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Ester-Nacke T, Berti K, Veit R, Dannecker C, Salvador R, Ruffini G, Heni M, Birkenfeld AL, Plewnia C, Preissl H, Kullmann S. Network-targeted transcranial direct current stimulation of the hypothalamus appetite-control network: a feasibility study. Sci Rep 2024; 14:11341. [PMID: 38762574 PMCID: PMC11102513 DOI: 10.1038/s41598-024-61852-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 05/10/2024] [Indexed: 05/20/2024] Open
Abstract
The hypothalamus is the key regulator for energy homeostasis and is functionally connected to striatal and cortical regions vital for the inhibitory control of appetite. Hence, the ability to non-invasively modulate the hypothalamus network could open new ways for the treatment of metabolic diseases. Here, we tested a novel method for network-targeted transcranial direct current stimulation (net-tDCS) to influence the excitability of brain regions involved in the control of appetite. Based on the resting-state functional connectivity map of the hypothalamus, a 12-channel net-tDCS protocol was generated (Neuroelectrics Starstim system), which included anodal, cathodal and sham stimulation. Ten participants with overweight or obesity were enrolled in a sham-controlled, crossover study. During stimulation or sham control, participants completed a stop-signal task to measure inhibitory control. Overall, stimulation was well tolerated. Anodal net-tDCS resulted in faster stop signal reaction time (SSRT) compared to sham (p = 0.039) and cathodal net-tDCS (p = 0.042). Baseline functional connectivity of the target network correlated with SSRT after anodal compared to sham stimulation (p = 0.016). These preliminary data indicate that modulating hypothalamus functional network connectivity via net-tDCS may result in improved inhibitory control. Further studies need to evaluate the effects on eating behavior and metabolism.
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Affiliation(s)
- Theresa Ester-Nacke
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany.
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany.
- German Center of Diabetes Research (DZD), Tübingen, Germany.
| | - Katharina Berti
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Ralf Veit
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Corinna Dannecker
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | | | | | - Martin Heni
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
- Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, Eberhard Karls University Tübingen, Tübingen, Germany
- Division of Endocrinology and Diabetology, Department of Internal Medicine 1, University Hospital Ulm, Ulm, Germany
| | - Andreas L Birkenfeld
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, German Center for Mental Health (DZPG), Neurophysiology and Interventional Neuropsychiatry, University Hospital Tübingen, Tübingen, Germany
| | - Hubert Preissl
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
| | - Stephanie Kullmann
- Institute for Diabetes Research and Metabolic Diseases (IDM) of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
- Department of Internal Medicine, Division of Endocrinology, Diabetology and Nephrology, Eberhard Karls University Tübingen, Tübingen, Germany
- German Center of Diabetes Research (DZD), Tübingen, Germany
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Cai B, Tang J, Sang H, Zhang Z, Wang A. Differential effects of high-definition transcranial direct current stimulation (HD-tDCS) on attentional guidance by working memory in males with substance use disorder according to memory modality. Brain Cogn 2024; 177:106149. [PMID: 38579372 DOI: 10.1016/j.bandc.2024.106149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/07/2024]
Abstract
Information stored in working memory can guide perception selection, and this process is modulated by cognitive control. Although previous studies have demonstrated that neurostimulation over the left dorsolateral prefrontal cortex (lDLPFC) contributes to restore cognitive control among individuals with substance use disorder (SUD), there remains an open question about the potential stimulation effects on memory-driven attention. To address this issue, the present study adopted a combined working memory/attention paradigm while employing high-definition transcranial direct current stimulation (HD-tDCS) to stimulate the lDLPFC. Observers were asked to maintain visual or audiovisual information in memory while executing a search task, while the validity of the memory contents for the subsequent search task could be either invalid or neutral. The results showed a faint memory-driven attentional suppression effect in sham stimulation only under the audiovisual condition. Moreover, anodal HD-tDCS facilitated attentional suppression effect in both the strength and temporal dynamics under the visual-only condition, whereas the effect was impaired or unchanged under the audiovisual condition. Surprisingly, cathodal HD-tDCS selectively improved temporal dynamics of the attentional suppression effect under the audiovisual condition. The present study revealed the differential enhancement of HD-tDCS on cognitive control over visual and audiovisual memory-driven attention among individuals with SUD.
