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Nissim NR, Fudge MR, Lachner C, Babulal GM, Allyse MA, Graff-Radford NR, Lucas JA, Day GS. Age-Specific Barriers and Facilitators to Research Participation Amongst African Americans in Observational Studies of Memory and Aging. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01741-z. [PMID: 37555913 PMCID: PMC10853486 DOI: 10.1007/s40615-023-01741-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/15/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Black/African Americans experience a high burden of Alzheimer disease and related dementias yet are critically underrepresented in corresponding research. Understanding barriers and facilitators to research participation among younger and older African Americans is necessary to inform age-specific strategies to promote equity in studies of early- and late-onset neurodegenerative diseases. STUDY DESIGN Survey respondents (n = 240) rated barriers and facilitators of research participation. Age-specific differences were evaluated using nonparametric Kruskal-Wallis tests across respondents aged 18-44 years (n = 76), 45-64 years (n = 83), and ≥ 65 years (n = 81). Strategies to mitigate barriers and promote facilitators were further explored via community-based focus groups. Pooled frequency of common themes discussed in focus groups were evaluated and compared across different ages including ≥ 45 years, ≥ 65 years, and mixed ages ≥ 45 years. RESULTS Younger respondents (aged 18-44 and 45-64 years) expressed a greater need for flexibility in when, where, and how research testing takes place versus adults ≥ 65 years. Focus groups emphasized long-lasting consequences of systemic racism and the need to build and foster trust to resolve barriers and promote research engagement amongst African Americans. DISCUSSION Age-specific strategies are needed to increase engagement, address recruitment disparities, and promote retention of African American participants in memory and aging studies across the lifespan.
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Affiliation(s)
- Nicole R Nissim
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Michelle R Fudge
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Christian Lachner
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - Megan A Allyse
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, FL, 32224, USA
| | | | - John A Lucas
- Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, 32224, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic, Jacksonville, FL, 32224, USA.
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Nissim NR, Pham DVH, Poddar T, Blutt E, Hamilton RH. The impact of gamma transcranial alternating current stimulation (tACS) on cognitive and memory processes in patients with mild cognitive impairment or Alzheimer's disease: A literature review. Brain Stimul 2023; 16:748-755. [PMID: 37028756 PMCID: PMC10862495 DOI: 10.1016/j.brs.2023.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 03/16/2023] [Accepted: 04/02/2023] [Indexed: 04/08/2023] Open
Abstract
BACKGROUND Transcranial alternating current stimulation (tACS)-a noninvasive brain stimulation technique that modulates cortical oscillations through entrainment-has been demonstrated to alter oscillatory activity and enhance cognition in healthy adults. TACS is being explored as a tool to improve cognition and memory in patient populations with mild cognitive impairment (MCI) and Alzheimer's disease (AD). OBJECTIVE To review the growing body of literature and current findings obtained from the application of tACS in patients with MCI or AD, highlighting the effects of gamma tACS on brain function, memory, and cognition. Evidence on the use of brain stimulation in animal models of AD is also discussed. Important parameters of stimulation are underscored for consideration in protocols that aim to apply tACS as a therapeutic tool in patients with MCI/AD. FINDINGS The application of gamma tACS has shown promising results in the improvement of cognitive and memory processes that are impacted in patients with MCI/AD. These data demonstrate the potential for tACS as an interventional stand-alone tool or alongside pharmacological and/or other behavioral interventions in MCI/AD. CONCLUSIONS While the use of tACS in MCI/AD has evidenced encouraging results, the effects of this stimulation technique on brain function and pathophysiology in MCI/AD remains to be fully determined. This review explores the literature and highlights the need for continued research on tACS as a tool to alter the course of the disease by reinstating oscillatory activity, improving cognitive and memory processing, delaying disease progression, and remediating cognitive abilities in patients with MCI/AD.
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Affiliation(s)
- N R Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Pennsylvania, PA, USA; Moss Rehabilitation Research Institute, Einstein Medical Center, Elkins Park, PA, USA.
| | - D V H Pham
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Pennsylvania, PA, USA
| | - T Poddar
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Pennsylvania, PA, USA
| | - E Blutt
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Pennsylvania, PA, USA
| | - R H Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Pennsylvania, PA, USA; Moss Rehabilitation Research Institute, Einstein Medical Center, Elkins Park, PA, USA.
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Nissim NR, McAfee DC, Edwards S, Prato A, Lin JX, Lu Z, Coslett HB, Hamilton RH. Efficacy of Transcranial Alternating Current Stimulation in the Enhancement of Working Memory Performance in Healthy Adults: A Systematic Meta-Analysis. Neuromodulation 2023:S1094-7159(23)00009-0. [PMID: 36759231 DOI: 10.1016/j.neurom.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/22/2022] [Accepted: 12/29/2022] [Indexed: 02/10/2023]
Abstract
BACKGROUND Transcranial alternating current stimulation (tACS)-a noninvasive brain stimulation technique that modulates cortical oscillations in the brain-has shown the capacity to enhance working memory (WM) abilities in healthy individuals. The efficacy of tACS in the improvement of WM performance in healthy individuals is not yet fully understood. OBJECTIVE/HYPOTHESIS This meta-analysis aimed to systematically evaluate the efficacy of tACS in the enhancement of WM in healthy individuals and to assess moderators of response to stimulation. We hypothesized that active tACS would significantly enhance WM compared with sham. We further hypothesized that it would do so in a task-dependent manner and that differing stimulation parameters would affect response to tACS. MATERIALS AND METHODS Ten tACS studies met the inclusion criteria and provided 32 effects in the overall analysis. Random-effect models assessed mean change scores on WM tasks from baseline to poststimulation. The included studies involved varied in stimulation parameters, between-subject and within-subject study designs, and online vs offline tACS. RESULTS We observed a significant, heterogeneous, and moderate effect size for active tACS in the enhancement of WM performance over sham (Cohen's d = 0.5). Cognitive load, task domain, session number, and stimulation region showed a significant relationship between active tACS and enhanced WM behavior over sham. CONCLUSIONS Our findings indicate that active tACS enhances WM performance in healthy individuals compared with sham. Future randomized controlled trials are needed to further explore key parameters, including personalized stimulation vs standardized electroencephalography frequencies and maintenance of tACS effects, and whether tACS-induced effects translate to populations with WM impairments.
