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Winker M, Hoffmann S, Laborde S, Javelle F. The acute effects of motor cortex transcranial direct current stimulation on athletic performance in healthy adults: A systematic review and meta-analysis. Eur J Neurosci 2024; 60:5086-5110. [PMID: 39120435 DOI: 10.1111/ejn.16488] [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: 12/21/2023] [Revised: 07/02/2024] [Accepted: 07/13/2024] [Indexed: 08/10/2024]
Abstract
This systematic review and meta-analysis assesses independently the acute effects of anodal and cathodal motor cortex transcranial direct current stimulation (tDCS) on athletic performance in healthy adults. Besides, it evaluates the unique and conjoint effects of potential moderators (i.e., stimulation parameters, exercise type, subjects' training status and risk of bias). Online database search was performed from inception until March 18th 2024 (PROSPERO: CRD42023355461). Forty-three controlled trials were included in the systematic review, 40 in the anodal tDCS meta-analysis (68 effects), and 9 (11 effects) in the cathodal tDCS meta-analysis. Performance enhancement between pre- and post-stimulation was the main outcome measure considered. The anodal tDCS effects on physical performance were small to moderate (g = .29, 95%CI [.18, .40], PI = -.64 to 1.23, I2 = 64.0%). Exercise type, training status and use of commercial tDCS were significant moderators of the results. The cathodal tDCS effects were null (g = .04, 95%CI [-.05, .12], PI = -.14 to .23, I2 = 0%), with a small to moderate heterogeneity entirely due to sampling error, thus impairing further moderator analysis. These findings hold significant implications for the field of brain stimulation and physical performance, as they not only demonstrate a small to moderate effect of acute tDCS but also identify specific categories of individuals, devices and activities that are more susceptible to improvements. By addressing the multidimensional factors influencing the mechanisms of tDCS, we also provide suggestions for future research.
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Affiliation(s)
- Matteo Winker
- University of Cologne, Cologne, Germany
- Institute for Sport and Sport Science, Performance and Health (Sports Medicine), TU Dortmund University, Dortmund, Germany
- Department for Molecular and Cellular Sports Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Sven Hoffmann
- Psychological Methods and Evaluation, Institute of Psychology, University of Hagen, Hagen, Germany
| | - Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Florian Javelle
- NeuroPsychoImmunology research unit, Department for Molecular and Cellular Sports Medicine, Institute for Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
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de Souza Souto JJ, Edite Casé de Oliveira M, Silva GM, Nascimento de Sousa JM, Fernandes Franco CI, Dos Santos NA. Transcranial direct current stimulation and cognitive changes in Parkinson's disease, a systematic review with meta-analysis and meta-regression. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-11. [PMID: 38967481 DOI: 10.1080/23279095.2024.2367108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
Parkinson's disease is the second most common neurodegenerative disease, but therapeutic options such as neuromodulation continue to show variable effects, making clinical management of the disease difficult. This systematic review with meta-analysis and meta-regression aimed to analyze the isolated effect of cortical modulation with transcranial direct current stimulation (tDCS) compared to sham stimulation on cognitive changes in people with Parkinson's disease. The databases used were: Web of Science, Scopus, PsycINFO, PubMed, and Cochrane. The results showed that tDCS can influence the improvement of cognition in PD (Inverse Variance:0.24 [95% Confidence Interval: 0.09 to -0.40], p < 0.00). The meta-analysis showed that active tDCS can influence cognitive function by improving aspects related to memory (Inverse Variance:0.34 [95% Confidence Interval: 0.07 to 0.61], p < 0.01) and reducing reaction time in cognitive tasks (Inverse Variance:0.42 [95% Confidence Interval: 0.07 to 0.76], p < 0.02). Innovative meta-regression analyses showed that variables such as age (Q = 2.54, df = 1, p < 0.11), education level (Q = 2.62, df = 1, p < 0.10), disease duration (Q = 0.01, df = 1, p < 0.92), and Unified PD Rating Scale stage (Q = 0.01, df = 1, p < 0.92) did not influence the results. Thus, tDCS may be a therapeutic option for cognitive changes in people with PD, and we suggest further studies to identify protocols that can be replicated.
