (p = 0.020, d = 0.972) than those who received sham tDCS SOP-CRT. Non-significant small-to-medium effects were seen for driving violations, collisions, variability in lane positioning, and lane deviations. Combination tDCS SOP-CRT was found to increase indices of cautionary simulated driving behavior. Findings reveal a potential avenue of intervention and rehabilitation for improving driving safety among vulnerable at-risk populations, such as those aging with chronic disease.

Brain Oscillatory and Hemodynamic Activity in a Bimanual Coordination Task Following Transcranial Alternating Current Stimulation (tACS): A Combined EEG-fNIRS Study

Motor control is associated with synchronized oscillatory activity at alpha (8–12 Hz) and beta (12–30 Hz) frequencies in a cerebello-thalamo-cortical network. Previous studies demonstrated that transcranial alternating current stimulation (tACS) is capable of entraining ongoing oscillatory activity while also modulating motor control. However, the modulatory effects of tACS on both motor control and its underlying electro- and neurophysiological mechanisms remain ambiguous. Thus, the purpose of this study was to contribute to gathering neurophysiological knowledge regarding tACS effects by investigating the after-effects of 10 Hz tACS and 20 Hz tACS at parietal brain areas on bimanual coordination and its concurrent oscillatory and hemodynamic activity. Twenty-four right-handed healthy volunteers (12 females) aged between 18 and 30 (M = 22.35 ± 3.62) participated in the study and performed a coordination task requiring bimanual movements. Concurrent to bimanual motor training, participants received either 10 Hz tACS, 20 Hz tACS or a sham stimulation over the parietal cortex (at P3/P4 electrode positions) for 20 min via small gel electrodes (3,14 cm² Ag/AgCl, amperage = 1 mA). Before and three time-points after tACS (immediately, 30 min and 1 day), bimanual coordination performance was assessed. Oscillatory activities were measured by electroencephalography (EEG) and hemodynamic changes were examined using functional near-infrared spectroscopy (fNIRS). Improvements of bimanual coordination performance were not differently between groups, thus, no tACS-specific effect on bimanual coordination performance emerged. However, physiological measures during the task revealed significant increases in parietal alpha activity immediately following 10 Hz tACS and 20 Hz tACS which were accompanied by significant decreases of Hboxy concentration in the right hemispheric motor cortex compared to the sham group. Based on the physiological responses, we conclude that tACS applied at parietal brain areas provoked electrophysiological and hemodynamic changes at brain regions of the motor network which are relevant for bimanual motor behavior. The existence of neurophysiological alterations immediately following tACS, especially in the absence of behavioral effects, are elementary for a profound understanding of the mechanisms underlying tACS. The lack of behavioral modifications strengthens the need for further research on tACS effects on neurophysiology and behavior using combined electrophysiological and neuroimaging methods.

Parietotemporal Stimulation Affects Acquisition of Novel Grapheme-Phoneme Mappings in Adult Readers

Neuroimaging work from developmental and reading intervention research has suggested a cause of reading failure may be lack of engagement of parietotemporal cortex during initial acquisition of grapheme-phoneme (letter-sound) mappings. Parietotemporal activation increases following grapheme-phoneme learning and successful reading intervention. Further, stimulation of parietotemporal cortex improves reading skill in lower ability adults. However, it is unclear whether these improvements following stimulation are due to enhanced grapheme-phoneme mapping abilities. To test this hypothesis, we used transcranial direct current stimulation (tDCS) to manipulate parietotemporal function in adult readers as they learned a novel artificial orthography with new grapheme-phoneme mappings. Participants received real or sham stimulation to the left inferior parietal lobe (L IPL) for 20 min before training. They received explicit training over the course of 3 days on 10 novel words each day. Learning of the artificial orthography was assessed at a pre-training baseline session, the end of each of the three training sessions, an immediate post-training session and a delayed post-training session about 4 weeks after training. Stimulation interacted with baseline reading skill to affect learning of trained words and transfer to untrained words. Lower skill readers showed better acquisition, whereas higher skill readers showed worse acquisition, when training was paired with real stimulation, as compared to readers who received sham stimulation. However, readers of all skill levels showed better maintenance of trained material following parietotemporal stimulation, indicating a differential effect of stimulation on initial learning and consolidation. Overall, these results indicate that parietotemporal stimulation can enhance learning of new grapheme-phoneme relationships in readers with lower reading skill. Yet, while parietotemporal function is critical to new learning, its role in continued reading improvement likely changes as readers progress in skill.

Bilateral Transcranial Direct Current Stimulation Reshapes Resting-State Brain Networks: A Magnetoencephalography Assessment

Transcranial direct current stimulation (tDCS) can noninvasively induce brain plasticity, and it is potentially useful to treat patients affected by neurological conditions. However, little is known about tDCS effects on resting-state brain networks, which are largely involved in brain physiological functions and in diseases. In this randomized, sham-controlled, double-blind study on healthy subjects, we have assessed the effect of bilateral tDCS applied over the sensorimotor cortices on brain and network activity using a whole-head magnetoencephalography system. Bilateral tDCS, with the cathode (−) centered over C4 and the anode (+) centered over C3, reshapes brain networks in a nonfocal fashion. Compared to sham stimulation, tDCS reduces left frontal alpha, beta, and gamma power and increases global connectivity, especially in delta, alpha, beta, and gamma frequencies. The increase of connectivity is consistent across bands and widespread. These results shed new light on the effects of tDCS and may be of help in personalizing treatments in neurological disorders.