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Affiliation(s)
- Nicole R Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Moss Rehabilitation Research Institute, Einstein Medical Center, Elkins Park, PA, USA.
| | - Darrian C McAfee
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Shanna Edwards
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amara Prato
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jennifer X Lin
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhiye Lu
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - H Branch Coslett
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Moss Rehabilitation Research Institute, Einstein Medical Center, Elkins Park, PA, USA
| | - Roy H Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Moss Rehabilitation Research Institute, Einstein Medical Center, Elkins Park, PA, USA
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Nissim NR, Harvey DY, Haslam C, Friedman L, Bharne P, Litz G, Phillips JS, Cousins KAQ, Xie SX, Grossman M, Hamilton RH. Through Thick and Thin: Baseline Cortical Volume and Thickness Predict Performance and Response to Transcranial Direct Current Stimulation in Primary Progressive Aphasia. Front Hum Neurosci 2022; 16:907425. [PMID: 35874157 PMCID: PMC9302040 DOI: 10.3389/fnhum.2022.907425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 06/02/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives We hypothesized that measures of cortical thickness and volume in language areas would correlate with response to treatment with high-definition transcranial direct current stimulation (HD-tDCS) in persons with primary progressive aphasia (PPA). Materials and Methods In a blinded, within-group crossover study, PPA patients (N = 12) underwent a 2-week intervention HD-tDCS paired with constraint-induced language therapy (CILT). Multi-level linear regression (backward-fitted models) were performed to assess cortical measures as predictors of tDCS-induced naming improvements, measured by the Western Aphasia Battery-naming subtest, from baseline to immediately after and 6 weeks post-intervention. Results Greater baseline thickness of the pars opercularis significantly predicted naming gains (p = 0.03) immediately following intervention, while greater thickness of the middle temporal gyrus (MTG) and lower thickness of the superior temporal gyrus (STG) significantly predicted 6-week naming gains (p's < 0.02). Thickness did not predict naming gains in sham. Volume did not predict immediate gains for active stimulation. Greater volume of the pars triangularis and MTG, but lower STG volume significantly predicted 6-week naming gains in active stimulation. Greater pars orbitalis and MTG volume, and lower STG volume predicted immediate naming gains in sham (p's < 0.05). Volume did not predict 6-week naming gains in sham. Conclusion Cortical thickness and volume were predictive of tDCS-induced naming improvement in PPA patients. The finding that frontal thickness predicted immediate active tDCS-induced naming gains while temporal areas predicted naming changes at 6-week suggests that a broader network of regions may be important for long-term maintenance of treatment gains. The finding that volume predicted immediate naming performance in the sham condition may reflect the benefits of behavioral speech language therapy and neural correlates of its short-lived treatment gains. Collectively, thickness and volume were predictive of treatment gains in the active condition but not sham, suggesting that pairing HD-tDCS with CILT may be important for maintaining treatment effects.
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Affiliation(s)
- Nicole R. Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Moss Rehabilitation Research Institute, Elkins Park, PA, United States
| | - Denise Y. Harvey
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Haslam
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Leah Friedman
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Pandurang Bharne
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Geneva Litz
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Jeffrey S. Phillips
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Katheryn A. Q. Cousins
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Sharon X. Xie
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Murray Grossman
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
- Penn Frontotemporal Degeneration Center, University of Pennsylvania, Philadelphia, PA, United States
| | - Roy H. Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA, United States
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Caulfield KA, Indahlastari A, Nissim NR, Lopez JW, Fleischmann HH, Woods AJ, George MS. Electric Field Strength From Prefrontal Transcranial Direct Current Stimulation Determines Degree of Working Memory Response: A Potential Application of Reverse-Calculation Modeling? Neuromodulation 2022; 25:578-587. [PMID: 35670064 DOI: 10.1111/ner.13342] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) for working memory is an enticing treatment, but there is mixed evidence to date. OBJECTIVES We tested the effects of electric field strength from uniform 2 mA dosing on working memory change from prestimulation to poststimulation. Second, we statistically evaluated a reverse-calculation method of individualizing tDCS dose and its effect on normalizing electric field at the cortex. MATERIALS AND METHODS We performed electric field modeling on a data set of 28 healthy older adults (15 women, mean age = 73.7, SD = 7.3) who received ten sessions of active 2 mA tDCS (N = 14) or sham tDCS (N = 14) applied over bilateral dorsolateral prefrontal cortices (DLPFC) in a triple-blind design. We evaluated the relationship between electric field strength and working memory change on an N-back task in conditions of above-median, high electric field from active 2 mA (N = 7), below-median, low electric field from active 2 mA (N = 7), and sham (N = 14) at regions of interest (ROI) at the left and right DLPFC. We then determined the individualized reverse-calculation dose to produce the group average electric field and measured the electric field variance between uniform 2 mA doses vs individualized reverse-calculation doses at the same ROIs. RESULTS Working memory improvements from pre- to post-tDCS were significant for the above-median electric field from active 2 mA condition at the left DLPFC (mixed ANOVA, p = 0.013). Furthermore, reverse-calculation modeling significantly reduced electric field variance at both ROIs (Levene's test; p < 0.001). CONCLUSIONS Higher electric fields at the left DLPFC from uniform 2 mA doses appear to drive working memory improvements from tDCS. Individualized doses from reverse-calculation modeling significantly reduce electric field variance at the cortex. Taken together, using reverse-calculation modeling to produce the same, high electric fields at the cortex across participants may produce more effective future tDCS treatments for working memory.