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Hafezi S, Doustan M, Saemi E. The Effect of Brain Anodal and Cathodal Transcranial Direct Current Stimulation on Psychological Refractory Period at Different Stimulus-Onset Asynchrony in Non-Fatigue and Mental Fatigue Conditions. Brain Sci 2024; 14:477. [PMID: 38790455 PMCID: PMC11118837 DOI: 10.3390/brainsci14050477] [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: 04/08/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024] Open
Abstract
The psychological refractory period (PRP) effect occurs when two stimuli that require separate responses are presented sequentially, particularly with a short and variable time interval between them. Fatigue is a suboptimal psycho-physiological state that leads to changes in strategies. In recent years, numerous studies have investigated the effects of transcranial direct current stimulation (tDCS) on motor control. The present study aimed to investigate the effects of two tDCS methods, anodal and cathodal, on PRP in ten different conditions of stimulus-onset asynchronies (SOAs) under non-fatigue and mental fatigue conditions. The participants involved 39 male university students aged 19 to 25 years. In the pre-test, they were assessed using the PRP measurement tool under both non-fatigue and mental fatigue conditions. The mental fatigue was induced by a 30-min Stroop task. The test consisted of two stimuli with different SOAs (50, 75, 100, 150, 300, 400, 600, 900, 1200, and 1500 ms). The first was a visual stimulus with three choices (letters A, B, and C). After a random SOA, the second stimulus, a visual stimulus with three choices (colors red, yellow, and blue), was presented. Subsequently, participants were randomly assigned to the anodal, cathodal, and sham stimulation groups and underwent four consecutive sessions of tDCS stimulation. In the anodal and cathodal stimulation groups, 20 min of tDCS stimulation were applied to the PLPFC area in each session, while in the sham group, the stimulation was artificially applied. All participants were assessed using the same measurement tools as in the pre-test phase, in a post-test phase one day after the last stimulation session, and in a follow-up phase four days after that. Inferential statistics include mixed ANOVA, one-way ANOVA, independent, and dependent t-tests. The findings indicated that the response time to the second stimulus was longer at lower SOAs. However, there was no significant difference between the groups in this regard. Additionally, there was no significant difference in response time to the second stimulus between the fatigue and non-fatigue conditions, or between the groups. Therefore, tDCS had no significant effect. There was a significant difference between mental fatigue and non-fatigue conditions in the psychological refractory period. Moreover, at lower SOAs, the PRP was longer than at higher SOAs. In conditions of fatigue, the active stimulation groups (anodal and cathodal) performed better than the sham stimulation group at higher SOAs. Considering the difference in response to both stimuli at different SOAs, some central aspects of the response can be simultaneously parallel. Fatigue also affects parallel processing. This study supports the response integration phenomenon in PRP, which predicts that there will be an increase in response time to the first stimulus as the interval between the presentation of the two stimuli increases. This finding contradicts the bottleneck model. In this study, the effectiveness of cathodal and anodal tDCS on response time to the second stimulus and PRP was found to be very small.
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Affiliation(s)
| | - Mohammadreza Doustan
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz 6135783151, Iran; (S.H.); (E.S.)
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Dai J, Xiao Y, Chen G, Gu Z, Xu K. Anodal transcranial direct current stimulation enhances response inhibition and attention allocation in fencers. PeerJ 2024; 12:e17288. [PMID: 38699193 PMCID: PMC11064870 DOI: 10.7717/peerj.17288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
Background The aim of this study is to investigate the acute effects of anodal transcranial direct current stimulation (tDCS) on reaction time, response inhibition and attention in fencers. Methods Sixteen professional female fencers were recruited, and subjected to anodal tDCS and sham stimulation in the primary motor area (M1) one week apart in a randomized, crossover, single-blind design. A two-factor analysis of variance with repeated measures was used to analyze the effects of stimulation conditions (anodal stimulation, sham stimulation) and time (pre-stimulation, post-stimulation) on reaction time, response inhibition, and attention in fencers. Results The study found a significant improvement in response inhibition and attention allocation from pre-stimulation to post-stimulation following anodal tDCS but not after sham stimulation. There was no statistically significant improvement in reaction time and selective attention. Conclusions A single session of anodal tDCS could improve response inhibition, attention allocation in female fencers. This shows that tDCS has potential to improve aspects of an athlete's cognitive performance, although we do not know if such improvements would transfer to improved performance in competition. However, more studies involving all genders, large samples, and different sports groups are needed in the future to further validate the effect of tDCS in improving the cognitive performance of athletes.