Application of Functional Near-Infrared Spectroscopy to the Study of Brain Function in Humans and Animal Models

Functional near-infrared spectroscopy (fNIRS) is a noninvasive optical imaging technique that indirectly assesses neuronal activity by measuring changes in oxygenated and deoxygenated hemoglobin in tissues using near-infrared light. fNIRS has been used not only to investigate cortical activity in healthy human subjects and animals but also to reveal abnormalities in brain function in patients suffering from neurological and psychiatric disorders and in animals that exhibit disease conditions. Because of its safety, quietness, resistance to motion artifacts, and portability, fNIRS has become a tool to complement conventional imaging techniques in measuring hemodynamic responses while a subject performs diverse cognitive and behavioral tasks in test settings that are more ecologically relevant and involve social interaction. In this review, we introduce the basic principles of fNIRS and discuss the application of this technique in human and animal studies.

Frontoparietal neurostimulation modulates working memory training benefits and oscillatory synchronization

There is considerable interest in maintaining working memory (WM) because it is essential to accomplish most cognitive tasks, and it is correlated with fluid intelligence and ecologically valid measures of daily living. Toward this end, WM training protocols aim to improve WM capacity and extend improvements to unpracticed domains, yet success is limited. One emerging approach is to couple WM training with transcranial direct current stimulation (tDCS). This pairing of WM training with tDCS in longitudinal designs promotes behavioral improvement and evidence of transfer of performance gains to untrained WM tasks. However, the mechanism(s) underlying tDCS-linked training benefits remain unclear. Our goal was to gain purchase on this question by recording high-density EEG before and after a weeklong WM training+tDCS study. Participants completed four sessions of frontoparietal tDCS (active anodal or sham) during which they performed a visuospatial WM change detection task. Participants who received active anodal tDCS demonstrated significant improvement on the WM task, unlike those who received sham stimulation. Importantly, this pattern was mirrored by neural correlates in spectral and phase synchrony analyses of the HD-EEG data. Notably, the behavioral interaction was echoed by interactions in frontal-posterior alpha band power, and theta and low alpha oscillations. These findings indicate that one mechanism by which paired tDCS+WM training operates is to enhance cortical efficiency and connectivity in task-relevant networks.

Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis

OBJECTIVE

To explore the efficacy of remotely-supervised transcranial direct current stimulation (RS-tDCS) paired with cognitive training (CT) exercise in participants with multiple sclerosis (MS).

METHODS

In a feasibility study of RS-tDCS in MS, participants completed ten sessions of tDCS paired with CT (1.5 mA × 20 min, dorsolateral prefrontal cortex montage). RS-tDCS participants were compared to a control group of adults with MS who underwent ten 20-min CT sessions through the same remotely supervised procedures. Cognitive outcomes were tested by composite scores measuring change in performance on standard tests (Brief International Cognitive Assessment in MS or BICAMS), basic attention (ANT-I Orienting and Attention Networks, Cogstate Detection), complex attention (ANT-I Executive Network, Cogstate Identification and One-Back), and intra-individual response variability (ANT-I and Cogstate identification; sensitive markers of disease status).

RESULTS

After ten sessions, the tDCS group (n = 25) compared to the CT only group (n = 20) had significantly greater improvement in complex attention (p = 0.01) and response variability (p = 0.01) composites. The groups did not differ in measures of basic attention (p = 0.95) or standard cognitive measures (p = 0.99).

CONCLUSIONS

These initial findings indicate benefit for RS-tDCS paired with CT in MS. Exploratory analyses indicate that the earliest tDCS cognitive benefit is seen in complex attention and response variability. Telerehabilitation using RS-tDCS combined with CT may lead to improved outcomes in MS.

Prefrontal electrical stimulation in non-depressed reduces levels of reported negative affects from daily stressors

Advances in neuroscience and pharmacology have led to improvements in the cognitive performance of people with neurological disease and other forms of cognitive decline. These same methods may also afford cognitive enhancement in people of otherwise normal cognitive abilities. “Cosmetic”, or supranormal, cognitive enhancement offers opportunities to enrich our social or financial status, our interactions with others, and the common wealth of our community. It is common to focus on the potential benefits of cognitive enhancement, while being less than clear about the possible drawbacks. Here I examine the harms or side-effects associated with a range of cognitive enhancement interventions. I propose a taxonomy of harms in cognitive enhancement, with harms classified as (neuro)biological, ethical, or societal. Biological harms are those that directly affect the person’s biological functioning, such as when a drug affects a person’s mood or autonomic function. Ethical harms are those that touch on issues such as fairness and cheating, or on erosion of autonomy and coercion. Societal harms are harms that affect whole populations, and which are normally the province of governments, such as the use of enhancement in military contexts. This taxonomy of harms will help to focus the debate around the use and regulation of cognitive enhancement. In particular it will help to clarify the appropriate network of stakeholders who should take an interest in each potential harm, and in minimizing the impact of these harms.