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Mattioli F, Maglianella V, D'Antonio S, Trimarco E, Caligiore D. Non-invasive brain stimulation for patients and healthy subjects: Current challenges and future perspectives. J Neurol Sci 2024; 456:122825. [PMID: 38103417 DOI: 10.1016/j.jns.2023.122825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
Non-invasive brain stimulation (NIBS) techniques have a rich historical background, yet their utilization has witnessed significant growth only recently. These techniques encompass transcranial electrical stimulation and transcranial magnetic stimulation, which were initially employed in neuroscience to explore the intricate relationship between the brain and behaviour. However, they are increasingly finding application in research contexts as a means to address various neurological, psychiatric, and neurodegenerative disorders. This article aims to fulfill two primary objectives. Firstly, it seeks to showcase the current state of the art in the clinical application of NIBS, highlighting how it can improve and complement existing treatments. Secondly, it provides a comprehensive overview of the utilization of NIBS in augmenting the brain function of healthy individuals, thereby enhancing their performance. Furthermore, the article delves into the points of convergence and divergence between these two techniques. It also addresses the existing challenges and future prospects associated with NIBS from ethical and research standpoints.
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Affiliation(s)
- Francesco Mattioli
- AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, 00199 Rome, Italy; School of Computing, Electronics and Mathematics, University of Plymouth, Drake Circus, Plymouth PL4 8AA, United Kingdom
| | - Valerio Maglianella
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Sara D'Antonio
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Emiliano Trimarco
- Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy
| | - Daniele Caligiore
- AI2Life s.r.l., Innovative Start-Up, ISTC-CNR Spin-Off, Via Sebino 32, 00199 Rome, Italy; Computational and Translational Neuroscience Laboratory, Institute of Cognitive Sciences and Technologies, National Research Council (CTNLab-ISTC-CNR), Via San Martino della Battaglia 44, 00185 Rome, Italy.
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Liu Y, Liu Q, Zhao J, Leng X, Han J, Xia F, Pang Y, Chen H. Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex improves attentional control in chronically stressed adults. Front Neurosci 2023; 17:1182728. [PMID: 37397442 PMCID: PMC10309114 DOI: 10.3389/fnins.2023.1182728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/30/2023] [Indexed: 07/04/2023] Open
Abstract
Introduction Chronic stress is a long-term condition that negatively affects cognitive ability and mental health. Individuals who experience chronic stress show poor attentional control. Transcranial direct current stimulation (tDCS) to the dorsolateral prefrontal cortex (DLPFC) modulates executive function domains. Therefore, it is beneficial to investigate whether tDCS of the DLPFC could improve attentional control and relieve stress in chronically stressed individuals. Methods We assess the event-related potentials (ERPs) associated with attentional control in individuals with chronic stress after the tDCS intervention. Forty individuals were randomly assigned to either the anodal tDCS group, which received 5 sessions of the 20 min tDCS over the DLPFC (2 mA; n = 20), or the sham tDCS (n = 20). Participants' stress levels, anxiety, depressive symptoms, and state affects were assessed and compared before and after the intervention. The ERP was collected through electroencephalography (EEG) technology during an attentional network test. Results After the anodal tDCS, we found a significant decrease in the perceived stress scale (PSS) scores (from an average score of 35.05 to 27.75), p = 0.01 as well as the State-Trait Anxiety Inventory (STAI) scores, p = 0.002. Better performance in the attentional network test, a significant reduction in the N2 amplitudes, and an enhancement in the P3 amplitudes (both cues and targets) were also found in the anodal tDCS group. Discussion Our study findings suggest that tDCS to the left DLPFC could effectively relieve chronic stress, potentially reflected by increased attentional control.