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Affiliation(s)
- Jiansong Dai
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Yang Xiao
- Department of Graduate, Nanjing Sport Institute, Nanjing, China
| | - Gangrui Chen
- Department of Sport Research, Nanjing Sport Institute, Nanjing, China
| | - Zhongke Gu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
| | - Kai Xu
- Department of Sport and Health Sciences, Nanjing Sport Institute, Nanjing, China
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Kamali AM, Ijadi M, Keshtkarhesamabadi B, Kazemiha M, Mahmoudi R, Roozbehi A, Nami M. A dual-mode neurostimulation approach to enhance athletic performance outcome in experienced taekwondo practitioners. Sci Rep 2023; 13:251. [PMID: 36604440 PMCID: PMC9816304 DOI: 10.1038/s41598-022-26610-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/16/2022] [Indexed: 01/07/2023] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) is a growing empirical approach to improve athletic performance. Some recent studies have investigated the effects of transcutaneous spinal direct current stimulation (tsDCS) on the motor performance such as reaction time. TDCS and tsDCS can lead to alteration of the spontaneous neural activity, and the membrane potentials of motor neurons in cerebral cortex and spinal interneurons, respectively. Given the paucity of experimental studies on the non-invasive brain stimulation in the field of sports neuroscience, especially martial sports, the present study aimed at investigating the effects of neurostimulation in potentiating the motor and cognitive functions in experienced taekwondo practitioners. The study sample included 15 experienced male taekwondo players who received real or sham direct current stimulation on the primary motor cortex (M1) and the lumbar spinal segment (T12-L2) over two sessions, 72 h apart. Next, the performance of the participants was evaluated through a simulation of taekwondo exercise directly after the sham and real sessions. Moreover, a cognitive platform (CBS: Cambridge Brain Science) was used to investigate the participants' cognitive profile in each instance. Unlike sham stimulation, real tDCS was associated with improved selective attention and reaction time in both in the simulated task performance and cognitive examination. The concurrent cortical and trans-spinal tDCS was found to improve selective attention (31% performance improvement) (P < 0.0001) [EFFECT SIZE; 1.84]. and reduce reaction time (4.7% performance improvement) (P < 0.0001) [EFFECT SIZE; 0.02]. Meanwhile, the intervention failed to leave a significant change in cognitive functions evaluated through CBS (P > 0.05). As informed by our results, the present dual-mode neurostimulation could improve motor functions potentially through the effect of tsDCS over the spinal interneurons and tDCS over the primary motor cortex. Likewise, our findings suggested an improved performance in simulated taekwondo task after real- but not sham-stimulation. This study paves the way for designing neurostimulation protocols to improve the performance of professional athletes, namely martial art practitioners, including their accuracy and velocity of reactions. Such positive effects of neuostimulation in athletic performance as demonstrated in this research and similar reports are expected to enhance the athletes' success in professional competitions.
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Affiliation(s)
- Ali-Mohammad Kamali
- grid.412571.40000 0000 8819 4698Neuroscience Laboratory, NSL (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran ,Iranian Neuroscience Society-Fars Chapter, DANA Brain Health Institute, Shiraz, Iran
| | - Mojtaba Ijadi
- grid.413020.40000 0004 0384 8939Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Behnam Keshtkarhesamabadi
- Iranian Neuroscience Society-Fars Chapter, DANA Brain Health Institute, Shiraz, Iran ,High Performance Brain, Helena Félix Street, No. 7 to 7 D, 1600-121 Lisbon, Portugal
| | - Milad Kazemiha
- grid.412571.40000 0000 8819 4698Neuroscience Laboratory, NSL (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran ,Iranian Neuroscience Society-Fars Chapter, DANA Brain Health Institute, Shiraz, Iran
| | - Reza Mahmoudi
- grid.413020.40000 0004 0384 8939Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Amrollah Roozbehi
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran.
| | - Mohammad Nami
- Neuroscience Laboratory, NSL (Brain, Cognition and Behavior), Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran. .,Iranian Neuroscience Society-Fars Chapter, DANA Brain Health Institute, Shiraz, Iran. .,Instituto de Investigaciones Científicas Y Servicios de Alta Tecnología (INDICASAT AIP), City of Knowledge, Neuroscience Center, Panama City, Panama. .,Harvard Alumni in Healthcare, Harvard University, Boston, MA, USA. .,Brain, Cognition, and Behavior Unit, BrainHub Academy, Dubai, United Arab Emirates.
