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Gao Y, Koyun AH, Roessner V, Stock AK, Mückschel M, Colzato L, Hommel B, Beste C. Transcranial Direct Current Stimulation and Methylphenidate interact to increase Cognitive Persistence as a Core Component of Metacontrol: Evidence from aperiodic activity analyses. Brain Stimul 2025:S1935-861X(25)00081-6. [PMID: 40180219 DOI: 10.1016/j.brs.2025.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2024] [Revised: 03/13/2025] [Accepted: 03/31/2025] [Indexed: 04/05/2025] Open
Abstract
BACKGROUND Metacontrol is the ability to optimize the balance between cognitive persistence and flexibility. Recent research points to aperiodic EEG activity as a neurophysiological marker for metacontrol and its modulations. However, the causal link between metacontrol and aperiodic activity is still unclear. OBJECTIVE We provide mechanistic insights into the neurobiological foundations of metacontrol and the means to enhance it. We evaluated the interplay of anodal transcranial direct current stimulation (atDCS) and Methylphenidate (MPH), both of which are known to alter cortical noise, a factor that can be measured by aperiodic exponents derived from EEG data. METHODS We examined the impact of right inferior frontal (midpoint between electrodes FC4 and F8) 20 minutes offline atDCS at 2-mA and MPH administration, both separately and combined, on aperiodic EEG activity while healthy adult participants (N=98) performed a Go/NoGo task. We used the FOOOF (fitting oscillations & one over f) algorithm to examine aperiodic activity. RESULTS We obtained an interaction between atDCS stimulation and MPH administration, indicating that atDCS is effective in reducing aperiodic neural activity (i.e., increased aperiodic exponents) when being combined with MPH administration. CONCLUSION Aperiodic neural activity can be modulated through pharmacology-tuned atDCS. atDCS and MPH rely on overlapping neurobiological mechanisms. Metacontrol depending on aperiodic neural activity can be modulated through combined atDCS-MPH stimulation. Hence, atDCS and MPH are suitable tools to achieve an exogenous modulation of metacontrol bias and aperiodic exponents are indices to demonstrate the effectiveness of such tools.
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Affiliation(s)
- Yang Gao
- School of Psychology, Shandong Normal University, Jinan, China
| | - Anna Helin Koyun
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany; German Center for Child and Adolescent Health (DZKJ), partner site Leipzig/Dresden, Dresden, Germany
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Moritz Mückschel
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Lorenza Colzato
- School of Psychology, Shandong Normal University, Jinan, China.
| | - Bernhard Hommel
- School of Psychology, Shandong Normal University, Jinan, China.
| | - Christian Beste
- School of Psychology, Shandong Normal University, Jinan, China; Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany; German Center for Child and Adolescent Health (DZKJ), partner site Leipzig/Dresden, Dresden, Germany
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Soleimani G, Nitsche MA, Hanlon CA, Lim KO, Opitz A, Ekhtiari H. Four dimensions of individualization in brain stimulation for psychiatric disorders: context, target, dose, and timing. Neuropsychopharmacology 2025:10.1038/s41386-025-02094-3. [PMID: 40148682 DOI: 10.1038/s41386-025-02094-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 03/10/2025] [Accepted: 03/17/2025] [Indexed: 03/29/2025]
Abstract
Non-invasive Brain Stimulation (NIBS) technologies, including transcranial electrical (tES) and magnetic (TMS) stimulation, have emerged as promising interventions for various psychiatric disorders. FDA-approved TMS protocols in depression, OCD and nicotine use disorder provide a meaningful improvement. Treatment efficacy however remains inconsistent across individuals, and one relevant reason is intervention effect variability based on individual factors. There is a growing effort to develop individualized interventions, reinforced recently by FDA approval of a new TMS protocol that includes individualized fMRI-based targeting along with other modifications with higher reported effect size than previous "one size fits all" protocols. This paper discusses the dimensions for individualizing tES/TMS protocols to enhance therapeutic efficacy. We propose a multifaceted approach to personalizing NIBS, considering four levels: (1) context, (2) target, (3) dose, and (4) timing. By addressing inter- and intra-individual variability, we highlight a path toward precision medicine using individualized Brain Stimulation to treat psychiatric diseases. Despite challenges and limitations, this approach encourages broader and more systematic adoption of personalized Brain Stimulation techniques to improve clinical outcomes.
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Affiliation(s)
- Ghazaleh Soleimani
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, Dortmund, Germany
- Bielefeld University, University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy, Bielefeld, Germany
- Germany Center for Mental Health (DZPG) Center Bochum, Bochum, Germany
| | - Colleen A Hanlon
- Department of Cancer Biology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- BrainsWay, Burlington, MA, 01803, USA
| | - Kelvin O Lim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Hamed Ekhtiari
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA.
- Laureate Institute for Brain Researches (LIBR), Tulsa, OK, USA.
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Koyun AH, Wendiggensen P, Roessner V, Beste C, Stock AK. Neurophysiological insights into catecholamine-dependent tDCS modulation of cognitive control. Commun Biol 2025; 8:375. [PMID: 40050533 PMCID: PMC11885824 DOI: 10.1038/s42003-025-07805-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2024] [Accepted: 02/24/2025] [Indexed: 03/09/2025] Open
Abstract
Goal-directed behavior requires resolving both consciously and subconsciously induced response conflicts. Neuronal gain control, which enhances processing efficacy, is crucial for conflict resolution and can be increased through pharmacological or brain stimulation interventions, though it faces inherent physical limits. This study examined the effects of anodal transcranial direct current stimulation (atDCS) and methylphenidate (MPH) on conflict processing. Healthy adults (n = 105) performed a flanker task, with electroencephalography (EEG) used to assess alpha and theta band activity (ABA, TBA). Results showed that combining atDCS with MPH enhanced cognitive control and reduced response conflicts more effectively than atDCS alone, particularly when both conflict types co-occurred. Both atDCS and atDCS + MPH exhibited similar task-induced ABA and TBA modulations in the (pre)supplementary motor area, indicating heightened gain control. Overlapping neuroanatomical effects in mid-superior frontal areas suggest that atDCS and MPH share a common neuronal mechanism of gain control, especially in high-conflict/-demand situations.
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Affiliation(s)
- Anna Helin Koyun
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Paul Wendiggensen
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- German Center for Child and Adolescent Health (DZKJ), partner site Leipzig/Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany.
- German Center for Child and Adolescent Health (DZKJ), partner site Leipzig/Dresden, Dresden, Germany.
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Dresden, Germany
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Dai T, Liu M, Bao D, Manor B, Zhou J. Transcranial direct current stimulation alleviates the pain severity in people suffering from knee osteoarthritis: a systematic review and meta-analysis. Pain Rep 2025; 10:e1215. [PMID: 39664709 PMCID: PMC11630987 DOI: 10.1097/pr9.0000000000001215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 08/02/2024] [Accepted: 09/16/2024] [Indexed: 12/13/2024] Open
Abstract
Considerable research has shown the benefits of transcranial direct current stimulation (tDCS) for the alleviation of pain associated with knee osteoarthritis (KOA). Still, a large variance in study protocols and observations across publications exists. We here thus completed a systematic review and meta-analysis to comprehensively and quantitatively characterize the effects of tDCS on KOA-related pain. A search strategy based on the Population, Intervention, Comparison, Outcome, and Study design (PICOS) principle was used to obtain the publications in 7 databases. Studies exploring the effects of tDCS on KOA-related pain were screened, and eligible studies were included. Ten studies of 518 participants using Visual Analogue Scale or Numeric Rating Scale to assess pain were included in the systematic review, and 9 of them were included in meta-analysis. The quality of these studies was good. Compared to control, tDCS induced significant short-term improvements in KOA-related pain with medium heterogeneity (standardized mean difference [SMD] = -0.91, 95% confidence interval [-1.24, -0.58], P < 0.001, I2 = 61%). Subgroup analyses showed that both home-based (SMD = -1.32, 95% CI [-1.65, -0.99], P < 0.001, I 2 = 0%) and laboratory-based intervention (SMD = -0.66, 95% CI [-0.99, -0.33], P < 0.001, I 2 = 40%) with at least 5 sessions per week (SMD = -1.02, 95% CI [-1.41, -0.64], P < 0.001, I 2 = 65%) and/or with a total number of at least 10 sessions (SMD = -1.12, 95% CI [-1.51, -0.74], P < 0.001, I 2 = 59%) can induce maximum benefits for the alleviation of KOA-related pain. The results here showed that tDCS is of great promise to alleviate KOA-related pain. Still, future studies with more rigorous design are needed to confirm the observations from this work, which can ultimately help the determination of appropriate intervention protocol that can maximize such benefits.