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Affiliation(s)
- Biye Cai
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, China; School of Physical Education and Sports Science, Soochow University, Suzhou, China
| | - Junjie Tang
- Taihu Compulsory Isolated Detoxification Center in Jiangsu Province, Suzhou, China
| | - Hanbin Sang
- Key Laboratory of Child Cognition & Behavior Development of Hainan Province, Haikou, China; School of Teacher Education, Qiongtai Normal University, Haikou, China.
| | - Zonghao Zhang
- School of Physical Education and Sports Science, Soochow University, Suzhou, China.
| | - Aijun Wang
- Department of Psychology, Research Center for Psychology and Behavioral Sciences, Soochow University, Suzhou, China.
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Van Hoornweder S, Nuyts M, Frieske J, Verstraelen S, Meesen RLJ, Caulfield KA. Outcome measures for electric field modeling in tES and TMS: A systematic review and large-scale modeling study. Neuroimage 2023; 281:120379. [PMID: 37716590 PMCID: PMC11008458 DOI: 10.1016/j.neuroimage.2023.120379] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Electric field (E-field) modeling is a potent tool to estimate the amount of transcranial magnetic and electrical stimulation (TMS and tES, respectively) that reaches the cortex and to address the variable behavioral effects observed in the field. However, outcome measures used to quantify E-fields vary considerably and a thorough comparison is missing. OBJECTIVES This two-part study aimed to examine the different outcome measures used to report on tES and TMS induced E-fields, including volume- and surface-level gray matter, region of interest (ROI), whole brain, geometrical, structural, and percentile-based approaches. The study aimed to guide future research in informed selection of appropriate outcome measures. METHODS Three electronic databases were searched for tES and/or TMS studies quantifying E-fields. The identified outcome measures were compared across volume- and surface-level E-field data in ten tES and TMS modalities targeting two common targets in 100 healthy individuals. RESULTS In the systematic review, we extracted 308 outcome measures from 202 studies that adopted either a gray matter volume-level (n = 197) or surface-level (n = 111) approach. Volume-level results focused on E-field magnitude, while surface-level data encompassed E-field magnitude (n = 64) and normal/tangential E-field components (n = 47). E-fields were extracted in ROIs, such as brain structures and shapes (spheres, hexahedra and cylinders), or the whole brain. Percentiles or mean values were mostly used to quantify E-fields. Our modeling study, which involved 1,000 E-field models and > 1,000,000 extracted E-field values, revealed that different outcome measures yielded distinct E-field values, analyzed different brain regions, and did not always exhibit strong correlations in the same within-subject E-field model. CONCLUSIONS Outcome measure selection significantly impacts the locations and intensities of extracted E-field data in both tES and TMS E-field models. The suitability of different outcome measures depends on the target region, TMS/tES modality, individual anatomy, the analyzed E-field component and the research question. To enhance the quality, rigor, and reproducibility in the E-field modeling domain, we suggest standard reporting practices across studies and provide four recommendations.
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Affiliation(s)
- Sybren Van Hoornweder
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium.
| | - Marten Nuyts
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium
| | - Joana Frieske
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium; Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Stefanie Verstraelen
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium
| | - Raf L J Meesen
- REVAL - Rehabilitation Research Center, Faculty of Rehabilitation Sciences, University of Hasselt, Diepenbeek, Belgium; Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, Leuven, Belgium
| | - Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States.
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Hunold A, Haueisen J, Nees F, Moliadze V. Review of individualized current flow modeling studies for transcranial electrical stimulation. J Neurosci Res 2023; 101:405-423. [PMID: 36537991 DOI: 10.1002/jnr.25154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/30/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
There is substantial intersubject variability of behavioral and neurophysiological responses to transcranial electrical stimulation (tES), which represents one of the most important limitations of tES. Many tES protocols utilize a fixed experimental parameter set disregarding individual anatomical and physiological properties. This one-size-fits-all approach might be one reason for the observed interindividual response variability. Simulation of current flow applying head models based on available anatomical data can help to individualize stimulation parameters and contribute to the understanding of the causes of this response variability. Current flow modeling can be used to retrospectively investigate the characteristics of tES effectivity. Previous studies examined, for example, the impact of skull defects and lesions on the modulation of current flow and demonstrated effective stimulation intensities in different age groups. Furthermore, uncertainty analysis of electrical conductivities in current flow modeling indicated the most influential tissue compartments. Current flow modeling, when used in prospective study planning, can potentially guide stimulation configurations resulting in individually effective tES. Specifically, current flow modeling using individual or matched head models can be employed by clinicians and scientists to, for example, plan dosage in tES protocols for individuals or groups of participants. We review studies that show a relationship between the presence of behavioral/neurophysiological responses and features derived from individualized current flow models. We highlight the potential benefits of individualized current flow modeling.
