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Fasiello E, Gorgoni M, Galbiati A, Sforza M, Berra F, Scarpelli S, Alfonsi V, Annarumma L, Casoni F, Zucconi M, Castronovo V, Ferini-Strambi L, De Gennaro L. Decreased Delta/Beta ratio index as the sleep state-independent electrophysiological signature of sleep state misperception in Insomnia disorder: A focus on the sleep onset and the whole night. Neuroimage 2024; 298:120782. [PMID: 39128660 DOI: 10.1016/j.neuroimage.2024.120782] [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: 04/28/2024] [Revised: 08/02/2024] [Accepted: 08/08/2024] [Indexed: 08/13/2024] Open
Abstract
PURPOSE Sleep State Misperception (SSM) is described as the tendency of Insomnia Disorder (ID) patients to overestimate Sleep Latency (SL) and underestimate Total Sleep Time (TST). Literature exploring topographical components in ID with SSM is scarce and does not allow us to fully understand the potential mechanisms underlying this phenomenon. This study aims to evaluate the existence of sleep EEG topography alterations in ID patients associated with SSM compared to Healthy Controls (HC), focusing on two distinct periods: the Sleep Onset (SO) and the whole night. METHODS Twenty ID patients (mean age: 43.5 ± 12.7; 7 M/13F) and 18 HCs (mean age: 41.6 ± 11.9; 8 M/10F) underwent a night of Polysomnography (PSG) and completed sleep diaries the following morning upon awakening. Two SSM indices, referring to the misperception of SL (SLm) and TST (TSTm), were calculated by comparing objective and subjective sleep indices extracted by PSG and sleep diary. According to these indices, the entire sample was split into 4 sub-groups: ID +SLm vs HC -SLm; ID +TSTm vs HC -TSTm. RESULTS Considering the SO, the two-way mixed-design ANOVA showed a significant main effect of Groups pointing to a decreased delta/beta ratio in the whole scalp topography. Moreover, we found a significant interaction effect for the sigma and beta bands. Post Hoc tests showed higher sigma and beta power in anterior and temporo-parietal sites during the SO period in IDs +SLm compared to HC -SLm. Considering the whole night, the unpaired t-test revealed in IDs +TSTm significantly lower delta power during NREM, and lower delta/beta ratio index during NREM and REM sleep compared to HCs -TSTm. Finally, we found diffuse significant negative correlations between SSM indices and the delta/beta ratio during SO, NREM, and REM sleep. CONCLUSION The main finding of the present study suggests that higher SL overestimation and TST underestimation are both phenomena related to diffuse cortical hyperarousal interpreted as a sleep state-independent electrophysiological correlate of the SSM, both during the SO and the whole night.
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Affiliation(s)
- Elisabetta Fasiello
- Faculty of Psychology, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy; Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy.
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome Sapienza, Via dei Marsi, 78, 00185, Rome, Italy; Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Andrea Galbiati
- Faculty of Psychology, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy; Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Marco Sforza
- Faculty of Psychology, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy; Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Francesca Berra
- Faculty of Psychology, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy; Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Serena Scarpelli
- Department of Psychology, University of Rome Sapienza, Via dei Marsi, 78, 00185, Rome, Italy
| | - Valentina Alfonsi
- Department of Psychology, University of Rome Sapienza, Via dei Marsi, 78, 00185, Rome, Italy
| | - Ludovica Annarumma
- Department of Psychology, University of Rome Sapienza, Via dei Marsi, 78, 00185, Rome, Italy
| | - Francesca Casoni
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Marco Zucconi
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Vincenza Castronovo
- Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Luigi Ferini-Strambi
- Faculty of Psychology, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy; Department of Clinical Neurosciences, Neurology-Sleep Disorders Center, IRCCS San Raffaele Scientific Institute, Via Stamira d'Ancona, 20, 20127, Milan, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome Sapienza, Via dei Marsi, 78, 00185, Rome, Italy; Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
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2
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Gebodh N, Miskovic V, Laszlo S, Datta A, Bikson M. Frontal HD-tACS enhances behavioral and EEG biomarkers of vigilance in continuous attention task. Brain Stimul 2024; 17:683-686. [PMID: 38797371 DOI: 10.1016/j.brs.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/25/2024] [Accepted: 05/18/2024] [Indexed: 05/29/2024] Open
Affiliation(s)
- Nigel Gebodh
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, 85 St. Nicholas Terrace, Center for Discovery and Innovation (CDI), Rm 3.121, New York, NY, 10031, USA; Soterix Medical Inc., New York, USA.
| | - Vladimir Miskovic
- Google X Development LLC, The Moonshot Factory, Mountain View, CA, USA
| | - Sarah Laszlo
- Google X Development LLC, The Moonshot Factory, Mountain View, CA, USA
| | | | - Marom Bikson
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, 85 St. Nicholas Terrace, Center for Discovery and Innovation (CDI), Rm 3.121, New York, NY, 10031, USA
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3
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Zhu X, Ren Y, Tan S, Ma X. Efficacy of transcranial alternating current stimulation in treating chronic insomnia and the impact of age on its effectiveness: A multisite randomized, double-blind, parallel-group, placebo-controlled study. J Psychiatr Res 2024; 170:253-261. [PMID: 38176353 DOI: 10.1016/j.jpsychires.2023.12.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/01/2023] [Accepted: 12/27/2023] [Indexed: 01/06/2024]
Abstract
OBJECTIVE Insomnia is a significant health issue associated with various systemic diseases. Transcranial alternating current stimulation (tACS) has been proposed as a potential intervention for insomnia. However, the efficacy and mechanisms of tACS in chronic insomnia remain unclear. Accordingly, this study aimed to investigate the efficacy of tACS in treating chronic insomnia in adults and assess the impact of age on its effectiveness using a large sample from two centers. METHODS A total of 120 participants with chronic insomnia underwent 20 daily sessions of tACS (duration: 40 min, frequency: 77.5 Hz, and intensity: 15 mA) or sham tACS targeting the forehead and both mastoid areas over 4 weeks. Assessments were conducted at baseline, post-treatment, and 4-week follow-up. Primary outcomes included sleep quality and efficiency, onset latency, total sleep time, and daily disturbances. Secondary outcomes included depression, anxiety, and clinical impression. RESULTS Compared with the control group, the tACS group demonstrated improved sleep quality and efficiency, increased total sleep time, and reduced daily disturbance (all ps < 0.01). Moreover, tACS had a significant effect on clinical impression (p < 0.001), but not depression and anxiety scores. Subgroup analyses revealed that older participants experienced significant benefits from tACS in sleep quality, efficiency, and overall insomnia reduction at post-treatment and follow-up (p < 0.001). Notably, improved insomnia correlated with attenuated depressive and anxiety symptoms. CONCLUSIONS These findings suggest that tACS may be an effective intervention for chronic insomnia within an eight-week timeframe, and age affects the response to tACS in terms of insomnia improvement.
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Affiliation(s)
- Xiaolin Zhu
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China
| | - Yanping Ren
- Being An-ding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing, 100088, China
| | - Shuping Tan
- Beijing HuiLongGuan Hospital, Peking University HuiLongGuan Clinical Medical School, Beijing, 100096, China.
| | - Xin Ma
- Being An-ding Hospital, Capital Medical University, 5 Ankang Lane, Deshengmenwai Avenue, Xicheng District, Beijing, 100088, China.
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4
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Hohenester M, Langguth B, Wetter TC, Geisler P, Schecklmann M, Reissmann A. Single sessions of transcranial direct current stimulation and transcranial random noise stimulation exert no effect on sleepiness in patients with narcolepsy and idiopathic hypersomnia. Front Psychiatry 2023; 14:1288976. [PMID: 38146280 PMCID: PMC10749348 DOI: 10.3389/fpsyt.2023.1288976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/28/2023] [Indexed: 12/27/2023] Open
Abstract
Background Hypersomnia poses major challenges to treatment providers given the limitations of available treatment options. In this context, the application of non-invasive brain stimulation techniques such as transcranial electrical stimulation (tES) may open up new avenues to effective treatment. Preliminary evidence suggests both acute and longer-lasting positive effects of transcranial direct current stimulation (tDCS) on vigilance and sleepiness in hypersomniac patients. Based on these findings, the present study sought to investigate short-term effects of single sessions of tDCS and transcranial random noise stimulation (tRNS) on sleepiness in persons suffering from hypersomnia. Methods A sample of 29 patients suffering from narcolepsy or idiopathic hypersomnia (IH) was recruited from the Regensburg Sleep Disorder Center and underwent single sessions of tES (anodal tDCS, tRNS, sham) over the left and right dorsolateral prefrontal cortex on three consecutive days in a double-blind, sham-controlled, pseudorandomized crossover trial. The primary study endpoint was the mean reaction time measured by the Psychomotor Vigilance Task (PVT) before and directly after the daily tES sessions. Secondary endpoints were additional PVT outcome metrics as well as subjective outcome parameters (e.g., Karolinska Sleepiness Scale; KSS). Results There were no significant treatment effects neither on objective (i.e., PVT) nor on subjective indicators of sleepiness. Conclusion We could not demonstrate any clinically relevant effects of single sessions of tDCS or tRNS on objective or subjective measures of sleepiness in patients with hypersomnia. However, we cannot exclude that repeated sessions of tES may affect vigilance or sleepiness in hypersomniac patients.