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Huang YJ, Wang SM, Chen C, Chen CA, Wu CW, Chen JJ, Peng CW, Lin CW, Huang SW, Chen SC. High-Definition Transcranial Direct Current with Electrical Theta Burst on Post-Stroke Motor Rehabilitation: A Pilot Randomized Controlled Trial. Neurorehabil Neural Repair 2022; 36:645-654. [PMID: 36047662 DOI: 10.1177/15459683221121751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND High-definition transcranial electrical theta burst superimposing direct current stimulation (HD-tDCS-eTBS) not only incorporates the therapeutic advantages of tDCS and TBS but enhances stimulation focality and practicality. However, the applicability of this innovative neuromodulatory device in post-stroke rehabilitation remains uncertain. OBJECTIVE This study aimed to assess the efficacy and safety of the HD-tDCS-eTBS on upper extremity (UE) motor function in patients with chronic stroke. METHODS A patient-blinded, randomized controlled study was conducted. Twenty-four participants were randomly assigned into either the active HD-tDCS-eTBS group or sham HD-tDCS-eTBS group. Both groups received 20 minutes of active/sham HD-tDCS-eTBS combined with 30 minutes of conventional UE rehabilitation each time, 3 times a week for 4 weeks. Outcome measures including the Fugl-Meyer Assessment of Upper Extremity, Wolf Motor Function Test, Jebsen-Taylor Hand Function Test, Finger-Nose Test, and Modified Ashworth Scale were assessed before and immediately after the intervention period. RESULTS Spasticity of shoulder adductor (P = .05), elbow extensor (P = .04), and thumb flexor (P < .01) were significantly reduced in the active HD-tDCS-eTBS group versus the sham group. Nonsignificant trends in the improvements of most other outcome measures were in favor of the active HD-tDCS-eTBS group with moderate to large effect sizes (P = .06-.26, ηp2 = 0.06-0.16). No severe adverse events except for slight skin redness under the stimulus electrode was detected after the HD-tDCS-eTBS. CONCLUSIONS Our findings support that HD-tDCS-eTBS is safe and has therapeutic potential for post-stroke UE motor rehabilitation. TRIAL REGISTRATION ClinicalTrials.gov (ID: NCT04278105).
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Affiliation(s)
- Yi-Jing Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei
| | - Shun-Min Wang
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chieh Chen
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei
| | - Chien-An Chen
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chun-Wei Wu
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei
| | - Jia-Jin Chen
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan
| | - Chih-Wei Peng
- School of Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei.,International PhD Program in Biomedical Engineering, College of Biomedical Engineering, Taipei Medical University, Taipei.,School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, Taipei
| | - Che-Wei Lin
- Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan.,Medical Device Innovation Center, National Cheng Kung University, Tainan.,Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan.,Institute of Medical Informatics, College of Electrical Engineering and Computer Science, National Cheng Kung University, Tainan
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei.,Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, Taipei
| | - Shih-Ching Chen
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei.,Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei
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Ko MH, Yoon JY, Jo YJ, Son MN, Kim DS, Kim GW, Won YH, Park SH, Seo JH, Kim YH. Home-Based Transcranial Direct Current Stimulation to Enhance Cognition in Stroke: Randomized Controlled Trial. Stroke 2022; 53:2992-3001. [PMID: 35975663 DOI: 10.1161/strokeaha.121.037629] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is a promising tool for improving post-stroke cognitive function. Home-based rehabilitation is increasingly required for patients with stroke, and additional benefits are expected if supplemented with remotely supervised tDCS (RS-tDCS). We evaluated the cognitive improvement effect and feasibility of RS-tDCS in patients with chronic stroke. METHODS Twenty-six patients with chronic stroke and cognitive impairment (Korean version of the Montreal Cognitive Assessment [K-MoCA] score <26) were randomized into real and sham RS-tDCS groups and underwent concurrent computerized cognitive training and RS-tDCS. Patients and caregivers underwent training to ensure correct tDCS self-application, were monitored, and treated 5 d/wk for 4 weeks. We investigated several cognition tests including K-MoCA, Korean version of the Dementia Rating Scale-2, Korean-Boston Naming Test, Trail Making Test, Go/No Go, and Controlled Oral Word Association Test at the end of the training sessions and one month later. Repeated-measures ANOVA was used for comparison between the groups and within each group. The