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Affiliation(s)
- Alexander Hunold
- Institute of Biomedical Engineering and Informatics, TU Ilmenau, Ilmenau, Germany
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, TU Ilmenau, Ilmenau, Germany
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
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Menze I, Mueller NG, Zaehle T, Schmicker M. Individual response to transcranial direct current stimulation as a function of working memory capacity and electrode montage. Front Hum Neurosci 2023; 17:1134632. [PMID: 36968784 PMCID: PMC10034341 DOI: 10.3389/fnhum.2023.1134632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/01/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionAttempts to improve cognitive abilities via transcranial direct current stimulation (tDCS) have led to ambiguous results, likely due to the method’s susceptibility to methodological and inter-individual factors. Conventional tDCS, i.e., using an active electrode over brain areas associated with the targeted cognitive function and a supposedly passive reference, neglects stimulation effects on entire neural networks.MethodsWe investigated the advantage of frontoparietal network stimulation (right prefrontal anode, left posterior parietal cathode) against conventional and sham tDCS in modulating working memory (WM) capacity dependent transfer effects of a single-session distractor inhibition (DIIN) training. Since previous results did not clarify whether electrode montage drives this individual transfer, we here compared conventional to frontoparietal and sham tDCS and reanalyzed data of 124 young, healthy participants in a more robust way using linear mixed effect modeling.ResultsThe interaction of electrode montage and WM capacity resulted in systematic differences in transfer effects. While higher performance gains were observed with increasing WM capacity in the frontoparietal stimulation group, low WM capacity individuals benefited more in the sham condition. The conventional stimulation group showed subtle performance gains independent of WM capacity.DiscussionOur results confirm our previous findings of WM capacity dependent transfer effects on WM by a single-session DIIN training combined with tDCS and additionally highlight the pivotal role of the specific electrode montage. WM capacity dependent differences in frontoparietal network recruitment, especially regarding the parietal involvement, are assumed to underlie this observation.
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Affiliation(s)
- Inga Menze
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- *Correspondence: Inga Menze,
| | - Notger G. Mueller
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Tino Zaehle
- Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Marlen Schmicker
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
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Nikolin S, Martin D, Loo CK, Boonstra TW. Transcranial Direct Current Stimulation Modulates Working Memory Maintenance Processes in Healthy Individuals. J Cogn Neurosci 2023; 35:468-484. [PMID: 36603051 DOI: 10.1162/jocn_a_01957] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
The effects of transcranial direct current stimulation (tDCS) at the pFC are often investigated using cognitive paradigms, particularly working memory tasks. However, the neural basis for the neuromodulatory cognitive effects of tDCS, including which subprocesses are affected by stimulation, is not completely understood. We investigated the effects of tDCS on working memory task-related spectral activity during and after tDCS to gain better insights into the neurophysiological changes associated with stimulation. We reanalyzed data from 100 healthy participants grouped by allocation to receive either sham (0 mA, 0.016 mA, and 0.034 mA) or active (1 mA or 2 mA) stimulation during a 3-back task. EEG data were used to analyze event-related spectral power in frequency bands associated with working memory performance. Frontal theta event-related synchronization (ERS) was significantly reduced post-tDCS in the active group. Participants receiving active tDCS had slower RTs following tDCS compared with sham, suggesting interference with practice effects associated with task repetition. Theta ERS was not significantly correlated with RTs or accuracy. tDCS reduced frontal theta ERS poststimulation, suggesting a selective disruption to working memory cognitive control and maintenance processes. These findings suggest that tDCS selectively affects specific subprocesses during working memory, which may explain heterogenous behavioral effects.