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Affiliation(s)
- Michaela Hohenester
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
- Department of Hematology and Oncology, Krankenhaus der Barmherzigen Brüder Regensburg, Regensburg, Germany
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | | | - Peter Geisler
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Martin Schecklmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Andreas Reissmann
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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5
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Zheng S, Feng S, Yao H, Dong L, Feng Z, Liu X, Zhang B, Jia H, Ning Y. Altered functional connectivity after acute sleep deprivation reveals potential locations for noninvasive brain stimulation techniques. Sleep Med 2023; 110:212-219. [PMID: 37634325 DOI: 10.1016/j.sleep.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 07/18/2023] [Accepted: 08/19/2023] [Indexed: 08/29/2023]
Abstract
BACKGROUNDS Non-invasive brain stimulation (NIBS) techniques are emerging as efficacious treatments for sleep deprivation (SD). However, the stimulation location of NIBS (e.g. transcranial magnetic stimulation and transcranial direct current stimulation) on intervening acute SD is limited in previous studies. In this study, we aimed to investigate potentially effective targets of NIBS on intervening acute SD. METHODS We firstly performed a meta-analysis of 95 functional magnetic resonance imaging studies to find SD-related brain regions as regions of interest (ROI). Subsequently, we used resting-state functional connectivity analysis in 32 young individuals suffering from 24 h SD to identify brain surface regions associated with the ROIs. Finally, we applied 10-20 system coordinates to locate scalp sites for NIBS corresponding to the brain surface regions. RESULTS We identified the bilateral dorsolateral prefrontal cortex, bilateral inferior frontal gyrus, left supplementary motor area, precentral, right precuneus, bilateral inferior parietal gyrus, right middle temporal gyrus, and superior frontal gyrus as potential targets of NIBS for intervening SD. The 10-20 system coordinates corresponding to these brain surface regions were identified as potential sites for NIBS. CONCLUSIONS In conclusion, we identified several potential targets which could provide alternative stimulation locations for the use of NIBS on young patients suffering from acute SD.
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Affiliation(s)
- Sisi Zheng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Sitong Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Hao Yao
- Beijing University of Chinese Medicine, Beijing, 100029, China
| | - Linrui Dong
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Zhengtian Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Xinzi Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China
| | - Binlong Zhang
- Department of Acupuncture and Moxibustion, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Hongxiao Jia
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
| | - Yanzhe Ning
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, 100069, China.
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6
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Alfonsi V, D'Atri A, Scarpelli S, Gorgoni M, Giacinti F, Annarumma L, Salfi F, Amicucci G, Corigliano D, De Gennaro L. The effects of bifrontal anodal transcranial direct current stimulation (tDCS) on sleepiness and vigilance in partially sleep-deprived subjects: A multidimensional study. J Sleep Res 2023:e13869. [PMID: 36871580 DOI: 10.1111/jsr.13869] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/21/2023] [Accepted: 02/21/2023] [Indexed: 03/07/2023]
Abstract
In recent years, transcranial electrical stimulation techniques have demonstrated their ability to modulate our levels of sleepiness and vigilance. However, the outcomes differ among the specific aspects considered (physiological, behavioural or subjective). This study aimed to observe the effects of bifrontal anodal transcranial direct current stimulation. Specifically, we tested the ability of this stimulation protocol to reduce sleepiness and increase vigilance in partially sleep-deprived healthy participants. Twenty-three subjects underwent a within-subject sham-controlled stimulation protocol. We compared sleepiness and vigilance levels before and after the two stimulation conditions (active versus sham) by using behavioural (reaction-time task), subjective (self-report scales) and physiological (sleep-onset latency and electroencephalogram power [n = 20] during the Maintenance of Wakefulness Test) measures. We showed the efficacy of the active stimulation in reducing physiological sleepiness and preventing vigilance drop compared with the sham stimulation. Consistently, we observed a reduction of perceived sleepiness following the active stimulation for both self-report scales. However, the stimulation effect on subjective measures was not statistically significant probably due to the underpowered sample size for these measures, and to the possible influence of motivational and environmental factors. Our findings confirm the ability of this technique to influence vigilance and sleepiness, pointing out the potential for new treatment developments based on transcranial electrical stimulation.
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Affiliation(s)
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Serena Scarpelli
- Department of Psychology, University of Rome Sapienza, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome Sapienza, Rome, Italy.,Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | | | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Giulia Amicucci
- Department of Psychology, University of Rome Sapienza, Rome, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, University of Rome Sapienza, Rome, Italy.,Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
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7
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Transcutaneous auricular vagus stimulation (taVNS) improves human working memory performance under sleep deprivation stress. Behav Brain Res 2023; 439:114247. [PMID: 36473677 DOI: 10.1016/j.bbr.2022.114247] [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: 08/06/2022] [Revised: 11/23/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Abstract
Many human activities require high cognitive performance over long periods, while impairments induced by sleep deprivation influence various aspects of cognitive abilities, including working memory (WM), attention, and processing speed. Based on previous research, vagal nerve stimulation can modulate cognitive abilities, attention, and arousal. Two experiments were conducted to assess the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) to relieve the deleterious effects of sleep deprivation. In the first experiment, 35 participants completed N-back tasks at 8:00 a.m. for two consecutive days in a within-subject study. Then, the participants received either taVNS or earlobe stimulation (active control) intervention in two sessions at random orders after 24 h of sustained wakefulness. Then, they completed the N-back tasks again. In the second experiment, 30 participants completed the psychomotor vigilance task (PVT), and 32 completed the N-back tasks at 8:00 a.m. on the first and second days. Then, they received either taVNS or earlobe stimulation at random orders and finished the N-back and PVT tasks immediately after one hour. In Experiment 1, taVNS could significantly improve the accuracy rate of participants in spatial 3-back tasks compared to active control, which was consistent with experiment 2. However, taVNS did not specifically enhance PVT performance. Therefore, taVNS could be a powerful intervention for acute sleep deprivation as it can improve performance on high cognitive load tasks and is easy to administer.
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8
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Hemmerich K, Lupiáñez J, Luna FG, Martín-Arévalo E. The mitigation of the executive vigilance decrement via HD-tDCS over the right posterior parietal cortex and its association with neural oscillations. Cereb Cortex 2023:6988102. [PMID: 36646467 DOI: 10.1093/cercor/bhac540] [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: 07/21/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
Vigilance-maintaining a prolonged state of preparation to detect and respond to specific yet unpredictable environmental changes-usually decreases across prolonged tasks, causing potentially severe real-life consequences, which could be mitigated through transcranial direct current stimulation (tDCS). The present study aimed at replicating previous mitigatory effects observed with anodal high-definition tDCS (HD-tDCS) over the right posterior parietal cortex (rPPC) while extending the analyses on electrophysiological measures associated with vigilance. In sum, 60 participants completed the ANTI-Vea task while receiving anodal (1.5 mA, n = 30) or sham (0 mA, n = 30) HD-tDCS over the rPPC for ~ 28 min. EEG recordings were completed before and after stimulation. Anodal HD-tDCS specifically mitigated executive vigilance (EV) and reduced the alpha power increment across time-on-task while increasing the gamma power increment. To further account for the observed behavioral and physiological outcomes, a new index of Alphaparietal/Gammafrontal is proposed. Interestingly, the increment of this Alphaparietal/Gammafrontal Index with time-on-task is associated with a steeper EV decrement in the sham group, which was mitigated by anodal HD-tDCS. We highlight the relevance of replicating mitigatory effects of tDCS and the need to integrate conventional and novel physiological measures to account for how anodal HD-tDCS can be used to modulate cognitive performance.
