Portable Neuroimaging-Guided Noninvasive Brain Stimulation of the Cortico-Cerebello-Thalamo-Cortical Loop—Hypothesis and Theory in Cannabis Use Disorder

Brain-behavior analysis of transcranial direct current stimulation effects on a complex surgical motor task

Transcranial Direct Current Stimulation (tDCS) has demonstrated its potential in enhancing surgical training and performance compared to sham tDCS. However, optimizing its efficacy requires the selection of appropriate brain targets informed by neuroimaging and mechanistic understanding. Previous studies have established the feasibility of using portable brain imaging, combining functional near-infrared spectroscopy (fNIRS) with tDCS during Fundamentals of Laparoscopic Surgery (FLS) tasks. This allows concurrent monitoring of cortical activations. Building on these foundations, our study aimed to explore the multi-modal imaging of the brain response using fNIRS and electroencephalogram (EEG) to tDCS targeting the right cerebellar (CER) and left ventrolateral prefrontal cortex (PFC) during a challenging FLS suturing with intracorporeal knot tying task. Involving twelve novices with a medical/premedical background (age: 22-28 years, two males, 10 females with one female with left-hand dominance), our investigation sought mechanistic insights into tDCS effects on brain areas related to error-based learning, a fundamental skill acquisition mechanism. The results revealed that right CER tDCS applied to the posterior lobe elicited a statistically significant (q < 0.05) brain response in bilateral prefrontal areas at the onset of the FLS task, surpassing the response seen with sham tDCS. Additionally, right CER tDCS led to a significant (p < 0.05) improvement in FLS scores compared to sham tDCS. Conversely, the left PFC tDCS did not yield a statistically significant brain response or improvement in FLS performance. In conclusion, right CER tDCS demonstrated the activation of bilateral prefrontal brain areas, providing valuable mechanistic insights into the effects of CER tDCS on FLS peformance. These insights motivate future investigations into the effects of CER tDCS on error-related perception-action coupling through directed functional connectivity studies.

Applications of open-source software ROAST in clinical studies: A review

Background:

Transcranial electrical stimulation (TES) is broadly investigated as a therapeutic technique for a wide range of neurological disorders. The electric fields induced by TES in the brain can be estimated by computational models. A realistic and volumetric approach to simulate TES (ROAST) has been recently released as an open-source software package and has been widely used in TES research and its clinical applications. Rigor and reproducibility of TES studies have recently become a concern, especially in the context of computational modeling.

Methods:

Here we reviewed 94 clinical TES studies that leveraged ROAST for computational modeling. When reviewing each study, we pay attention to details related to the rigor and reproducibility as defined by the locations of stimulation electrodes and the dose of stimulating current. Specifically, we compared across studies the electrode montages, stimulated brain areas, achieved electric field strength, and the relations between modeled electric field and clinical outcomes.

Results:

We found that over 1800 individual heads have been modeled by ROAST for more than 30 different clinical applications. Similar electric field intensities were found to be reproducible by ROAST across different studies at the same brain area under same or similar stimulation montages.

Conclusion:

This article reviews the use cases of ROAST and provides an overview of how ROAST has been leveraged to enhance the rigor and reproducibility of TES research and its applications.