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Affiliation(s)
- Yong Liu
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- School of Psychology, Southwest University, Chongqing, China
| | - Qingjin Liu
- The Clinical Hospital of Chengdu Brain Science Institute, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
- MOE Key Lab for Neuroinformation, High-Field Magnetic Resonance Brain Imaging Key Laboratory of Sichuan Province, University of Electronic Science and Technology of China, Chengdu, China
| | - Jia Zhao
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- School of Psychology, Southwest University, Chongqing, China
| | - Xuechen Leng
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- School of Psychology, Southwest University, Chongqing, China
| | - Jinfeng Han
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- School of Psychology, Southwest University, Chongqing, China
| | - Feng Xia
- Department of Hepatobiliary Surgery, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yazhi Pang
- School of Psychology, Southwest University, Chongqing, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (Ministry of Education), Southwest University, Chongqing, China
- School of Psychology, Southwest University, Chongqing, China
- Faculty of Psychology, Research Center of Psychology and Social Development, Southwest University, Chongqing, China
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Association of Long-Term Speech Therapy and Neuromodulation in Primary Progressive Aphasia: Lessons from a Case Report. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2022. [DOI: 10.3390/ctn6030017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary progressive aphasia (PPA) is a neurodegenerative disorder with a progressive loss of language. Long-term support requires speech therapy but also individually set training programs. Here we propose an 8-month individualized speech-training program which alternates 3-week periods of transcranial direct current stimulation (tDCS) treatment with intensive daily language exercises and a 3-week period without tDCS treatment and a less intensive language exercise from home in a patient with non-fluent variant PPA (nfvPPA). The endpoints were the following: adherence to this program, language data after 8 months, questionnaires related to emotional valence, and brain volume changes. The results showed a persistent adherence after 8 months and a positive compliance reported by both the patient and the partner. The language evaluation showed a clinical stabilization. Moreover, a significant and positive influence of tDCS on mood was observed. This is, to our knowledge, the first ever published report of a combined neuromodulation and language training during the course of 8 months. Our finding suggests the feasibility of programs integrating hospital speech therapy, home training, and tDCS modulation in PPA. Further studies should be conducted in order to disentangle the contextual influences on language performance from the tDCS intervention effects and to address the observation of an initial improvement and a subsequent stabilization effect of language performances.
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Davis NJ. Variance in cortical depth across the brain surface: Implications for transcranial stimulation of the brain. Eur J Neurosci 2020; 53:996-1007. [PMID: 32877015 DOI: 10.1111/ejn.14957] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Accepted: 08/20/2020] [Indexed: 01/12/2023]
Abstract
The distance between the surface of the scalp and the surface of the grey matter of the brain is a key factor in determining the effective dose of non-invasive brain stimulation for an individual person. The highly folded nature of the cortical surface means that the depth of a particular brain area is likely to vary between individuals. The question addressed here is: what is the variability of this measure of cortical depth? Ninety-four anatomical MRI images were taken from the OASIS database. For each image, the minimum distance from each point in the grey matter to the scalp surface was determined. Transforming these estimates into standard space meant that the coefficient of variation could be determined across the sample. The results indicated that depth variability is high across the cortical surface, even when taking sulcal depth into account. This was true even for the primary visual and motor areas, which are often used in setting TMS dosage. The correlation of the depth of these areas and the depth of other brain areas was low. The results suggest that dose setting of TMS based on visual or evoked potentials may offer poor reliability, and that individual brain images should be used when targeting non-primary brain areas.
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Affiliation(s)
- Nick J Davis
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
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Freidle M, Nilsson J, Lebedev AV, Lövdén M. No evidence for any effect of multiple sessions of frontal transcranial direct stimulation on mood in healthy older adults. Neuropsychologia 2020; 137:107325. [PMID: 31877311 DOI: 10.1016/j.neuropsychologia.2019.107325] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 12/06/2019] [Accepted: 12/20/2019] [Indexed: 11/28/2022]
Abstract
The dorsolateral prefrontal cortex (DLPFC) is part of a network important for emotional regulation and the possibility of modulating activity in this region with transcranial direct current stimulation (TDCS) to change mood has gained great interest, particularly for application in clinical populations. Whilst results in major depressive disorder have been promising, less is known about the effects of TDCS on mood in non-clinical populations. We hypothesized that multiple sessions of anodal TDCS applied over the left DLPFC would enhance mood, primarily as measured by the Profile of Mood States questionnaire, in healthy older adults. In addition, in an exploratory analysis, we examined the potentially moderating role of working memory training. Working memory, just like emotional regulation, taxes the DLPFC, which suggests that engaging in a working memory task whilst receiving TDCS may have a different effect on activity in this region and consequently mood. A total of 123 participants between 65 and 75 years of age were randomly assigned to receive either 20 sessions of TDCS, with or without working memory training, or 20 sessions sham stimulation, with or without working memory training. We found no support for enhancement of mood due to TDCS in healthy older adults, with or without cognitive training and conclude that the TDCS protocol used is unlikely to improve mood in non-depressed older individuals.