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Affiliation(s)
- Klara Hemmerich
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada 18071, Spain
| | - Juan Lupiáñez
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada 18071, Spain
| | - Fernando G Luna
- Instituto de Investigaciones Psicológicas (IIPsi, CONICET-UNC), Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba 5010, Argentina
| | - Elisa Martín-Arévalo
- Department of Experimental Psychology, and Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada 18071, Spain
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9
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Moreira CG, Hofmann P, Müllner A, Baumann CR, Ginde VR, Kollarik S, Morawska MM, Noain D. Down-phase auditory stimulation is not able to counteract pharmacologically or physiologically increased sleep depth in traumatic brain injury rats. J Sleep Res 2022; 31:e13615. [PMID: 35474362 PMCID: PMC9786351 DOI: 10.1111/jsr.13615] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/30/2022] [Accepted: 04/05/2022] [Indexed: 12/30/2022]
Abstract
Modulation of slow-wave activity, either via pharmacological sleep induction by administering sodium oxybate or sleep restriction followed by a strong dissipation of sleep pressure, has been associated with preserved posttraumatic cognition and reduced diffuse axonal injury in traumatic brain injury rats. Although these classical strategies provided promising preclinical results, they lacked the specificity and/or translatability needed to move forward into clinical applications. Therefore, we recently developed and implemented a rodent auditory stimulation method that is a scalable, less invasive and clinically meaningful approach to modulate slow-wave activity by targeting a particular phase of slow waves. Here, we assessed the feasibility of down-phase targeted auditory stimulation of slow waves and evaluated its comparative modulatory strength in relation to the previously employed slow-wave activity modulators in our rat model of traumatic brain injury. Our results indicate that, in spite of effectively reducing slow-wave activity in both healthy and traumatic brain injury rats via down-phase targeted stimulation, this method was not sufficiently strong to counteract the boost in slow-wave activity associated with classical modulators, nor to alter concomitant posttraumatic outcomes. Therefore, the usefulness and effectiveness of auditory stimulation as potential standalone therapeutic strategy in the context of traumatic brain injury warrants further exploration.
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Affiliation(s)
- Carlos G. Moreira
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Pascal Hofmann
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Adrian Müllner
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Christian R. Baumann
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland,University Center of Competence Sleep & Health Zurich (CRPP)University of ZurichZurichSwitzerland,Neuroscience Center Zurich (ZNZ)ZurichSwitzerland
| | - Varun R. Ginde
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Sedef Kollarik
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Marta M. Morawska
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland
| | - Daniela Noain
- Department of NeurologyUniversity Hospital Zurich, University of ZurichZurichSwitzerland,University Center of Competence Sleep & Health Zurich (CRPP)University of ZurichZurichSwitzerland,Neuroscience Center Zurich (ZNZ)ZurichSwitzerland
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10
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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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11
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Translational Approaches to Influence Sleep and Arousal. Brain Res Bull 2022; 185:140-161. [PMID: 35550156 PMCID: PMC9554922 DOI: 10.1016/j.brainresbull.2022.05.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/27/2022] [Accepted: 05/03/2022] [Indexed: 12/16/2022]
Abstract
Sleep disorders are widespread in society and are prevalent in military personnel and in Veterans. Disturbances of sleep and arousal mechanisms are common in neuropsychiatric disorders such as schizophrenia, post-traumatic stress disorder, anxiety and affective disorders, traumatic brain injury, dementia, and substance use disorders. Sleep disturbances exacerbate suicidal ideation, a major concern for Veterans and in the general population. These disturbances impair quality of life, affect interpersonal relationships, reduce work productivity, exacerbate clinical features of other disorders, and impair recovery. Thus, approaches to improve sleep and modulate arousal are needed. Basic science research on the brain circuitry controlling sleep and arousal led to the recent approval of new drugs targeting the orexin/hypocretin and histamine systems, complementing existing drugs which affect GABAA receptors and monoaminergic systems. Non-invasive brain stimulation techniques to modulate sleep and arousal are safe and show potential but require further development to be widely applicable. Invasive viral vector and deep brain stimulation approaches are also in their infancy but may be used to modulate sleep and arousal in severe neurological and psychiatric conditions. Behavioral, pharmacological, non-invasive brain stimulation and cell-specific invasive approaches covered here suggest the potential to selectively influence arousal, sleep initiation, sleep maintenance or sleep-stage specific phenomena such as sleep spindles or slow wave activity. These manipulations can positively impact the treatment of a wide range of neurological and psychiatric disorders by promoting the restorative effects of sleep on memory consolidation, clearance of toxic metabolites, metabolism, and immune function and by decreasing hyperarousal.
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Herrmann O, Ficek B, Webster KT, Frangakis C, Spira AP, Tsapkini K. Sleep as a predictor of tDCS and language therapy outcomes. Sleep 2022; 45:zsab275. [PMID: 34875098 PMCID: PMC8919198 DOI: 10.1093/sleep/zsab275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/01/2021] [Indexed: 12/17/2022] Open
Abstract
STUDY OBJECTIVES To determine whether sleep at baseline (before therapy) predicted improvements in language following either language therapy alone or coupled with transcranial direct current stimulation (tDCS) in individuals with primary progressive aphasia (PPA). METHODS Twenty-three participants with PPA (mean age 68.13 ± 6.21) received written naming/spelling therapy coupled with either anodal tDCS over the left inferior frontal gyrus (IFG) or sham condition in a crossover, sham-controlled, double-blind design (ClinicalTrials.gov identifier: NCT02606422). The outcome measure was percent of letters spelled correctly for trained and untrained words retrieved in a naming/spelling task. Given its particular importance as a sleep parameter in older adults, we calculated sleep efficiency (total sleep time/time in bed x100) based on subjective responses on the Pittsburgh Sleep Quality Index (PSQI). We grouped individuals based on a median split: high versus low sleep efficiency. RESULTS Participants with high sleep efficiency benefited more from written naming/spelling therapy than participants with low sleep efficiency in learning therapy materials (trained words). There was no effect of sleep efficiency in generalization of therapy materials to untrained words. Among participants with high sleep efficiency, those who received tDCS benefitted more from therapy than those who received sham condition. There was no additional benefit from tDCS in participants with low sleep efficiency. CONCLUSION Sleep efficiency modified the effects of language therapy and tDCS on language in participants with PPA. These results suggest sleep is a determinant of neuromodulation effects.Clinical Trial: tDCS Intervention in Primary Progressive Aphasia https://clinicaltrials.gov/ct2/show/NCT02606422.
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Affiliation(s)
- Olivia Herrmann
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Bronte Ficek
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kimberly T Webster
- Department of Otolaryngology, Head & Neck Surgery, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Constantine Frangakis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Adam P Spira
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
| | - Kyrana Tsapkini
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Cognitive Science, The Johns Hopkins University, Baltimore, MD, USA
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13
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Abstract
Sleep homeostasis is a complex neurobiologic phenomenon involving a number of molecular pathways, neurotransmitter release, synaptic activity, and factors modulating neural networks. Sleep plasticity allows for homeostatic optimization of neural networks and the replay-based consolidation of specific circuits, especially important for cognition, behavior, and information processing. Furthermore, research is currently moving from an essentially brain-focused to a more comprehensive view involving other systems, such as the immune system, hormonal status, and metabolic pathways. When dysfunctional, these systems contribute to sleep loss and fragmentation as well as to sleep need. In this chapter, the implications of neural plasticity and sleep homeostasis for the diagnosis and treatment of some major sleep disorders, such as insomnia and sleep deprivation, obstructive sleep apnea syndrome, restless legs syndrome, REM sleep behavior disorder, and narcolepsy are discussed in detail with their therapeutical implications. This chapter highlights that sleep is necessary for the maintenance of an optimal brain function and is sensitive to both genetic background and environmental enrichment. Even in pathologic conditions, sleep acts as a resilient plastic state that consolidates prior information and prioritizes network activity for efficient brain functioning.
