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Ross G, Radtke-Schuller S, Frohlich F. Ferret as a model system for studying the anatomy and function of the prefrontal cortex: A systematic review. Neurosci Biobehav Rev 2024; 162:105701. [PMID: 38718987 DOI: 10.1016/j.neubiorev.2024.105701] [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: 10/30/2023] [Revised: 04/12/2024] [Accepted: 05/01/2024] [Indexed: 05/19/2024]
Abstract
There is a lack of consensus on anatomical nomenclature, standards of documentation, and functional equivalence of the frontal cortex between species. There remains a major gap between human prefrontal function and interpretation of findings in the mouse brain that appears to lack several key prefrontal areas involved in cognition and psychiatric illnesses. The ferret is an emerging model organism that has gained traction as an intermediate model species for the study of top-down cognitive control and other higher-order brain functions. However, this research has yet to benefit from synthesis. Here, we provide a summary of all published research pertaining to the frontal and/or prefrontal cortex of the ferret across research scales. The targeted location within the ferret brain is summarized visually for each experiment, and the anatomical terminology used at time of publishing is compared to what would be the appropriate term to use presently. By doing so, we hope to improve clarity in the interpretation of both previous and future publications on the comparative study of frontal cortex.
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Affiliation(s)
- Grace Ross
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
| | - Susanne Radtke-Schuller
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA.
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2
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Riddle J, McPherson T, Sheikh A, Shin H, Hadar E, Frohlich F. Internal Representations Are Prioritized by Frontoparietal Theta Connectivity and Suppressed by alpha Oscillation Dynamics: Evidence from Concurrent Transcranial Magnetic Stimulation EEG and Invasive EEG. J Neurosci 2024; 44:e1381232024. [PMID: 38395616 PMCID: PMC11007311 DOI: 10.1523/jneurosci.1381-23.2024] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 01/22/2024] [Accepted: 02/15/2024] [Indexed: 02/25/2024] Open
Abstract
Control over internal representations requires the prioritization of relevant information and suppression of irrelevant information. The frontoparietal network exhibits prominent neural oscillations during these distinct cognitive processes. Yet, the causal role of this network-scale activity is unclear. Here, we targeted theta-frequency frontoparietal coherence and dynamic alpha oscillations in the posterior parietal cortex using online rhythmic transcranial magnetic stimulation (TMS) in women and men while they prioritized or suppressed internally maintained working memory (WM) representations. Using concurrent high-density EEG, we provided evidence that we acutely drove the targeted neural oscillation and TMS improved WM capacity only when the evoked activity corresponded with the desired cognitive process. To suppress an internal representation, we increased the amplitude of lateralized alpha oscillations in the posterior parietal cortex contralateral to the irrelevant visual field. For prioritization, we found that TMS to the prefrontal cortex increased theta-frequency connectivity in the prefrontoparietal network contralateral to the relevant visual field. To understand the spatial specificity of these effects, we administered the WM task to participants with implanted electrodes. We found that theta connectivity during prioritization was directed from the lateral prefrontal to the superior posterior parietal cortex. Together, these findings provide causal evidence in support of a model where a frontoparietal theta network prioritizes internally maintained representations and alpha oscillations in the posterior parietal cortex suppress irrelevant representations.
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Affiliation(s)
- Justin Riddle
- Department of Psychology, Florida State University, Tallahassee, Florida 32304
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
| | - Trevor McPherson
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Department of Neurosciences, University of California, San Diego, San Diego, California 92161
| | - Atif Sheikh
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
| | - Haewon Shin
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Department of Neurology, University of New Mexico, Albuquerque, New Mexico 87106
| | - Eldad Hadar
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599
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Huang WA, Zhou ZC, Stitt IM, Ramasamy NS, Radtke-Schuller S, Frohlich F. Causal oscillations in the visual thalamo-cortical network in sustained attention in ferrets. Curr Biol 2024; 34:727-739.e5. [PMID: 38262418 PMCID: PMC10922762 DOI: 10.1016/j.cub.2023.12.067] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/07/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
Sustained visual attention allows us to process and react to unpredictable, behaviorally relevant sensory input. Sustained attention engages communication between the higher-order visual thalamus and its connected cortical regions. However, it remains unclear whether there is a causal relationship between oscillatory circuit dynamics and attentional behavior in these thalamo-cortical circuits. By using rhythmic optogenetic stimulation in the ferret, we provide causal evidence that higher-order visual thalamus coordinates thalamo-cortical and cortico-cortical functional connectivity during sustained attention via spike-field phase locking. Increasing theta but not alpha power in the thalamus improved accuracy and reduced omission rates in a sustained attention task. Further, the enhancement of effective connectivity by stimulation was correlated with improved behavioral performance. Our work demonstrates a potential circuit-level causal mechanism for how the higher-order visual thalamus modulates cortical communication through rhythmic synchronization during sustained attention.
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Affiliation(s)
- Wei A Huang
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Zhe C Zhou
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Iain M Stitt
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Nivetha S Ramasamy
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Susanne Radtke-Schuller
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC 27599, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC 27599, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC 27599, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC 27599, USA.
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Stewart Z, Korsapathy S, Frohlich F. Crowd-sourced investigation of a potential relationship between Bartonella-associated cutaneous lesions and neuropsychiatric symptoms. Front Psychiatry 2023; 14:1244121. [PMID: 37941969 PMCID: PMC10628448 DOI: 10.3389/fpsyt.2023.1244121] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/19/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Preliminary studies suggest that infection with Bartonella bacteria can not only cause a characteristic rash, headache, fever, and fatigue but also neuropsychiatric symptoms. To date, this association has only been reported in case studies, and it remains unclear if this association generalizes to larger samples. Methods We used Amazon's Mechanical Turk (MTurk) to crowdsource a large sample (N = 996) of individuals to ascertain the extent to which the presence of participant-identified Bartonella-associated cutaneous lesions (BACL) was associated with self-reported measures of anxiety, depression, and schizotypy. Participants were asked to select images of cutaneous lesions they had seen on their own bodies and complete a battery of self-report questionnaires to assess psychiatric symptoms. Participants were not informed that the focus of the study was on potential dermatological lesions associated with Bartonella. Point-biserial correlations were used to determine the potential relationship between selecting a BACL image and the severity of self-reported psychiatric symptoms. Results Scores of anxiety, depression, and schizotypy were positively and significantly correlated with selecting a BACL image. Furthermore, self-report scores of 10 or higher on the GAD-7 and PHQ-9, which represent the suggested clinical cutoffs for meeting criteria for a depressive or anxiety-related disorder, were also significantly associated with selecting a BACL image. Non-Bartonella-associated cutaneous legions were also significantly associated with self-reported measures of psychiatric symptoms. Discussion The current study broadens the link between the presence of BACL and the presence of psychiatric symptoms of anxiety, depression, and schizotypy and extends a potential relationship beyond the small sample sizes of previous case studies and case series. Further investigation is recommended to address limitations and expand on these findings.
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Affiliation(s)
- Zachary Stewart
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Sanvi Korsapathy
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Fang Q, Frohlich F. Dissection of neuronal circuits underlying sustained attention with the five-choice serial reaction time task. Neurosci Biobehav Rev 2023; 152:105306. [PMID: 37419229 PMCID: PMC10517644 DOI: 10.1016/j.neubiorev.2023.105306] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/09/2023]
Abstract
Attention deficits are common in psychiatric and neurological disorders. The transdiagnostic nature of impaired attention suggests a common set of underlying neural circuits. Yet, there are no circuit-based treatments such as non-invasive brain stimulation currently available due to the lack of sufficiently delineated network targets. Therefore, to better treat attentional deficits, a comprehensive functional dissection of neural circuits underlying attention is imperative. This can be achieved by taking advantage of preclinical animal models and well-designed behavioral assays of attention. The resulting findings in turn can be translated to the development of novel interventions with the goal of advancing them to clinical practice. Here we show that the five-choice serial reaction time task has greatly facilitated the study of the neural circuits underlying attention in a well-controlled setting. We first introduce the task and then focus on its application in preclinical studies on sustained attention, especially in the context of state-of-the-art neuronal perturbations.
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Affiliation(s)
- Qi Fang
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA.
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Sidelinger L, Zhang M, Frohlich F, Daughters S. Day-to-Day Individual Alpha Frequency Variability Measured by a Mobile EEG Device Relates to Anxiety. Eur J Neurosci 2023. [PMID: 37139573 DOI: 10.1111/ejn.16002] [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: 10/23/2022] [Revised: 04/12/2023] [Accepted: 04/22/2023] [Indexed: 05/05/2023]
Abstract
The individual alpha frequency (IAF) has previously been identified as a unique neural signature within the 8-12 Hz alpha frequency band. However, the day-to-day variability of this feature is unknown. To accomplish this, healthy participants recorded their own brain activity daily at home using the Muse 2 headband, a low-cost consumer-grade mobile electroencephalography (EEG) device. Resting-state recordings of all participants using a high-density (HD) EEG were also collected in lab before and after the at-home data collection period. We found that the IAF extracted from the Muse 2 was comparable to that of location-matched HD-EEG electrodes. No significant difference was found between these IAF values before and after the at-home recording period for the HD-EEG device. Similarly, there was also no statistically significant difference between the beginning and end of the at-home recording period for the Muse 2 headband over one month. Despite the group-level stability of IAF, the individual-level day-to-day IAF variability carried mental health-relevant information: exploratory analyses revealed a relationship between IAF day-to-day variability and trait anxiety. We also noted that the IAF systematically varied across the scalp and although the Muse 2 electrodes do not cover the occipital lobe where alpha oscillations were the strongest, IAFs measured in the temporal lobe and occipital lobe were strongly correlated. Altogether, these results show that mobile EEG devices are useful for studying IAF variability. The relationship between day-to-day variability of region-specific IAF and the dynamics of psychiatric symptoms, particularly anxiety, should be further investigated.