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Affiliation(s)
- Malin Freidle
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Jonna Nilsson
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Alexander V Lebedev
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Martin Lövdén
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Increased Neural Activity in Mesostriatal Regions after Prefrontal Transcranial Direct Current Stimulation and l-DOPA Administration. J Neurosci 2019; 39:5326-5335. [PMID: 31043485 DOI: 10.1523/jneurosci.3128-18.2019] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/10/2019] [Accepted: 04/10/2019] [Indexed: 12/20/2022] Open
Abstract
Dopamine dysfunction is associated with a wide range of neuropsychiatric disorders commonly treated pharmacologically or invasively. Recent studies provide evidence for a nonpharmacological and noninvasive alternative that allows similar manipulation of the dopaminergic system: transcranial direct current stimulation (tDCS). In rodents, tDCS has been shown to increase neural activity in subcortical parts of the dopaminergic system, and recent studies in humans provide evidence that tDCS over prefrontal regions induces striatal dopamine release and affects reward-related behavior. Based on these findings, we used fMRI in healthy human participants and measured the fractional amplitude of low-frequency fluctuations to assess spontaneous neural activity strength in regions of the mesostriatal dopamine system before and after tDCS over prefrontal regions (n = 40, 22 females). In a second study, we examined the effect of a single dose of the dopamine precursor levodopa (l-DOPA) on mesostriatal fractional amplitude of low-frequency fluctuation values in male humans (n = 22) and compared the results between both studies. We found that prefrontal tDCS and l-DOPA both enhance neural activity in core regions of the dopaminergic system and show similar subcortical activation patterns. We furthermore assessed the spatial similarity of whole-brain statistical parametric maps, indicating tDCS- and l-DOPA-induced activation, and >100 neuronal receptor gene expression maps based on transcriptional data from the Allen Institute for Brain Science. In line with a specific activation of the dopaminergic system, we found that both interventions predominantly activated regions with high expression levels of the dopamine receptors D2 and D3.SIGNIFICANCE STATEMENT Studies in animals and humans provide evidence that transcranial direct current stimulation (tDCS) allows a manipulation of the dopaminergic system. Based on these findings, we used fMRI to assess changes in spontaneous neural activity strength in the human dopaminergic system after prefrontal tDCS compared with the administration of the dopamine precursor and standard anti-Parkinson drug levodopa (l-DOPA). We found that prefrontal tDCS and l-DOPA both enhance neural activity in core regions of the dopaminergic system and show similar subcortical activation patterns. Using whole-brain transcriptional data of >100 neuronal receptor genes, we found that both interventions specifically activated regions with high expression levels of the dopamine receptors D2 and D3.
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Subhani AR, Kamel N, Mohamad Saad MN, Nandagopal N, Kang K, Malik AS. Mitigation of stress: new treatment alternatives. Cogn Neurodyn 2017; 12:1-20. [PMID: 29435084 DOI: 10.1007/s11571-017-9460-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 10/23/2017] [Accepted: 11/17/2017] [Indexed: 12/27/2022] Open
Abstract
Complaints of stress are common in modern life. Psychological stress is a major cause of lifestyle-related issues, contributing to poor quality of life. Chronic stress impedes brain function, causing impairment of many executive functions, including working memory, decision making and attentional control. The current study sought to describe newly developed stress mitigation techniques, and their influence on autonomic and endocrine functions. The literature search revealed that the most frequently studied technique for stress mitigation was biofeedback (BFB). However, evidence suggests that neurofeedback (NFB) and noninvasive brain stimulation (NIBS) could potentially provide appropriate approaches. We found that recent studies of BFB methods have typically used measures of heart rate variability, respiration and skin conductance. In contrast, studies of NFB methods have typically utilized neurocomputation techniques employing electroencephalography, functional magnetic resonance imaging and near infrared spectroscopy. NIBS studies have typically utilized transcranial direct current stimulation methods. Mitigation of stress is a challenging but important research target for improving quality of life.