adherence rate of the appropriate RS-tDCS session was also investigated. RESULTS In within-group comparison, unlike the sham group, the real group showed significant improvement in K-MoCA (Preal=0.004 versus Psham=0.132), particularly in patients with lower baseline K-MoCA (K-MoCA10-17; Preal=0.001 versus Psham=0.835, K-MoCA18-25; Preal=0.060 versus Psham=0.064) or with left hemispheric lesions (left; Preal=0.010 versus Psham=0.454, right; Preal=0.106 versus Psham=0.128). In between-group comparison, a significant difference was observed in K-MoCA in the lower baseline K-MoCA subgroup (K-MoCA10-17; Ptime×group=0.048), but no significant difference was found in other cognitive tests. The adherence rate of successful application of the RS-tDCS was 98.4%, and no serious adverse effects were detected. CONCLUSIONS RS-tDCS is a safe and feasible rehabilitation modality for post-stroke cognitive dysfunction. Specifically, RS-tDCS is effective in patients with moderate cognitive decline. Additionally, these data demonstrate the potential to enhance home-based cognitive training, although significant differences were not consistently found in between-group comparisons; therefore, further larger studies are needed. REGISTRATION URL: https://cris.nih.go.kr; Unique identifier: KCT0003427.
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Affiliation(s)
- Myoung-Hwan Ko
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Translational Research & Clinical Trials Center for Medical Devices, Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., G.-W.K.)
| | - Ju-Yul Yoon
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)
| | - Yun-Ju Jo
- Translational Research & Clinical Trials Center for Medical Devices, Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., G.-W.K.)
| | - Mi-Nam Son
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (M.-N.S., Y.-H.K.)
| | - Da-Sol Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)
| | - Gi-Wook Kim
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Translational Research & Clinical Trials Center for Medical Devices, Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., G.-W.K.)
| | - Yu Hui Won
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)
| | - Sung-Hee Park
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)
| | - Jeong-Hwan Seo
- Department of Physical Medicine and Rehabilitation, Jeonbuk National University Medical School, Jeonju, Republic of Korea (M.-H.K., J.-Y.Y., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.).,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea (M.-H.K., Y.-J.J., D.-S.K., G.-W.K., Y.H.W., S.-H.P., J.-H.S.)
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (M.-N.S., Y.-H.K.).,Department of Health Science and Technology, Department of Medical Device Management and Research, Department of Digital Healthcare, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea (Y.-H.K.)
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Sadler CM, Kami AT, Nantel J, Lommen J, Carlsen AN. Transcranial Direct Current Stimulation Over Motor Areas Improves Reaction Time in Parkinson's Disease. Front Neurol 2022; 13:913517. [PMID: 35775046 PMCID: PMC9237404 DOI: 10.3389/fneur.2022.913517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) has been shown to modulate cortical motor excitability and improve bradykinesia symptoms in Parkinson's disease. It is unclear how targeting different cortical motor areas with tDCS may differentially influence upper limb function for individuals diagnosed with PD. Objective This study investigated whether anodal tDCS applied separately to the primary motor cortex and the supplementary motor area would improve upper limb function for individuals with Parkinson's disease. In addition, a startling acoustic stimulus was used to differentiate between the effect of stimulation on motor preparatory and initiation processes associated with upper limb movements. Methods Eleven participants with idiopathic Parkinson's disease performed two upper limb simple reaction time tasks, involving elbow extension or a button press before and after either anodal tDCS or sham tDCS was applied over the primary motor cortex or supplementary motor area. A loud, startling stimulus was presented on a selection of trials to involuntarily trigger the prepared action. Results Anodal tDCS led to improved premotor reaction time in both tasks, but this was moderated by reaction time in pre-tDCS testing, such that individuals with slower pre-tDCS reaction time showed the greatest reaction time improvements. Startle-trial reaction time was not modified following tDCS, suggesting that the stimulation primarily modulated response initiation processes. Conclusion Anodal tDCS improved response initiation speed, but only in slower reacting individuals with PD. However, no differences attributable to tDCS were observed in clinical measures of bradykinesia or kinematic variables, suggesting that reaction time may represent a more sensitive measure of some components of bradykinesia.