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Affiliation(s)
- Lauren Sidelinger
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mengsen Zhang
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA
- Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Stacey Daughters
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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7
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Zhang M, Force RB, Walker C, Ahn S, Jarskog LF, Frohlich F. Alpha transcranial alternating current stimulation reduces depressive symptoms in people with schizophrenia and auditory hallucinations: a double-blind, randomized pilot clinical trial. Schizophrenia (Heidelb) 2022; 8:114. [PMID: 36566277 PMCID: PMC9789318 DOI: 10.1038/s41537-022-00321-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/29/2022] [Indexed: 12/25/2022]
Abstract
People with schizophrenia exhibit reduced alpha oscillations and frontotemporal coordination of brain activity. Alpha oscillations are associated with top-down inhibition. Reduced alpha oscillations may fail to censor spurious endogenous activity, leading to auditory hallucinations. Transcranial alternating current stimulation (tACS) at the alpha frequency was shown to enhance alpha oscillations in people with schizophrenia and may thus be a network-based treatment for auditory hallucinations. We conducted a double-blind, randomized, placebo-controlled pilot clinical trial to examine the efficacy of 10-Hz tACS in treating auditory hallucinations in people with schizophrenia. 10-Hz tACS was administered in phase at the dorsolateral prefrontal cortex and the temporoparietal junction with a return current at Cz. Patients were randomized to receive tACS or sham for five consecutive days during the treatment week (40 min/day), followed by a maintenance period, during which participants received weekly tACS (40 min/visit) or sham. tACS treatment reduced general psychopathology (p < 0.05, Cohen's d = -0.690), especially depression (p < 0.005, Cohen's d = -0.806), but not auditory hallucinations. tACS treatment increased alpha power in the target region (p < 0.05), increased the frequency of peak global functional connectivity towards 10 Hz (p < 0.05), and reduced left-right frontal functional connectivity (p < 0.005). Importantly, changes in brain functional connectivity significantly correlated with symptom improvement (p < 0.05). Daily 10 Hz-tACS increased alpha power and altered alpha-band functional connectivity. Successful target engagement reduced depression and other general psychopathology symptoms, but not auditory hallucinations. Considering existing research of 10Hz tACS as a treatment for major depressive disorder, our study demonstrates its transdiagnostic potential for treating depression.
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Affiliation(s)
- Mengsen Zhang
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC USA
| | - Rachel B. Force
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC USA
| | - Christopher Walker
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Sangtae Ahn
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA ,grid.258803.40000 0001 0661 1556School of Electronic and Electrical Engineering, Kyungpook National University, Daegu, South Korea
| | - L. Fredrik Jarskog
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA
| | - Flavio Frohlich
- grid.410711.20000 0001 1034 1720Department of Psychiatry, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Neuroscience Center, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC USA ,grid.410711.20000 0001 1034 1720Department of Neurology, University of North Carolina, Chapel Hill, NC USA
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8
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Brunoni AR, Ekhtiari H, Antal A, Auvichayapat P, Baeken C, Benseñor IM, Bikson M, Boggio P, Borroni B, Brighina F, Brunelin J, Carvalho S, Caumo W, Ciechanski P, Charvet L, Clark VP, Cohen Kadosh R, Cotelli M, Datta A, Deng ZD, De Raedt R, De Ridder D, Fitzgerald PB, Floel A, Frohlich F, George MS, Ghobadi-Azbari P, Goerigk S, Hamilton RH, Jaberzadeh SJ, Hoy K, Kidgell DJ, Zonoozi AK, Kirton A, Laureys S, Lavidor M, Lee K, Leite J, Lisanby SH, Loo C, Martin DM, Miniussi C, Mondino M, Monte-Silva K, Morales-Quezada L, Nitsche MA, Okano AH, Oliveira CS, Onarheim B, Pacheco-Barrios K, Padberg F, Nakamura-Palacios EM, Palm U, Paulus W, Plewnia C, Priori A, Rajji TK, Razza LB, Rehn EM, Ruffini G, Schellhorn K, Zare-Bidoky M, Simis M, Skorupinski P, Suen P, Thibaut A, Valiengo LCL, Vanderhasselt MA, Vanneste S, Venkatasubramanian G, Violante IR, Wexler A, Woods AJ, Fregni F. Digitalized transcranial electrical stimulation: A consensus statement. Clin Neurophysiol 2022; 143:154-165. [PMID: 36115809 PMCID: PMC10031774 DOI: 10.1016/j.clinph.2022.08.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [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: 04/06/2022] [Revised: 08/16/2022] [Accepted: 08/20/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome methodological barriers and increase equity of access. The study aims are to discuss the implementation of tES digital trials by performing a systematic scoping review and strategic process mapping, evaluate methodological aspects of tES digital trial designs, and provide Delphi-based recommendations for implementing digital trials using tES. METHODS We convened 61 highly-productive specialists and contacted 8 tES companies to assess 71 issues related to tES digitalization readiness, and processes, barriers, advantages, and opportunities for implementing tES digital trials. Delphi-based recommendations (>60% agreement) were provided. RESULTS The main strengths/opportunities of tES were: (i) non-pharmacological nature (92% of agreement), safety of these techniques (80%), affordability (88%), and potential scalability (78%). As for weaknesses/threats, we listed insufficient supervision (76%) and unclear regulatory status (69%). Many issues related to methodological biases did not reach consensus. Device appraisal showed moderate digitalization readiness, with high safety and potential for trial implementation, but low connectivity. CONCLUSIONS Panelists recognized the potential of tES for scalability, generalizability, and leverage of digital trials processes; with no consensus about aspects regarding methodological biases. SIGNIFICANCE We further propose and discuss a conceptual framework for exploiting shared aspects between mobile-Health tES technologies with digital trials methodology to drive future efforts for digitizing tES trials.
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Affiliation(s)
- Andre R Brunoni
- Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo & Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil; Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
| | - Hamed Ekhtiari
- Laureate Institute for Brain Research (LIBR), Tulsa, OK, USA
| | - Andrea Antal
- Department of Neurology, University Medical Center Göttingen, Göttingen, Germany
| | - Paradee Auvichayapat
- Department of Physiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chris Baeken
- Vrije Universiteit Brussel (VUB): Department of Psychiatry University Hospital (UZBrussel), Brussels, Belgium; Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, the Netherlands
| | - Isabela M Benseñor
- Center for Clinical and Epidemiological Research, University of São Paulo, São Paulo, Brazil
| | - Marom Bikson
- The Department of Biomedical Engineering, The City College of New York, The City University of New York, NY, USA
| | - Paulo Boggio
- Social and Cognitive Neuroscience Laboratory, Center for Biological Science and Health, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Barbara Borroni
- Centre for Neurodegenerative Disorders, Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy
| | - Jerome Brunelin
- Centre Hospitalier le Vinatier, Bron, France; INSERM U1028, CNRS UMR 5292, PSYR2 Team, Centre de recherche en Neurosciences de Lyon (CRNL), Université Lyon 1, Lyon, France
| | - Sandra Carvalho
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Wolnei Caumo
- Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Brazil; Laboratory of Pain and Neuromodulation at Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil; Pain and Palliative Care Service at HCPA, Brazil; Department of Surgery, School of Medicine, UFRGS, Brazil
| | - Patrick Ciechanski
- Faculty of Medicine and Dentistry, University of Alberta, 1-002 Katz Group Centre for Pharmacy and Health Research, Edmonton, Alberta, Canada
| | - Leigh Charvet
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Vincent P Clark
- Psychology Clinical Neuroscience Center, Department of Psychology, The University of New Mexico, Albuquerque, NM, USA
| | - Roi Cohen Kadosh
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Maria Cotelli
- Neuropsychology Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Abhishek Datta
- Research and Development, Soterix Medical Inc., New York, USA
| | - Zhi-De Deng
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Rudi De Raedt
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Paul B Fitzgerald
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Agnes Floel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, Germany
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA
| | - Mark S George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Peyman Ghobadi-Azbari
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Department of Biomedical Engineering, Shahed University, Tehran, Iran
| | - Stephan Goerigk
- Department of Psychiatry and Psychotherapy, LMU Hospital, Munich, Germany; Department of Psychological Methodology and Assessment, LMU, Munich, Germany; Hochschule Fresenius, University of Applied Sciences, Munich, Germany
| | - Roy H Hamilton
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Shapour J Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Kate Hoy
- Epworth Centre for Innovation in Mental Health, Epworth Healthcare and Monash University Department of Psychiatry, Camberwell, Victoria, Australia
| | - Dawson J Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Arash Khojasteh Zonoozi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Adam Kirton
- Department of Clinical Neurosciences and Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, GIGA Institute, University of Liège, Liege, Belgium
| | - Michal Lavidor
- Bar Ilan University, Department of Psychology, and the Gonda Brain Research Center, Israel
| | - Kiwon Lee
- Ybrain Corporation, Gyeonggi-do, Republic of Korea
| | - Jorge Leite
- INPP, Portucalense University, Porto, Portugal
| | - Sarah H Lisanby
- Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Colleen Loo
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Donel M Martin
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia; Black Dog Institute, Sydney, NSW, Australia
| | - Carlo Miniussi
- Center for Mind/Brain Sciences - CIMeC, University of Trento, Rovereto, Italy
| | - Marine Mondino
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (Bi.N.D.), University of Palermo, Palermo, Italy; Centre Hospitalier le Vinatier, Bron, France
| | - Katia Monte-Silva
- Applied Neuroscience Laboratory, Department of Physical Therapy, Universidade Federal de Pernambuco, UFPE, Recife, PE, Brazil; NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil
| | - Leon Morales-Quezada
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02215, USA
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Alexandre H Okano
- NAPeN Network (Núcleo de Assistência e Pesquisa em Neuromodulação), Brazil; Center for Mathematics, Computation, and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil; Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Claudia S Oliveira
- Master's and Doctoral Program in Health Sciences, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, Brazil; Master's and Doctoral Program in Human Movement and Rehabilitation, Evangelical University of Goiás, Anápolis, Brazil
| | | | - Kevin Pacheco-Barrios
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Lima, Peru
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ester M Nakamura-Palacios
- Laboratory of Cognitive Sciences and Neuropsychopharmacology, Program of Post-Graduation in Physiological Sciences, Health Sciences Center, Federal University of Espirito Santo, Vitória, ES, Brazil
| | - Ulrich Palm
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Munich, Germany; Medical Park Chiemseeblick, Rasthausstr. 25, 83233 Bernau-Felden, Germany
| | - Walter Paulus
- Department of Neurology. Ludwig Maximilians University Munich, Klinikum Großhadern, Marchioninistr, München, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), Neurophysiology and Interventional Neuropsychiatry, University of Tübingen, Tübingen, Germany
| | - Alberto Priori
- Aldo Ravelli Research Center for Neurotechnology and Experimental Neurotherapeutics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Tarek K Rajji
- Centre for Addiction and Mental Health, Toronto, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Toronto Dementia Research Alliance, Toronto, Canada
| | - Lais B Razza
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | | | | | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran; School of Medicine, Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Marcel Simis