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Poltorak A. Replicating Cortical Signatures May Open the Possibility for "Transplanting" Brain States via Brain Entrainment. Front Hum Neurosci 2021; 15:710003. [PMID: 34630058 PMCID: PMC8492906 DOI: 10.3389/fnhum.2021.710003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 08/18/2021] [Indexed: 02/03/2023] Open
Abstract
Brain states, which correlate with specific motor, cognitive, and emotional states, may be monitored with noninvasive techniques such as electroencephalography (EEG) and magnetoencephalography (MEG) that measure macroscopic cortical activity manifested as oscillatory network dynamics. These rhythmic cortical signatures provide insight into the neuronal activity used to identify pathological cortical function in numerous neurological and psychiatric conditions. Sensory and transcranial stimulation, entraining the brain with specific brain rhythms, can effectively induce desired brain states (such as state of sleep or state of attention) correlated with such cortical rhythms. Because brain states have distinct neural correlates, it may be possible to induce a desired brain state by replicating these neural correlates through stimulation. To do so, we propose recording brain waves from a "donor" in a particular brain state using EEG/MEG to extract cortical signatures of the brain state. These cortical signatures would then be inverted and used to entrain the brain of a "recipient" via sensory or transcranial stimulation. We propose that brain states may thus be transferred between people by acquiring an associated cortical signature from a donor, which, following processing, may be applied to a recipient through sensory or transcranial stimulation. This technique may provide a novel and effective neuromodulation approach to the noninvasive, non-pharmacological treatment of a variety of psychiatric and neurological disorders for which current treatments are mostly limited to pharmacotherapeutic interventions.
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Affiliation(s)
- Alexander Poltorak
- Neuroenhancement Lab, Suffern, NY, United States
- The City College of New York, New York, NY, United States
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15
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郭 娅, 焦 学, 姜 劲, 曹 勇, 楚 洪, 李 启. [Research on enhancement of mental rotation ability based on transcranial direct current stimulation]. SHENG WU YI XUE GONG CHENG XUE ZA ZHI = JOURNAL OF BIOMEDICAL ENGINEERING = SHENGWU YIXUE GONGCHENGXUE ZAZHI 2021; 38:630-637. [PMID: 34459161 PMCID: PMC9927530 DOI: 10.7507/1001-5515.202011083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 04/10/2021] [Indexed: 11/03/2022]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive low-current brain stimulation technique, which is mainly based on the different polarity of electrode stimulation to make the activation threshold of neurons different, thereby regulating the excitability of the cerebral cortex. In this paper, healthy subjects were randomly divided into three groups: anodal stimulation group, cathodal stimulation group and sham stimulation group, with 5 subjects in each group. Then, the performance data of the three groups of subjects were recorded before and after stimulation to test their mental rotation ability, and resting state and task state electroencephalogram (EEG) data were collected. Finally, through comparative analysis of the behavioral data and EEG data of the three groups of subjects, the effect of electrical stimulation of different polarities on the three-dimensional mental rotation ability was explored. The results of the study found that the correct response time/accuracy rate and the accuracy rate performance of the anodal stimulation group were higher than those of the cathodal stimulation and sham stimulation groups, and there was a significant difference ( P < 0.05). The alpha wave power analysis found that the mental rotation mainly activates the frontal lobe, central area, parietal lobe and occipital lobe. In the anodal stimulation group, the alpha wave power changed significantly in the frontal lobe and occipital lobe ( P < 0.05). The results of this paper show that anodal stimulation group can improve the mental rotation ability of the subjects to a certain extent. The results of this paper can provide important theoretical support for further research on the mechanism of tDCS on mental rotation ability.
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Affiliation(s)
- 娅美 郭
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
- 中国航天员科研训练中心 人因工程国防科技重点实验室(北京 100094)Key Laboratory of Human Factors Engineering, China Astronaut Research and Training Centre, Beijing 100094, P.R.China
| | - 学军 焦
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
| | - 劲 姜
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
| | - 勇 曹
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
| | - 洪祚 楚
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
| | - 启杰 李
- 航天工程大学 研究生院(北京 101416)Department of Graduate School, Space Engineering University, Beijing 101416, P.R.China
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16
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Singh S, Meena AK, Sharma G, Deshpande SN. A pilot study on effect of adjunctive transcranial direct current stimulation on symptom domains of depression in patients with depressive disorder. Ind Psychiatry J 2021; 30:305-309. [PMID: 35017816 PMCID: PMC8709522 DOI: 10.4103/ipj.ipj_38_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/11/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Depression is a highly prevalent condition and includes clusters of symptoms, namely, depressive cognition, anxiety, and visceral symptoms. Depressive symptoms often respond sub-optimally to pharmacotherapy. Adjunctive transcranial direct current stimulation (tDCS), a noninvasive brain stimulation modality, may improve depressive symptomatology. AIM The aim of this study was to study the effect of tDCS as an augmentation strategy in depression and its various symptom domains. MATERIALS AND METHODS It is a prospective interventional study. Patients diagnosed with depressive disorder (based on International Classification of Disease- 10 criteria, diagnosed by treating psychiatrist), aged 18-70 years, who showed inadequate improvement on antidepressant selective serotonin reuptake inhibitors, were recruited after informed consent. Each participant was administered 20 sessions of tDCS over 2 weeks, each session of 20 min, with anode placement at left dorsolateral prefrontal cortex and cathode at right supraorbital region. Hamilton Rating Scale for Depression (HAM-D) was administered pre- and post-intervention to assess the change in symptoms. RESULTS Of a total of 35 participants, the mean score on HAM-D prior to and postintervention was 19.97 (standard deviation [SD] = 3.519) and 13.17 (SD = 3.365), respectively. The difference was statistically highly significant (P = 0.000) on paired t-test. All symptom domains of HAM-D, identified using the Cole and Motivala model (Cole et al., 2004), also showed significant reduction from pre-tDCS to post-tDCS scores (P = 0.000). CONCLUSION Positive effect of tDCS on depressive symptoms, its tolerability and safety profile, and affordability makes it an effective therapeutic strategy in augmenting antidepressants in patients with depression. However, longer period studies with larger sample size may yield more generalizable results.
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Affiliation(s)
- Shipra Singh
- Department of Psychiatry, Postgraduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Amit K Meena
- Department of Psychiatry, G.B. Pant Hospital, Delhi, India
| | - Gautam Sharma
- Department of Psychiatry, ABVIMS, Dr. R.M.L. Hospital, Delhi, India
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Rezaei M, Shariat Bagheri MM, Ahmadi M. Clinical and demographic predictors of response to anodal tDCS treatment in major depression disorder (MDD). J Psychiatr Res 2021; 138:68-74. [PMID: 33831679 DOI: 10.1016/j.jpsychires.2021.03.047] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/17/2021] [Accepted: 03/24/2021] [Indexed: 11/18/2022]
Abstract
Transcranial direct current stimulation (tDCS) of the prefrontal cortex is known as a promising intervention in major depression disorder (MDD). However, limited information on predictors of therapeutic response to tDCS are available. This study aimed to investigate clinical and demographic predictors of therapeutic response in patients taking no medications. For this purpose, the required data were collected from 2 independent tDCS trials on 116 MDD patients. Accordingly, 84 patients underwent 10 sessions of 2 mA tDCS daily each one lasted for 20 min and 32 patients received 10 twice sessions of 2 mA tDCS daily each one lasted for 20 min. Anodal electrode was located over the left dorsolateral prefrontal cortex (DLPFC), and cathode was over the right supraorbital region. Depression symptoms and the underlying clinical dimensions were assessed using the Beck Depression Inventory (BDI-II) at baseline and after the tDCS treatment. Of the included 116 patients, 47.4% showed an antidepressant response. Results of logistic regression analysis showed that the reduction in BDI-II scores after tDCS was associated with the baseline values of cognitive-affective symptoms factor, loss of pleasure, loss of interest, and sleep problems. Pronounced sleep disturbances and cognitive-affective symptoms were identified as the potential clinical predictors of response to tDCS. However, more prospective tDCS studies are necessary to validate the predictive value of the derived model.