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Affiliation(s)
- Tian Dai
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- National Sports Training Center, Beijing, China
| | - Meng Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
- School of Physical Education, University of Jinan, Shandong, China
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- Medical examination center, Peking University, Third Hospital, Beijing, China
| | - Brad Manor
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USA
| | - Junhong Zhou
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Boston, MA, USA
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Saccenti D, Lauro LJR, Crespi SA, Moro AS, Vergallito A, Grgič RG, Pretti N, Lamanna J, Ferro M. Boosting Psychotherapy With Noninvasive Brain Stimulation: The Whys and Wherefores of Modulating Neural Plasticity to Promote Therapeutic Change. Neural Plast 2024; 2024:7853199. [PMID: 39723244 PMCID: PMC11669434 DOI: 10.1155/np/7853199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Accepted: 12/04/2024] [Indexed: 12/28/2024] Open
Abstract
The phenomenon of neural plasticity pertains to the intrinsic capacity of neurons to undergo structural and functional reconfiguration through learning and experiential interaction with the environment. These changes could manifest themselves not only as a consequence of various life experiences but also following therapeutic interventions, including the application of noninvasive brain stimulation (NIBS) and psychotherapy. As standalone therapies, both NIBS and psychotherapy have demonstrated their efficacy in the amelioration of psychiatric disorders' symptoms, with a certain variability in terms of effect sizes and duration. Consequently, scholars suggested the convenience of integrating the two interventions into a multimodal treatment to boost and prolong the therapeutic outcomes. Such an approach is still in its infancy, and the physiological underpinnings substantiating the effectiveness and utility of combined interventions are still to be clarified. Therefore, this opinion paper aims to provide a theoretical framework consisting of compelling arguments as to why adding NIBS to psychotherapy can promote therapeutic change. Namely, we will discuss the physiological effects of the two interventions, thus providing a rationale to explain the potential advantages of a combined approach.
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Affiliation(s)
- Daniele Saccenti
- Department of Psychology, Sigmund Freud University, Milan, Italy
| | - Leonor J. Romero Lauro
- Department of Psychology and NeuroMi, University of Milano-Bicocca, Milan, Italy
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - Sofia A. Crespi
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
| | - Andrea S. Moro
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Milan, Italy
| | | | | | - Novella Pretti
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
- Clinical Psychology Center, Division of Neurology, Galliera Hospital, Genoa, Italy
| | - Jacopo Lamanna
- Faculty of Psychology, Vita-Salute San Raffaele University, Milan, Italy
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Milan, Italy
| | - Mattia Ferro
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Center for Behavioral Neuroscience and Communication (BNC), Vita-Salute San Raffaele University, Milan, Italy
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Wu YL, Luo Y, Yang JM, Wu YQ, Zhu Q, Li Y, Hu H, Zhang JH, Zhong YB, Wang MY. Effects of transcranial direct current stimulation on pain and physical function in patients with knee osteoarthritis: a systematic review and meta-analysis. BMC Musculoskelet Disord 2024; 25:703. [PMID: 39227806 PMCID: PMC11370230 DOI: 10.1186/s12891-024-07805-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 08/21/2024] [Indexed: 09/05/2024] Open
Abstract
BACKGROUND Keen Osteoarthritis (KOA) is a common chronic disabling disease characterized by joint pain and dysfunction, which seriously affects patients' quality of life. Recent studies have shown that transcranial direct current stimulation (tDCS) was a promising treatment for KOA. PURPOSE Investigate the effects of tDCS on pain and physical function in patients with KOA. METHODS Randomized controlled trials related to tDCS and KOA were systematically searched in the PubMed, Embase, Medline, Cochrane Library, CINHL, and Web of Science databases from inception to July 23, 2024. The pain intensity was evaluated using the visual analog scale or the numeric rating scale, and the pain sensitivity was assessed using conditioned pain modulation, pressure pain threshold, heat pain threshold, or heat pain tolerance. The physical function outcome was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index or the Knee injury and Osteoarthritis Outcome Score. Statistical analysis was performed using Review Manager 5.4. RESULTS Seven studies with a total of 503 participants were included. Compared to sham tDCS, tDCS was effective in reducing the short-term pain intensity (SMD: -0.58; 95% CI: -1.02, -0.14; p = 0.01) and pain sensitivity (SMD: -0.43; 95% CI: -0.70, -0.16; p = 0.002) but failed to significantly improve the long-term pain intensity (SMD: -0.26; 95% CI: -0.59, 0.08; p = 0.13) in KOA patients. In addition, tDCS did not significantly improve the short-term (SMD: -0.13; 95% CI: -0.35, 0.08; p = 0.22) and long-term (SMD: 0.02; 95% CI: -0.22, 0.25; p = 0.90) physical function in patients with KOA. CONCLUSIONS The tDCS can reduce short-term pain intensity and sensitivity but fails to significantly relieve long-term pain intensity and improve the physical function in patients with KOA. Thus, tDCS may be a potential therapeutic tool to reduce short-term pain intensity and pain sensitivity in patients with KOA.
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Affiliation(s)
- Yan-Lin Wu
- Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Yun Luo
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Jia-Ming Yang
- Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Yong-Qiang Wu
- Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Qiang Zhu
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Yi Li
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Hao Hu
- Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Jia-Hong Zhang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Yan-Biao Zhong
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China
| | - Mao-Yuan Wang
- Department of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China.
- Ganzhou Key Laboratory of Rehabilitation Medicine, First Affiliated Hospital of Gannan Medical University, Ganzhou City, Jiangxi Province, 341000, China.
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Delucenay-Clarke R, Niérat MC, Frugière A, Similowski T, Cayetanot F, Bodineau L. Direct current stimulation as a non-invasive therapeutic alternative for treating autonomic or non-autonomic neurological disorders affecting breathing. Clin Auton Res 2024; 34:395-411. [PMID: 39133345 DOI: 10.1007/s10286-024-01055-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/22/2024] [Indexed: 08/13/2024]
Abstract
Direct current stimulation (DCS) is a non-invasive approach to stimulate the nervous system that is now considered a powerful tool for treating neurological diseases such as those affecting cognitive or locomotor functions. DCS, as applied clinically today, is an approach built on early uses in antiquity and knowledge gained over time. Its current use makes use of specific devices and takes into account knowledge of the mechanisms by which this approach modulates functioning of the nervous system at the cellular level. Over the last 20 years, although there are few studies, it has been shown that DCS can also modulate the breathing autonomic function. In this narrative review, after briefly providing the historical perspective and describing the principles and the main cellular and molecular effects, we summarize the currently available data regarding the modulation of ventilation, and propose that DCS could be used to treat autonomic or non-autonomic neurological disorders affecting breathing.
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Affiliation(s)
- Roman Delucenay-Clarke
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France
| | - Marie-Cécile Niérat
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France
| | - Alain Frugière
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France
| | - Thomas Similowski
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France
| | - Florence Cayetanot
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France
| | - Laurence Bodineau
- Sorbonne Université, Inserm, UMR_S1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005, Paris, France.
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Sloane KL, Hamilton RH. Transcranial Direct Current Stimulation to Ameliorate Post-Stroke Cognitive Impairment. Brain Sci 2024; 14:614. [PMID: 38928614 PMCID: PMC11202055 DOI: 10.3390/brainsci14060614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/04/2024] [Accepted: 06/12/2024] [Indexed: 06/28/2024] Open
Abstract
Post-stroke cognitive impairment is a common and disabling condition with few effective therapeutic options. After stroke, neural reorganization and other neuroplastic processes occur in response to ischemic injury, which can result in clinical improvement through spontaneous recovery. Neuromodulation through transcranial direct current stimulation (tDCS) is a promising intervention to augment underlying neuroplasticity in order to improve cognitive function. This form of neuromodulation leverages mechanisms of neuroplasticity post-stroke to optimize neural reorganization and improve function. In this review, we summarize the current state of cognitive neurorehabilitation post-stroke, the practical features of tDCS, its uses in stroke-related cognitive impairment across cognitive domains, and special considerations for the use of tDCS in the post-stroke patient population.