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Affiliation(s)
| | - Aline Tiemi Kami
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Jonathan Lommen
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| | - Anthony N. Carlsen
- School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
- *Correspondence: Anthony N. Carlsen ; ; orcid.org/0000-0001-6015-8991
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Sevilla-Sanchez M, Hortobágyi T, Carballeira E, Fogelson N, Fernandez-del-Olmo M. A lack of timing-dependent effects of transcranial direct current stimulation (tDCS) on the performance of a choice reaction time task. Neurosci Lett 2022; 782:136691. [DOI: 10.1016/j.neulet.2022.136691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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10
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Sefat O, Salehinejad MA, Danilewitz M, Shalbaf R, Vila-Rodriguez F. Combined Yoga and Transcranial Direct Current Stimulation Increase Functional Connectivity and Synchronization in the Frontal Areas. Brain Topogr 2022; 35:207-218. [DOI: 10.1007/s10548-022-00887-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 01/02/2022] [Indexed: 11/28/2022]
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11
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Ownby RL, Kim J. Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial. Front Aging Neurosci 2021; 13:766311. [PMID: 34867291 PMCID: PMC8634723 DOI: 10.3389/fnagi.2021.766311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/20/2021] [Indexed: 01/13/2023] Open
Abstract
Objective: HIV infection is associated with impaired cognition, and as individuals grow older, they may also experience age-related changes in mental abilities. Previous studies have shown that computer-based cognitive training (CCT) and transcranial direct current stimulation (tDCS) may be useful in improving cognition in older persons. This study evaluated the acceptability of CCT and tDCS to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed. Methods: In a single-blind randomized study, 46 individuals with HIV-associated mild neurocognitive disorder completed neuropsychological assessments and six 20-min training sessions to which they had been randomly assigned to one of the following conditions: (1) CCT with active tDCS; (2) CCT with sham tDCS, or (3) watching educational videos with sham tDCS. Immediately after training and again 1 month later, participants completed follow-up assessments. Outcomes were evaluated via repeated measures mixed effects models. Results: Participant ratings of the intervention were positive. Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention. Conclusion: Both CCT and tDCS were highly acceptable to older persons with HIV infection. CCT and tDCS may improve cognitive in affected individuals. Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03440840].
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Affiliation(s)
- Raymond L. Ownby
- Department of Psychiatry and Behavioral Medicine, Nova Southeastern University, Fort Lauderdale, FL, United States
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12
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Jo NG, Kim GW, Won YH, Park SH, Seo JH, Ko MH. Timing-Dependent Effects of Transcranial Direct Current Stimulation on Hand Motor Function in Healthy Individuals: A Randomized Controlled Study. Brain Sci 2021; 11:1325. [PMID: 34679390 PMCID: PMC8534210 DOI: 10.3390/brainsci11101325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Revised: 09/30/2021] [Accepted: 09/30/2021] [Indexed: 11/18/2022] Open
Abstract
The timing of transcranial direct current stimulation (tDCS) is essential for enhancing motor skill learning. Previously, tDCS, before or concurrently, with motor training was evaluated in healthy volunteers or elderly patients, but the optimal timing of stimulation has not been determined. In this study, we aimed to optimize the existing tDCS protocols by exploring the timing-dependent stimulation effects on finger movements in healthy individuals. We conducted a single-center, prospective, randomized controlled trial. The study participants (n = 39) were randomly assigned into three groups: tDCS concurrently with finger tapping training (CON), tDCS prior to finger tapping training (PRI), and SHAM-tDCS simultaneously with finger tapping training (SHAM). In all groups, the subjects participated in five 40-min training sessions for one week. Motor performance was measured before and after treatment using the finger-tapping task (FTT), the grooved pegboard test (GPT), and hand strength tests. tDCS treatment prior to finger tapping training significantly improved motor skill learning, as indicated by the GPT and hand strength measurements. In all groups, the treatment improved the FTT performance. Our results indicate that applying tDCS before training could be optimal for enhancing motor skill learning. Further research is required to confirm these findings.