- Physical and Rehabilitation Medicine Institute, General Hospital, Medical School of the University of Sao Paulo, São Paulo, Brazil
| | | | - Paulo Suen
- Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness & Centre du Cerveau, University and University Hospital of Liège, Liège, Belgium
| | - Leandro C L Valiengo
- Laboratory of Neurosciences (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBioN), Service of Interdisciplinary Neuromodulation (SIN), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Marie-Anne Vanderhasselt
- Department of Head and Skin, Ghent University Hospital, Ghent University, Ghent, Belgium; Ghent Experimental Psychiatry (GHEP) Lab, Ghent, Belgium
| | - Sven Vanneste
- Lab for Clinical & Integrative Neuroscience, Trinity College of Neuroscience, Trinity College Dublin, Ireland
| | - Ganesan Venkatasubramanian
- Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Anna Wexler
- Department of Medical Ethics and Health Policy, University of Pennsylvania, Philadelphia, PA, 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
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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Riddle J, Rubinow DR, Frohlich F. Effect of tACS on prefrontal neural activity is menstrual phase dependent in patients with premenstrual dysphoric disorder. Brain Stimul 2022; 15:1088-1090. [PMID: 35921958 DOI: 10.1016/j.brs.2022.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 07/25/2022] [Indexed: 11/02/2022] Open
Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Riddle J, Frohlich F. Mental Activity as the Bridge between Neural Biomarkers and Symptoms of Psychiatric Illness. Clin EEG Neurosci 2022:15500594221112417. [PMID: 35861807 DOI: 10.1177/15500594221112417] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Research Domain Criteria (RDoC) initiative challenges researchers to build neurobehavioral models of psychiatric illness with the hope that such models identify better targets that will yield more effective treatment. However, a guide for building such models was not provided and symptom heterogeneity within Diagnostic Statistical Manual categories has hampered progress in identifying endophenotypes that underlie mental illness. We propose that the best chance to discover viable biomarkers and treatment targets for psychiatric illness is to investigate a triangle of relationships: severity of a specific psychiatric symptom that correlates to mental activity that correlates to a neural activity signature. We propose that this is the minimal model complexity required to advance the field of psychiatry. With an understanding of how neural activity relates to the experience of the patient, a genuine understanding for how treatment imparts its therapeutic effect is possible. After the discovery of this three-fold relationship, causal testing is required in which the neural activity pattern is directly enhanced or suppressed to provide causal, instead of just correlational, evidence for the biomarker. We suggest using non-invasive brain stimulation (NIBS) as these techniques provide tools to precisely manipulate spatial and temporal activity patterns. We detail how this approach enabled the discovery of two orthogonal electroencephalography (EEG) activity patterns associated with anhedonia and anxiosomatic symptoms in depression that can serve as future treatment targets. Altogether, we propose a systematic approach for building neurobehavioral models for dimensional psychiatry.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Neurology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Cell Biology and Physiology, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Biomedical Engineering, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Neuroscience Center, 6797University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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12
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Riddle J, Alexander ML, Schiller CE, Rubinow DR, Frohlich F. Reward-Based Decision-Making Engages Distinct Modes of Cross-Frequency Coupling. Cereb Cortex 2022; 32:2079-2094. [PMID: 34622271 PMCID: PMC9113280 DOI: 10.1093/cercor/bhab336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 04/13/2021] [Revised: 08/18/2021] [Accepted: 08/22/2021] [Indexed: 11/13/2022] Open
Abstract
Prefrontal cortex exerts control over sensory and motor systems via cross-frequency coupling. However, it is unknown whether these signals play a role in reward-based decision-making and whether such dynamic network configuration is altered in a major depressive episode. We recruited men and women with and without depression to perform a streamlined version of the Expenditure of Effort for Reward Task during recording of electroencephalography. Goal-directed behavior was quantified as willingness to exert physical effort to obtain reward, and reward-evaluation was the degree to which the decision to exert effort was modulated by incentive level. We found that the amplitude of frontal-midline theta oscillations was greatest in participants with the greatest reward-evaluation. Furthermore, coupling between frontal theta phase and parieto-occipital gamma amplitude was positively correlated with reward-evaluation. In addition, goal-directed behavior was positively correlated with coupling between frontal delta phase to motor beta amplitude. Finally, we performed a factor analysis to derive 2 symptom dimensions and found that mood symptoms positively tracked with reward-evaluation and motivation symptoms negatively tracked with goal-directed behavior. Altogether, these results provide evidence that 2 aspects of reward-based decision-making are instantiated by different modes of prefrontal top-down control and are modulated in different symptom dimensions of depression.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Morgan L Alexander
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Crystal Edler Schiller
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Frohlich F, Riddle J. Transcranial alternating current stimulation (tACS) as a treatment for fibromyalgia syndrome? Eur Arch Psychiatry Clin Neurosci 2022; 272:349-350. [PMID: 33715022 PMCID: PMC9332915 DOI: 10.1007/s00406-021-01253-z] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/03/2021] [Indexed: 11/25/2022]
Affiliation(s)
- Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Justin Riddle
- Department of Psychiatry, University of North Carolina at
Chapel Hill, Chapel Hill, NC, USA,Carolina Center for Neurostimulation, University of North
Carolina at Chapel Hill, Chapel Hill, NC, USA
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Riddle J, Alexander ML, Schiller CE, Rubinow DR, Frohlich F. Reduction in Left Frontal Alpha Oscillations by Transcranial Alternating Current Stimulation in Major Depressive Disorder Is Context Dependent in a Randomized Clinical Trial. Biol Psychiatry Cogn Neurosci Neuroimaging 2022; 7:302-311. [PMID: 34273556 PMCID: PMC8758795 DOI: 10.1016/j.bpsc.2021.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Left frontal alpha oscillations are associated with decreased approach motivation and have been proposed as a target for noninvasive brain stimulation for the treatment of depression and anhedonia. Indeed, transcranial alternating current stimulation (tACS) at the alpha frequency reduced left frontal alpha power and was associated with a higher response rate than placebo stimulation in patients with major depressive disorder (MDD) in a recent double-blind, placebo-controlled clinical trial. METHODS In this current study, we aimed to replicate successful target engagement by delineating the effects of a single session of bifrontal tACS at the individualized alpha frequency (IAF-tACS) on alpha oscillations in patients with MDD. Eighty-four participants were randomized to receive verum or sham IAF-tACS. Electrical brain activity was recorded during rest and while viewing emotionally salient images before and after stimulation to investigate whether the modulation of alpha oscillation by tACS exhibited specificity with regard to valence. RESULTS In agreement with the previous study of tACS in MDD, we found that a single session of bifrontal IAF-tACS reduced left frontal alpha power during the resting state when compared with placebo. Furthermore, the reduction of left frontal alpha oscillation by tACS was specific for stimuli with positive valence. In contrast, these effects on left frontal alpha power were not found in healthy control participants. CONCLUSIONS Together, these results support an important role of tACS in reducing left frontal alpha oscillations as a future treatment for MDD.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Morgan L. Alexander
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - David R. Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Sklerov M, Browner N, Dayan E, Rubinow D, Frohlich F. Autonomic and Depression Symptoms in Parkinson's Disease: Clinical Evidence for Overlapping Physiology. J Parkinsons Dis 2022; 12:1059-1067. [PMID: 35124662 DOI: 10.3233/jpd-213075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Autonomic dysfunction and depression are common non-motor symptoms of Parkinson's disease (PD) that confer poorer prognosis. These PD symptoms may have overlapping pathophysiologic underpinnings. OBJECTIVE To investigate associations between autonomic and depression symptoms in early PD, and their evolution over time. METHODS We obtained data from the Parkinson's Progression Markers Initiative, a prospective open-access database of early PD. Regression analyses were used to model effects of depression on autonomic symptoms in controls and in PD at baseline, visit 6 (24 months after baseline), and visit 12 (60 months after baseline), correcting for multiple comparisons. RESULTS Data from 421 people with PD at baseline, 360 at visit 6, 300 at visit 12, and 193 controls were included. When controlling for age, depression, and anti-hypertensive medications, depression predicted autonomic symptoms in all groups. Accounting for motor symptoms did not alter these associations. When comparing groups, the influence of depression on autonomic symptoms was stronger in all PD groups compared to controls, and strongest in PD at visit 12. Depression predicted the presence of orthostatic hypotension only in the PD group at visit 12. CONCLUSION We demonstrated the important impact of depression on autonomic symptoms in early and middle stages of PD, which are independent of motor symptoms. Though the physiologic basis of these two PD symptoms are not fully understood, our findings add to pathologic evidence of a shared mechanistic substrate, separate from that responsible for PD motor symptoms. These findings may influence clinical management and development of novel therapies.
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Affiliation(s)
- Miriam Sklerov
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Nina Browner
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Eran Dayan
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, NC, USA
| | - David Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Zhang M, Frohlich F. Cell type-specific excitability probed by optogenetic stimulation depends on the phase of the alpha oscillation. Brain Stimul 2022; 15:472-482. [PMID: 35219922 PMCID: PMC8975618 DOI: 10.1016/j.brs.2022.02.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/08/2021] [Revised: 01/30/2022] [Accepted: 02/21/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Alpha oscillations have been proposed to provide phasic inhibition in the brain. Yet, pinging alpha oscillations with transcranial magnetic stimulation (TMS) to examine phase-dependent network excitability has resulted in conflicting findings. At the cellular level, such gating by the alpha oscillation remains poorly understood. OBJECTIVE We examine how the excitability of pyramidal cells and presumed fast-spiking inhibitory interneurons depends on the phase of the alpha oscillation. METHODS Optogenetic stimulation pulses were administered at random phases of the alpha oscillation in the posterior parietal cortex (PPC) of two adult ferrets that expressed channelrhodopsin in pyramidal cells. Post-stimulation firing probability was calculated as a function of the stimulation phase of the alpha oscillation for both verum and sham stimulation. RESULTS The excitability of pyramidal cells depended on the alpha phase, in anticorrelation with their intrinsic phase preference; pyramidal cells were more responsive to optogenetic stimulation at the alpha phase with intrinsically low firing rates. In contrast, presumed fast-spiking inhibitory interneurons did not show such a phase dependency despite their stronger intrinsic phase preference. CONCLUSIONS Alpha oscillations gate input to PPC in a phase-dependent manner such that low intrinsic activity was associated with higher responsiveness to input. This finding supports a model of cortical oscillation, in which internal processing and communication are limited to the depolarized half-cycle, whereas the other half-cycle serves as a signal detector for unexpected input. The functional role of different parts of the alpha cycle may vary across the cortex depending on local neuronal firing properties.
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Affiliation(s)
- Mengsen Zhang
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina, Chapel Hill, NC, USA.