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Affiliation(s)
- Kelly L. Sloane
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Roy H. Hamilton
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Department of Physical Medicine and Rehabilitation, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Koyun AH, Wendiggensen P, Roessner V, Beste C, Stock AK. Effects of Catecholaminergic and Transcranial Direct Current Stimulation on Response Inhibition. Int J Neuropsychopharmacol 2024; 27:pyae023. [PMID: 38742426 PMCID: PMC11184454 DOI: 10.1093/ijnp/pyae023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/08/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND The principle of gain control determines the efficiency of neuronal processing and can be enhanced with pharmacological or brain stimulation methods. It is a key factor for cognitive control, but the degree of how much gain control may be enhanced underlies a physical limit. METHODS To investigate whether methylphenidate (MPH) and transcranial direct current stimulation (tDCS) share common underlying mechanisms and cognitive effects, we administered MPH and anodal tDCS (atDCS) over the right inferior frontal gyrus both separately and combined, while healthy adult participants (n = 104) performed a response selection and inhibition task. The recorded EEG data were analyzed with a focus on theta band activity, and source estimation analyses were conducted. RESULTS The behavioral data show that MPH and atDCS revealed interactive effects on the ability to inhibit responses. Both MPH and atDCS modulated task-related theta oscillations in the supplementary motor area when applied separately, making a common underlying mechanism likely. When both stimulation methods were combined, there was no doubling of effects in the supplementary motor area but a shift to inferior frontal areas in the cortical network responsible for theta-driven processing. CONCLUSIONS The results indicate that both MPH and atDCS likely share a common underlying neuronal mechanism, and interestingly, they demonstrate interactive effects when combined, which are most likely due to the physical limitations of gain control increases. The current study provides critical groundwork for future combined applications of MPH and non-invasive brain stimulation.
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Affiliation(s)
- Anna Helin Koyun
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Paul Wendiggensen
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Veit Roessner
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Ann-Kathrin Stock
- University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
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Vimolratana O, Aneksan B, Siripornpanich V, Hiengkaew V, Prathum T, Jeungprasopsuk W, Khaokhiew T, Vachalathiti R, Klomjai W. Effects of anodal tDCS on resting state eeg power and motor function in acute stroke: a randomized controlled trial. J Neuroeng Rehabil 2024; 21:6. [PMID: 38172973 PMCID: PMC10765911 DOI: 10.1186/s12984-023-01300-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Anodal transcranial direct current stimulation (tDCS) is a beneficial adjunctive tool in stroke rehabilitation. However, only a few studies have investigated its effects on acute stroke and recruited only individuals with mild motor deficits. This study investigated the effect of five consecutive sessions of anodal tDCS and conventional physical therapy on brain activity and motor outcomes in individuals with acute stroke, with low and high motor impairments. METHODS Thirty participants were recruited and randomly allocated to either the anodal or sham tDCS group. Five consecutive sessions of tDCS (1.5 mA anodal or sham tDCS for 20 min) were administered, followed by conventional physical therapy. Electroencephalography (EEG), Fugl-Meyer Motor Assessment (FMA), and Wolf Motor Function Test (WMFT) were performed at pre-, post-intervention (day 5), and 1-month follow-up. Sub-analyses were performed on participants with low and high motor impairments. The relationship between EEG power and changes in motor functions was assessed. RESULTS Linear regression showed a significant positive correlation between beta bands and the FMA score in the anodal group. Elevated high frequency bands (alpha and beta) were observed at post-intervention and follow-up in all areas of both hemispheres in the anodal group, while only in the posterior area of the non-lesioned hemisphere in the sham group; however, such elevation induced by tDCS was not greater than sham. Lower limb function assessed by FMA was improved in the anodal group compared with the sham group at post-intervention and follow-up only in those with low motor impairment. For the upper limb outcomes, no difference between groups was found. CONCLUSIONS Five consecutive days of anodal tDCS and physical therapy in acute stroke did not result in a superior improvement of beta bands that commonly related to stroke recovery over sham, but improved lower extremity functions with a post-effect at 1-month follow-up in low motor impairment participants. The increase of beta bands in the lesioned brain in the anodal group was associated with improvement in lower limb function. TRIAL REGISTRATION NCT04578080, date of first registration 10/01/2020.
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Affiliation(s)
- O Vimolratana
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
- Neuro Electrical Stimulation Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
- School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, 57100, Thailand
| | - B Aneksan
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
- Neuro Electrical Stimulation Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - V Siripornpanich
- Institute of Molecular Biosciences, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - V Hiengkaew
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
| | - T Prathum
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
- Neuro Electrical Stimulation Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - W Jeungprasopsuk
- Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - T Khaokhiew
- Faculty of Medical Technology, Mahidol University, Nakhon Pathom, 73170, Thailand
| | - R Vachalathiti
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
| | - W Klomjai
- Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
- Neuro Electrical Stimulation Laboratory, Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, 73170, Thailand.
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11
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Thorstensen JR, Henderson TT, Kavanagh JJ. Serotonergic and noradrenergic contributions to motor cortical and spinal motoneuronal excitability in humans. Neuropharmacology 2024; 242:109761. [PMID: 37838337 DOI: 10.1016/j.neuropharm.2023.109761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/05/2023] [Accepted: 10/11/2023] [Indexed: 10/16/2023]
Abstract
Animal models indicate that motor behaviour is shaped by monoamine neuromodulators released diffusely throughout the brain and spinal cord. As an alternative to conducting a single study to explore the effects of neuromodulators on the human motor system, we have identified and collated human experiments investigating motor effects of well-characterised drugs that act on serotonergic and noradrenergic networks. In doing so, we present strong neuropharmacology evidence that human motor pathways are affected by neuromodulators across both healthy and clinical populations, insight that cannot be determined from a single reductionist experiment. We have focused our review on the effects that monoaminergic drugs have on muscle responses to non-invasive stimulation of the motor cortex and peripheral nerves, and other closely related tests of motoneuron excitability, and discuss how these measurement techniques elucidate the effects of neuromodulators at motor cortical and spinal motoneuronal levels. Although there is some heterogeneity in study methods, we find drugs acting to enhance extracellular concentrations of serotonin tend to reduce the excitability of the human motor cortex, and enhanced extracellular concentrations of noradrenaline increases motor cortical excitability by enhancing intracortical facilitation and reducing inhibition. Both monoamines tend to enhance the excitability of spinal motoneurons. Overall, this review details the importance of neuromodulators for the output of human motor pathways and suggests that commonly prescribed monoaminergic drugs target the motor system in addition to their typical psychiatric/neurological indications.
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Affiliation(s)
- Jacob R Thorstensen
- School of Biomedical Sciences, The University of Queensland, Brisbane, Australia.
| | - Tyler T Henderson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
| | - Justin J Kavanagh
- Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia
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12
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Van Zyl J, Knotkova H, Kim P, Henderson CR, Portenoy RK, Berman N, Frederic MW, Reid MC. Delivery of an at-home transcranial direct current stimulation intervention to mitigate pain in patients with end-stage kidney disease receiving hemodialysis (ESKD/HD). FRONTIERS IN PAIN RESEARCH 2023; 4:1132625. [PMID: 37092011 PMCID: PMC10113462 DOI: 10.3389/fpain.2023.1132625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
Background Poorly controlled pain remains a problem for many patients with end-stage kidney disease requiring hemodialysis (ESKD/HD) and customary approaches to pain management (e.g., opioids, non-steroidals) confer substantial risk. Accordingly, non-pharmacologic therapies are needed for use in this population. Non-invasive transcranial Direct Current Simulation (tDCS) constitutes a promising nonpharmacologic method for pain management in affected individuals. Aims This study seeks to: 1) determine the effects of an 8-week course of at-home tDCS vs. sham tDCS on pain intensity, pain interference, medication usage, quality of life, and mood; 2) determine if tDCS effects vary by race/ethnicity; and 3) ascertain patient satisfaction with device use. Methods This double-blind, randomized, sham-controlled clinical trial will enroll 100 ESKD/HD patients with moderate-to-severe (≥4 on 0-10 scale) chronic pain. The active study intervention consists of 20 min of tDCS delivered over the primary motor cortex 5 days/week for 8 weeks. The comparator is a sham procedure that provides no effective stimulation. The primary outcome analysis will evaluate efficacy of tDCS for pain reduction after two months of stimulation. We will also assess the effects of treatment on analgesic consumption, pain interference, depressed mood, and quality of life. The statistical plan will include fixed classification factors for treatment (vs. sham), clinic sites, and assessment time, and the interaction of these factors adjusting for covariates (e.g., race/ethnicity, pain level). Conclusion At-home tDCS constitutes a promising nonpharmacologic treatment for pain mitigation in persons with ESKD/HD. This unique RCT could transform the way pain is managed in this vulnerable population. Trial Registration NCT05311956.