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Affiliation(s)
- Nam-Gyu Jo
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
| | - Gi-Wook Kim
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
| | - Yu Hui Won
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
| | - Sung-Hee Park
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
| | - Jeong-Hwan Seo
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
| | - Myoung-Hwan Ko
- Department of Physical Medicine & Rehabilitation, Jeonbuk National University Medical School, Geonjiro 20, Deokjin-gu, Jeonju 54097, Korea; (N.-G.J.); (G.-W.K.); (Y.H.W.); (S.-H.P.); (J.-H.S.)
- Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Geonjiro 20, Deokjin-gu, Jeonju 54907, Korea
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13
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Sadler CM, Kami AT, Nantel J, Carlsen AN. Transcranial direct current stimulation of supplementary motor area improves upper limb kinematics in Parkinson's disease. Clin Neurophysiol 2021; 132:2907-2915. [PMID: 34412968 DOI: 10.1016/j.clinph.2021.06.031] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 05/18/2021] [Accepted: 06/20/2021] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Bradykinesia, defined as slowness of movements, is among the most functionally debilitating symptoms of Parkinson's disease (PD). Hypoactivation of cortical neurons in supplementary motor area (SMA) has been linked to the progression of bradykinesia symptoms. This study investigated the influence of transcranial direct current stimulation (tDCS) applied over SMA on upper limb movement for individuals diagnosed with PD. METHODS Thirteen individuals with PD performed a simple reaction time (RT) task involving elbow extension following an auditory go-signal. Sham or anodal tDCS was then applied over SMA for 10 minutes before participants repeated the simple RT task. Participants were unaware of which stimulation they received in each testing session. Electromyography (EMG) and kinematic data were recorded on all trials. RESULTS While there were no significant differences in premotor RT, anodal tDCS applied over SMA led to significantly shorter time to peak displacement (p = .015) and movement time (p = .003) compared to pre-tDCS trials, whereas sham stimulation had no impact on these variables. CONCLUSIONS These results provide evidence that anodal tDCS applied over SMA contributes to improvements in movement kinematics of an upper limb simple RT task. SIGNIFICANCE Anodal tDCS over SMA could be a useful therapy to mitigate bradykinesia associated with PD.
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Affiliation(s)
- Christin M Sadler
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Aline Tiemi Kami
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Julie Nantel
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Anthony N Carlsen
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
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14
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TDCS effects on pointing task learning in young and old adults. Sci Rep 2021; 11:3421. [PMID: 33564052 PMCID: PMC7873227 DOI: 10.1038/s41598-021-82275-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/14/2021] [Indexed: 01/19/2023] Open
Abstract
Skill increase in motor performance can be defined as explicitly measuring task success but also via more implicit measures of movement kinematics. Even though these measures are often related, there is evidence that they represent distinct concepts of learning. In the present study, the effect of multiple tDCS-sessions on both explicit and implicit measures of learning are investigated in a pointing task in 30 young adults (YA) between 27.07 ± 3.8 years and 30 old adults (OA) between 67.97 years ± 5.3 years. We hypothesized, that OA would show slower explicit skill learning indicated by higher movement times/lower accuracy and slower implicit learning indicated by higher spatial variability but profit more from anodal tDCS compared with YA. We found age-related differences in movement time but not in accuracy or spatial variability. TDCS did not skill learning facilitate learning neither in explicit nor implicit parameters. However, contrary to our hypotheses, we found tDCS-associated higher accuracy only in YA but not in spatial variability. Taken together, our data shows limited overlapping of tDCS effects in explicit and implicit skill parameters. Furthermore, it supports the assumption that tDCS is capable of producing a performance-enhancing brain state at least for explicit skill acquisition.
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15
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Wang A, Chen L, Jiang Y. Anodal Occipital Transcranial Direct Current Stimulation Enhances Perceived Visual Size Illusions. J Cogn Neurosci 2020; 33:528-535. [PMID: 33326330 DOI: 10.1162/jocn_a_01664] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Human early visual cortex has long been suggested to play a crucial role in context-dependent visual size perception through either lateral interaction or feedback projections from higher to lower visual areas. We investigated the causal contribution of early visual cortex to context-dependent visual size perception using the technique of transcranial direct current stimulation and two well-known size illusions (i.e., the Ebbinghaus and Ponzo illusions) and further elucidated the underlying mechanism that mediates the effect of transcranial direct current stimulation over early visual cortex. The results showed that the magnitudes of both size illusions were significantly increased by anodal stimulation relative to sham stimulation but left unaltered by cathodal stimulation. Moreover, the anodal effect persisted even when the central target and surrounding inducers of the Ebbinghaus configuration were presented to different eyes, with the effect lasting no more than 15 min. These findings provide compelling evidence that anodal occipital stimulation enhances the perceived visual size illusions, which is possibly mediated by weakening the suppressive function of the feedback connections from higher to lower visual areas. Moreover, the current study provides further support for the causal role of early visual cortex in the neural processing of context-dependent visual size perception.