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McFerren A, Riddle J, Walker C, Buse JB, Frohlich F. Causal role of frontal-midline theta in cognitive effort: a pilot study. J Neurophysiol 2021; 126:1221-1233. [PMID: 34469696 PMCID: PMC8560423 DOI: 10.1152/jn.00068.2021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 02/08/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 11/22/2022] Open
Abstract
Frontal-midline theta (FMT) oscillations are increased in amplitude during cognitive control tasks. Since these tasks often conflate cognitive control and cognitive effort, it remains unknown if FMT amplitude maps onto cognitive control or effort. To address this gap, we utilized the glucose facilitation effect to manipulate cognitive effort without changing cognitive control demands. We performed a single-blind, crossover human study in which we provided participants with a glucose drink (control session: volume-matched water) to reduce cognitive effort and improve performance on a visuospatial working memory task. Following glucose consumption, participants performed the working memory task at multiple time points of a 3-h window to sample across the rise and fall of blood glucose. Using high-density electroencephalography (EEG), we calculated FMT amplitude during the delay period of the working memory task. Source localization analysis revealed that FMT oscillations originated from bilateral prefrontal cortex. We found that glucose increased working memory accuracy during the high working memory load condition but decreased FMT amplitude. The decrease in FMT amplitude coincided with both peak blood glucose elevation and peak performance enhancement for glucose relative to water. Therefore, the positive association between glucose consumption and task performance provided causal evidence that the amplitude of FMT oscillations may correspond to cognitive effort, rather than cognitive control. Due to the COVID-19 pandemic, data collection was terminated prematurely; the preliminary nature of these findings due to small sample size should be contextualized by rigorous experimental design and use of a novel causal perturbation to dissociate cognitive effort and cognitive control.NEW & NOTEWORTHY We investigated whether frontal-midline theta (FMT) oscillations tracked with cognitive control or cognitive effort by simultaneous manipulation of cognitive control demands in a working memory task and causal perturbation of cognitive effort using glucose consumption. Facilitation of performance from glucose consumption corresponded with decreased FMT amplitude, which provided preliminary causal evidence for a relationship between FMT amplitude with cognitive effort.
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Affiliation(s)
- Amber McFerren
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
- Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, North Carolina
| | - Justin Riddle
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
- Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, North Carolina
| | - Christopher Walker
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
- Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, North Carolina
| | - John B Buse
- Division of Endocrinology and Metabolism, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
- Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, North Carolina
- Department of Neurology, University of North Carolina, Chapel Hill, North Carolina
- Department of Cell Biology and Physiology, University of North Carolina, Chapel Hill, North Carolina
- Department of Biomedical Engineering, University of North Carolina, Chapel Hill, North Carolina
- Neuroscience Center, University of North Carolina, Chapel Hill, North Carolina
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Riddle J, Frohlich F. Targeting neural oscillations with transcranial alternating current stimulation. Brain Res 2021; 1765:147491. [PMID: 33887251 PMCID: PMC8206031 DOI: 10.1016/j.brainres.2021.147491] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/26/2021] [Accepted: 04/13/2021] [Indexed: 11/16/2022]
Abstract
Neural oscillations at the network level synchronize activity between regions and temporal scales. Transcranial alternating current stimulation (tACS), the delivery of low-amplitude electric current to the scalp, provides a tool for investigating the causal role of neural oscillations in cognition. The parameter space for tACS is vast and optimization is required in terms of temporal and spatial targeting. We review emerging techniques and suggest novel approaches that capitalize on the non-sinusoidal and transient nature of neural oscillations and leverage the flexibility provided by a customizable electrode montage and electrical waveform. The customizability and safety profile of tACS make it a promising tool for precision intervention in psychiatric illnesses.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Reese ED, Kane LF, Paquette CE, Frohlich F, Daughters SB. Lost in Translation: the Gap Between Neurobiological Mechanisms and Psychosocial Treatment Research for Substance Use Disorders. Curr Addict Rep 2021. [DOI: 10.1007/s40429-021-00382-8] [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: 10/20/2022]
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Riddle J, McFerren A, Frohlich F. Causal role of cross-frequency coupling in distinct components of cognitive control. Prog Neurobiol 2021; 202:102033. [PMID: 33741402 PMCID: PMC8184612 DOI: 10.1016/j.pneurobio.2021.102033] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [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: 02/24/2021] [Accepted: 03/14/2021] [Indexed: 01/13/2023]
Abstract
Cognitive control is the capacity to guide motor and perceptual systems towards abstract goals. High-frequency neural oscillations related to motor activity in the beta band (13-30 Hz) and to visual processing in the gamma band (>30 Hz) are known to be modulated by cognitive control signals. One proposed mechanism for cognitive control is via cross-frequency coupling whereby low frequency network oscillations in prefrontal cortex (delta from 2-3 Hz and theta from 4-8 Hz) guide the expression of motor-related activity in action planning and guide perception-related activity in memory access. However, there is no causal evidence for cross-frequency coupling in these dissociable components of cognitive control. To address this important gap in knowledge, we delivered cross-frequency transcranial alternating current stimulation (CF-tACS) during performance of a task that manipulated cognitive control demands along two dimensions: the abstraction of the rules of the task (nested levels of action selection) that increased delta-beta coupling and the number of rules (set-size held in memory) that increased theta-gamma coupling. As hypothesized, we found that CF-tACS increased the targeted phase-amplitude coupling and modulated task performance of the associated cognitive control component. These findings provide causal evidence that prefrontal cortex orchestrates different components of cognitive control via two different cross-frequency coupling modalities.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Amber McFerren
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Frohlich F, Riddle J, Abramowitz JS. Transcranial alternating current stimulation for the treatment of obsessive-compulsive disorder? Brain Stimul 2021; 14:1048-1050. [PMID: 34192553 PMCID: PMC9337719 DOI: 10.1016/j.brs.2021.06.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jonathan S Abramowitz
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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22
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Frohlich F, Ahn S. Differing dose details and controlling confounding covariates in modulating motor cortex excitability by transcranial direct current stimulation. Brain Stimul 2021; 14:947-948. [PMID: 34118495 DOI: 10.1016/j.brs.2021.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/24/2021] [Indexed: 11/16/2022] Open
Affiliation(s)
- Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Sangtae Ahn
- School of Electronic and Electrical Engineering, Kyungpook National University, Daegu, South Korea; School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
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23
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Lashnits E, Maggi R, Jarskog F, Bradley J, Breitschwerdt E, Frohlich F. Schizophrenia and Bartonella spp. Infection: A Pilot Case-Control Study. Vector Borne Zoonotic Dis 2021; 21:413-421. [PMID: 33728987 PMCID: PMC8170724 DOI: 10.1089/vbz.2020.2729] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [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] [Indexed: 12/13/2022] Open
Abstract
Recently, infections with emerging zoonotic bacteria of the genus Bartonella have been reported in association with a range of central nervous system (CNS) symptoms. Currently, it remains unknown if Bartonella spp. infection is associated with symptoms of schizophrenia/schizoaffective disorder (SCZ/SAD). The objective of this study was to determine if there is an association between Bartonella species infection and SCZ/SAD. A secondary objective was to determine if SCZ/SAD symptoms were more severe among participants with documented Bartonella spp. infection. Using a case-control study design, 17 cases and 13 controls were evaluated with a series of clinical and cognitive assessments. Blood samples were collected and tested for Bartonella spp. infection using serological, microbiological, and molecular techniques. People with SCZ/SAD were more likely than healthy volunteers to have Bartonella spp. DNA in their bloodstream, with 11 of 17 cases (65%) positive by Bartonella spp. droplet digital PCR (ddPCR). In comparison, only one healthy volunteer was Bartonella spp. ddPCR positive (8%, p = 0.0024). Based on serology, Bartonella spp. exposure was common among people with SCZ/SAD (12 of 17) as well as among healthy volunteers (12 of 13), with no significant difference between the groups (p = 0.196). Within the case group of people with SCZ/SAD, there was no significant difference in SCZ/SAD severity scores between people with and without ddPCR evidence of Bartonella spp. infection. This pilot study provides preliminary evidence in support of future investigations that should examine a potential contribution of Bartonella spp. infection to SCZ/SAD.
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Affiliation(s)
- Erin Lashnits
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Ricardo Maggi
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Fredrik Jarskog
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Julie Bradley
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Edward Breitschwerdt
- Comparative Medicine Institute, Department of Clinical Sciences, Intracellular Pathogens Research Laboratory, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Carolina Center for Neurostimulation and Neuroscience Center, Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Neurology and University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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West EA, Niedringhaus M, Ortega HK, Haake RM, Frohlich F, Carelli RM. Noninvasive Brain Stimulation Rescues Cocaine-Induced Prefrontal Hypoactivity and Restores Flexible Behavior. Biol Psychiatry 2021; 89:1001-1011. [PMID: 33678418 PMCID: PMC8106639 DOI: 10.1016/j.biopsych.2020.12.027] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND To obtain desirable goals, individuals must predict the outcome of specific choices, use that information to direct appropriate actions, and adjust behavior accordingly in changing environments (behavioral flexibility). Substance use disorders are marked by impairments in behavioral flexibility along with decreased prefrontal cortical function that limits the efficacy of treatment strategies. Restoring prefrontal hypoactivity, ideally in a noninvasive manner, is an intriguing target for improving flexible behavior and treatment outcomes. METHODS A behavioral flexibility task was used in Long-Evans male rats (n = 97) in conjunction with electrophysiology, optogenetics, and a novel rat model of transcranial alternating current stimulation (tACS) to examine the prelimbic cortex (PrL) to nucleus accumbens (NAc) core circuit in behavioral flexibility and determine whether tACS can restore cocaine-induced neural and cognitive dysfunction. RESULTS Optogenetic inactivation revealed that the PrL-NAc core circuit is necessary for the ability to learn strategies to flexibly shift behavior. Cocaine self-administration history caused aberrant PrL-NAc core neural encoding and deficits in flexibility. Optogenetics that selectively activated the PrL-NAc core pathway prior to learning rescued cocaine-induced cognitive flexibility deficits. Remarkably, tACS prior to learning the task reestablished adaptive signaling in the PrL-NAc circuit and restored flexible behavior in a relatively noninvasive and frequency-specific manner. CONCLUSIONS We establish a role of NAc core-projecting PrL neurons in behavioral flexibility and provide a novel noninvasive brain stimulation method in rats to rescue cocaine-induced frontal hypofunction and restore flexible behavior, supporting a role of tACS as a therapeutic to treat cognitive deficits in substance use disorders.
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Affiliation(s)
- Elizabeth A West
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, New Jersey.
| | - Mark Niedringhaus
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Cell Biology and Neuroscience, Rowan University School of Osteopathic Medicine, Stratford, New Jersey
| | - Heather K Ortega
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Rachel M Haake
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Regina M Carelli
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
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Frohlich F, Riddle J. Conducting double-blind placebo-controlled clinical trials of transcranial alternating current stimulation (tACS). Transl Psychiatry 2021; 11:284. [PMID: 33980854 PMCID: PMC8116328 DOI: 10.1038/s41398-021-01391-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/08/2021] [Accepted: 04/19/2021] [Indexed: 12/13/2022] Open
Abstract
Many psychiatric and neurological illnesses can be conceptualized as oscillopathies defined as pathological changes in brain network oscillations. We previously proposed the application of rational design for the development of non-invasive brain stimulation for the modulation and restoration of cortical oscillations as a network therapeutic. Here, we show how transcranial alternating current stimulation (tACS), which applies a weak sine-wave electric current to the scalp, may serve as a therapeutic platform for the treatment of CNS illnesses. Recently, an initial series of double-blind, placebo-controlled treatment trials of tACS have been published. Here, we first map out the conceptual underpinnings of such trials with focus on target identification, engagement, and validation. Then, we discuss practical aspects that need to be considered for successful trial execution, with particular regards to ensuring successful study blind. Finally, we briefly review the few published double-blind tACS trials and conclude with a proposed roadmap to move the field forward with the goal of moving from pilot trials to convincing efficacy studies of tACS.