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Affiliation(s)
- Mehdi Rezaei
- Department of Psychology, Shahryar Branch, Islamic Azad University, Shahryar, Iran.
| | | | - Mehdi Ahmadi
- Department of Clinical Psychology, Shahed University, Tehran, Iran
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18
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Towards the endotyping of the sleep-pain interaction: a topical review on multitarget strategies based on phenotypic vulnerabilities and putative pathways. Pain 2021; 162:1281-1288. [PMID: 33105436 DOI: 10.1097/j.pain.0000000000002124] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/20/2020] [Indexed: 12/17/2022]
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19
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Thibaut A, Shie VL, Ryan CM, Zafonte R, Ohrtman EA, Schneider JC, Fregni F. A review of burn symptoms and potential novel neural targets for non-invasive brain stimulation for treatment of burn sequelae. Burns 2021; 47:525-537. [PMID: 33293156 PMCID: PMC8685961 DOI: 10.1016/j.burns.2020.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 04/30/2020] [Accepted: 06/06/2020] [Indexed: 12/12/2022]
Abstract
Burn survivors experience myriad associated symptoms such as pain, pruritus, fatigue, impaired motor strength, post-traumatic stress, depression, anxiety, and sleep disturbance. Many of these symptoms are common and remain chronic, despite current standard of care. One potential novel intervention to target these post burn symptoms is transcranial direct current stimulation (tDCS). tDCS is a non-invasive brain stimulation (NIBS) technique that modulates neural excitability of a specific target or neural network. The aim of this work is to review the neural circuits of the aforementioned clinical sequelae associated with burn injuries and to provide a scientific rationale for specific NIBS targets that can potentially treat these conditions. We ran a systematic review, following the PRISMA statement, of tDCS effects on burn symptoms. Only three studies matched our criteria. One was a feasibility study assessing cortical plasticity in chronic neuropathic pain following burn injury, one looked at the effects of tDCS to reduce pain anxiety during burn wound care, and one assessed the effects of tDCS to manage pain and pruritus in burn survivors. Current literature on NIBS in burn remains limited, only a few trials have been conducted. Based on our review and results in other populations suffering from similar symptoms as patients with burn injuries, three main areas were selected: the prefrontal region, the parietal area and the motor cortex. Based on the importance of the prefrontal cortex in the emotional component of pain and its implication in various psychosocial symptoms, targeting this region may represent the most promising target. Our review of the neural circuitry involved in post burn symptoms and suggested targeted areas for stimulation provide a spring board for future study initiatives.
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Affiliation(s)
- Aurore Thibaut
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States; GIGA-Institute and Neurology Department, University of Liège and University Hospital of Liège, Liège, Belgium
| | - Vivian L Shie
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Colleen M Ryan
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Shriners Hospitals for Children-Boston, Boston, MA, United States
| | - Ross Zafonte
- Massachusetts General Hospital and Brigham and Women's Hospital, Boston, United States
| | - Emily A Ohrtman
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Jeffrey C Schneider
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
| | - Felipe Fregni
- Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States.
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20
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Cordone S, Scarpelli S, Alfonsi V, De Gennaro L, Gorgoni M. Sleep-Based Interventions in Alzheimer's Disease: Promising Approaches from Prevention to Treatment along the Disease Trajectory. Pharmaceuticals (Basel) 2021; 14:ph14040383. [PMID: 33921870 PMCID: PMC8073746 DOI: 10.3390/ph14040383] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/10/2021] [Accepted: 04/16/2021] [Indexed: 02/07/2023] Open
Abstract
The multifactorial nature of Alzheimer’s disease (AD) has led scientific researchers to focus on the modifiable and treatable risk factors of AD. Sleep fits into this context, given the bidirectional relationship with AD confirmed by several studies over the last years. Sleep disorders appear at an early stage of AD and continue throughout the entire course of the pathology. Specifically, sleep abnormalities, such as more fragmented sleep, increase in time of awakenings, worsening of sleep quality and primary sleep disorders raise with the severity and progression of AD. Intervening on sleep, therefore, means acting both with prevention strategies in the pre-clinical phase and with treatments during the course of the disease. This review explores sleep disturbances in the different stages of AD, starting from the pre-clinical stage. Particular attention is given to the empirical evidence investigating obstructive sleep apnea (OSA) disorder and the mechanisms overlapping and sharing with AD. Next, we discuss sleep-based intervention strategies in the healthy elderly population, mild cognitive impairment (MCI) and AD patients. We mention interventions related to behavioral strategies, combination therapies, and bright light therapy, leaving extensive space for new and raising evidence on continuous positive air pressure (CPAP) treatment effectiveness. Finally, we clarify the role of NREM sleep across the AD trajectory and consider the most recent studies based on the promising results of NREM sleep enhancement, which use innovative experimental designs and techniques.
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Affiliation(s)
- Susanna Cordone
- UniCamillus, Saint Camillus International University of Health Sciences, 00131 Rome, Italy;
| | - Serena Scarpelli
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
| | | | - Luigi De Gennaro
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy;
- Correspondence:
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome “Sapienza”, 00185 Rome, Italy; (S.S.); (M.G.)
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Masina F, Arcara G, Galletti E, Cinque I, Gamberini L, Mapelli D. Neurophysiological and behavioural effects of conventional and high definition tDCS. Sci Rep 2021; 11:7659. [PMID: 33828202 PMCID: PMC8027218 DOI: 10.1038/s41598-021-87371-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/26/2021] [Indexed: 11/09/2022] Open
Abstract
High-definition transcranial direct current stimulation (HD-tDCS) seems to overcome a drawback of traditional bipolar tDCS: the wide-spread diffusion of the electric field. Nevertheless, most of the differences that characterise the two techniques are based on mathematical simulations and not on real, behavioural and neurophysiological, data. The study aims to compare a widespread tDCS montage (i.e., a Conventional bipolar montage with extracephalic return electrode) and HD-tDCS, investigating differences both at a behavioural level, in terms of dexterity performance, and a neurophysiological level, as modifications of alpha and beta power as measured with EEG. Thirty participants took part in three sessions, one for each montage: Conventional tDCS, HD-tDCS, and sham. In all the conditions, the anode was placed over C4, while the cathode/s placed according to the montage. At baseline, during, and after each stimulation condition, dexterity was assessed with a Finger Tapping Task. In addition, resting-state EEG was recorded at baseline and after the stimulation. Power spectrum density was calculated, selecting two frequency bands: alpha (8-12 Hz) and beta (18-22 Hz). Linear mixed effect models (LMMs) were used to analyse the modulation induced by tDCS. To evaluate differences among the montages and consider state-dependency phenomenon, the post-stimulation measurements were covariate-adjusted for baseline levels. We observed that HD-tDCS induced an alpha power reduction in participants with lower alpha at baseline. Conversely, Conventional tDCS induced a beta power reduction in participants with higher beta at baseline. Furthermore, data showed a trend towards a behavioural effect of HD-tDCS in participants with lower beta at baseline showing faster response times. Conventional and HD-tDCS distinctively modulated cortical activity. The study highlights the importance of considering state-dependency to determine the effects of tDCS on individuals.
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Affiliation(s)
- Fabio Masina
- IRCCS San Camillo Hospital, Venice, Italy. .,Human Inspired Technologies Research Center, University of Padova, Padua, Italy.
| | | | - Eleonora Galletti
- Department of General Psychology, University of Padova, Padua, Italy
| | - Isabella Cinque
- Department of General Psychology, University of Padova, Padua, Italy
| | - Luciano Gamberini
- Human Inspired Technologies Research Center, University of Padova, Padua, Italy.,Department of General Psychology, University of Padova, Padua, Italy
| | - Daniela Mapelli
- Human Inspired Technologies Research Center, University of Padova, Padua, Italy.,Department of General Psychology, University of Padova, Padua, Italy
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Scarpelli S, Alfonsi V, Gorgoni M, Giannini AM, De Gennaro L. Investigation on Neurobiological Mechanisms of Dreaming in the New Decade. Brain Sci 2021; 11:brainsci11020220. [PMID: 33670180 PMCID: PMC7916906 DOI: 10.3390/brainsci11020220] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 02/05/2023] Open
Abstract
Dream research has advanced significantly over the last twenty years, thanks to the new applications of neuroimaging and electrophysiological techniques. Many findings pointed out that mental activity during sleep and wakefulness shared similar neural bases. On the other side, recent studies have highlighted that dream experience is promoted by significant brain activation, characterized by reduced low frequencies and increased rapid frequencies. Additionally, several studies confirmed that the posterior parietal area and prefrontal cortex are responsible for dream experience. Further, early results revealed that dreaming might be manipulated by sensory stimulations that would provoke the incorporation of specific cues into the dream scenario. Recently, transcranial stimulation techniques have been applied to modulate the level of consciousness during sleep, supporting previous findings and adding new information about neural correlates of dream recall. Overall, although multiple studies suggest that both the continuity and activation hypotheses provide a growing understanding of neural processes underlying dreaming, several issues are still unsolved. The impact of state-/trait-like variables, the influence of circadian and homeostatic factors, and the examination of parasomnia-like events to access dream contents are all opened issues deserving further deepening in future research.