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Affiliation(s)
- Stevan Nikolin
- University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
| | - Donel Martin
- University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
| | - Colleen K Loo
- University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, New South Wales, Australia
| | - Tjeerd W Boonstra
- University of New South Wales, Sydney, Australia
- Maastricht University, The Netherlands
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Masina F, Montemurro S, Marino M, Manzo N, Pellegrino G, Arcara G. State-dependent tDCS modulation of the somatomotor network: A MEG study. Clin Neurophysiol 2022; 142:133-142. [PMID: 36037749 DOI: 10.1016/j.clinph.2022.07.508] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/13/2022] [Accepted: 07/30/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Transcranial direct current stimulation (tDCS) is a non-invasive technique widely used to investigate brain excitability and activity. However, the variability in both brain and behavioral responses to tDCS limits its application for clinical purposes. This study aims to shed light on state-dependency, a phenomenon that contributes to the variability of tDCS. METHODS To this aim, we investigated changes in spectral activity and functional connectivity in somatomotor regions after Real and Sham tDCS using generalized additive mixed models (GAMMs), which allowed us to investigate how modulation depends on the initial state of the brain. RESULTS Results showed that changes in spectral activity, but not connectivity, in the somatomotor regions depend on the initial state of the brain, confirming state-dependent effects. Specifically, we found a non-linear interaction between stimulation conditions (Real vs Sham) and initial state: a reduction of alpha and beta power was observed only in participants that had higher alpha and beta power before Real tDCS. CONCLUSIONS This study highlights the importance of considering state-dependency to tDCS and shows how it can be taken into account with appropriate statistical models. SIGNIFICANCE Our findings bear insight into tDCS mechanisms, potentially leading to discriminate between tDCS responders and non-responders.
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Affiliation(s)
| | | | - Marco Marino
- IRCCS San Camillo Hospital, Venice, Italy; Department of Movement Sciences, Research Center for Motor Control and Neuroplasticity, KU Leuven, Belgium.
| | - Nicoletta Manzo
- IRCCS San Camillo Hospital, Venice, Italy; Department of Human Neurosciences, Sapienza, University of Rome, Rome, Italy.
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Smits FM, Geuze E, de Kort GJ, Kouwer K, Geerlings L, van Honk J, Schutter DJ. Effects of Multisession Transcranial Direct Current Stimulation on Stress Regulation and Emotional Working Memory: A Randomized Controlled Trial in Healthy Military Personnel. Neuromodulation 2022:S1094-7159(22)00721-8. [DOI: 10.1016/j.neurom.2022.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 10/16/2022]
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9
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Steyaert A, Lenoir C, Lavand’homme P, van den Broeke EN, Mouraux A. Multichannel transcranial direct current stimulation over the left dorsolateral prefrontal cortex may modulate the induction of secondary hyperalgesia, a double-blinded cross-over study in healthy volunteers. PLoS One 2022; 17:e0270047. [PMID: 35709234 PMCID: PMC9202873 DOI: 10.1371/journal.pone.0270047] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
Background Central sensitization is thought to play a critical role in the development of chronic pain, and secondary mechanical hyperalgesia is considered one of its hall-mark features. Consequently, interventions capable of modulating its development could have important therapeutic value. Non-invasive neuromodulation of the left dorsolateral prefrontal cortex (DLPFC) has shown potential to reduce pain, both in healthy volunteers and in patients. Whether it can modulate the induction of central sensitization, however, is less well known. Objective To determine whether multifocal transcranial direct current stimulation (tDCS) targeting the left DLPFC affects the development of secondary mechanical hyperalgesia. Methods In this within-subjects, cross-over, double-blinded study, eighteen healthy volunteers participated in three experimental sessions. After 20 minutes of either anodal, cathodal, or sham multichannel tDCS over the left DLPFC, secondary mechanical hyperalgesia was induced using high-frequency electrical stimulation (HFS) of the volar forearm. We assessed intensity of perception to 128 mN mechanical pinprick stimuli at baseline and up to 240 minutes after HFS. We also mapped the area of mechanical hyperalgesia. Results HFS resulted in a robust and unilateral increase in the intensity of perception to mechanical pinprick stimuli at the HFS arm, which was not different between tDCS stimulation conditions. However, the area of hyperalgesia was reduced after anodal tDCS compared to sham. Conclusion Anodal tDCS over the left DLPFC modestly modulates the size of the HFS-induced area of secondary mechanical hyperalgesia, suggesting that non-invasive neuromodulation targeting the left DLPFC may be a potential intervention to limit the development of central sensitization.