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Affiliation(s)
- Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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26
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Abstract
With the emergence of glycated hemoglobin as a diagnostic test for diabetes, oral glucose tolerance tests (OGTTs) have become rare in endocrinology practice. As they have moved out of favor, the importance of patient instructions on preparation prior to OGTT has faded from memory. Decades-old literature, well-known to endocrinologists a generation ago, emphasized the importance of carbohydrate intake prior to OGTT. In this expert endocrine consult, we discuss an OGTT performed in a research setting without adequate carbohydrate intake at the evening meal prior to the OGTT. The resultant elevated plasma glucose levels at 1-hour and 2-hours mimicked the loss of first-phase insulin release seen in early type 1 and type 2 diabetes. With clinical concern that the research participant had evolving type 1 or type 2 diabetes, the volunteer was subjected to additional testing and experienced anxiety. Repeat OGTT was normal after adequate carbohydrate intake (>150 grams/day and >50 grams the evening prior to overnight fast for the study). The physiology of this phenomenon is explored and is likely mediated through beta cell adaptation and alteration in peripheral glucose uptake in response to nutrient exposure. The learnings of decades ago have clearly faded, and this literature should be revisited to ensure that OGTT results are not compromised when ordered for clinical or research purposes.
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Affiliation(s)
- Klara R Klein
- Division of Endocrinology and Metabolism, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
| | - Christopher P Walker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Amber L McFerren
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Halie Huffman
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - John B Buse
- Division of Endocrinology and Metabolism, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA
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Riddle J, Rubinow DR, Girdler S, Frohlich F. Disinhibition of right inferior frontal gyrus underlies alpha asymmetry in women with low testosterone. Biol Psychol 2021; 161:108061. [PMID: 33705806 DOI: 10.1016/j.biopsycho.2021.108061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/15/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
Abstract
Asymmetrical expression of alpha oscillations in the frontal cortex, increased left relative to right, is a phenotype associated with increased behavioral inhibition and mood-related psychiatric illnesses. However, investigations of frontal alpha asymmetry in mood-disorders have yielded inconsistent findings. A better understanding of factors that contribute to individual differences is required to establish a useful biomarker for the diagnosis and treatment of mood and stress related disorders. A novel factor is hormone concentration, as steroid hormones play a prominent role in regulating mood and stress. To investigate this question, concentrations of testosterone and estradiol were sampled. Multiple linear regression revealed that low levels of testosterone correlated with greater frontal alpha asymmetry in women. Source localization found that frontal asymmetry was driven by decreased alpha power in right inferior frontal gyrus that correlated with increased behavioral inhibition in women. Together, these findings might explain inconsistencies in previous investigation on frontal alpha asymmetry.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, 304 MacNider Hall, 101 Manning Drive, Chapel Hill, NC, 27599, USA; Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Neurosciences Hospital, 101 Manning Drive, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, 6201 Mary Ellen Jones Building, 116 Manning Drive, Chapel Hill, NC, 27599, USA.
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, 304 MacNider Hall, 101 Manning Drive, Chapel Hill, NC, 27599, USA; Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Neurosciences Hospital, 101 Manning Drive, Chapel Hill, NC, 27599, USA.
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, 304 MacNider Hall, 101 Manning Drive, Chapel Hill, NC, 27599, USA; Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Neurosciences Hospital, 101 Manning Drive, Chapel Hill, NC, 27599, USA.
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, 304 MacNider Hall, 101 Manning Drive, Chapel Hill, NC, 27599, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, 6201 Mary Ellen Jones Building, 116 Manning Drive, Chapel Hill, NC, 27599, USA; Department of Neurology, University of North Carolina at Chapel Hill, 170 Manning Drive, Chapel Hill, NC, 27599, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, 5200 Medical Biomolecular Research Building, 111 Mason Farm Road, Chapel Hill, NC, 27599, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, 10010 Mary Ellen Jones, 116 Manning Drive, Chapel Hill, NC, 27599, USA; Neuroscience Center, University of North Carolina at Chapel Hill, 116 Manning Drive, Chapel Hill, NC, 27599, USA.
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28
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Frohlich F, Townsend L. Closed-Loop Transcranial Alternating Current Stimulation: Towards Personalized Non-invasive Brain Stimulation for the Treatment of Psychiatric Illnesses. Curr Behav Neurosci Rep 2021. [DOI: 10.1007/s40473-021-00227-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Frohlich F, Riddle J, Ugen G, Lersch F. Brainwave entrainment for the treatment of chronic pain: comment on Br J Pain 2020; 14: 161-70. Br J Pain 2021; 15:369-370. [PMID: 34381615 DOI: 10.1177/2049463721994614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Walker CP, Buse JB, Frohlich F. Experimental increase of blood glucose alters resting state EEG measures of excitation-inhibition balance. Exp Physiol 2021; 106:803-811. [PMID: 33507550 DOI: 10.1113/ep089211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 10/26/2020] [Accepted: 01/25/2021] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of this study? Glucose is the dominant energy source for the brain. However, little is known about how glucose metabolism impacts the coordination of network activity in the brain in healthy adults. What is the main finding and its importance? We demonstrate that both α oscillations and the aperiodic signal components of the resting EEG are modulated by experimentally elevated blood glucose concentrations. Our findings suggest that glucose increases measures associated with excitation-inhibition (E:I) balance, but that the effect on α oscillations might plateau. Understanding the relationship between glucose consumption and E:I balance is crucial to developing our understanding of how metabolism shapes human brain activity. ABSTRACT Brain network oscillations can be divided broadly into periodic and aperiodic signal components, which are sensitive to state-dependent changes in network coordination and excitation-inhibition (E:I) balance. We sought to address whether the dominant energy source of the brain, glucose, is implicated in the regulation of network activity and excitability. We conducted an experimenter-blind, crossover study of the effect of blood glucose level (BGL) on the resting EEG frequency spectrum. Participants consumed a glucose drink (75 g glucose) or an equivalent volume of water on two separate visits. EEG data were sampled before and ≤3 h after the drink. We found that the experimentally induced changes in BGL exhibited an inverted U-shaped relationship, with changes in the individual α frequency peak, whereas the slope of the aperiodic signal component of the frequency spectrum showed a positive linear association suggestive of greater excitation. In contrast, peak α power, which is typically associated with top-down inhibitory processes, was negatively associated with changes in BGL. Collectively, these results suggest that high BGL alters brain network coordination in the form of α oscillations and measures associated with E:I balance.
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Affiliation(s)
- Christopher P Walker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John B Buse
- Department of Medicine, Division of Endocrinology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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31
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Walker CP, McFerren AL, Rammani DR, Buse JB, Frohlich F. Metabolic state and gustatory perception shapes dynamic interplay between cortical excitability and motor response. Brain Stimul 2020; 14:202-205. [PMID: 33309841 DOI: 10.1016/j.brs.2020.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 11/29/2020] [Accepted: 12/04/2020] [Indexed: 12/15/2022] Open
Affiliation(s)
- Christopher P Walker
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber L McFerren
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Davindra R Rammani
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John B Buse
- Department of Medicine, Division of Endocrinology, University of North Carolina at Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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32
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Lersch F, Hight D, Frohlich F. Entrainment of brain network oscillations in anaesthesia. Comment on Br J Anaesth 2020; 125: 330-335. Br J Anaesth 2020; 126:e11-e12. [PMID: 32917374 DOI: 10.1016/j.bja.2020.08.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/22/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Friedrich Lersch
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Darren Hight
- Department of Anaesthesiology and Pain Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Flavio Frohlich
- Department of Psychiatry, Carolina Center for Neurostimulation, University of North Carolina, Chapel Hill, NC, USA
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33
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Riddle J, Ahn S, McPherson T, Girdler S, Frohlich F. Progesterone modulates theta oscillations in the frontal-parietal network. Psychophysiology 2020; 57:e13632. [PMID: 33400260 DOI: 10.1111/psyp.13632] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 02/19/2020] [Revised: 04/27/2020] [Accepted: 05/24/2020] [Indexed: 11/27/2022]
Abstract
The neuroactive metabolites of the steroid hormones progesterone (P4) and testosterone (T) are GABAergic modulators that influence cognition, yet, the specific effect of P4 and T on brain network activity remains poorly understood. Here, we investigated if a fundamental oscillatory network activity pattern, often related to cognitive control, frontal midline theta (FMT) oscillations, are modulated by steroids hormones, P4 and T. We measured the concentration of P4 and T using salivary enzyme immunoassay and FMT oscillations using high-density electroencephalography (EEG) during eyes-open resting-state in 55 healthy women and men. Electrical brain activity was analyzed using Fourier analysis, aperiodic signal fitting, and beamformer source localization. Steroid hormone concentrations and biological sex were used as predictors for scalp and source-estimated amplitude of theta oscillations. Elevated concentrations of P4 predicted increased amplitude of FMT oscillations across both sexes, and no relationship was found with T. The positive correlation with P4 was specific to the frontal midline electrodes and survived correction for the background aperiodic signal of the brain. Using source localization, FMT oscillations were localized to the frontal-parietal network (FPN). Additionally, theta amplitude within the FPN, but not the default mode network, positively correlated with P4 concentration. Our results suggest that P4 concentration modulates brain activity via upregulation of theta oscillations in the FPN.
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Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sangtae Ahn
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,School of Electronic Engineering, Kyungpook National University, Daegu, South Korea
| | - Trevor McPherson
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Susan Girdler
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Center for Women's Mood Disorders, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Riddle J, McPherson T, Atkins AK, Walker CP, Ahn S, Frohlich F. Brain-derived neurotrophic factor (BDNF) polymorphism may influence the efficacy of tACS to modulate neural oscillations. Brain Stimul 2020; 13:998-999. [PMID: 32330606 PMCID: PMC8191595 DOI: 10.1016/j.brs.2020.04.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 11/22/2022] Open
Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, USA
| | - Trevor McPherson
- Department of Psychiatry, University of North Carolina at Chapel Hill, USA; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, USA
| | - Alana K Atkins
- Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, USA; Department of Psychiatry, University of North Carolina at Chapel Hill, USA
| | - Christopher P Walker
- Department of Psychiatry, University of North Carolina at Chapel Hill; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill
| | - Sangtae Ahn
- Department of Psychiatry, University of North Carolina at Chapel Hill; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill; School of Electronics Engineering, Kyungpook National University, Daegu, South Korea
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill; Department of Neurology, University of North Carolina at Chapel Hill; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill; Department of Biomedical Engineering, University of North Carolina at Chapel Hill; Neuroscience Center, University of North Carolina at Chapel Hill.