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Affiliation(s)
- Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - James W Lopez
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Holly H Fleischmann
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Mark S George
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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Hardcastle C, Kraft JN, Hausman HK, O'Shea A, Albizu A, Evangelista ND, Boutzoukas E, Nissim NR, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander G, Woods AJ. Only within resting state network connectivity of the frontoparietal control and Cingulo Opercular networks predict useful field of view performance. Alzheimers Dement 2021. [DOI: 10.1002/alz.052217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Indahlastari A, Albizu A, Kraft JN, O'Shea A, Nissim NR, Dunn AL, Carballo D, Gordon MP, Taank S, Kahn AT, Hernandez C, Zucker WM, Woods AJ. Individualized tDCS modeling predicts functional connectivity changes within the working memory network in older adults. Brain Stimul 2021; 14:1205-1215. [PMID: 34371212 PMCID: PMC8892686 DOI: 10.1016/j.brs.2021.08.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Working memory decline has been associated with normal aging. The frontal brain structure responsible for this decline is primarily located in the prefrontal cortex (PFC). Our previous neuroimaging study demonstrated a significant change in functional connectivity between the left dorsolateral PFC (DLPFC) and left ventrolateral PFC (VLPFC) when applying 2 mA tDCS in MRI scanner during an N-Back task. These regions were part of the working memory network. The present study is the first study that utilizes individualized finite element models derived from older adults' MRI to predict significant changes of functional connectivity observed from an acute tDCS application. METHODS Individualized head models from 15 healthy older adults (mean age = 71.3 years) were constructed to create current density maps. Each head model was segmented into 11 tissue types: white matter, gray matter, CSF, muscle, blood vessels, fat, eyes, air, skin, cancellous, and cortical bone. Electrodes were segmented from T1-weighted images and added to the models. Computed median and maximum current density values in the left DLPFC and left VLPFC regions of interest (ROIs) were correlated with beta values as functional connectivity metrics measured in different timepoint (baseline, during stimulation) and stimulation condition (active and sham). MAIN RESULTS Positive significant correlations (R2 = 0.523 for max J, R2 = 0.367 for median J, p < 0.05) were found between the beta values and computed current densities in the left DLPFC ROIs for active stimulation, but no significant correlation was found during sham stimulation. We found no significant correlation between connectivity and current densities computed in the left VLPFC for both active and sham stimulation. CONCLUSIONS The amount of current within the left DLPFC ROIs was found positively correlated with changes in functional connectivity between left DLPFC and left VLPFC during active 2 mA stimulation. Future work may include expansion of number of participants to further test the accuracy of tDCS models used to predict tDCS-induced functional connectivity changes within the working memory network.
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Affiliation(s)
- Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
| | - Ayden L Dunn
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Daniela Carballo
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Michael P Gordon
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Shreya Taank
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Alex T Kahn
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Cindy Hernandez
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - William M Zucker
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA; Department of Neuroscience, University of Florida, Gainesville, FL, USA
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Evangelista ND, O'Shea A, Kraft JN, Hausman HK, Boutzoukas EM, Nissim NR, Albizu A, Hardcastle C, Van Etten EJ, Bharadwaj PK, Smith SG, Song H, Hishaw GA, DeKosky S, Wu S, Porges E, Alexander GE, Marsiske M, Cohen R, Woods AJ. Independent Contributions of Dorsolateral Prefrontal Structure and Function to Working Memory in Healthy Older Adults. Cereb Cortex 2021; 31:1732-1743. [PMID: 33188384 PMCID: PMC7869098 DOI: 10.1093/cercor/bhaa322] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 10/06/2020] [Accepted: 10/07/2020] [Indexed: 12/25/2022] Open
Abstract
Age-related differences in dorsolateral prefrontal cortex (DLPFC) structure and function have each been linked to working memory. However, few studies have integrated multimodal imaging to simultaneously investigate relationships among structure, function, and cognition. We aimed to clarify how specifically DLPFC structure and function contribute to working memory in healthy older adults. In total, 138 participants aged 65-88 underwent 3 T neuroimaging and were divided into higher and lower groups based on a median split of in-scanner n-back task performance. Three a priori spherical DLPFC regions of interest (ROIs) were used to quantify blood-oxygen-level-dependent (BOLD) signal and FreeSurfer-derived surface area, cortical thickness, and white matter volume. Binary logistic regressions adjusting for age, sex, education, and scanner type revealed that greater left and right DLPFC BOLD signal predicted the probability of higher performing group membership (P values<.05). Binary logistic regressions also adjusting for total intracranial volume revealed left DLPFC surface area that significantly predicted the probability of being in the higher performing group (P = 0.017). The left DLPFC BOLD signal and surface area were not significantly associated and did not significantly interact to predict group membership (P values>.05). Importantly, this suggests BOLD signal and surface area may independently contribute to working memory performance in healthy older adults.