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Affiliation(s)
- Arnaud Steyaert
- Institute of Neuroscience (IONS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
- Departement of Anaesthesiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- * E-mail:
| | - Cédric Lenoir
- Institute of Neuroscience (IONS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
| | - Patricia Lavand’homme
- Institute of Neuroscience (IONS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
- Departement of Anaesthesiology, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - André Mouraux
- Institute of Neuroscience (IONS), Université catholique de Louvain (UCLouvain), Brussels, Belgium
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Inter-Individual Variability in tDCS Effects: A Narrative Review on the Contribution of Stable, Variable, and Contextual Factors. Brain Sci 2022; 12:brainsci12050522. [PMID: 35624908 PMCID: PMC9139102 DOI: 10.3390/brainsci12050522] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Due to its safety, portability, and cheapness, transcranial direct current stimulation (tDCS) use largely increased in research and clinical settings. Despite tDCS’s wide application, previous works pointed out inconsistent and low replicable results, sometimes leading to extreme conclusions about tDCS’s ineffectiveness in modulating behavioral performance across cognitive domains. Traditionally, this variability has been linked to significant differences in the stimulation protocols across studies, including stimulation parameters, target regions, and electrodes montage. Here, we reviewed and discussed evidence of heterogeneity emerging at the intra-study level, namely inter-individual differences that may influence the response to tDCS within each study. This source of variability has been largely neglected by literature, being results mainly analyzed at the group level. Previous research, however, highlighted that only a half—or less—of studies’ participants could be classified as responders, being affected by tDCS in the expected direction. Stable and variable inter-individual differences, such as morphological and genetic features vs. hormonal/exogenous substance consumption, partially account for this heterogeneity. Moreover, variability comes from experiments’ contextual elements, such as participants’ engagement/baseline capacity and individual task difficulty. We concluded that increasing knowledge on inter-dividual differences rather than undermining tDCS effectiveness could enhance protocols’ efficiency and reproducibility.
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Ikeda T, Nishida K, Yoshimura M, Ishii R, Tsukuda B, Bunai T, Ouchi Y, Kikuchi M. Toward the Development of tES- Based Telemedicine System: Insights From the Digital Transformation and Neurophysiological Evidence. Front Psychiatry 2022; 13:782144. [PMID: 35898624 PMCID: PMC9309473 DOI: 10.3389/fpsyt.2022.782144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Takashi Ikeda
- Research Center for Child Mental Development, Kanazawa University, Kanazawa, Japan.,United Graduate School of Child Development, Osaka University, Osaka, Japan
| | - Keiichiro Nishida
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Masafumi Yoshimura
- Department of Occupational Therapy, Faculty of Rehabilitation Kansai Medical University, Osaka, Japan.,Department of Neuropsychiatry, Kansai Medical University Medical Center, Osaka, Japan
| | - Ryouhei Ishii
- Occupational Therapy Major, Graduate School of Rehabilitation Science, Osaka Metropolitan University, Habikino, Japan
| | - Banri Tsukuda
- Department of Neuropsychiatry, Kansai Medical University, Osaka, Japan
| | - Tomoyasu Bunai
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yasuomi Ouchi
- Department of Biofunctional Imaging, Preeminent Medical Photonics Education & Research Center, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Mitsuru Kikuchi
- United Graduate School of Child Development, Osaka University, Osaka, Japan.,Department of Psychiatry and Neurobiology, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan
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Diana L, Scotti G, Aiello EN, Pilastro P, Eberhard-Moscicka AK, Müri RM, Bolognini N. Conventional and HD-tDCS May (or May Not) Modulate Overt Attentional Orienting: An Integrated Spatio-Temporal Approach and Methodological Reflections. Brain Sci 2021; 12:brainsci12010071. [PMID: 35053814 PMCID: PMC8773815 DOI: 10.3390/brainsci12010071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 11/16/2022] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) has been employed to modulate visuo-spatial attentional asymmetries, however, further investigation is needed to characterize tDCS-associated variability in more ecological settings. In the present research, we tested the effects of offline, anodal conventional tDCS (Experiment 1) and HD-tDCS (Experiment 2) delivered over the posterior parietal cortex (PPC) and Frontal Eye Field (FEF) of the right hemisphere in healthy participants. Attentional asymmetries were measured by means of an eye tracking-based, ecological paradigm, that is, a Free Visual Exploration task of naturalistic pictures. Data were analyzed from a spatiotemporal perspective. In Experiment 1, a pre-post linear mixed model (LMM) indicated a leftward attentional shift after PPC tDCS; this effect was not confirmed when the individual baseline performance was considered. In Experiment 2, FEF HD-tDCS was shown to induce a significant leftward shift of gaze position, which emerged after 6 s of picture exploration and lasted for 200 ms. The present results do not allow us to conclude on a clear efficacy of offline conventional tDCS and HD-tDCS in modulating overt visuospatial attention in an ecological setting. Nonetheless, our findings highlight a complex relationship among stimulated area, focality of stimulation, spatiotemporal aspects of deployment of attention, and the role of individual baseline performance in shaping the effects of tDCS.