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Affiliation(s)
- Serena Scarpelli
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (V.A.); (L.D.G.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (A.M.G.)
- Correspondence: ; Tel.: +39-06-4991-7508
| | - Valentina Alfonsi
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (V.A.); (L.D.G.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (A.M.G.)
| | - Anna Maria Giannini
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (A.M.G.)
| | - Luigi De Gennaro
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy; (V.A.); (L.D.G.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (A.M.G.)
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The effects of non-invasive brain stimulation on sleep disturbances among different neurological and neuropsychiatric conditions: A systematic review. Sleep Med Rev 2021; 55:101381. [DOI: 10.1016/j.smrv.2020.101381] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/17/2020] [Accepted: 06/09/2020] [Indexed: 12/11/2022]
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Cheng JX, Zhao X, Qiu J, Jiang Y, Ren J, Sun S, Wang R, Su C. Effects of transcranial direct current stimulation on performance and recovery sleep during acute sleep deprivation: a pilot study. Sleep Med 2021; 79:124-133. [PMID: 33524838 DOI: 10.1016/j.sleep.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies claimed that transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) improves cognition in neuropsychiatric patients with cognitive impairment, schizophrenia, organic hypersomnia, etc, but few studies evaluated the effects of tDCS on cognitive improvement following sleep deprivation. The objective of this study was to determine whether tDCS (anode on the left DLPFC and cathode on the right DLPFC with a 2-mA current for 30 min) improves cognition following sleep deprivation. METHODS Seven participants received active tDCS and eight participants received sham tDCS when their cognition declined during at least 30 h of sleep deprivation. All participants completed the psychomotor vigilance task, Trail Making Tests A and B, digit cancellation test, Stroop color word test, the Brief Visuospatial Memory Test-Revised and a procedural game every 2 h during the sleep deprivation and after recovery sleep. RESULTS Compared to the sham stimulation, active tDCS (anode on the left DLPFC and cathode on the right DLPFC at a 2-mA current for 30 min) had beneficial effects on attention, memory, executive function, processing speed, and the ability to inhibit cognitive interference, and improved in subjective drowsiness and fatigue following sleep deprivation. The lasting effect of a single tDCS on cognition during sleep deprivation was greater than 2 h. In all participants, tDCS did not disturb recovery sleep, and cognitive performance recovered to the baseline levels after recovery sleep. CONCLUSIONS The study results indicate that tDCS can improve cognition following sleep deprivation and does not disturb recovery sleep or cognitive performance after recovery sleep. The possible pathophysiological mechanisms might be related to the modulation of the corticothalamic pathway. We believe that tDCS can be applied in the treatment of sleep disorders involving sleepiness. TRIAL REGISTRATION NUMBER ChiCTR2000029420. DATE OF REGISTRATION 2020-1-31.
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Affiliation(s)
- Jin-Xiang Cheng
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
| | - Xianchao Zhao
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Jian Qiu
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Yingcong Jiang
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Jiafeng Ren
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Shuyu Sun
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Rong Wang
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Changjun Su
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
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Wang HX, Wang L, Zhang WR, Xue Q, Peng M, Sun ZC, Li LP, Wang K, Yang XT, Jia Y, Zhou QL, Xu ZX, Li N, Dong K, Zhang Q, Song HQ, Zhan SQ, Min BQ, Fan CQ, Zhou AH, Guo XH, Li HB, Liang LR, Yin L, Si TM, Huang J, Yan TY, Cosci F, Kamiya A, Lu J, Wang YP. Effect of Transcranial Alternating Current Stimulation for the Treatment of Chronic Insomnia: A Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Clinical Trial. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:38-47. [PMID: 31846980 DOI: 10.1159/000504609] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 11/05/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Not all adults with chronic insomnia respond to the recommended therapeutic options of cognitive behavioral therapy and approved hypnotic drugs. Transcranial alternating current stimulation (tACS) may offer a novel potential treatment modality for insomnia. OBJECTIVES This study aimed to examine the efficacy and safety of tACS for treating adult patients with chronic insomnia. METHODS Sixty-two participants with chronic primary insomnia received 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas in the laboratory on weekdays for 4 consecutive weeks, followed by a 4-week follow-up period. The primary outcome was response rate measured by the Pittsburgh Sleep Quality Index (PSQI) at week 8. Secondary outcomes were remission rate, insomnia severity, sleep onset latency (SOL), total sleep time (TST), sleep efficiency, sleep quality, daily disturbances, and adverse events at the end of the 4-week intervention and at the 4-week follow-up. RESULTS Of 62 randomized patients, 60 completed the trial. During the 4-week intervention, 1 subject per group withdrew due to loss of interest and time restriction, respectively. Based on PSQI, at 4-week follow-up, the active group had a higher response rate compared to the sham group (53.4% [16/30] vs. 16.7% [5/30], p = 0.009), but remission rates were not different between groups. At the end of the 4-week intervention, the active group had higher response and remission rates than the sham group (p < 0.001 and p = 0.026, respectively). During the trial, compared with the sham group, the active group showed a statistically significant decrease in PSQI total score, a shortened SOL, an increased TST, improved sleep efficiency, and improved sleep quality (p < 0.05 or p < 0.001). Post hoc analysis revealed that, in comparison with the sham group, the active group had improved symptoms, except for daily disturbances, at the end of the 4-week intervention, and significant improvements in all symptoms at the 4-week follow-up. No adverse events or serious adverse responses occurred during the study. CONCLUSION The findings show that the tACS applied in the present study has potential as an effective and safe intervention for chronic insomnia within 8 weeks.
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Affiliation(s)
- Hong-Xing Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China, .,Beijing Key Laboratory of Neuromodulation, Beijing, China, .,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China,
| | - Li Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Wen-Rui Zhang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qing Xue
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Mao Peng
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhi-Chao Sun
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li-Ping Li
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kun Wang
- Department of Neurology, Beijing Puren Hospital, Beijing, China
| | - Xiao-Tong Yang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Jia
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qi-Lin Zhou
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhe-Xue Xu
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ning Li
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kai Dong
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Qian Zhang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hai-Qing Song
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shu-Qin Zhan
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Bao-Quan Min
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Chun-Qiu Fan
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ai-Hong Zhou
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiu-Hua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Hai-Bin Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Li-Rong Liang
- Department of Epidemiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Lu Yin
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing, China
| | - Tian-Mei Si
- Peking University Sixth Hospital, Beijing, China
| | - Jing Huang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tian-Yi Yan
- School of Life Science, Beijing Institute of Technology, Beijing, China
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Atsushi Kamiya
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jie Lu
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu-Ping Wang
- Division of Neuropsychiatry and Psychosomatics, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Neuromodulation, Beijing, China.,Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China
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26
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A direct comparison of the electrophysiological effects of transcranial direct and alternating current stimulation in healthy subjects. Brain Res 2020; 1747:147065. [DOI: 10.1016/j.brainres.2020.147065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 08/10/2020] [Accepted: 08/14/2020] [Indexed: 12/21/2022]
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27
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Bystad M, Storø B, Gundersen N, Wiik IL, Nordvang L, Grønli O, Rasmussen ID, Aslaksen PM. Can accelerated transcranial direct current stimulation improve memory functions? An experimental, placebo-controlled study. Heliyon 2020; 6:e05132. [PMID: 33033765 PMCID: PMC7533366 DOI: 10.1016/j.heliyon.2020.e05132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 07/18/2020] [Accepted: 09/28/2020] [Indexed: 02/07/2023] Open
Abstract
The aim of this study was to investigate whether transcranial Direct Current Stimulation (tDCS) could improve verbal memory functions in healthy old and younger participants. We hypothesized that active tDCS led to significantly improved memory function, compared to placebo tDCS. Forty healthy participants (20 old and 20 younger participants) were included in the study. We applied a novel stimulation protocol, where six sessions of anodal tDCS were administrated during two consecutive days. Each tDCS session lasted 30 min. The current intensity was 2mA and the stimulation area was the left temporal lobe at T3 in the 10-20 EEG system. Immediate recall, delayed recall and recognition memory were assessed with California Verbal Learning Test II (CVLT-II) and executive functions were assessed with the Trail Making Test (TMT) before the first tDCS session and after the last tDCS session. Half of the participants received placebo tDCS, whereas the other half received active tDCS. We did not reveal any significant differences between active and placebo tDCS in memory functions. However, there was a significant difference between active and placebo tDCS in executive function measured by the Trail Making Test (TMT). This experimental study failed to reveal significant differences between active and placebo accelerated tDCS for verbal memory functions. However, accelerated tDCS was found to be well-tolerated in this study.