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Affiliation(s)
- Nicole D Evangelista
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Neuroscience, College of Medicine, University of Florida
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, 19104, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Neuroscience, College of Medicine, University of Florida
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Emily J Van Etten
- Department of Psychology and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA
| | - Samantha G Smith
- Department of Psychology and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA
| | - Hyun Song
- Department of Psychology and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA
| | - Georg A Hishaw
- Department of Psychiatry, Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, 85721, USA
| | - Steven DeKosky
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Neurology, College of Medicine, University of Florida
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, 32611, USA
| | - Eric Porges
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Gene E Alexander
- Department of Psychology and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA.,Brain Imaging, Behavior and Aging Laboratory, Departments of Psychology and Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, BIO5 Institute and McKnight Brain Institute, University of Arizona, Tucson, AZ, 85721, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, 32611, USA.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, 32611, USA.,Department of Neuroscience, College of Medicine, University of Florida
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Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O’Shea A, Indahlastari A, Albizu A, Nissim NR, Evangelista ND, Cohen R, Porges EC, Woods AJ. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci 2021; 13:761348. [PMID: 34744698 PMCID: PMC8568306 DOI: 10.3389/fnagi.2021.761348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Objective: This study examines the impact of transcranial direct current stimulation (tDCS) combined with cognitive training on neurotransmitter concentrations in the prefrontal cortex. Materials and Methods: Twenty-three older adults were randomized to either active-tDCS or sham-tDCS in combination with cognitive training for 2 weeks. Active-tDCS was delivered over F3 (cathode) and F4 (anode) electrode placements for 20 min at 2 mA intensity. For each training session, 40-min of computerized cognitive training were applied with active or sham stimulation delivered during the first 20-min. Glutamine/glutamate (Glx) and gamma-aminobutyric acid (GABA) concentrations via proton magnetic resonance spectroscopy were evaluated at baseline and at the end of 2-week intervention. Results: Glx concentrations increased from pre- to post-intervention (p = 0.010) in the active versus sham group after controlling for age, number of intervention days, MoCA scores, and baseline Glx concentration. No difference in GABA concentration was detected between active and sham groups (p = 0.650) after 2-week intervention. Conclusion: Results provide preliminary evidence suggesting that combining cognitive training and tDCS over the prefrontal cortex elicits sustained increase in excitatory neurotransmitter concentrations. Findings support the combination of tDCS and cognitive training as a potential method for altering neurotransmitter concentrations in the frontal cortices, which may have implications for neuroplasticity in the aging brain.
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Affiliation(s)
- Stacey Alvarez-Alvarado
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- *Correspondence: Stacey Alvarez-Alvarado,
| | - Emanuel M. Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Jessica N. Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O’Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole R. Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Nicole D. Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Eric C. Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States
- Department of Neuroscience, University of Florida, Gainesville, FL, United States
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10
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Albizu A, Fang R, Indahlastari A, O'Shea A, Stolte SE, See KB, Boutzoukas EM, Kraft JN, Nissim NR, Woods AJ. Machine learning and individual variability in electric field characteristics predict tDCS treatment response. Brain Stimul 2020; 13:1753-1764. [PMID: 33049412 PMCID: PMC7731513 DOI: 10.1016/j.brs.2020.10.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/30/2020] [Accepted: 10/02/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is widely investigated as a therapeutic tool to enhance cognitive function in older adults with and without neurodegenerative disease. Prior research demonstrates that electric current delivery to the brain can vary significantly across individuals. Quantification of this variability could enable person-specific optimization of tDCS outcomes. This pilot study used machine learning and MRI-derived electric field models to predict working memory improvements as a proof of concept for precision cognitive intervention. METHODS Fourteen healthy older adults received 20 minutes of 2 mA tDCS stimulation (F3/F4) during a two-week cognitive training intervention. Participants performed an N-back working memory task pre-/post-intervention. MRI-derived current models were passed through a linear Support Vector Machine (SVM) learning algorithm to characterize crucial tDCS current components (intensity and direction) that induced working memory improvements in tDCS responders versus non-responders. MAIN RESULTS SVM models of tDCS current components had 86% overall accuracy in classifying treatment responders vs. non-responders, with current intensity producing the best overall model differentiating changes in working memory performance. Median current intensity and direction in brain regions near the electrodes were positively related to intervention responses (r=0.811,p<0.001 and r=0.774,p=0.001). CONCLUSIONS This study provides the first evidence that pattern recognition analyses of MRI-derived tDCS current models can provide individual prognostic classification of tDCS treatment response with 86% accuracy. Individual differences in current intensity and direction play important roles in determining treatment response to tDCS. These findings provide important insights into mechanisms of tDCS response as well as proof of concept for future precision dosing models of tDCS intervention.
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Affiliation(s)
- Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA
| | - Ruogu Fang
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, USA
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, USA
| | - Skylar E Stolte
- J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, USA
| | - Kyle B See
- J. Crayton Pruitt Family Department of Biomedical Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA
| | - Nicole R Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, USA; Department of Neuroscience, College of Medicine, University of Florida, Gainesville, USA; Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, USA.
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11
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Kraft JN, O'Shea A, Albizu A, Evangelista ND, Hausman HK, Boutzoukas E, Nissim NR, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, Porges E, DeKosky S, Hishaw GA, Wu S, Marsiske M, Cohen R, Alexander GE, Woods AJ. Structural Neural Correlates of Double Decision Performance in Older Adults. Front Aging Neurosci 2020; 12:278. [PMID: 33117145 PMCID: PMC7493680 DOI: 10.3389/fnagi.2020.00278] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 08/11/2020] [Indexed: 11/13/2022] Open
Abstract
Speed of processing is a cognitive domain that encompasses the speed at which an individual can perceive a given stimulus, interpret the information, and produce a correct response. Speed of processing has been shown to decline more rapidly than other cognitive domains in an aging population, suggesting that this domain is particularly vulnerable to cognitive aging (Chee et al., 2009). However, given the heterogeneity of neuropsychological measures used to assess the domains underpinning speed of processing, a diffuse pattern of brain regions has been implicated. The current study aims to investigate the structural neural correlates of speed of processing by assessing cortical volume and speed of processing scores on the POSIT Double Decision task within a healthy older adult population (N = 186; mean age = 71.70 ± 5.32 years). T1-weighted structural images were collected via a 3T Siemens scanner. The current study shows that less cortical thickness in right temporal, posterior frontal, parietal and occipital lobe structures were significantly associated with poorer Double Decision scores. Notably, these include the lateral orbitofrontal gyrus, precentral gyrus, superior, transverse, and inferior temporal gyrus, temporal pole, insula, parahippocampal gyrus, fusiform gyrus, lingual gyrus, superior and inferior parietal gyrus and lateral occipital gyrus. Such findings suggest that speed of processing performance is associated with a wide array of cortical regions that provide unique contributions to performance on the Double Decision task.