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Riddle J, Rubinow DR, Frohlich F. A case study of weekly tACS for the treatment of major depressive disorder. Brain Stimul 2019; 13:576-577. [PMID: 32289679 PMCID: PMC8210803 DOI: 10.1016/j.brs.2019.12.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 10/30/2022] Open
Affiliation(s)
- Justin Riddle
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, United States
| | - David R Rubinow
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, United States; Carolina Center for Neurostimulation, University of North Carolina at Chapel Hill, United States; Neurobiology Curriculum, University of North Carolina at Chapel Hill, United States; Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, United States; Department of Biological Engineering, University of North Carolina at Chapel Hill, United States; Neuroscience Center, University of North Carolina at Chapel Hill, United States; Department of Neurology, University of North Carolina at Chapel Hill, United States.
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36
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Ekhtiari H, Tavakoli H, Addolorato G, Baeken C, Bonci A, Campanella S, Castelo-Branco L, Challet-Bouju G, Clark VP, Claus E, Dannon PN, Del Felice A, den Uyl T, Diana M, di Giannantonio M, Fedota JR, Fitzgerald P, Gallimberti L, Grall-Bronnec M, Herremans SC, Herrmann MJ, Jamil A, Khedr E, Kouimtsidis C, Kozak K, Krupitsky E, Lamm C, Lechner WV, Madeo G, Malmir N, Martinotti G, McDonald WM, Montemitro C, Nakamura-Palacios EM, Nasehi M, Noël X, Nosratabadi M, Paulus M, Pettorruso M, Pradhan B, Praharaj SK, Rafferty H, Sahlem G, Salmeron BJ, Sauvaget A, Schluter RS, Sergiou C, Shahbabaie A, Sheffer C, Spagnolo PA, Steele VR, Yuan TF, van Dongen JDM, Van Waes V, Venkatasubramanian G, Verdejo-García A, Verveer I, Welsh JW, Wesley MJ, Witkiewitz K, Yavari F, Zarrindast MR, Zawertailo L, Zhang X, Cha YH, George TP, Frohlich F, Goudriaan AE, Fecteau S, Daughters SB, Stein EA, Fregni F, Nitsche MA, Zangen A, Bikson M, Hanlon CA. Transcranial electrical and magnetic stimulation (tES and TMS) for addiction medicine: A consensus paper on the present state of the science and the road ahead. Neurosci Biobehav Rev 2019; 104:118-140. [PMID: 31271802 PMCID: PMC7293143 DOI: 10.1016/j.neubiorev.2019.06.007] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [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: 04/11/2019] [Revised: 05/30/2019] [Accepted: 06/08/2019] [Indexed: 12/21/2022]
Abstract
There is growing interest in non-invasive brain stimulation (NIBS) as a novel treatment option for substance-use disorders (SUDs). Recent momentum stems from a foundation of preclinical neuroscience demonstrating links between neural circuits and drug consuming behavior, as well as recent FDA-approval of NIBS treatments for mental health disorders that share overlapping pathology with SUDs. As with any emerging field, enthusiasm must be tempered by reason; lessons learned from the past should be prudently applied to future therapies. Here, an international ensemble of experts provides an overview of the state of transcranial-electrical (tES) and transcranial-magnetic (TMS) stimulation applied in SUDs. This consensus paper provides a systematic literature review on published data - emphasizing the heterogeneity of methods and outcome measures while suggesting strategies to help bridge knowledge gaps. The goal of this effort is to provide the community with guidelines for best practices in tES/TMS SUD research. We hope this will accelerate the speed at which the community translates basic neuroscience into advanced neuromodulation tools for clinical practice in addiction medicine.
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Affiliation(s)
| | - Hosna Tavakoli
- Institute for Cognitive Science Studies (ICSS), Iran; Iranian National Center for Addiction Studies (INCAS), Iran
| | - Giovanni Addolorato
- Alcohol Use Disorder Unit, Division of Internal Medicine, Gastroenterology and Hepatology Unit, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy; Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Antonello Bonci
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Vincent P Clark
- University of New Mexico, USA; The Mind Research Network, USA
| | | | | | - Alessandra Del Felice
- University of Padova, Department of Neuroscience, Padova, Italy; Padova Neuroscience Center (PNC), University of Padova, Padova, Italy
| | | | - Marco Diana
- 'G. Minardi' Laboratory of Cognitive Neuroscience, Department of Chemistry and Pharmacy, University of Sassari, Italy
| | | | - John R Fedota
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | | | - Luigi Gallimberti
- Novella Fronda Foundation, Human Science and Brain Research, Padua, Italy
| | | | - Sarah C Herremans
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
| | - Martin J Herrmann
- Center of Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany
| | - Asif Jamil
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Karolina Kozak
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Evgeny Krupitsky
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, St.-Petersburg, Russia; St.-Petersburg First Pavlov State Medical University, Russia
| | - Claus Lamm
- Department of Basic Psychological Research and Research Methods, Faculty of Psychology, University of Vienna, Austria
| | | | - Graziella Madeo
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | | | | | - William M McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Chiara Montemitro
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA; University G.d'Annunzio of Chieti-Pescara, Italy
| | | | - Mohammad Nasehi
- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences, Islamic Azad University, Tehran, Iran
| | - Xavier Noël
- Université Libre de Bruxelles (ULB), Belgium
| | | | | | | | | | - Samir K Praharaj
- Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - Haley Rafferty
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | | | - Betty Jo Salmeron
- Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, USA
| | - Anne Sauvaget
- Laboratory «Movement, Interactions, Performance» (E.A. 4334), University of Nantes, 25 Bis Boulevard Guy Mollet, BP 72206, 44322, Nantes Cedex 3, France; CHU de Nantes Addictology and Liaison Psychiatry Department, University Hospital Nantes, Nantes Cedex 3, France
| | - Renée S Schluter
- Laureate Institute for Brain Research, USA; Institute for Cognitive Science Studies (ICSS), Iran
| | | | - Alireza Shahbabaie
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | | | | | - Vaughn R Steele
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Ti-Fei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, China
| | | | - Vincent Van Waes
- Laboratoire de Neurosciences Intégratives et Cliniques EA481, Université Bourgogne Franche-Comté, Besançon, France
| | | | | | | | - Justine W Welsh
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - Fatemeh Yavari
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohammad-Reza Zarrindast
- Department of Pharmacology School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Laurie Zawertailo
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | - Xiaochu Zhang
- University of Science and Technology of China, China
| | | | - Tony P George
- University of Toronto, Canada; Centre for Addiction and Mental Health (CAMH), Canada
| | | | - Anna E Goudriaan
- Department of Psychiatry, Amsterdam Institute for Addiction Research, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands; Arkin, Department of Research and Quality of Care, Amsterdam, The Netherlands
| | | | | | - Elliot A Stein
- Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA
| | - Felipe Fregni
- Spaulding Rehabilitation Hospital, Harvard Medical School, USA
| | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; University Medical Hospital Bergmannsheil, Dept. Neurology, Bochum, Germany
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Bikson M, Brunoni AR, Charvet LE, Clark VP, Cohen LG, Deng ZD, Dmochowski J, Edwards DJ, Frohlich F, Kappenman ES, Lim KO, Loo C, Mantovani A, McMullen DP, Parra LC, Pearson M, Richardson JD, Rumsey JM, Sehatpour P, Sommers D, Unal G, Wassermann EM, Woods AJ, Lisanby SH. Rigor and reproducibility in research with transcranial electrical stimulation: An NIMH-sponsored workshop. Brain Stimul 2018; 11:465-480. [PMID: 29398575 PMCID: PMC5997279 DOI: 10.1016/j.brs.2017.12.008] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 12/01/2017] [Accepted: 12/21/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Neuropsychiatric disorders are a leading source of disability and require novel treatments that target mechanisms of disease. As such disorders are thought to result from aberrant neuronal circuit activity, neuromodulation approaches are of increasing interest given their potential for manipulating circuits directly. Low intensity transcranial electrical stimulation (tES) with direct currents (transcranial direct current stimulation, tDCS) or alternating currents (transcranial alternating current stimulation, tACS) represent novel, safe, well-tolerated, and relatively inexpensive putative treatment modalities. OBJECTIVE This report seeks to promote the science, technology and effective clinical applications of these modalities, identify research challenges, and suggest approaches for addressing these needs in order to achieve rigorous, reproducible findings that can advance clinical treatment. METHODS The National Institute of Mental Health (NIMH) convened a workshop in September 2016 that brought together experts in basic and human neuroscience, electrical stimulation biophysics and devices, and clinical trial methods to examine the physiological mechanisms underlying tDCS/tACS, technologies and technical strategies for optimizing stimulation protocols, and the state of the science with respect to therapeutic applications and trial designs. RESULTS Advances in understanding mechanisms, methodological and technological improvements (e.g., electronics, computational models to facilitate proper dosing), and improved clinical trial designs are poised to advance rigorous, reproducible therapeutic applications of these techniques. A number of challenges were identified and meeting participants made recommendations made to address them. CONCLUSIONS These recommendations align with requirements in NIMH funding opportunity announcements to, among other needs, define dosimetry, demonstrate dose/response relationships, implement rigorous blinded trial designs, employ computational modeling, and demonstrate target engagement when testing stimulation-based interventions for the treatment of mental disorders.