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Affiliation(s)
- Lorenzo Diana
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- Correspondence:
| | - Giulia Scotti
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Edoardo N. Aiello
- Ph.D. Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
| | - Patrick Pilastro
- Department of Psychology, University of Milano-Bicocca, 20126 Milan, Italy; (G.S.); (P.P.)
| | - Aleksandra K. Eberhard-Moscicka
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - René M. Müri
- Perception and Eye Movement Laboratory, Departments of Neurology and BioMedical Research, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland; (A.K.E.-M.); (R.M.M.)
- Department of Neurology, Bern University Hospital Inselspital, University of Bern, 3010 Bern, Switzerland
| | - Nadia Bolognini
- Department of Psychology & Milan Center for Neuroscience (NeuroMI), University of Milano-Bicocca, 20126 Milan, Italy;
- Laboratory of Neuropsychology, Istituto Auxologico Italiano, IRCCS, 20122 Milan, Italy
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Individually optimized multi-channel tDCS for targeting somatosensory cortex. Clin Neurophysiol 2021; 134:9-26. [PMID: 34923283 DOI: 10.1016/j.clinph.2021.10.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/19/2021] [Accepted: 10/13/2021] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Transcranial direct current stimulation (tDCS) is a non-invasive neuro-modulation technique that delivers current through the scalp by a pair of patch electrodes (2-Patch). This study proposes a new multi-channel tDCS (mc-tDCS) optimization method, the distributed constrained maximum intensity (D-CMI) approach. For targeting the P20/N20 somatosensory source at Brodmann area 3b, an integrated combined magnetoencephalography (MEG) and electroencephalography (EEG) source analysis is used with individualized skull conductivity calibrated realistic head modeling. METHODS Simulated electric fields (EF) for our new D-CMI method and the already known maximum intensity (MI), alternating direction method of multipliers (ADMM) and 2-Patch methods were produced and compared for the individualized P20/N20 somatosensory target for 10 subjects. RESULTS D-CMI and MI showed highest intensities parallel to the P20/N20 target compared to ADMM and 2-Patch, with ADMM achieving highest focality. D-CMI showed a slight reduction in intensity compared to MI while reducing side effects and skin level sensations by current distribution over multiple stimulation electrodes. CONCLUSION Individualized D-CMI montages are preferred for our follow up somatosensory experiment to provide a good balance between high current intensities at the target and reduced side effects and skin sensations. SIGNIFICANCE An integrated combined MEG and EEG source analysis with D-CMI montages for mc-tDCS stimulation potentially can improve control, reproducibility and reduce sensitivity differences between sham and real stimulations.
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14
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Multichannel anodal tDCS over the left dorsolateral prefrontal cortex in a paediatric population. Sci Rep 2021; 11:21512. [PMID: 34728684 PMCID: PMC8563927 DOI: 10.1038/s41598-021-00933-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/18/2021] [Indexed: 02/06/2023] Open
Abstract
Methodological studies investigating transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (lDLPFC) in paediatric populations are limited. Therefore, we investigated in a paediatric population whether stimulation success of multichannel tDCS over the lDLPFC depends on concurrent task performance and individual head anatomy. In a randomised, sham-controlled, double-blind crossover study 22 healthy participants (10–17 years) received 2 mA multichannel anodal tDCS (atDCS) over the lDLPFC with and without a 2-back working memory (WM) task. After stimulation, the 2-back task and a Flanker task were performed. Resting state and task-related EEG were recorded. In 16 participants we calculated the individual electric field (E-field) distribution. Performance and neurophysiological activity in the 2-back task were not affected by atDCS. atDCS reduced reaction times in the Flanker task, independent of whether atDCS had been combined with the 2-back task. Flanker task related beta oscillation increased following stimulation without 2-back task performance. atDCS effects were not correlated with the E-field. We found no effect of multichannel atDCS over the lDLPFC on WM in children/adolescents but a transfer effect on interference control. While this effect on behaviour was independent of concurrent task performance, neurophysiological activity might be more sensitive to cognitive activation during stimulation. However, our results are limited by the small sample size, the lack of an active control group and variations in WM performance.