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Affiliation(s)
- Anqi Wang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University.,Key Laboratory of Brain and Cognitive Neuroscience, Dalian, China
| | - Lihong Chen
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University.,Key Laboratory of Brain and Cognitive Neuroscience, Dalian, China
| | - Yi Jiang
- State Key Laboratory of Brain and Cognitive Science, CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Psychology, Chinese Academy of Sciences.,University of Chinese Academy of Sciences.,Chinese Institute for Brain Research, Beijing, China.,Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
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Wertheim J, Colzato LS, Nitsche MA, Ragni M. Enhancing spatial reasoning by anodal transcranial direct current stimulation over the right posterior parietal cortex. Exp Brain Res 2019; 238:181-192. [DOI: 10.1007/s00221-019-05699-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 11/22/2019] [Indexed: 01/18/2023]
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17
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Di Rosa E, Brigadoi S, Cutini S, Tarantino V, Dell'Acqua R, Mapelli D, Braver TS, Vallesi A. Reward motivation and neurostimulation interact to improve working memory performance in healthy older adults: A simultaneous tDCS-fNIRS study. Neuroimage 2019; 202:116062. [PMID: 31369810 DOI: 10.1016/j.neuroimage.2019.116062] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/25/2019] [Accepted: 07/27/2019] [Indexed: 01/12/2023] Open
Abstract
Several studies have evaluated the effect of anodal transcranial direct current stimulation (tDCS) over the prefrontal cortex (PFC) for the enhancement of working memory (WM) performance in healthy older adults. However, the mixed results obtained so far suggest the need for concurrent brain imaging, in order to more directly examine tDCS effects. The present study adopted a continuous multimodal approach utilizing functional near-infrared spectroscopy (fNIRS) to examine the interactive effects of tDCS combined with manipulations of reward motivation. Twenty-one older adults (mean age = 69.7 years; SD = 5.05) performed an experimental visuo-spatial WM task before, during and after the delivery of 1.5 mA anodal tDCS/sham over the left prefrontal cortex (PFC). During stimulation, participants received performance-contingent reward for every fast and correct response during the WM task. In both sessions, hemodynamic activity of the bilateral frontal, motor and parietal areas was recorded across the entire duration of the WM task. Cognitive functions and reward sensitivity were also assessed with standard measures. Results demonstrated a significant impact of tDCS on both WM performance and hemodynamic activity. Specifically, faster responses in the WM task were observed both during and after anodal tDCS, while no differences were found under sham control conditions. However, these effects emerged only when taking into account individual visuo-spatial WM capacity. Additionally, during and after the anodal tDCS, increased hemodynamic activity relative to sham was observed in the bilateral PFC, while no effects of tDCS were detected in the motor and parietal areas. These results provide the first evidence of tDCS-dependent functional changes in PFC activity in healthy older adults during the execution of a WM task. Moreover, they highlight the utility of combining reward motivation with prefrontal anodal tDCS, as a potential strategy to improve WM efficiency in low performing healthy older adults.
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Affiliation(s)
- Elisa Di Rosa
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA.
| | - Sabrina Brigadoi
- Department of Developmental Psychology, University of Padova, Padova, Italy; Department of Information Engineering, University of Padova, Padova, Italy
| | - Simone Cutini
- Department of Developmental Psychology, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Vincenza Tarantino
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Roberto Dell'Acqua
- Department of Developmental Psychology, University of Padova, Padova, Italy; Padova Neuroscience Center, University of Padova, Padova, Italy
| | - Daniela Mapelli
- Department of General Psychology, University of Padova, Padova, Italy
| | - Todd S Braver
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, USA
| | - Antonino Vallesi
- Department of Neuroscience & Padova Neuroscience Center, University of Padova, Padova, Italy; Brain Imaging and Neural Dynamics Research Group, IRCCS San Camillo Hospital, Venice, Italy
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