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Affiliation(s)
- Marom Bikson
- Department of Biomedical Engineering, The City College of the City University of New York, United States
| | - Andre R Brunoni
- Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, University of Sao Paulo, Sao Paulo, Brazil
| | - Leigh E Charvet
- Department of Neurology, New York University School of Medicine, New York, NY, United States
| | - Vincent P Clark
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States
| | - Leonardo G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Zhi-De Deng
- Experimental Therapeutics and Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Jacek Dmochowski
- Department of Biomedical Engineering, The City College of the City University of New York, United States
| | - Dylan J Edwards
- Non-invasive Brain Stimulation and Human Motor Control Laboratory, Burke Rehabilitation and Research, Burke-Cornell Medical Research Facility, White Plains, New York and School of Medicine and Health Sciences, Edith Cowan University, Perth, Australia
| | - Flavio Frohlich
- Department of Psychiatry, Cell Biology and Physiology, Biomedical Engineering, and Neurology, Carolina Center for Neurostimulation, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Emily S Kappenman
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Kelvin O Lim
- Department of Psychiatry, University of Minnesota, Minneapolis Veterans Administration Health Care System, and Defense Veterans Brain Injury Center, Minneapolis, MN, United States
| | - Colleen Loo
- School of Psychiatry and Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Antonio Mantovani
- Department of Physiology, Pharmacology and Neuroscience, City College of the City University of New York, New York, NY, United States
| | - David P McMullen
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, United States
| | - Lucas C Parra
- Department of Biomedical Engineering, The City College of the City University of New York, United States
| | - Michele Pearson
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, United States
| | - Jessica D Richardson
- Department of Speech and Hearing Sciences, University of New Mexico, Albuquerque, NM, United States
| | - Judith M Rumsey
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, United States.
| | - Pejman Sehatpour
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - David Sommers
- Scientific Review Branch, National Institute of Mental Health, Bethesda, MD, United States
| | - Gozde Unal
- Department of Biomedical Engineering, The City College of the City University of New York, United States
| | - Eric M Wassermann
- Behavioral Neurology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD, United States
| | - Adam J Woods
- Department of Clinical and Health Psychology, Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Sarah H Lisanby
- Division of Translational Research, National Institute of Mental Health, Bethesda, MD, United States
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Lefebvre J, Hutt A, Frohlich F. Stochastic resonance mediates the state-dependent effect of periodic stimulation on cortical alpha oscillations. eLife 2017; 6:32054. [PMID: 29280733 PMCID: PMC5832422 DOI: 10.7554/elife.32054] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [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: 09/15/2017] [Accepted: 12/22/2017] [Indexed: 12/14/2022] Open
Abstract
Brain stimulation can be used to engage and modulate rhythmic activity in brain networks. However, the outcomes of brain stimulation are shaped by behavioral states and endogenous fluctuations in brain activity. To better understand how this intrinsic oscillatory activity controls the susceptibility of the brain to stimulation, we analyzed a computational model of the thalamo-cortical system in two distinct states (rest and task-engaged) to identify the mechanisms by which endogenous alpha oscillations (8Hz–12Hz) are modulated by periodic stimulation. Our analysis shows that the different responses to stimulation observed experimentally in these brain states can be explained by a passage through a bifurcation combined with stochastic resonance — a mechanism by which irregular fluctuations amplify the response of a nonlinear system to weak periodic signals. Indeed, our findings suggest that modulation of brain oscillations is best achieved in states of low endogenous rhythmic activity, and that irregular state-dependent fluctuations in thalamic inputs shape the susceptibility of cortical population to periodic stimulation.
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Affiliation(s)
| | - Axel Hutt
- FE12 - Data Assimilation, Deutscher Wetterdienst, Offenbach am Main, Germany
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, United States
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Li Y, Yu C, Zhou ZC, Stitt I, Sellers KK, Gilmore JH, Frohlich F. Early Development of Network Oscillations in the Ferret Visual Cortex. Sci Rep 2017; 7:17766. [PMID: 29259184 PMCID: PMC5736753 DOI: 10.1038/s41598-017-17502-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 11/27/2017] [Indexed: 01/25/2023] Open
Abstract
Although oscillations during development have been characterized in a wide range of neural systems, little is known about the interaction between these network oscillations and neuronal spiking, and the interactions among different oscillation frequencies. Here we recorded the spontaneous and visual-elicited local field potential (LFP) and multi-unit activity (MUA) in the visual cortex of freely-moving juvenile ferrets before and after eye-opening. We found that both the spontaneous and visually-elicited LFP power was increased after eye-opening, especially in higher frequency bands (>30 Hz). Spike LFP phase coupling was decreased for lower frequency bands (theta and alpha) but slightly increased for higher frequencies (high-gamma band). A similar shift towards faster frequencies also occurred for phase-amplitude coupling; with maturation, the coupling of the theta/alpha/beta band amplitude to the delta phase was decreased and the high-gamma amplitude coupling to theta/alpha phase was increased. This shift towards higher frequencies was also reflected in the visual responses; the LFP oscillation became more entrained by visual stimulation with higher frequencies (>10 Hz). Taken together, these results suggest gamma oscillation as a signature of the maturation of cortical circuitry.
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Affiliation(s)
- Yuhui Li
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Chunxiu Yu
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Zhe Charles Zhou
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Neurobiology Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Iain Stitt
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Kristin K Sellers
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.,Neurobiology Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Flavio Frohlich
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Neurobiology Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA. .,Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
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Rubchinsky LL, Ahn S, Klijn W, Cumming B, Yates S, Karakasis V, Peyser A, Woodman M, Diaz-Pier S, Deraeve J, Vassena E, Alexander W, Beeman D, Kudela P, Boatman-Reich D, Anderson WS, Luque NR, Naveros F, Carrillo RR, Ros E, Arleo A, Huth J, Ichinose K, Park J, Kawai Y, Suzuki J, Mori H, Asada M, Oprisan SA, Dave AI, Babaie T, Robinson P, Tabas A, Andermann M, Rupp A, Balaguer-Ballester E, Lindén H, Christensen RK, Nakamura M, Barkat TR, Tosi Z, Beggs J, Lonardoni D, Boi F, Di Marco S, Maccione A, Berdondini L, Jędrzejewska-Szmek J, Dorman DB, Blackwell KT, Bauermeister C, Keren H, Braun J, Dornas JV, Mavritsaki E, Aldrovandi S, Bridger E, Lim S, Brunel N, Buchin A, Kerr CC, Chizhov A, Huberfeld G, Miles R, Gutkin B, Spencer MJ, Meffin H, Grayden DB, Burkitt AN, Davey CE, Tao L, Tiruvadi V, Ali R, Mayberg H, Butera R, Gunay C, Lamb D, Calabrese RL, Doloc-Mihu A, López-Madrona VJ, Matias FS, Pereda E, Mirasso CR, Canals S, Geminiani A, Pedrocchi A, D’Angelo E, Casellato C, Chauhan A, Soman K, Srinivasa Chakravarthy V, Muddapu VR, Chuang CC, Chen NY, Bayati M, Melchior J, Wiskott L, Azizi AH, Diba K, Cheng S, Smirnova EY, Yakimova EG, Chizhov AV, Chen NY, Shih CT, Florescu D, Coca D, Courtiol J, Jirsa VK, Covolan RJM, Teleńczuk B, Kempter R, Curio G, Destexhe A, Parker J, Klishko AN, Prilutsky BI, Cymbalyuk G, Franke F, Hierlemann A, da Silveira RA, Casali S, Masoli S, Rizza M, Rizza MF, Masoli S, Sun Y, Wong W, Farzan F, Blumberger DM, Daskalakis ZJ, Popovych S, Viswanathan S, Rosjat N, Grefkes C, Daun S, Gentiletti D, Suffczynski P, Gnatkovski V, De Curtis M, Lee H, Paik SB, Choi W, Jang J, Park Y, Song JH, Song M, Pallarés V, Gilson M, Kühn S, Insabato A, Deco G, Glomb K, Ponce-Alvarez A, Ritter P, Gilson M, Campo AT, Thiele A, Deeba F, Robinson PA, van Albada SJ, Rowley A, Hopkins M, Schmidt M, Stokes AB, Lester DR, Furber S, Diesmann M, Barri A, Wiechert MT, DiGregorio DA, Dimitrov AG, Vich C, Berg RW, Guillamon A, Ditlevsen S, Cazé RD, Girard B, Doncieux S, Doyon N, Boahen F, Desrosiers P, Laurence E, Doyon N, Dubé LJ, Eleonora R, Durstewitz D, Schmidt D, Mäki-Marttunen T, Krull F, Bettella F, Metzner C, Devor A, Djurovic S, Dale AM, Andreassen OA, Einevoll GT, Næss S, Ness TV, Halnes G, Halgren E, Halnes G, Mäki-Marttunen T, Pettersen KH, Andreassen OA, Sætra MJ, Hagen E, Schiffer A, Grzymisch A, Persike M, Ernst U, Harnack D, Ernst UA, Tomen N, Zucca S, Pasquale V, Pica G, Molano-Mazón M, Chiappalone M, Panzeri S, Fellin T, Oie KS, Boothe DL, Crone JC, Yu AB, Felton MA, Zulfiqar I, Moerel M, De Weerd P, Formisano E, Boothe DL, Crone JC, Felton MA, Oie K, Franaszczuk P, Diggelmann R, Fiscella M, Hierlemann A, Franke F, Guarino D, Antolík J, Davison AP, Frègnac Y, Etienne BX, Frohlich F, Lefebvre J, Marcos E, Mattia M, Genovesio A, Fedorov LA, Dijkstra TM, Sting L, Hock H, Giese MA, Buhry L, Langlet C, Giovannini F, Verbist C, Salvadé S, Giugliano M, Henderson JA, Wernecke H, Sándor B, Gros C, Voges N, Dabrovska P, Riehle A, Brochier T, Grün S, Gu Y, Gong P, Dumont G, Novikov NA, Gutkin BS, Tewatia P, Eriksson O, Kramer A, Santos J, Jauhiainen A, Kotaleski JH, Belić JJ, Kumar A, Kotaleski JH, Shimono M, Hatano N, Ahmad S, Cui Y, Hawkins J, Senk J, Korvasová K, Tetzlaff T, Helias M, Kühn T, Denker M, Mana P, Grün S, Dahmen D, Schuecker J, Goedeke S, Keup C, Goedeke S, Heuer K, Bakker R, Tiesinga P, Toro R, Qin W, Hadjinicolaou A, Grayden DB, Ibbotson MR, Kameneva T, Lytton WW, Mulugeta L, Drach A, Myers JG, Horner M, Vadigepalli R, Morrison T, Walton M, Steele M, Anthony Hunt C, Tam N, Amaducci R, Muñiz C, Reyes-Sánchez M, Rodríguez FB, Varona P, Cronin JT, Hennig MH, Iavarone E, Yi J, Shi Y, Zandt BJ, Van Geit W, Rössert C, Markram H, Hill S, O’Reilly C, Iavarone E, Shi Y, Perin R, Lu H, Zandt BJ, Bryson A, Rössert C, Hadrava M, Hlinka J, Hosaka R, Olenik M, Houghton C, Iannella N, Launey T, Kameneva T, Kotsakidis R, Meffin H, Soriano J, Kubo T, Inoue T, Kida H, Yamakawa T, Suzuki M, Ikeda K, Abbasi S, Hudson AE, Heck DH, Jaeger D, Lee J, Abbasi S, Janušonis S, Saggio ML, Spiegler A, Stacey WC, Bernard C, Lillo D, Bernard C, Petkoski S, Spiegler A, Drakesmith M, Jones DK, Zadeh AS, Kambhampati C, Karbowski J, Kaya ZG, Lakretz Y, Treves A, Li LW, Lizier J, Kerr CC, Masquelier T, Kheradpisheh SR, Kim H, Kim CS, Marakshina JA, Vartanov AV, Neklyudova AA, Kozlovskiy SA, Kiselnikov AA, Taniguchi K, Kitano K, Schmitt O, Lessmann F, Schwanke S, Eipert P, Meinhardt J, Beier J, Kadir K, Karnitzki A, Sellner L, Klünker AC, Kuch L, Ruß F, Jenssen J, Wree A, Sanz-Leon P, Knock SA, Chien SC, Maess B, Knösche TR, Cohen CC, Popovic MA, Klooster J, Kole MH, Roberts EA, Kopell NJ, Kepple D, Giaffar H, Rinberg D, Koulakov A, Forlim CG, Klock L, Bächle J, Stoll L, Giemsa P, Fuchs M, Schoofs N, Montag C, Gallinat J, Lee RX, Stephens GJ, Kuhn B, Tauffer L, Isope P, Inoue K, Ohmura Y, Yonekura S, Kuniyoshi Y, Jang HJ, Kwag J, de Kamps M, Lai YM, dos Santos F, Lam KP, Andras P, Imperatore J, Helms J, Tompa T, Lavin A, Inkpen FH, Ashby MC, Lepora NF, Shifman AR, Lewis JE, Zhang Z, Feng Y, Tetzlaff C, Kulvicius T, Li Y, Pena RFO, Bernardi D, Roque AC, Lindner B, Bernardi D, Vellmer S, Saudargiene A, Maninen T, Havela R, Linne ML, Powanwe A, Longtin A, Naveros F, Garrido JA, Graham JW, Dura-Bernal S, Angulo SL, Neymotin SA, Antic SD. 26th Annual Computational Neuroscience Meeting (CNS*2017): Part 2. BMC Neurosci 2017. [PMCID: PMC5592442 DOI: 10.1186/s12868-017-0371-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Abstract
Neurostimulation is rapidly emerging as an important treatment modality for psychiatric disorders. One of the fastest-growing and least-regulated approaches to noninvasive therapeutic stimulation involves the application of weak electrical currents. Widespread enthusiasm for low-intensity transcranial electrical current stimulation (tCS) is reflected by the recent surge in direct-to-consumer device marketing, do-it-yourself enthusiasm, and an escalating number of clinical trials. In the wake of this rapid growth, clinicians may lack sufficient information about tCS to inform their clinical practices. Interpretation of tCS clinical trial data is aided by familiarity with basic neurophysiological principles, potential mechanisms of action of tCS, and the complicated regulatory history governing tCS devices. A growing literature includes randomized controlled trials of tCS for major depression, schizophrenia, cognitive disorders, and substance use disorders. The relative ease of use and abundant access to tCS may represent a broad-reaching and important advance for future mental health care. Evidence supports application of one type of tCS, transcranial direct current stimulation (tDCS), for major depression. However, tDCS devices do not have regulatory approval for treating medical disorders, evidence is largely inconclusive for other therapeutic areas, and their use is associated with some physical and psychiatric risks. One unexpected finding to arise from this review is that the use of cranial electrotherapy stimulation devices-the only category of tCS devices cleared for use in psychiatric disorders-is supported by low-quality evidence.