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Affiliation(s)
- Jordan Van Zyl
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States
| | - Helena Knotkova
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States
- Department of Family & Social Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Patricia Kim
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, United States
| | | | - Russell K. Portenoy
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States
- Department of Family & Social Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Nathaniel Berman
- Rogosin Institute, Weill Cornell Medicine, New York, NY, United States
- Division of Nephrology and Hypertension, Weill Cornell Medicine, New York, NY, United States
| | - Melissa W. Frederic
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, United States
| | - M. Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, United States
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Peng L, Tian L, Wang T, Wang Q, Li N, Zhou H. Effects of non-invasive brain stimulation (NIBS) for executive function on subjects with ADHD: a protocol for a systematic review and meta-analysis. BMJ Open 2023; 13:e069004. [PMID: 36878663 PMCID: PMC9990641 DOI: 10.1136/bmjopen-2022-069004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/20/2023] [Indexed: 03/08/2023] Open
Abstract
INTRODUCTION Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder with a high risk of multiple mental health and social difficulties. Executive function domains are associated with distinct ADHD symptom burdens. Non-invasive brain stimulation (NIBS) mainly includes repetitive transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), which is a promising technique, but its impact on the executive function of ADHD is uncertain. Therefore, the aim of this systematic review and meta-analysis is to derive solid and updated estimates on the effect of NIBS on executive function in children/adults with ADHD. METHODS AND ANALYSIS A systematic search will be performed through EMBASE, MEDLINE, PsycINFO and Web of Science databases from inception until 22 August 2022. Handsearching of grey literature and the reference lists of selected articles will also be conducted. Empirical studies assessing the effect of NIBS (TMS or tDCS) on executive function in children or adults with ADHD will be included. Two investigators will independently perform literature identification, data extraction and risk of bias assessment. Relevant data will be pooled by a fixed-effects or random-effects model according to I2 statistic. Sensitivity analysis will be performed to test the robustness of the pooled estimates. Subgroup analyses will be conducted to investigate the potential heterogeneity. This protocol will generate a systematic review and meta-analysis that comprehensively synthesises the evidence on the NIBS treatment of executive function deficit of ADHD.Ethics approval is not required as this is a protocol for a systematic review of published literature. The results will be submitted to a peer-reviewed journal or a conference. PROSPERO REGISTRATION NUMBER CRD42022356476.
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Affiliation(s)
- Lihong Peng
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liyan Tian
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tiantian Wang
- Rehabilitation Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qiu Wang
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Na Li
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hui Zhou
- Department of Rehabilitation Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
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14
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Koo GK, Gaur A, Tumati S, Kusumo RW, Bawa KK, Herrmann N, Gallagher D, Lanctôt KL. Identifying factors influencing cognitive outcomes after anodal transcranial direct current stimulation in older adults with and without cognitive impairment: A systematic review. Neurosci Biobehav Rev 2023; 146:105047. [PMID: 36646259 DOI: 10.1016/j.neubiorev.2023.105047] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Anodal transcranial direct current stimulation (tDCS) can improve cognition in healthy older adults, those with Alzheimer's disease (AD) and mild cognitive impairment (MCI), albeit with considerable variability in response. This systematic review identifies interindividual factors that may influence tDCS outcomes in older individuals with or without cognitive impairment. Peer-reviewed articles were included if they assessed whether cognitive outcomes (memory or global cognition) after tDCS were associated with pre-intervention factors in healthy older adults or individuals with AD/MCI. We identified eight factors that may affect cognitive outcomes after tDCS. Improved tDCS outcomes were predicted by lower baseline cognitive function when tDCS was combined with a co-intervention (but not when used alone). Preserved brain structure and better baseline functional connectivity, genetic polymorphisms, and the use of concomitant medications may predict better tDCS outcomes, but further research is warranted. tDCS outcomes were not consistently associated with age, cognitive reserve, sex, and AD risk factors. Accounting for individual differences in baseline cognition, particularly for combined interventions, may thus maximize the therapeutic potential of tDCS.
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Affiliation(s)
- Grace Ky Koo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Amish Gaur
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada
| | - Shankar Tumati
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Raphael W Kusumo
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Kritleen K Bawa
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada
| | - Nathan Herrmann
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Damien Gallagher
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada
| | - Krista L Lanctôt
- Neuropsychopharmacology Research Group, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Program, Sunnybrook Research Institute, 2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada; Department of Pharmacology & Toxicology, University of Toronto, 1 King's College Circle, Toronto, ON M5S 1A8, Canada; Department of Psychiatry, Faculty of Medicine, University of Toronto, 250 College Street, 8th floor, Toronto, ON M5T 1R8, Canada.
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15
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Jung B, Yang C, Lee SH. Electroceutical and Bioelectric Therapy: Its Advantages and Limitations. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2023; 21:19-31. [PMID: 36700309 PMCID: PMC9889897 DOI: 10.9758/cpn.2023.21.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 01/27/2023]
Abstract
Given the long history, the field of electroceutical and bioelectric therapy has grown impressively, recognized as the main modality of mental health treatments along with psychotherapy and pharmacotherapy. Electroceutical and bioelectric therapy comprises electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), repetitive transcranial magnetic stimulation (rTMS), deep brain stimulation (DBS), transcranial electrical stimulation (tES), and other brain stimulation techniques. Much empirical research has been published regarding the application guidelines, mechanism of action, and efficacy of respective brain stimulation techniques, but no comparative study that delineates the advantages and limitations of each therapy exists for a comprehensive understanding of each technique. This review provides a comparison of existing electroceutical and bioelectric techniques, primarily focusing on the therapeutic advantages and limitations of each therapy in the current electroceutical and bioelectric field.
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Affiliation(s)
- Bori Jung
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea,Department of Psychology, Sogang University, Seoul, Korea
| | - Chaeyeon Yang
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea
| | - Seung-Hwan Lee
- Clinical Emotion and Cognition Research Laboratory, Inje University, Goyang, Korea,Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea,Address for correspondence: Seung-Hwan Lee Department of Psychiatry, Ilsan Paik Hospital, Inje University College of Medicine, Juhwa-ro 170, Ilsanseo-gu, Goyang 10380, Korea, E-mail: , ORCID: https://orcid.org/0000-0003-0305-3709
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16
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Therrien-Blanchet JM, Ferland MC, Badri M, Rousseau MA, Merabtine A, Boucher E, Hofmann LH, Lepage JF, Théoret H. The neurophysiological aftereffects of brain stimulation in human primary motor cortex: a Sham-controlled comparison of three protocols. Cereb Cortex 2023:7030623. [PMID: 36749004 DOI: 10.1093/cercor/bhad021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/14/2023] [Accepted: 01/15/2023] [Indexed: 02/08/2023] Open
Abstract
Paired associative stimulation (PAS), transcranial direct current stimulation (tDCS), and transcranial alternating current stimulation (tACS) are non-invasive brain stimulation methods that are used to modulate cortical excitability. Whether one technique is superior to the others in achieving this outcome and whether individuals that respond to one intervention are more likely to respond to another remains largely unknown. In the present study, the neurophysiological aftereffects of three excitatory neurostimulation protocols were measured with transcranial magnetic stimulation (TMS). Twenty minutes of PAS at an ISI of 25 ms, anodal tDCS, 20-Hz tACS, and Sham stimulation were administered to 31 healthy adults in a repeated measures design. Compared with Sham, none of the stimulation protocols significantly modulated corticospinal excitability (input/ouput curve and slope, TMS stimulator intensity required to elicit MEPs of 1-mV amplitude) or intracortical excitability (short- and long-interval intracortical inhibition, intracortical facilitation, cortical silent period). Sham-corrected responder analysis estimates showed that an average of 41 (PAS), 39 (tDCS), and 39% (tACS) of participants responded to the interventions with an increase in corticospinal excitability. The present data show that three stimulation protocols believed to increase cortical excitability are associated with highly heterogenous and variable aftereffects that may explain a lack of significant group effects.