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Affiliation(s)
- Jessica N Kraft
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Emanuel Boutzoukas
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Nicole R Nissim
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Emily J Van Etten
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Pradyumna K Bharadwaj
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Hyun Song
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Samantha G Smith
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Steven DeKosky
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Georg A Hishaw
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, United States
| | - Samuel Wu
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Michael Marsiske
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Gene E Alexander
- Brain Imaging, Behavior and Aging Laboratory, Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, United States.,Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Consortium, Tucson, AZ, United States
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States.,Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
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Nissim NR, Moberg PJ, Hamilton RH. Efficacy of Noninvasive Brain Stimulation (tDCS or TMS) Paired with Language Therapy in the Treatment of Primary Progressive Aphasia: An Exploratory Meta-Analysis. Brain Sci 2020; 10:E597. [PMID: 32872344 PMCID: PMC7563447 DOI: 10.3390/brainsci10090597] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/12/2022] Open
Abstract
Noninvasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), paired with behavioral language therapy, have demonstrated the capacity to enhance language abilities in primary progressive aphasia (PPA), a debilitating degenerative neurological syndrome that leads to declines in communication abilities. The aim of this meta-analysis is to systematically evaluate the efficacy of tDCS and TMS in improving language outcomes in PPA, explore the magnitude of effects between stimulation modalities, and examine potential moderators that may influence treatment effects. Standard mean differences for change in performance from baseline to post-stimulation on language-related tasks were evaluated. Six tDCS studies and two repetitive TMS studies met inclusion criteria and provided 22 effects in the analysis. Random effect models revealed a significant, heterogeneous, and moderate effect size for tDCS and TMS in the enhancement of language outcomes. Findings demonstrate that naming ability significantly improves due to brain stimulation, an effect found to be largely driven by tDCS. Future randomized controlled trials are needed to determine long-term effectiveness of noninvasive brain stimulation techniques on language abilities, further delineate the efficacy of tDCS and TMS, and identify optimal parameters to enable the greatest gains for persons with PPA.
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Affiliation(s)
- Nicole R. Nissim
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Moss Rehabilitation Research Institute, Elkins Park, PA 19027, USA
| | - Paul J. Moberg
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Department of Otorhinolaryngology: Head & Neck Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Roy H. Hamilton
- Laboratory for Cognition and Neural Stimulation, Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA;
- Department of Neurology, University of Pennsylvania, Philadelphia, PA 19104, USA
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13
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Indahlastari A, Albizu A, O'Shea A, Forbes MA, Nissim NR, Kraft JN, Evangelista ND, Hausman HK, Woods AJ. Modeling transcranial electrical stimulation in the aging brain. Brain Stimul 2020; 13:664-674. [PMID: 32289695 DOI: 10.1016/j.brs.2020.02.007] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 01/30/2020] [Accepted: 02/03/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Varying treatment outcomes in transcranial electrical stimulation (tES) recipients may depend on the amount of current reaching the brain. Brain atrophy associated with normal aging may affect tES current delivery to the brain. Computational models have been employed to compute predicted tES current inside the brain. This study is the largest study that uses computational models to investigate tES field distribution in healthy older adults. METHODS Individualized head models from 587 healthy older adults (mean = 73.9years, 51-95 years) were constructed to create field maps. Two electrode montages (F3-F4, M1-SO) with 2 mA input current were modeled using ROAST with modified codes. A customized template of healthy older adults, the UFAB-587, was created from the same dataset and used to warp individual brains into the same space. Warped models were analyzed to determine the relationship between computed field measures, brain atrophy and age. MAIN RESULTS Computed field measures were inversely correlated with brain atrophy (R2 = 0.0829, p = 1.14e-12). Field pattern showed negative correlation with age in brain sub-regions including part of DLPFC and precentral gyrus. Mediation analysis revealed that the negative correlation between age and current density is partially mediated by brain-to-CSF ratio. CONCLUSIONS Computed field measures showed decreasing amount of tES current reaching the brain with increasing atrophy. Therefore, adjusting current dose by modifying tES stimulation parameters in older adults based on degree of atrophy may be necessary to achieve desired stimulation benefits. Results from this study may inform future tES application in healthy older adults.