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Affiliation(s)
- Noah S. Philip
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Brent G. Nelson
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Flavio Frohlich
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Kelvin O. Lim
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Alik S. Widge
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
| | - Linda L. Carpenter
- From the Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, and the Center of Excellence for Neurorestoration and Neurotechnology, Providence VA Medical Center, Providence, R.I.; the Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass., and the Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Cambridge, Mass.; the Department of Psychiatry, the Department of Biomedical Engineering, the
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Wollstadt P, Sellers KK, Hutt A, Frohlich F, Wibral M. Anesthesia-related changes in information transfer may be caused by reduction in local information generation. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:4045-8. [PMID: 26737182 DOI: 10.1109/embc.2015.7319282] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In anesthesia research it is an open question how general anesthetics lead to loss of consciousness (LOC). It has been proposed that LOC may be caused by the disruption of cortical information processing, preventing information integration. Therefore, recent studies investigating information processing under anesthesia focused on changes in information transfer, measured by transfer entropy (TE). However, often this complex technique was not applied rigorously, using time series in symbolic representation, or using TE differences without accounting for neural conduction delays, or without accounting for signal history. Here, we used current best-practice in TE estimation to investigate information transfer under anesthesia: We conducted simultaneous recordings in primary visual cortex (V1) and prefrontal cortex (PFC) of head-fixed ferrets in a dark environment under different levels of anesthesia (awake, 0.5% isoflurane, 1.0 % isoflurane). To elucidate reasons for changes in TE, we further quantified information processing within brain areas by estimating active information storage (AIS) as an estimator of predictable information, and Lempel-Ziv complexity (LZC) as an estimator of signal entropy. Under anesthesia, we found a reduction in information transfer (TE) between PFC and V1 with a stronger reduction for the feedback direction (PFC to V1), validating previous results. Furthermore, entropy (LZC) was reduced and activity became more predictable as indicated by higher values of AIS. We conclude that higher anesthesia concentrations indeed lead to reduced inter-areal information transfer, which may be partly caused by decreases in local entropy and increases in local predictability. In revealing a possible reason for reduced TE that is potentially independent of inter-areal coupling, we demonstrate the value of directly quantifying information processing in addition to focusing on dynamic properties such as coupling strength.
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Youngblood MW, Chen WC, Mishra AM, Enamandram S, Sanganahalli BG, Motelow JE, Bai HX, Frohlich F, Gribizis A, Lighten A, Hyder F, Blumenfeld H. Rhythmic 3-4Hz discharge is insufficient to produce cortical BOLD fMRI decreases in generalized seizures. Neuroimage 2015; 109:368-77. [PMID: 25562830 DOI: 10.1016/j.neuroimage.2014.12.066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 05/20/2014] [Revised: 12/01/2014] [Accepted: 12/25/2014] [Indexed: 01/13/2023] Open
Abstract
Absence seizures are transient episodes of impaired consciousness accompanied by 3-4 Hz spike-wave discharge on electroencephalography (EEG). Human functional magnetic resonance imaging (fMRI) studies have demonstrated widespread cortical decreases in the blood oxygen-level dependent (BOLD) signal that may play an important role in the pathophysiology of these seizures. Animal models could provide an opportunity to investigate the fundamental mechanisms of these changes, however they have so far failed to consistently replicate the cortical fMRI decreases observed in human patients. This may be due to important differences between human seizures and animal models, including a lack of cortical development in rodents or differences in the frequencies of rodent (7-8 Hz) and human (3-4 Hz) spike-wave discharges. To examine the possible contributions of these differences, we developed a ferret model that exhibits 3-4 Hz spike-wave seizures in the presence of a sulcated cortex. Measurements of BOLD fMRI and simultaneous EEG demonstrated cortical fMRI increases during and following spike-wave seizures in ferrets. However unlike human patients, significant fMRI decreases were not observed. The lack of fMRI decreases was consistent across seizures of different durations, discharge frequencies, and anesthetic regimes, and using fMRI analysis models similar to human patients. In contrast, generalized tonic-clonic seizures under the same conditions elicited sustained postictal fMRI decreases, verifying that the lack of fMRI decreases with spike-wave was not due to technical factors. These findings demonstrate that 3-4 Hz spike-wave discharge in a sulcated animal model does not necessarily produce fMRI decreases, leaving the mechanism for this phenomenon open for further investigation.
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Affiliation(s)
- Mark W Youngblood
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - William C Chen
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Asht M Mishra
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Core Center for Quantitative Neuroscience with Magnetic Resonance (QNMR), New Haven, CT 06520, USA
| | - Sheila Enamandram
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Basavaraju G Sanganahalli
- Core Center for Quantitative Neuroscience with Magnetic Resonance (QNMR), New Haven, CT 06520, USA; Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Joshua E Motelow
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Harrison X Bai
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Flavio Frohlich
- Department of Neurobiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Alexandra Gribizis
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Alexis Lighten
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Fahmeed Hyder
- Core Center for Quantitative Neuroscience with Magnetic Resonance (QNMR), New Haven, CT 06520, USA; Department of Diagnostic Radiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Department of Biomedical Engineering, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Hal Blumenfeld
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Core Center for Quantitative Neuroscience with Magnetic Resonance (QNMR), New Haven, CT 06520, USA; Department of Neurobiology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA.
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Hammad M, Schmidt SL, Zhang X, Bray R, Frohlich F, Ghashghaei HT. Transplantation of GABAergic Interneurons into the Neonatal Primary Visual Cortex Reduces Absence Seizures in Stargazer Mice. Cereb Cortex 2014; 25:2970-9. [PMID: 24812085 DOI: 10.1093/cercor/bhu094] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Epilepsies are debilitating neurological disorders characterized by repeated episodes of pathological seizure activity. Absence epilepsy (AE) is a poorly understood type of seizure with an estimated 30% of affected patients failing to respond to antiepileptic drugs. Thus, novel therapies are needed for the treatment of AE. A promising cell-based therapeutic strategy is centered on transplantation of embryonic neural stem cells from the medial ganglionic eminence (MGE), which give rise to gamma-aminobutyric acidergic (GABAergic) interneurons during embyronic development. Here, we used the Stargazer (Stg) mouse model of AE to map affected loci using c-Fos immunohistochemistry, which revealed intense seizure-induce activity in visual and somatosensory cortices. We report that transplantation of MGE cells into the primary visual cortex (V1) of Stg mice significantly reduces AE episodes and lowers mortality. Electrophysiological analysis in acute cortical slices of visual cortex demonstrated that Stg V1 neurons exhibit more pronounced increases in activity in response to a potassium-mediated excitability challenge than wildtypes (WT). The defective network activity in V1 was significantly altered following WT MGE transplantation, associating it with behavioral rescue of seizures in Stgs. Taken together, these findings present MGE grafting in the V1 as a possible clinical approach in the treatment of AE.
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Affiliation(s)
- Mohamed Hammad
- Department of Molecular Biomedical Sciences, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine
| | - Stephen L Schmidt
- UNC Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Xuying Zhang
- Department of Molecular Biomedical Sciences, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine
| | - Ryan Bray
- Department of Molecular Biomedical Sciences, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine
| | - Flavio Frohlich
- UNC Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Department of Cell Biology and Physiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - H Troy Ghashghaei
- Department of Molecular Biomedical Sciences, Center for Comparative Medicine and Translational Research, College of Veterinary Medicine Program in Genetics, North Carolina State University, Raleigh, NC 27607, USA
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Frohlich F, Sellers K, Boyle M, Ali M, Cordle A, Vaughn B, Gilmore J. OP 9. Tailoring transcranial current stimulation to modulate cortical oscillations in computer simulations, ferrets, and humans. Clin Neurophysiol 2013. [DOI: 10.1016/j.clinph.2013.04.076] [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: 11/16/2022]
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