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Affiliation(s)
- Martin Bystad
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, University of Tromsø, Norway.,Department of Geropsychiatry, University Hospital of North Norway, Norway
| | - Benedicte Storø
- Department of Psychology, Faculty of Health Sciences, University of Tromsø, Norway
| | - Nina Gundersen
- Department of Psychology, Faculty of Health Sciences, University of Tromsø, Norway
| | - Ida Larsen Wiik
- Department of Psychology, Faculty of Health Sciences, University of Tromsø, Norway
| | - Lene Nordvang
- Department of Psychology, Faculty of Health Sciences, University of Tromsø, Norway
| | - Ole Grønli
- Department of Geropsychiatry, University Hospital of North Norway, Norway
| | - Ingrid Daae Rasmussen
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, University of Tromsø, Norway
| | - Per M Aslaksen
- Department of Psychology, Research Group for Cognitive Neuroscience, Faculty of Health Sciences, University of Tromsø, Norway.,Department of Child and Adolescent Psychiatry, University Hospital of North Norway, Norway
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Gorgoni M, Scarpelli S, Reda F, De Gennaro L. Sleep EEG oscillations in neurodevelopmental disorders without intellectual disabilities. Sleep Med Rev 2020; 49:101224. [PMID: 31731102 DOI: 10.1016/j.smrv.2019.101224] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 08/29/2019] [Accepted: 10/15/2019] [Indexed: 02/08/2023]
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Abstract
Sleep spindles are burstlike signals in the electroencephalogram (EEG) of the sleeping mammalian brain and electrical surface correlates of neuronal oscillations in thalamus. As one of the most inheritable sleep EEG signatures, sleep spindles probably reflect the strength and malleability of thalamocortical circuits that underlie individual cognitive profiles. We review the characteristics, organization, regulation, and origins of sleep spindles and their implication in non-rapid-eye-movement sleep (NREMS) and its functions, focusing on human and rodent. Spatially, sleep spindle-related neuronal activity appears on scales ranging from small thalamic circuits to functional cortical areas, and generates a cortical state favoring intracortical plasticity while limiting cortical output. Temporally, sleep spindles are discrete events, part of a continuous power band, and elements grouped on an infraslow time scale over which NREMS alternates between continuity and fragility. We synthesize diverse and seemingly unlinked functions of sleep spindles for sleep architecture, sensory processing, synaptic plasticity, memory formation, and cognitive abilities into a unifying sleep spindle concept, according to which sleep spindles 1) generate neural conditions of large-scale functional connectivity and plasticity that outlast their appearance as discrete EEG events, 2) appear preferentially in thalamic circuits engaged in learning and attention-based experience during wakefulness, and 3) enable a selective reactivation and routing of wake-instated neuronal traces between brain areas such as hippocampus and cortex. Their fine spatiotemporal organization reflects NREMS as a physiological state coordinated over brain and body and may indicate, if not anticipate and ultimately differentiate, pathologies in sleep and neurodevelopmental, -degenerative, and -psychiatric conditions.
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Affiliation(s)
- Laura M J Fernandez
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
| | - Anita Lüthi
- Department of Fundamental Neurosciences, University of Lausanne, Lausanne, Switzerland
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Distinct Montages of Slow Oscillatory Transcranial Direct Current Stimulation (so-tDCS) Constitute Different Mechanisms during Quiet Wakefulness. Brain Sci 2019; 9:brainsci9110324. [PMID: 31739576 PMCID: PMC6896026 DOI: 10.3390/brainsci9110324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/06/2019] [Accepted: 11/11/2019] [Indexed: 12/13/2022] Open
Abstract
Slow oscillatory- (so-) tDCS has been applied in many sleep studies aimed to modulate brain rhythms of slow wave sleep and memory consolidation. Yet, so-tDCS may also modify coupled oscillatory networks. Efficacy of weak electric brain stimulation is however variable and dependent upon the brain state at the time of stimulation (subject and/or task-related) as well as on stimulation parameters (e.g., electrode placement and applied current. Anodal so-tDCS was applied during wakefulness with eyes-closed to examine efficacy when deviating from the dominant brain rhythm. Additionally, montages of different electrodes size and applied current strength were used. During a period of quiet wakefulness bilateral frontolateral stimulation (F3, F4; return electrodes at ipsilateral mastoids) was applied to two groups: ‘Group small’ (n = 16, f:8; small electrodes: 0.50 cm2; maximal current per electrode pair: 0.26 mA) and ‘Group Large’ (n = 16, f:8; 35 cm2; 0.35 mA). Anodal so-tDCS (0.75 Hz) was applied in five blocks of 5 min epochs with 1 min stimulation-free epochs between the blocks. A finger sequence tapping task (FSTT) was used to induce comparable cortical activity across sessions and subject groups. So-tDCS resulted in a suppression of alpha power over the parietal cortex. Interestingly, in Group Small alpha suppression occurred over the standard band (8–12 Hz), whereas for Group Large power of individual alpha frequency was suppressed. Group Small also revealed a decrease in FSTT performance at retest after stimulation. It is essential to include concordant measures of behavioral and brain activity to help understand variability and poor reproducibility in oscillatory-tDCS studies.
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31
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Kosari Z, Dadashi M, Maghbouli M, Mostafavi H. Comparing the Effectiveness of Neurofeedback and Transcranial Direct Current Stimulation on Sleep Quality of Patients With Migraine. Basic Clin Neurosci 2019; 10:579-588. [PMID: 32477475 PMCID: PMC7253802 DOI: 10.32598/bcn.10.6.651.3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/25/2019] [Accepted: 09/24/2019] [Indexed: 02/06/2023] Open
Abstract
Introduction Migraine is considered one of the most common primary headache disorders. Migraine attacks may occur due to a lack of sleep. Furthermore, sleep is regarded as one of the smoothing factors of migraine pain. Patients with sleep disorders often suffer from headaches when they wake up compared with healthy individuals. Methods This research was a quasi-experimental study with a pre-test-post-test design and a 2-month follow-up. The samples included 20 migraine patients within the age range of 15 to 55 years who were selected as volunteers for treatment by the neurologists and psychiatrists during 2017. The initial evaluation was then conducted based on the inclusion and exclusion criteria and using the Ahvaz migraine questionnaire, and Pittsburgh sleep quality index. The patients were randomly assigned to two neurofeedback (n=10) and transcranial Direct Current Stimulation (tDCS) (n=10) groups and evaluated three times. The obtained data were analyzed by the repeated measures ANCOVA and Chi-square test in SPSS. Results Based on the scores of both groups, no significant difference was observed between neurofeedback and tDCS groups. However, based on the results, neurofeedback decreased sleep latency, whereas tDCS increased sleep efficiency. Overall, these two treatments were effective in improving subjective sleep quality and sleep quality. Conclusion Both neurofeedback and tDCS treatments could significantly enhance sleep quality of the patients in the post-test and 2-month follow-up. Given the effectiveness of both treatments, neurofeedback and tDCS are recommended to be used for improving the sleep status of patients with migraine.