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Affiliation(s)
- Aprinda Indahlastari
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
| | - Alejandro Albizu
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Megan A Forbes
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Jessica N Kraft
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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14
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Nissim NR, O'Shea A, Indahlastari A, Kraft JN, von Mering O, Aksu S, Porges E, Cohen R, Woods AJ. Effects of Transcranial Direct Current Stimulation Paired With Cognitive Training on Functional Connectivity of the Working Memory Network in Older Adults. Front Aging Neurosci 2019; 11:340. [PMID: 31998111 PMCID: PMC6961663 DOI: 10.3389/fnagi.2019.00340] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/22/2019] [Indexed: 01/10/2023] Open
Abstract
Background Working memory, a fundamental short-term cognitive process, is known to decline with advanced age even in healthy older adults. Normal age-related declines in working memory can cause loss of independence and decreased quality of life. Cognitive training has shown some potential at enhancing certain cognitive processes, although, enhancements are variable. Transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation, has shown promise at enhancing working memory abilities, and may further the benefits from cognitive training interventions. However, the neural mechanisms underlying tDCS brain-based enhancements remain unknown. Objective/Hypothesis Assess the effects of a 2-week intervention of active-tDCS vs. sham paired with cognitive training on functional connectivity of the working memory network during an N-Back working memory task. Methods Healthy older adults (N = 28; mean age = 74 ± 7.3) completed 10-sessions of cognitive training paired with active or sham-tDCS. Functional connectivity was evaluated at baseline and post-intervention during an N-Back task (2-Back vs. 0-Back). Results Active-tDCS vs. sham demonstrated a significant increase in connectivity between the left dorsolateral prefrontal cortex and right inferior parietal lobule at post-intervention during 2-Back. Target accuracy on 2-Back was significantly improved for active vs. sham at post-intervention. Conclusion These results suggest pairing tDCS with cognitive training enhances functional connectivity and working memory performance in older adults, and thus may hold promise as a method for remediating age-related cognitive decline. Future studies evaluating optimal dose and long-term effects of tDCS on brain function will help to maximize potential clinical impacts of tDCS paired with cognitive training in older adults. Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT02137122.
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Affiliation(s)
- Nicole R Nissim
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Olivia von Mering
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Serkan Aksu
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Adam J Woods
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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Szymkowicz SM, Woods AJ, Dotson VM, Porges EC, Nissim NR, O’Shea A, Cohen RA, Ebner NC. Associations between subclinical depressive symptoms and reduced brain volume in middle-aged to older adults. Aging Ment Health 2019; 23:819-830. [PMID: 29381390 PMCID: PMC6066456 DOI: 10.1080/13607863.2018.1432030] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVES The associations between subclinical depressive symptoms, as well specific symptom subscales, on brain structure in aging are not completely elucidated. This study investigated the extent to which depressive symptoms were related to brain volumes in fronto-limbic structures in a sample of middle-aged to older adults. METHOD Eighty participants underwent structural neuroimaging and completed the Beck Depression Inventory, 2nd Edition (BDI-II), which comprises separate affective, cognitive, and somatic subscales. Gray matter volumes were extracted from the caudal and rostral anterior cingulate, posterior cingulate, hippocampus, and amygdala. Hierarchical regression models examined the relationship between brain volumes and (i) total depressive symptoms and (ii) BDI-II subscales were conducted. RESULTS After adjusting for total intracranial volume, race, and age, higher total depressive symptoms were associated with smaller hippocampal volume (p = 0.005). For the symptom subscales, after controlling for the abovementioned covariates and the influence of the other symptom subscales, more somatic symptoms were related to smaller posterior cingulate (p = 0.025) and hippocampal (p < 0.001) volumes. In contrast, the affective and cognitive subscales were not associated with brain volumes in any regions of interest. CONCLUSION Our data showed that greater symptomatology was associated with smaller volume in limbic brain regions. These findings provide evidence for preclinical biological markers of major depression and specifically advance knowledge of the relationship between subclinical depressive symptoms and brain volume. Importantly, we observed variations by specific depressive symptom subscales, suggesting a symptom-differential relationship between subclinical depression and brain volume alterations in middle-aged and older individuals.
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Affiliation(s)
- Sarah M. Szymkowicz
- Sarah M. Szymkowicz, M.S., 1Department of Clinical & Health Psychology, University of Florida, P.O. Box 100165, Gainesville, FL, 32610-0165. Phone: +1 (352) 273-6058.
| | - Adam J. Woods
- Adam J. Woods, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, P.O. Box 100015, Gainesville, FL, 32610-0015, 3Department of Neuroscience, University of Florida, P.O. Box 100244, Gainesville, FL, 32610-0244. Phone: +1 (352) 294-5842.
| | - Vonetta M. Dotson
- Vonetta M. Dotson, Ph.D., 4Department of Psychology, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010. Phone: +1 (404) 413-6207.
| | - Eric C. Porges
- Eric C. Porges, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5838.
| | - Nicole R. Nissim
- Nicole R. Nissim, M.S., 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, 3Department of Neuroscience, University of Florida. Phone: +1 (352) 294-5742.
| | - Andrew O’Shea
- Andrew O’Shea, M.S., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5827.
| | - Ronald A. Cohen
- Ronald A. Cohen, Ph.D., 1Department of Clinical & Health Psychology, University of Florida, 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida. Phone: +1 (352) 294-5840.
| | - Natalie C. Ebner
- Natalie C. Ebner, Ph.D., 2Center for Cognitive Aging & Memory, McKnight Brain Institute, University of Florida, 5Department of Psychology, University of Florida, P.O. Box 112250, Gainesville, FL, 32611, 6Department of Aging & Geriatric Research, University of Florida, 2004 Mowry Road, Gainesville, FL, 32611. Phone: +1 (203) 691-0371.