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Affiliation(s)
- Ahmad Rauf Subhani
- 1Centre for Intelligent Signal and Imaging Research, Department of Electrical and Electronics Engineering, Universiti Teknologi PETRONAS, 32610 Bandar, Seri Iskandar, Perak Malaysia
| | - Nidal Kamel
- 1Centre for Intelligent Signal and Imaging Research, Department of Electrical and Electronics Engineering, Universiti Teknologi PETRONAS, 32610 Bandar, Seri Iskandar, Perak Malaysia
| | - Mohamad Naufal Mohamad Saad
- 1Centre for Intelligent Signal and Imaging Research, Department of Electrical and Electronics Engineering, Universiti Teknologi PETRONAS, 32610 Bandar, Seri Iskandar, Perak Malaysia
| | - Nanda Nandagopal
- 2Cognitive Neuro-Engineering Laboratory, Division of IT, Engineering and Environment, University of South Australia, Mawson Lakes Campus, Adelaide, 5001 Australia
| | - Kenneth Kang
- Spectrum Learning Pte Ltd, 81 Clemenceau Avenue #04-15/16, UE Square, Singapore, 239917 Singapore
| | - Aamir Saeed Malik
- 1Centre for Intelligent Signal and Imaging Research, Department of Electrical and Electronics Engineering, Universiti Teknologi PETRONAS, 32610 Bandar, Seri Iskandar, Perak Malaysia
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Acute and repetitive fronto-cerebellar tDCS stimulation improves mood in non-depressed participants. Exp Brain Res 2017; 236:83-97. [PMID: 29098314 DOI: 10.1007/s00221-017-5109-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/16/2017] [Indexed: 01/28/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation, which allows for selective inhibition or excitation of neural structures. It has demonstrated some efficacy in the treatment of mood disorders. However, these studies have predominately focused on stimulation of the prefrontal cortex (PFC). The cerebellum has an increasingly recognized role in emotional control, affective state, and some psychopathologies. As such, tDCS research into mood modulation needs to expand beyond conventional PFC-focused paradigms. Using a contralateral stimulation electrode placement [anodal left dorsolateral(dl)PFC, cathodal right cerebellum], and a single-blind, repeated-measures design, we initially assessed changes in the mood of healthy participants in response to acute stimulation (n = 44) and three repeated stimulations delivered second-daily (n = 21). In a second experiment, we separately investigated the influence of reversed polarity upon these same measures, in response to acute stimulation (n = 23) and repeated stimulation (n = 11). We observed a systematic elevation of mood in both active conditions following single and repeated tDCS, the latter of which displayed a progressive elevation of mood from baseline. No mood change was noted in response to either single or repeated stimulation in the sham condition. Frontocerebellar tDCS stimulation advantageously influences mood in healthy participants, with an accumulative and potentiated effect following successive stimulations. The possibility that frontocerebellar stimulation may provide a novel therapeutic adjunctive or pre-emptive intervention in stress-related disorders and mood-related psychopathologies should be considered.
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Brain Stimulation for Cognitive Enhancement in the Older Person: State of the Art and Future Directions. JOURNAL OF COGNITIVE ENHANCEMENT 2017. [DOI: 10.1007/s41465-017-0036-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Davis NJ. Prefrontal electrical stimulation in non-depressed reduces levels of reported negative affects from daily stressors. Front Hum Neurosci 2017; 11:63. [PMID: 28261075 PMCID: PMC5306201 DOI: 10.3389/fnhum.2017.00063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 01/30/2017] [Indexed: 01/17/2023] Open
Abstract
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.
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Affiliation(s)
- Nick J Davis
- Department of Psychology, Manchester Metropolitan University Manchester, UK
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Balzarotti S, Colombo B. Effects of Unilateral Transcranial Direct Current Stimulation of Left Prefrontal Cortex on Processing and Memory of Emotional Visual Stimuli. PLoS One 2016; 11:e0159555. [PMID: 27433807 PMCID: PMC4951131 DOI: 10.1371/journal.pone.0159555] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 07/04/2016] [Indexed: 11/18/2022] Open
Abstract
The dorsolateral prefrontal cortex (DLPFC) is generally thought to be involved in affect and emotional processing; however, the specific contribution of each hemisphere continues to be debated. In the present study, we employed unilateral tDCS to test the unique contribution of left DLPFC in the encoding and retrieval of emotional stimuli in healthy subjects. Forty-two right handed undergraduate students received either anodal, cathodal or sham stimulation of left DLPFC while viewing neutral, pleasant, and unpleasant pictures. After completing a filler task, participants were asked to remember as many pictures as possible. Results showed that participants were able to remember a larger amount of emotional (both pleasant and unpleasant) pictures than of neutral ones, regardless of the type of tDCS condition. Participants who received anodal stimulation recalled a significantly higher number of pleasant images than participants in the sham and cathodal conditions, while no differences emerged in the recall of neutral and unpleasant pictures. We conclude that our results provide some support to the role of left prefrontal cortex in the encoding and retrieval of pleasant stimuli.
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Affiliation(s)
- Stefania Balzarotti
- Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milano, Italy
| | - Barbara Colombo
- Department of Psychology, Catholic University of the Sacred Heart, Largo Gemelli 1, 20123 Milano, Italy
- Division of Education and Human Studies, Champlain College, 251 South Willard Street, Burlington, VT 05402, United States of America
- * E-mail:
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