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Affiliation(s)
- Zahra Kosari
- Department of Clinical Psychology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohsen Dadashi
- Department of Clinical Psychology, Social Determinants of Health Research Center, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahdi Maghbouli
- Department of Neurology, Faculty of Medicine, Vali Asr Hospital, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Hossin Mostafavi
- Department of Physiology, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Donaldson PH, Kirkovski M, Yang JS, Bekkali S, Enticott PG. High-definition tDCS to the right temporoparietal junction modulates slow-wave resting state power and coherence in healthy adults. J Neurophysiol 2019; 122:1735-1744. [DOI: 10.1152/jn.00338.2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The right temporoparietal junction (rTPJ) is a multisensory integration hub that is increasingly utilized as a target of stimulation studies exploring its rich functional network roles and potential clinical applications. While transcranial direct current stimulation (tDCS) is frequently employed in such studies, there is still relatively little known regarding its local and network neurophysiological effects, particularly at important nonmotor sites such as the rTPJ. The current study applied either anodal, cathodal, or sham high-definition tDCS to the rTPJ of 53 healthy participants and used offline EEG to assess the impacts of stimulation on resting state (eyes open and eyes closed) band power and coherence. Temporoparietal and central region delta power was increased after anodal stimulation (the latter trend only), whereas cathodal stimulation increased frontal region delta and theta power. Increased coherence between right and left temporoparietal regions was also observed after anodal stimulation. All significant effects occurred in the eyes open condition. These findings are discussed with reference to domain general and mechanistic theories of rTPJ function. Low-frequency oscillatory activity may exert long-range inhibitory network influences that enable switching between and integration of endogenous/exogenous processing streams.NEW & NOTEWORTHY Through the novel use of high-definition transcranial direct current stimulation (tDCS) and EEG, we provide evidence that both anodal and cathodal stimulation of the right temporoparietal junction selectively modulate slow-wave power and coherence in distributed network regions of known relevance to proposed temporoparietal junction functionality. These results also provide direct evidence of the ability of tDCS to modulate oscillatory activity at a long-range network level, which may have explanatory power in terms of both neurophysiological and behavioral effects.
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Affiliation(s)
| | - Melissa Kirkovski
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Joel S. Yang
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Soukayna Bekkali
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Peter G. Enticott
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Al-Shargie F, Tariq U, Mir H, Alawar H, Babiloni F, Al-Nashash H. Vigilance Decrement and Enhancement Techniques: A Review. Brain Sci 2019; 9:E178. [PMID: 31357524 PMCID: PMC6721323 DOI: 10.3390/brainsci9080178] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 01/05/2023] Open
Abstract
This paper presents the first comprehensive review on vigilance enhancement using both conventional and unconventional means, and further discusses the resulting contradictory findings. It highlights the key differences observed between the research findings and argues that variations of the experimental protocol could be a significant contributing factor towards such contradictory results. Furthermore, the paper reveals the effectiveness of unconventional means of enhancement in significant reduction of vigilance decrement compared to conventional means. Meanwhile, a discussion on the challenges of enhancement techniques is presented, with several suggested recommendations and alternative strategies to maintain an adequate level of vigilance for the task at hand. Additionally, this review provides evidence in support of the use of unconventional means of enhancement on vigilance studies, regardless of their practical challenges.
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Affiliation(s)
- Fares Al-Shargie
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates.
| | - Usman Tariq
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Hasan Mir
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
| | - Hamad Alawar
- Dubai Police Headquarters, Dubai 1493, United Arab Emirates
| | - Fabio Babiloni
- Dept. Molecular Medicine, University of Rome Sapienza, 00185 Rome, Italy
- College of Computer Science and Technology, Hangzhou Dianzi University, Hangzhou 310018, China
| | - Hasan Al-Nashash
- Department of Electrical Engineering, Biosciences and Bioengineering Research Institute, American University of Sharjah, Sharjah 26666, United Arab Emirates
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34
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Gorgoni M, Bartolacci C, D’Atri A, Scarpelli S, Marzano C, Moroni F, Ferrara M, De Gennaro L. The Spatiotemporal Pattern of the Human Electroencephalogram at Sleep Onset After a Period of Prolonged Wakefulness. Front Neurosci 2019; 13:312. [PMID: 31001079 PMCID: PMC6456684 DOI: 10.3389/fnins.2019.00312] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/19/2019] [Indexed: 02/05/2023] Open
Abstract
During the sleep onset (SO) process, the human electroencephalogram (EEG) is characterized by an orchestrated pattern of spatiotemporal changes. Sleep deprivation (SD) strongly affects both wake and sleep EEG, but a description of the topographical EEG power spectra and oscillatory activity during the wake-sleep transition after a period of prolonged wakefulness is still missing. The increased homeostatic sleep pressure should induce an earlier onset of sleep-related EEG oscillations. The aim of the present study was to assess the spatiotemporal EEG pattern at SO following SD. A dataset of a previous study was analyzed. We assessed the spatiotemporal EEG changes (19 cortical derivations) during the SO (5 min before vs. 5 min after the first epoch of Stage 2) of a recovery night after 40 h of SD in 39 healthy subjects, analyzing the EEG power spectra (fast Fourier transform) and the oscillatory activity [better oscillation (BOSC) detection method]. The spatiotemporal pattern of the EEG power spectra mostly confirmed the changes previously observed during the wake-sleep transition at baseline. The comparison between baseline and recovery showed a wide increase of the post- vs. pre-SO ratio during the recovery night in the frequency bins ≤10 Hz. We found a predominant alpha oscillatory rhythm in the pre-SO period, while after SO the theta oscillatory activity was prevalent. The oscillatory peaks showed a generalized increase in all frequency bands from delta to sigma with different predominance, while beta activity increased only in the fronto-central midline derivations. Overall, the analysis of the EEG power replicated the topographical pattern observed during a baseline night of sleep but with a stronger intensity of the SO-induced changes in the frequencies ≤10 Hz, and the detection of the rhythmic activity showed the rise of several oscillations at SO after SD that was not observed during the wake-sleep transition at baseline (e.g., alpha and frontal theta in correspondence of their frequency peaks). Beyond confirming the local nature of the EEG pattern at SO, our results show that SD has an impact on the spatiotemporal modulation of cortical activity during the falling-asleep process, inducing the earlier emergence of sleep-related EEG oscillations.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Aurora D’Atri
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Cristina Marzano
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Fabio Moroni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, L’Aquila, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- IRCCS Santa Lucia Foundation, Rome, Italy
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D'Atri A, Scarpelli S, Gorgoni M, Alfonsi V, Annarumma L, Giannini AM, Ferrara M, Ferlazzo F, Rossini PM, De Gennaro L. Bilateral Theta Transcranial Alternating Current Stimulation (tACS) Modulates EEG Activity: When tACS Works Awake It Also Works Asleep. Nat Sci Sleep 2019; 11:343-356. [PMID: 31819688 PMCID: PMC6875492 DOI: 10.2147/nss.s229925] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 10/21/2019] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Recent studies demonstrate that 5-Hz bilateral transcranial alternating current stimulation (θ-tACS) on fronto-temporal areas affects resting EEG enhancing cortical synchronization, but it does not affect subjective sleepiness. This dissociation raises questions on the resemblance of this effect to the physiological falling asleep process. The current study aimed to evaluate the ability of fronto-temporal θ-tACS to promote sleep. SUBJECTS AND METHODS Twenty subjects (10 F/10 M; mean age: 24.60 ± 2.9 y) participated in a single-blind study consisting of two within-subject sessions (active/sham), one week apart in counterbalanced order. Stimulation effects on EEG were assessed during wake and post-stimulation nap. The final sample included participants who fell asleep in both sessions (n=17). RESULTS Group analyses on the whole sample reported no θ-tACS effects on subjective sleepiness and sleep measures, while a different scenario came to light by analysing data of responders to the stimulation (ie, subjects actually showing the expected increase of theta activity in the wake EEG after the θ-tACS, n=7). Responders reported a significant increase in subjective sleepiness during wakefulness after the active stimulation as compared to the sham. Moreover, the sleep after the θ-tACS compared to sham in this sub-group showed: (1) greater slow-wave activity (SWA); (2) SWA time-course revealing increases much larger as closer to the sleep onset; (3) stimulation-induced changes in SWA during sleep topographically associated to those in theta activity during wake. CONCLUSION Subjects who show the expected changes during wake after the stimulation also had a consistent pattern of changes during sleep. The enhancement of cortical synchronization by θ-tACS during wakefulness actually corresponds to increased sleep pressure, but it occurs only in some individuals. Thus, θ-tACS can enhance sleep, although individual factors to be further investigated affect the actual responsiveness to this treatment.
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Affiliation(s)
- Aurora D'Atri
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,Area of Neuroscience, IRCCS San Raffaele Pisana, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | - Valentina Alfonsi
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | | | | | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Fabio Ferlazzo
- Department of Psychology, University of Rome "Sapienza", Rome, Italy
| | - Paolo Maria Rossini
- Institute of Neurology, Catholic University of the Sacred Heart, Rome, Italy.,Department Geriatrics, Neuroscience & Orthopaedics, Policlinic A. Gemelli Foundation-IRCCS, Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, University of Rome "Sapienza", Rome, Italy.,Area of Neuroscience, IRCCS San Raffaele Pisana, Rome, Italy
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