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Nissim NR, O'Shea A, Indahlastari A, Telles R, Richards L, Porges E, Cohen R, Woods AJ. Effects of in-Scanner Bilateral Frontal tDCS on Functional Connectivity of the Working Memory Network in Older Adults. Front Aging Neurosci 2019; 11:51. [PMID: 30930766 PMCID: PMC6428720 DOI: 10.3389/fnagi.2019.00051] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 02/22/2019] [Indexed: 11/13/2022] Open
Abstract
Working memory is an executive memory process essential for everyday decision-making and problem solving that declines with advanced age. Transcranial direct current stimulation (tDCS) is a non-invasive form of brain stimulation that has demonstrated potential for improving working memory performance in older adults. However, the neural mechanisms underlying effects of tDCS on working memory are not well understood. This mechanistic study investigated the acute and after-effects of bilateral frontal (F3/F4) tDCS at 2 mA for 12-min on functional connectivity of the working memory network in older adults. We hypothesized active tDCS over sham would increase frontal connectivity during working memory performance. The study used a double-blind within-subject 2 session crossover design. Participants performed an functional magnetic resonance imaging (fMRI) N-Back working memory task before, during, and after active or sham stimulation. Functional connectivity of the working memory network was assessed within and between stimulation conditions (FDR < 0.05). Active tDCS produced a significant increase in functional connectivity between left ventrolateral prefrontal cortex (VLPFC) and left dorsolateral PFC (DLPFC) during stimulation, but not after stimulation. Connectivity did not significantly increase with sham stimulation. In addition, our data demonstrated both state-dependent and time-dependent effects of tDCS working memory network connectivity in older adults. tDCS during working memory performance produces a selective change in functional connectivity of the working memory network in older adults. These data provide important mechanistic insight into the effects of tDCS on brain connectivity in older adults, as well as key methodological considerations for tDCS-working memory studies.
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Affiliation(s)
- Nicole R Nissim
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Rachel Telles
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Lindsey Richards
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Eric Porges
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Adam J Woods
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, McKnight Brain Institute, University of Florida, Gainesville, FL, United States.,Department of Neuroscience, University of Florida, Gainesville, FL, United States
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Indahlastari A, Albizu A, Nissim NR, Traeger KR, O’Shea A, Woods AJ. Proceedings #25: Methods to Determine Accuracy in tDCS Electrode Placements. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Nissim NR, O'Shea A, Richards LA, Telles R, Porges E, Cohen R, Woods AJ. Abstract #41: Effects of Bilateral-Frontal tDCS on the Working Memory Network: an fMRI-tDCS Study in Older Adults. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Indahlastari A, Albizu A, Nissim NR, Traeger KR, O'Shea A, Woods AJ. Methods to monitor accurate and consistent electrode placements in conventional transcranial electrical stimulation. Brain Stimul 2019; 12:267-274. [PMID: 30420198 PMCID: PMC6348875 DOI: 10.1016/j.brs.2018.10.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Inaccurate electrode placement and electrode drift during a transcranial electrical stimulation (tES) session have been shown to alter predicted field distributions in the brain and thus may contribute to a large variation in tES study outcomes. Currently, there is no objective and independent measure to quantify electrode placement accuracy/drift in tES clinical studies. OBJECTIVE/HYPOTHESIS We proposed and tested novel methods to quantify accurate and consistent electrode placements in tES using models generated from a 3D scanner. METHODS Accurate electrode placements were quantified as Discrepancy in eight tES participants by comparing landmark distances of physical electrode locations F3/F4 to their model counterparts. Distances in models were computed using curve and linear based methods. Variability of landmark locations in a single subject was computed for multiple stimulation sessions to determine consistent electrode placements across four experimenters. MAIN RESULTS We obtained an average of 0.4 cm in Discrepancy, which was within the placement accuracy/drift threshold (1 cm) for conventional tES electrodes (∼35 cm2) to achieve reliable tES sessions suggested in the literature. Averaged Variability was 5.2%, with F4 electrode location as the least consistent placement. CONCLUSIONS These methods provide objective feedback for experimenters on their performance in placing tES electrodes. Applications of these methods can be used to monitor electrode locations in tES studies of a larger cohort using F3/F4 montage and other conventional electrode arrangements. Future studies may include co-registering the landmark locations with imaging-derived head models to quantify the effects of electrode accuracy/drift on predicted field distributions in the brain.
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Affiliation(s)
- Aprinda Indahlastari
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA.
| | - Alejandro Albizu
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Kelsey R Traeger
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
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Gomes-Osman J, Indahlastari A, Fried PJ, Cabral DLF, Rice J, Nissim NR, Aksu S, McLaren ME, Woods AJ. Non-invasive Brain Stimulation: Probing Intracortical Circuits and Improving Cognition in the Aging Brain. Front Aging Neurosci 2018; 10:177. [PMID: 29950986 PMCID: PMC6008650 DOI: 10.3389/fnagi.2018.00177] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 05/22/2018] [Indexed: 12/14/2022] Open
Abstract
The impact of cognitive aging on brain function and structure is complex, and the relationship between aging-related structural changes and cognitive function are not fully understood. Physiological and pathological changes to the aging brain are highly variable, making it difficult to estimate a cognitive trajectory with which to monitor the conversion to cognitive decline. Beyond the information on the structural and functional consequences of cognitive aging gained from brain imaging and neuropsychological studies, non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) can enable stimulation of the human brain in vivo, offering useful insights into the functional integrity of intracortical circuits using electrophysiology and neuromodulation. TMS measurements can be used to identify and monitor changes in cortical reactivity, the integrity of inhibitory and excitatory intracortical circuits, the mechanisms of long-term potentiation (LTP)/depression-like plasticity and central cholinergic function. Repetitive TMS and tDCS can be used to modulate neuronal excitability and enhance cortical function, and thus offer a potential means to slow or reverse cognitive decline. This review will summarize and critically appraise relevant literature regarding the use of TMS and tDCS to probe cortical areas affected by the aging brain, and as potential therapeutic tools to improve cognitive function in the aging population. Challenges arising from intra-individual differences, limited reproducibility, and methodological differences will be discussed.
