Distinct Montages of Slow Oscillatory Transcranial Direct Current Stimulation (so-tDCS) Constitute Different Mechanisms during Quiet Wakefulness

Abnormal EEG Signal Energy in the Elderly: A Wavelet Analysis of Event-related Potentials During a Stroop Task

BACKGROUND

Previous work showed that elderly with excess in theta activity in their resting state electroencephalogram (EEG) are at higher risk of cognitive decline than those with a normal EEG. By using event-related potentials (ERP) during a counting Stroop task, our prior work showed that elderly with theta excess have a large P300 component compared with normal EEG group. This increased activity could be related to a higher EEG signal energy used during this task.

NEW METHOD

By wavelet analysis applied to ERP obtained during a counting Stroop task we quantified the energy in the different frequency bands of a group of elderly with altered EEG.

RESULTS

In theta and alpha bands, the total energy was higher in elderly subjects with theta excess, specifically in the stimulus categorization window (258-516 ms). Both groups solved the task with similar efficiency.

COMPARISON WITH EXISTING METHODS

The traditional ERP analysis in elderly compares voltage among conditions and groups for a given time windows, while the frequency composition is not usually examined. We complemented our previous ERP analysis using a wavelet methodology. Furthermore, we showed the advantages of wavelet analysis over Short Time Fourier Transform when exploring EEG signal during this task.

CONCLUSIONS

The higher EEG signal energy in ERP might reflect undergoing neurobiological mechanisms that allow the elderly with theta excess to cope with the cognitive task with similar behavioral results as the normal EEG group. This increased energy could promote a metabolic and cellular dysregulation causing a greater decline in cognitive function.

Effect of the anodal transcranial direct current electrical stimulation on cognition of medical residents with acute sleep deprivation

Background

Medical residents must sustain acute sleep deprivation, which can lead to nonfatal and fatal consequences in hospitals due to cognitive decline. Anodal transcranial direct current stimulation (a-tDCS) is a safe noninvasive neuromodulation technique that can induce depolarization of neurons. Previous studies in pilots have shown benefits against fatigue increasing wakefulness and cognitive performance. However, the effects of a-tDCS on cognition in acute sleep deprived healthcare workers remains unknown.

Purpose

To evaluate cognitive changes in sleep deprived medical residents after one session of a-tDCS.

Methods

Open clinical test-re-test study including 13 medical residents with acute sleep deprivation. Subjects received 1 session of bifrontal a-tDCS (2mAx20min), anodal over the left dorsolateral prefrontal region. Pre-and-post treatment subjects were tested with Beck anxiety inventory, Beck depression and HVLT tests, Rey´s and Taylor´s figures, Trail Making A/B, Stroop, Aleatory Digit retention test (WAIS), Digits and symbols and MoCA tests. Post-intervention was added the Executive functions and Frontal Lobes Neuropsychological Battery (BANFE2) test and changing the Taylor figure for Reyfigure.

Results

Twelve medical residents were analyzed; 8 men and 4 women, 29.5 (+/-2.2) years mean age. All had a mean of 21.6 (+/-1.3) hours of sleep deprivation. There were no serious adverse events. We found statistically significant difference in Rey´s/Taylor´s figures (p=0.002), Trail Making Test (p=0.005), WAIS IV symbols (p=0.003), Word Stroop (p=0.021). BANFE-2 showed that the main affected area was the orbito-medial prefrontal region.

Conclusion

a-tDCS appears safe and improves working memory, attention, response time and distractors elimination in acute sleep deprived medical residents.