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Affiliation(s)
| | | | - Meriem Badri
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | | | - Amira Merabtine
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Emelie Boucher
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
| | - Lydia Helena Hofmann
- Department of Psychology and Neuroscience, Maastricht University, Maastricht 6229, The Netherlands
| | - Jean-François Lepage
- Département de Pédiatrie, Faculté de Médecine et des Sciences de la Santé de l'Université de Sherbrooke, Centre de Recherche du CHU Sherbrooke, Sherbrooke, QC J1H 5N4, Canada
| | - Hugo Théoret
- Département de psychologie, Université de Montréal, Montréal, QC H3C 3J7, Canada
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17
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Gaugain G, Quéguiner L, Bikson M, Sauleau R, Zhadobov M, Modolo J, Nikolayev D. Quasi-static approximation error of electric field analysis for transcranial current stimulation. J Neural Eng 2023; 20. [PMID: 36621858 DOI: 10.1088/1741-2552/acb14d] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 01/06/2023] [Indexed: 01/10/2023]
Abstract
Objective.Numerical modeling of electric fields induced by transcranial alternating current stimulation (tACS) is currently a part of the standard procedure to predict and understand neural response. Quasi-static approximation (QSA) for electric field calculations is generally applied to reduce the computational cost. Here, we aimed to analyze and quantify the validity of the approximation over a broad frequency range.Approach.We performed electromagnetic modeling studies using an anatomical head model and considered approximations assuming either a purely ohmic medium (i.e. static formulation) or a lossy dielectric medium (QS formulation). The results were compared with the solution of Maxwell's equations in the cases of harmonic and pulsed signals. Finally, we analyzed the effect of electrode positioning on these errors.Main results.Our findings demonstrate that the QSA is valid and produces a relative error below 1% up to 1.43 MHz. The largest error is introduced in the static case, where the error is over 1% across the entire considered spectrum and as high as 20% in the brain at 10 Hz. We also highlight the special importance of considering the capacitive effect of tissues for pulsed waveforms, which prevents signal distortion induced by the purely ohmic approximation. At the neuron level, the results point a difference of sense electric field as high as 22% at focusing point, impacting pyramidal cells firing times.Significance.QSA remains valid in the frequency range currently used for tACS. However, neglecting permittivity (static formulation) introduces significant error for both harmonic and non-harmonic signals. It points out that reliable low frequency dielectric data are needed for accurate transcranial current stimulation numerical modeling.
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Affiliation(s)
- Gabriel Gaugain
- Univ Rennes, CNRS, IETR (Institut d'électronique et des technologies du numérique) - UMR 6164, 35000 Rennes, France
| | - Lorette Quéguiner
- Univ Rennes, CNRS, IETR (Institut d'électronique et des technologies du numérique) - UMR 6164, 35000 Rennes, France
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, CUNY, New York, NY, United States of America
| | - Ronan Sauleau
- Univ Rennes, CNRS, IETR (Institut d'électronique et des technologies du numérique) - UMR 6164, 35000 Rennes, France
| | - Maxim Zhadobov
- Univ Rennes, CNRS, IETR (Institut d'électronique et des technologies du numérique) - UMR 6164, 35000 Rennes, France
| | - Julien Modolo
- Univ Rennes, INSERM, LTSI (Laboratoire traitement du signal et de l'image) - U1099, 35000 Rennes, France
| | - Denys Nikolayev
- Univ Rennes, CNRS, IETR (Institut d'électronique et des technologies du numérique) - UMR 6164, 35000 Rennes, France
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Hodkinson DJ, Jackson SR, Jung J. Task-dependent plasticity in distributed neural circuits after transcranial direct current stimulation of the human motor cortex: A proof-of-concept study. FRONTIERS IN PAIN RESEARCH 2022; 3:1005634. [PMID: 36506269 PMCID: PMC9732378 DOI: 10.3389/fpain.2022.1005634] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/07/2022] [Indexed: 11/27/2022] Open
Abstract
The ability of non-invasive brain stimulation to induce neuroplasticity and cause long-lasting functional changes is of considerable interest for the reversal of chronic pain and disability. Stimulation of the primary motor cortex (M1) has provided some of the most encouraging after-effects for therapeutic purposes, but little is known about its underlying mechanisms. In this study we combined transcranial Direct Current Stimulation (tDCS) and fMRI to measure changes in task-specific activity and interregional functional connectivity between M1 and the whole brain. Using a randomized counterbalanced sham-controlled design, we applied anodal and cathodal tDCS stimulation over the left M1. In agreement with previous studies, we demonstrate that tDCS applied to the target region induces task-specific facilitation of local brain activity after anodal tDCS, with the stimulation effects having a negative relationship to the resting motor threshold. Beyond the local effects, tDCS also induced changes in multiple downstream regions distinct from the motor system that may be important for therapeutic efficacy, including the operculo-insular and cingulate cortex. These results offer opportunities to improve outcomes of tDCS for the individual patient based on the degree of presumed neuroplasticity. Further research is still warranted to address the optimal stimulation targets and parameters for those with disease-specific symptoms of chronic pain.
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Affiliation(s)
- Duncan J. Hodkinson
- Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- Sir Peter Mansfield Imaging Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Queens Medical Center, Nottingham, United Kingdom
- Versus Arthritis Pain Centre, University of Nottingham, Nottingham, United Kingdom
| | - Stephen R. Jackson
- National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Queens Medical Center, Nottingham, United Kingdom
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - JeYoung Jung
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
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Yamada Y, Inagawa T, Hirabayashi N, Sumiyoshi T. Emotion Recognition Deficits in Psychiatric Disorders as a Target of Non-invasive Neuromodulation: A Systematic Review. Clin EEG Neurosci 2022; 53:506-512. [PMID: 33587001 PMCID: PMC9548945 DOI: 10.1177/1550059421991688] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background. Social cognition deficits are a core feature of psychiatric disorders, such as schizophrenia and mood disorder, and deteriorate the functionality of patients. However, no definite strategy has been established to treat social cognition (eg, emotion recognition) impairments in these illnesses. Here, we provide a systematic review of the literature regarding transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for the treatment of social cognition deficits in individuals with psychiatric disorders. Methods. A literature search was conducted on English articles identified by PubMed, PsycINFO, and Web of Science databases, according to the guidelines of the PRISMA statement. We defined the inclusion criteria as follows: (1) randomized controlled trials (RCTs), (2) targeting patients with psychiatric disorders (included in F20-F39 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems [ICD-10]), (3) evaluating the effect of tDCS or rTMS, (4) reporting at least one standardized social cognition test. Results. Five papers (3 articles on tDCS and 2 articles on rTMS) met the inclusion criteria which deal with schizophrenia or depression. The significant effects of tDCS or rTMS targeting the left dorsolateral prefrontal cortex on the emotion recognition domain were reported in patients with schizophrenia or depression. In addition, rTMS on the right inferior parietal lobe was shown to ameliorate social perception impairments of schizophrenia. Conclusions. tDCS and rTMS may enhance some domains of social cognition in patients with psychiatric disorders. Further research is warranted to identify optimal parameters to maximize the cognitive benefits of these neuromodulation methods.
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Affiliation(s)
- Yuji Yamada
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Takuma Inagawa
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naotsugu Hirabayashi
- Department of Psychiatry, National Center Hospital, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention, National Institute of Mental Health, 26353National Center of Neurology and Psychiatry, Tokyo, Japan
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No robust online effects of transcranial direct current stimulation on corticospinal excitability. Brain Stimul 2022; 15:1254-1268. [PMID: 36084908 DOI: 10.1016/j.brs.2022.08.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 08/05/2022] [Accepted: 08/31/2022] [Indexed: 11/22/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has been used for over twenty years to modulate cortical (particularly motor corticospinal) excitability both during (online) and outlasting (offline) the stimulation, with the former effects associated to the latter. However, tDCS effects are highly variable, partially because stimulation intensity is commonly not adjusted individually (in contrast to transcranial magnetic stimulation, TMS). In Experiment 1, we therefore explored an empirical approach of personalizing tDCS intensity for the primary motor cortex (M1) based on dose-response curves (DRCs), individually relating tDCS Intensity (in steps from 0.3 to 2.0 mA) and Polarity (anodal, cathodal) to the online modulation of concurrent TMS motor evoked potentials (MEP), assessing DRC reliability across two separate days. No robust DRCs could be observed, neither at the individual nor at the group level, with the only robust effect being a (paradoxical) MEP facilitation during cathodal tDCS at 2.0 mA, but no modulation at traditional intensities of or near 1 mA. In Experiment 2, we therefore attempted to replicate the classical bidirectional online MEP modulation during 1 mA tDCS that had been reported by several of the early seminal tDCS papers. We either closely recreated stimulation parameters and temporal protocol of these original studies (Experiment 2A) or slightly modernized them according to current standards (Experiment 2B). In neither experiment did we observed any significant online MEP modulation. We conclude that an empirical titration of individually effective tDCS intensities may not be feasible as online tDCS effects do not appear to be sufficiently robust.
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Perspectives on the Combined Use of Electric Brain Stimulation and Perceptual Learning in Vision. Vision (Basel) 2022; 6:vision6020033. [PMID: 35737420 PMCID: PMC9227313 DOI: 10.3390/vision6020033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 11/29/2022] Open
Abstract
A growing body of literature offers exciting perspectives on the use of brain stimulation to boost training-related perceptual improvements in humans. Recent studies suggest that combining visual perceptual learning (VPL) training with concomitant transcranial electric stimulation (tES) leads to learning rate and generalization effects larger than each technique used individually. Both VPL and tES have been used to induce neural plasticity in brain regions involved in visual perception, leading to long-lasting visual function improvements. Despite being more than a century old, only recently have these techniques been combined in the same paradigm to further improve visual performance in humans. Nonetheless, promising evidence in healthy participants and in clinical population suggests that the best could still be yet to come for the combined use of VPL and tES. In the first part of this perspective piece, we briefly discuss the history, the characteristics, the results and the possible mechanisms behind each technique and their combined effect. In the second part, we discuss relevant aspects concerning the use of these techniques and propose a perspective concerning the combined use of electric brain stimulation and perceptual learning in the visual system, closing with some open questions on the topic.