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Affiliation(s)
- Joyce Gomes-Osman
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
- Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, United States
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Aprinda Indahlastari
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Peter J. Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - Danylo L. F. Cabral
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Jordyn Rice
- Department of Physical Therapy, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Nicole R. Nissim
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Serkan Aksu
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Molly E. McLaren
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Adam J. Woods
- Department of Clinical and Health Psychology, Department of Neuroscience, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
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McLaren ME, Nissim NR, Woods AJ. The effects of medication use in transcranial direct current stimulation: A brief review. Brain Stimul 2017; 11:52-58. [PMID: 29066167 DOI: 10.1016/j.brs.2017.10.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/05/2017] [Accepted: 10/07/2017] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND There has been increased interest in the potential use of transcranial direct current stimulation (tDCS) as treatment for multiple conditions including depression, pain, and cognitive impairment. However, few studies account for the possible influence of comorbid medications when conducting tDCS research. OBJECTIVE/HYPOTHESIS This literature review was conducted to examine what is currently known about the impact of medications on tDCS, provide recommendations for future research practices, and highlight areas where more research is needed. METHODS Key terms were searched in PubMed and Web of Science to identify studies that examine the impact of medication on tDCS effects in adults. Relevant papers' reference lists were also reviewed for thoroughness. Studies examined the effects of medication on 1 mA tDCS delivered to M1 (motor) and orbit/supraorbital (SO) area. All studies measured the effects of tDCS via MEP TMS paradigm. RESULTS Results of the literature review suggest multiple classes of medications, including sodium and calcium channel blockers, and medications that influence various neurotransmitter systems (GABA, dopamine, serotonin, etc.) may all impact tDCS effects on tissue excitability. CONCLUSIONS Research to date suggests multiple classes of medications may impact tDCS effects. These results highlight the importance of documenting medication use in research subjects and carefully considering what types of medications should be allowed into tDCS trials. Many questions still remain regarding the exact mechanisms of action for tDCS and how various parameters (medication dosages, tDCS stimulation intensity, etc.) may further impact the effects of medications on tDCS.
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Affiliation(s)
- Molly E McLaren
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA.
| | - Nicole R Nissim
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA; Department of Neuroscience, University of Florida, PO Box 100244, Gainesville, FL 32610, USA.
| | - Adam J Woods
- Center for Cognitive Aging and Memory, Department of Clinical and Health Psychology, University of Florida, PO Box 100165, Gainesville, FL 32610, USA; Department of Neuroscience, University of Florida, PO Box 100244, Gainesville, FL 32610, USA.
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Nissim NR, O’Shea A, Richards L, Telles R, Porges E, Cohen R, Woods AJ. Bilateral frontal tDCS reduces DLPFC activation during working memory performance in older adults. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.04.079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Nissim NR, O'Shea AM, Bryant V, Porges EC, Cohen R, Woods AJ. Frontal Structural Neural Correlates of Working Memory Performance in Older Adults. Front Aging Neurosci 2017; 8:328. [PMID: 28101053 PMCID: PMC5210770 DOI: 10.3389/fnagi.2016.00328] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 12/19/2016] [Indexed: 01/26/2023] Open
Abstract
Working memory is an executive memory process that allows transitional information to be held and manipulated temporarily in memory stores before being forgotten or encoded into long-term memory. Working memory is necessary for everyday decision-making and problem solving, making it a fundamental process in the daily lives of older adults. Working memory relies heavily on frontal lobe structures and is known to decline with age. The current study aimed to determine the neural correlates of decreased working memory performance in the frontal lobes by comparing cortical thickness and cortical surface area from two demographically matched groups of healthy older adults, free from cognitive impairment, with high versus low N-Back working memory performance (N = 56; average age = 70.29 ± 10.64). High-resolution structural T1-weighted images (1 mm isotropic voxels) were obtained on a 3T Philips MRI scanner. When compared to high performers, low performers exhibited significantly decreased cortical surface area in three frontal lobe regions lateralized to the right hemisphere: medial orbital frontal gyrus, inferior frontal gyrus, and superior frontal gyrus (FDR p < 0.05). There were no significant differences in cortical thickness between groups, a proxy for neurodegenerative tissue loss. Our results suggest that decreases in cortical surface area (a proxy for brain structural integrity) in right frontal regions may underlie age-related decline of working memory function.
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Affiliation(s)
- Nicole R Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of FloridaGainesville, FL, USA; Department of Neuroscience, University of FloridaGainesville, FL, USA
| | - Andrew M O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Vaughn Bryant
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of FloridaGainesville, FL, USA; Department of Neuroscience, University of FloridaGainesville, FL, USA
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Abstract
The hippocampus is one of the most well studied structures in the human brain. While age-related decline in hippocampal volume is well documented, most of our knowledge about hippocampal structure-function relationships was discovered in the context of neurological and neurodegenerative diseases. The relationship between cognitive aging and hippocampal structure in the absence of disease remains relatively understudied. Furthermore, the few studies that have investigated the role of the hippocampus in cognitive aging have produced contradictory results. To address these issues, we assessed 93 older adults from the general community (mean age = 71.9 ± 9.3 years) on the Montreal Cognitive Assessment (MoCA), a brief cognitive screening measure for dementia, and the NIH Toolbox-Cognitive Battery (NIHTB-CB), a computerized neurocognitive battery. High-resolution structural magnetic resonance imaging (MRI) was used to estimate hippocampal volume. Lower MoCA Total (p = 0.01) and NIHTB-CB Fluid Cognition (p < 0.001) scores were associated with decreased hippocampal volume, even while controlling for sex and years of education. Decreased hippocampal volume was significantly associated with decline in multiple NIHTB-CB subdomains, including episodic memory, working memory, processing speed and executive function. This study provides important insight into the multifaceted role of the hippocampus in cognitive aging.
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Affiliation(s)
- Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Ronald A Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida Gainesville, FL, USA
| | - Nicole R Nissim
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of FloridaGainesville, FL, USA; Department of Neuroscience, University of FloridaGainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of FloridaGainesville, FL, USA; Department of Neuroscience, University of FloridaGainesville, FL, USA
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