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15
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Wischnewski M, Mantell KE, Opitz A. Identifying regions in prefrontal cortex related to working memory improvement: A novel meta-analytic method using electric field modeling. Neurosci Biobehav Rev 2021; 130:147-161. [PMID: 34418436 DOI: 10.1016/j.neubiorev.2021.08.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/09/2021] [Accepted: 08/15/2021] [Indexed: 12/17/2022]
Abstract
Altering cortical activity using transcranial direct current stimulation (tDCS) has been shown to improve working memory (WM) performance. Due to large inter-experimental variability in the tDCS montage configuration and strength of induced electric fields, results have been mixed. Here, we present a novel meta-analytic method relating behavioral effect sizes to electric field strength to identify brain regions underlying largest tDCS-induced WM improvement. Simulations on 69 studies targeting left prefrontal cortex showed that tDCS electric field strength in lower dorsolateral prefrontal cortex (Brodmann area 45/47) relates most strongly to improved WM performance. This region explained 7.8 % of variance, equaling a medium effect. A similar region was identified when correlating WM performance and electric field strength of right prefrontal tDCS studies (n = 18). Maximum electric field strength of five previously used tDCS configurations were outside of this location. We thus propose a new tDCS montage which maximizes the tDCS electric field strength in that brain region. Our findings can benefit future tDCS studies that aim to affect WM function.
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Affiliation(s)
- Miles Wischnewski
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States.
| | - Kathleen E Mantell
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, United States
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Brauer H, Breitling-Ziegler C, Moliadze V, Galling B, Prehn-Kristensen A. Transcranial direct current stimulation in attention-deficit/hyperactivity disorder: A meta-analysis of clinical efficacy outcomes. PROGRESS IN BRAIN RESEARCH 2021; 264:91-116. [PMID: 34167666 DOI: 10.1016/bs.pbr.2021.01.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Evidence for the application of transcranial direct current stimulation (tDCS) in the clinical care of attention-deficit/hyperactivity disorder (ADHD) is limited. Therefore, we aimed to summarize study results using meta-analyses of measures of the cardinal symptoms of ADHD. METHODS We conducted a systematic literature search (PubMed/pubpsych/PsychInfo/WOS) until 01/05/2020 for randomized controlled trials (RCTs) evaluating tDCS vs. control condition in patients with ADHD. A random effects meta-analysis of symptom-related outcomes was performed separately for data on the immediate effect and follow-up. Subgroup- and metaregression analyses for patient characteristics and tDCS parameters were included. RESULTS Meta-analyzing 13 studies (n=308, age=23.7±13.3), including 20 study arms, tDCS had an immediate effect on overall symptom severity, inattention, and impulsivity, but not on hyperactivity. Results were significant in children and adolescents (8 studies, n=133, age=12.4±3.0). Follow-up data (3 days-4 weeks after stimulation) suggested an ongoing beneficial effect regarding overall symptom severity and a delayed effect on hyperactivity. DISCUSSION TDCS seems to be a promising method to treat clinical symptoms in ADHD with long-lasting effects. Still, more research considering the individual neuropsychological and anatomical dispositions of the subjects is needed to optimize tDCS protocols and efficacy. Safety issues of tDCS treatment in children and adolescents are addressed.
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Affiliation(s)
- Hannah Brauer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany.
| | - Carolin Breitling-Ziegler
- Department of Child and Adolescent Psychiatry and Psychotherapy, Otto von Guericke University, Magdeburg, Germany
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Britta Galling
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany; Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Child and Adolescent Psychosomatic Medicine and Psychotherapy, Altona Children's Hospital, Hamburg, Germany
| | - Alexander Prehn-Kristensen
- Department of Child and Adolescent Psychiatry and Psychotherapy, Centre for Integrative Psychiatry, School of Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany
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