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Vergallito A, Feroldi S, Pisoni A, Romero Lauro LJ. Inter-Individual Variability in tDCS Effects: A Narrative Review on the Contribution of Stable, Variable, and Contextual Factors. Brain Sci 2022; 12:522. [PMID: 35624908 PMCID: PMC9139102 DOI: 10.3390/brainsci12050522] [Citation(s) in RCA: 60] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 04/08/2022] [Accepted: 04/14/2022] [Indexed: 01/27/2023] Open
Abstract
Due to its safety, portability, and cheapness, transcranial direct current stimulation (tDCS) use largely increased in research and clinical settings. Despite tDCS's wide application, previous works pointed out inconsistent and low replicable results, sometimes leading to extreme conclusions about tDCS's ineffectiveness in modulating behavioral performance across cognitive domains. Traditionally, this variability has been linked to significant differences in the stimulation protocols across studies, including stimulation parameters, target regions, and electrodes montage. Here, we reviewed and discussed evidence of heterogeneity emerging at the intra-study level, namely inter-individual differences that may influence the response to tDCS within each study. This source of variability has been largely neglected by literature, being results mainly analyzed at the group level. Previous research, however, highlighted that only a half-or less-of studies' participants could be classified as responders, being affected by tDCS in the expected direction. Stable and variable inter-individual differences, such as morphological and genetic features vs. hormonal/exogenous substance consumption, partially account for this heterogeneity. Moreover, variability comes from experiments' contextual elements, such as participants' engagement/baseline capacity and individual task difficulty. We concluded that increasing knowledge on inter-dividual differences rather than undermining tDCS effectiveness could enhance protocols' efficiency and reproducibility.
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Affiliation(s)
- Alessandra Vergallito
- Department of Psychology & NeuroMi, University of Milano Bicocca, 20126 Milano, Italy; (A.P.); (L.J.R.L.)
| | - Sarah Feroldi
- School of Medicine and Surgery, University of Milano-Bicocca, 20854 Monza, Italy;
| | - Alberto Pisoni
- Department of Psychology & NeuroMi, University of Milano Bicocca, 20126 Milano, Italy; (A.P.); (L.J.R.L.)
| | - Leonor J. Romero Lauro
- Department of Psychology & NeuroMi, University of Milano Bicocca, 20126 Milano, Italy; (A.P.); (L.J.R.L.)
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Effects of Transcranial Direct Durrent Stimulation on Post-stroke Dysphagia: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Arch Phys Med Rehabil 2022; 103:1436-1447. [PMID: 35337844 DOI: 10.1016/j.apmr.2022.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 02/20/2022] [Accepted: 03/01/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This review aimed to systematically evaluate the effect of transcranial direct current stimulation (tDCS) on post-stroke dysphagia. DATA SOURCES PubMed, Cochrane Library (CENTRAL), Web of Science, VIP, CNKI, and Wanfang databases were systematically searched up to June 2021. STUDY SELECTION Randomized controlled trials (RCTs) on the effects of tDCS on post-stroke dysphagia DATA EXTRACTION: The extracted data included the author, country of publication, time of publication, key elements of bias risk assessment (such as randomized controlled trials and blind methods), sample size and basic information (age, course of disease, stroke location), intervention measures, treatment methods of tDCS (stimulation location, intensity, and duration), relevant outcome indicators, and relevant data (standard deviations).The Cochrane Risk of Bias Assessment Tool and PEDro Scale were used to assess the risk of bias. DATA SYNTHESIS Sixteen RCTs were included in this meta-analysis. Overall, the results revealed a large and statistically significant pooled effect size (0.80, CI 0.45-1.14; p<0.00001). The subgroup that explored the course of the disease yielded a large and significant effect size for the chronic phase group (0.80, CI 0.43-1.16; p<0.0001). For the stimulation intensity, 1 mA and 1.6 mA showed a moderate and significant effect sizes (0.47, CI 0.13-0.81; p=0.006 vs 1.39, CI 0.69-2.08; p<0.0001). In the subgroup analyses, the affected (0.87, CI 0.26-1.48; p=0.005) vs. unaffected (0.61, CI 0.23-0.99; p=0.002) hemisphere showed a significant result, and stimulation of the affected hemisphere had a more obvious effect. Subgroup analysis of stroke location showed that tDCS was effective for dysphagia after unilateral hemispheric stroke, bulbar paralysis, and brainstem stroke but not for dysphagia after ataxic and basal ganglia stroke. However, the subgroup analysis of stroke location revealed a significant result (0.81, CI 0.44-1.18; p<0.001). CONCLUSION This meta-analysis demonstrated the height and significant beneficial effect of tDCS on improving post-stroke dysphagia.
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Astha, Tekkalaki B. Cessation of clozapine-induced severe hypersalivation along with improvement of residual persistent auditory hallucinations by tDCS in a patient of chronic schizophrenia - A case report. Indian J Psychiatry 2022; 64:110-111. [PMID: 35400741 PMCID: PMC8992747 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_552_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/18/2021] [Accepted: 12/19/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Astha
- Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi - 590 010, Karnataka, India E-mail:
| | - Bheemsain Tekkalaki
- Department of Psychiatry, KAHER's Jawaharlal Nehru Medical College, Belagavi - 590 010, Karnataka, India E-mail:
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25
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Ghin F, Beste C, Stock AK. Neurobiological mechanisms of control in alcohol use disorder - moving towards mechanism-based non-invasive brain stimulation treatments. Neurosci Biobehav Rev 2021; 133:104508. [PMID: 34942268 DOI: 10.1016/j.neubiorev.2021.12.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 12/14/2021] [Accepted: 12/19/2021] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) is characterized by excessive habitual drinking and loss of control over alcohol intake despite negative consequences. Both of these aspects foster uncontrolled drinking and high relapse rates in AUD patients. Yet, common interventions mostly focus on the phenomenological level, and prioritize the reduction of craving and withdrawal symptoms. Our review provides a mechanistic understanding of AUD and suggests alternative therapeutic approaches targeting the mechanisms underlying dysfunctional alcohol-related behaviours. Specifically, we explain how repeated drinking fosters the development of rigid drinking habits and is associated with diminished cognitive control. These behavioural and cognitive effects are then functionally related to the neurobiochemical effects of alcohol abuse. We further explain how alterations in fronto-striatal network activity may constitute the neurobiological correlates of these alcohol-related dysfunctions. Finally, we discuss limitations in current pharmacological AUD therapies and suggest non-invasive brain stimulation (like TMS and tDCS interventions) as a potential addition/alternative for modulating the activation of both cortical and subcortical areas to help re-establish the functional balance between controlled and automatic behaviour.
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Affiliation(s)
- Filippo Ghin
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; University Neuropsychology Center, Faculty of Medicine, TU Dresden, Germany; Biopsychology, Faculty of Psychology, TU Dresden, Dresden, Germany.
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Effect of transcranial direct current stimulation on in-vivo assessed neuro-metabolites through magnetic resonance spectroscopy: a systematic review. Acta Neuropsychiatr 2021; 33:242-253. [PMID: 33926587 DOI: 10.1017/neu.2021.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Previous studies have examined the effect of transcranial direct current stimulation (tDCS) on the in-vivo concentrations of neuro-metabolites assessed through magnetic resonance spectroscopy (MRS) in neurological and psychiatry disorders. This review aims to systematically evaluate the data on the effect of tDCS on MRS findings and thereby attempt to understand the potential mechanism of tDCS on neuro-metabolites. METHODS The relevant literature was obtained through PubMed and cross-reference (search till June 2020). Thirty-four studies were reviewed, of which 22 reported results from healthy controls and 12 were from patients with neurological and psychiatric disorders. RESULTS The evidence converges to highlight that tDCS modulates the neuro-metabolite levels at the site of stimulation, which, in turn, translates into alterations in the behavioural outcome. It also shows that the baseline level of these neuro-metabolites can, to a certain extent, predict the outcome after tDCS. However, even though tDCS has shown promising effects in alleviating symptoms of various psychiatric disorders, there are limited studies that have reported the effect of tDCS on neuro-metabolite levels. CONCLUSIONS There is a compelling need for more systematic studies examining patients with psychiatric/neurological disorders with larger samples and harmonised tDCS protocols. More studies will potentially help us to understand the tDCS mechanism of action pertinent to neuro-metabolite levels modulation. Further, studies should be conducted in psychiatric patients to understand the neurological changes in this population and potentially unravel the neuro-metabolite × tDCS interaction effect that can be translated into individualised treatment.
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27
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Gezels L, van Kernebeek MW, Van den Ameele S, Vanderbruggen N, Baeken C, Crunelle CL. Prolonged seizure duration of electroconvulsive therapy in a patient pre-stimulated with transcranial direct current stimulation. Brain Stimul 2021; 14:1172-1173. [PMID: 34375693 DOI: 10.1016/j.brs.2021.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 07/30/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022] Open
Affiliation(s)
- Liselotte Gezels
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium.
| | - Michiel W van Kernebeek
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Seline Van den Ameele
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Nathalie Vanderbruggen
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Chris Baeken
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium; Ghent Experimental Psychiatry Laboratory, Department of Head and Skin, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium; Eindhoven University of Technology, Department of Electrical Engineering, Eindhoven, The Netherlands
| | - Cleo L Crunelle
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Department of Psychiatry, Laarbeeklaan 101, 1090 Brussels, Belgium
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Yamada Y, Sumiyoshi T. Neurobiological Mechanisms of Transcranial Direct Current Stimulation for Psychiatric Disorders; Neurophysiological, Chemical, and Anatomical Considerations. Front Hum Neurosci 2021; 15:631838. [PMID: 33613218 PMCID: PMC7890188 DOI: 10.3389/fnhum.2021.631838] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/11/2021] [Indexed: 12/23/2022] Open
Abstract
Backgrounds: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique for the treatment of several psychiatric disorders, e.g., mood disorders and schizophrenia. Therapeutic effects of tDCS are suggested to be produced by bi-directional changes in cortical activities, i.e., increased/decreased cortical excitability via anodal/cathodal stimulation. Although tDCS provides a promising approach for the treatment of psychiatric disorders, its neurobiological mechanisms remain to be explored. Objectives: To review recent findings from neurophysiological, chemical, and brain-network studies, and consider how tDCS ameliorates psychiatric conditions. Findings: Enhancement of excitatory synaptic transmissions through anodal tDCS stimulation is likely to facilitate glutamate transmission and suppress gamma-aminobutyric acid transmission in the cortex. On the other hand, it positively or negatively modulates the activities of dopamine, serotonin, and acetylcholine transmissions in the central nervous system. These neural events by tDCS may change the balance between excitatory and inhibitory inputs. Specifically, multi-session tDCS is thought to promote/regulate information processing efficiency in the cerebral cortical circuit, which induces long-term potentiation (LTP) by synthesizing various proteins. Conclusions: This review will help understand putative mechanisms underlying the clinical benefits of tDCS from the perspective of neurotransmitters, network dynamics, intracellular events, and related modalities of the brain function.
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Affiliation(s)
- Yuji Yamada
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
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Elyamany O, Leicht G, Herrmann CS, Mulert C. Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry. Eur Arch Psychiatry Clin Neurosci 2021; 271:135-156. [PMID: 33211157 PMCID: PMC7867505 DOI: 10.1007/s00406-020-01209-9] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
Transcranial alternating current stimulation (tACS) is a unique form of non-invasive brain stimulation. Sinusoidal alternating electric currents are delivered to the scalp to affect mostly cortical neurons. tACS is supposed to modulate brain function and, in turn, cognitive processes by entraining brain oscillations and inducing long-term synaptic plasticity. Therefore, tACS has been investigated in cognitive neuroscience, but only recently, it has been also introduced in psychiatric clinical trials. This review describes current concepts and first findings of applying tACS as a potential therapeutic tool in the field of psychiatry. The current understanding of its mechanisms of action is explained, bridging cellular neuronal activity and the brain network mechanism. Revisiting the relevance of altered brain oscillations found in six major psychiatric disorders, putative targets for the management of mental disorders using tACS are discussed. A systematic literature search on PubMed was conducted to report findings of the clinical studies applying tACS in patients with psychiatric conditions. In conclusion, the initial results may support the feasibility of tACS in clinical psychiatric populations without serious adverse events. Moreover, these results showed the ability of tACS to reset disturbed brain oscillations, and thus to improve behavioural outcomes. In addition to its potential therapeutic role, the reactivity of the brain circuits to tACS could serve as a possible tool to determine the diagnosis, classification or prognosis of psychiatric disorders. Future double-blind randomised controlled trials are necessary to answer currently unresolved questions. They may aim to detect response predictors and control for various confounding factors.
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Affiliation(s)
- Osama Elyamany
- Centre of Psychiatry, Justus-Liebig University, Klinikstrasse 36, 35392, Giessen, Hessen, Germany
- Centre for Mind, Brain and Behaviour (CMBB), University of Marburg and Justus-Liebig University Giessen, Marburg, Germany
| | - Gregor Leicht
- Department of Psychiatry and Psychotherapy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph S Herrmann
- Experimental Psychology Lab, Centre for Excellence "Hearing4all," European Medical School, University of Oldenburg, Oldenburg, Lower Saxony, Germany
- Research Centre Neurosensory Science, University of Oldenburg, Oldenburg, Lower Saxony, Germany
| | - Christoph Mulert
- Centre of Psychiatry, Justus-Liebig University, Klinikstrasse 36, 35392, Giessen, Hessen, Germany.
- Centre for Mind, Brain and Behaviour (CMBB), University of Marburg and Justus-Liebig University Giessen, Marburg, Germany.
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Delcourte S, Etievant A, Haddjeri N. Role of central serotonin and noradrenaline interactions in the antidepressants' action: Electrophysiological and neurochemical evidence. PROGRESS IN BRAIN RESEARCH 2021; 259:7-81. [PMID: 33541681 DOI: 10.1016/bs.pbr.2021.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The development of antidepressant drugs, in the last 6 decades, has been associated with theories based on a deficiency of serotonin (5-HT) and/or noradrenaline (NA) systems. Although the pathophysiology of major depression (MD) is not fully understood, numerous investigations have suggested that treatments with various classes of antidepressant drugs may lead to an enhanced 5-HT and/or adapted NA neurotransmissions. In this review, particular morpho-physiological aspects of these systems are first considered. Second, principal features of central 5-HT/NA interactions are examined. In this regard, the effects of the acute and sustained antidepressant administrations on these systems are discussed. Finally, future directions including novel therapeutic strategies are proposed.
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Affiliation(s)
- Sarah Delcourte
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, Stem Cell and Brain Research Institute U1208, Bron, France
| | - Adeline Etievant
- Integrative and Clinical Neurosciences EA481, University of Bourgogne Franche-Comté, Besançon, France
| | - Nasser Haddjeri
- Univ Lyon, Université Claude Bernard Lyon 1, Inserm, Stem Cell and Brain Research Institute U1208, Bron, France.
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Habich A, Fehér KD, Antonenko D, Boraxbekk CJ, Flöel A, Nissen C, Siebner HR, Thielscher A, Klöppel S. Stimulating aged brains with transcranial direct current stimulation: Opportunities and challenges. Psychiatry Res Neuroimaging 2020; 306:111179. [PMID: 32972813 DOI: 10.1016/j.pscychresns.2020.111179] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 06/30/2020] [Accepted: 09/03/2020] [Indexed: 02/06/2023]
Abstract
Ageing involves significant neurophysiological changes that are both systematic while at the same time exhibiting divergent trajectories across individuals. These changes underlie cognitive impairments in elderly while also affecting the response of aged brains to interventions like transcranial direct current stimulation (tDCS). While the cognitive benefits of tDCS are more variable in elderly, older adults also respond differently to stimulation protocols compared to young adults. The age-related neurophysiological changes influencing the responsiveness to tDCS remain to be addressed in-depth. We review and discuss the premise that, in comparison to the better calibrated brain networks present in young adults, aged systems perform further away from a homoeostatic set-point. We argue that this age-related neurophysiological deviation from the homoeostatic optimum extends the leeway for tDCS to modulate the aged brain. This promotes the potency of immediate tDCS effects to induce directional plastic changes towards the homoeostatic equilibrium despite the impaired plasticity induction in elderly. We also consider how age-related neurophysiological changes pose specific challenges for tDCS that necessitate proper adaptations of stimulation protocols. Appreciating the distinctive properties of aged brains and the accompanying adjustment of stimulation parameters can increase the potency and reliability of tDCS as a treatment avenue in older adults.
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Affiliation(s)
- Annegret Habich
- University Hospital of Old Age Psychiatry and Psychotherpa, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland; Faculty of Biology, University of Freiburg, Schänzlestrasse 1, 79104 Freiburg, Germany.
| | - Kristoffer D Fehér
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Daria Antonenko
- Department of Neurology, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Østvej, 2650 Hvidovre, Denmark; Department of Radiation Sciences, Umeå University, 90187 Umeå, Sweden; Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark
| | - Agnes Flöel
- Department of Neurology, University of Greifswald, Ferdinand-Sauerbruch-Straße, 17475 Greifswald, Germany; German Center for Neurodegenerative Diseases, Ellernholzstraße 1-2, 17489 Greifswald, Germany
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland; Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Hauptstraße 5, 79104 Freiburg, Germany
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Østvej, 2650 Hvidovre, Denmark; Department of Neurology, Copenhagen University Hospital Bispebjerg, Bispebjerg Bakke 23, 2400 Copenhagen, Denmark; Institute for Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Nørre Allé 20, 2200 Copenhagen, Denmark
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Østvej, 2650 Hvidovre, Denmark; Department of Electrical Engineering, Technical University of Denmark, Ørsteds Pl. 348, 2800 Kgs. Lyngby, Denmark
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherpa, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
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Madrid J, Benninger DH. Non-invasive brain stimulation for Parkinson's disease: Clinical evidence, latest concepts and future goals: A systematic review. J Neurosci Methods 2020; 347:108957. [PMID: 33017643 DOI: 10.1016/j.jneumeth.2020.108957] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/27/2020] [Accepted: 09/18/2020] [Indexed: 12/16/2022]
Abstract
Parkinson's disease (PD) is becoming a major public-health issue in an aging population. Available approaches to treat advanced PD still have limitations; new therapies are needed. The non-invasive brain stimulation (NIBS) may offer a complementary approach to treat advanced PD by personalized stimulation. Although NIBS is not as effective as the gold-standard levodopa, recent randomized controlled trials show promising outcomes in the treatment of PD symptoms. Nevertheless, only a few NIBS-stimulation paradigms have shown to improve PD's symptoms. Current clinical recommendations based on the level of evidence are reported in Table 1 through Table 3. Furthermore, novel technological advances hold promise and may soon enable the non-invasive stimulation of deeper brain structures for longer periods.
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Affiliation(s)
- Julian Madrid
- Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - David H Benninger
- Service of Neurology, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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Gao Y, Cavuoto L, Schwaitzberg S, Norfleet JE, Intes X, De S. The Effects of Transcranial Electrical Stimulation on Human Motor Functions: A Comprehensive Review of Functional Neuroimaging Studies. Front Neurosci 2020; 14:744. [PMID: 32792898 PMCID: PMC7393222 DOI: 10.3389/fnins.2020.00744] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/24/2020] [Indexed: 01/05/2023] Open
Abstract
Transcranial electrical stimulation (tES) is a promising tool to enhance human motor skills. However, the underlying physiological mechanisms are not fully understood. On the other hand, neuroimaging modalities provide powerful tools to map some of the neurophysiological biomarkers associated with tES. Here, a comprehensive review was undertaken to summarize the neuroimaging evidence of how tES affects human motor skills. A literature search has been done on the PubMed database, and 46 relative articles were selected. After reviewing these articles, we conclude that neuroimaging techniques are feasible to be coupled with tES and offer valuable information of cortical excitability, connectivity, and oscillations regarding the effects of tES on human motor behavior. The biomarkers derived from neuroimaging could also indicate the motor performance under tES conditions. This approach could advance the understanding of tES effects on motor skill and shed light on a new generation of adaptive stimulation models.
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Affiliation(s)
- Yuanyuan Gao
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - Lora Cavuoto
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, United States
| | | | - Jack E. Norfleet
- U.S. Army Combat Capabilities Development Command, Soldier Center (CCDC SC), Orlando, FL, United States
- SFC Paul Ray Smith Simulation & Training Technology Center (STTC), Orlando, FL, United States
- Medical Simulation Research Branch (MSRB), Orlando, FL, United States
| | - Xavier Intes
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, United States
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, United States
| | - Suvranu De
- Center for Modeling, Simulation and Imaging in Medicine, Rensselaer Polytechnic Institute, Troy, NY, United States
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, United States
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Tanaka T, Isomura Y, Kobayashi K, Hanakawa T, Tanaka S, Honda M. Electrophysiological Effects of Transcranial Direct Current Stimulation on Neural Activity in the Rat Motor Cortex. Front Neurosci 2020; 14:495. [PMID: 32714126 PMCID: PMC7340144 DOI: 10.3389/fnins.2020.00495] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 04/20/2020] [Indexed: 02/04/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive technique that modulates the neuronal membrane potential. We have previously documented a sustainable increase in extracellular dopamine levels in the rat striatum of cathodal tDCS, suggesting that cathodal tDCS enhances the neuronal excitability of the cortex. In the present study, we investigated changes in neuronal activity in the cerebral cortex induced by tDCS at the point beneath the stimulus electrode in anesthetized rats in vivo. Multiunit recordings were performed to examine changes in neuronal activity before and after the application of tDCS. In the cathodal tDCS group, multiunit activity (indicating the collective firing rate of recorded neuronal populations) increased in the cerebral cortex. Both anodal and cathodal tDCS increased the firing rate of isolated single units in the cerebral cortex. Significant differences in activity were observed immediately following stimulation and persisted for more than an hour after stimulation. The primary finding of this study was that both anodal and cathodal tDCS increased in vivo neuronal activity in the rat cerebral cortex underneath the stimulus electrode.
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Affiliation(s)
- Tomoko Tanaka
- Department of Brain Development and Neural Regeneration, Tokyo Metropolitan Institute of Medical Science, Setagaya, Japan.,Department of Information Medicine, National Institute of Neuroscience, National Centre of Neurology and Psychiatry, Kodaira, Japan
| | - Yoshikazu Isomura
- Physiology and Cell Biology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo, Japan
| | - Kazuto Kobayashi
- Department of Molecular Genetics, Institute of Biomedical Sciences, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takashi Hanakawa
- Department of Information Medicine, National Institute of Neuroscience, National Centre of Neurology and Psychiatry, Kodaira, Japan.,Department of Advanced Neuroimaging, Integrative Brain Imaging Centre, National Centre of Neurology and Psychiatry, Kodaira, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Manabu Honda
- Department of Information Medicine, National Institute of Neuroscience, National Centre of Neurology and Psychiatry, Kodaira, Japan
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35
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Transcranial Direct Current Stimulation for Motor Recovery Following Brain Injury. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2020. [DOI: 10.1007/s40141-020-00262-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Guerra A, López-Alonso V, Cheeran B, Suppa A. Solutions for managing variability in non-invasive brain stimulation studies. Neurosci Lett 2020; 719:133332. [DOI: 10.1016/j.neulet.2017.12.060] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 12/18/2017] [Accepted: 12/27/2017] [Indexed: 12/22/2022]
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37
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Spagnolo PA, Montemitro C, Pettorruso M, Martinotti G, Di Giannantonio M. Better Together? Coupling Pharmacotherapies and Cognitive Interventions With Non-invasive Brain Stimulation for the Treatment of Addictive Disorders. Front Neurosci 2020; 13:1385. [PMID: 31998061 PMCID: PMC6967837 DOI: 10.3389/fnins.2019.01385] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 12/09/2019] [Indexed: 01/11/2023] Open
Affiliation(s)
- Primavera A Spagnolo
- Human Motor Control Section, Medical Neurology Branch, National Institute on Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Chiara Montemitro
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy.,Neuroimaging Research Branch, National Institute on Drug Abuse, Intramural Research Program, National Institutes of Health, Baltimore, MD, United States
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, G. D'Annunzio University, Chieti, Italy
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Guggisberg AG, Koch PJ, Hummel FC, Buetefisch CM. Brain networks and their relevance for stroke rehabilitation. Clin Neurophysiol 2019; 130:1098-1124. [PMID: 31082786 DOI: 10.1016/j.clinph.2019.04.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 03/04/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022]
Abstract
Stroke has long been regarded as focal disease with circumscribed damage leading to neurological deficits. However, advances in methods for assessing the human brain and in statistics have enabled new tools for the examination of the consequences of stroke on brain structure and function. Thereby, it has become evident that stroke has impact on the entire brain and its network properties and can therefore be considered as a network disease. The present review first gives an overview of current methodological opportunities and pitfalls for assessing stroke-induced changes and reorganization in the human brain. We then summarize principles of plasticity after stroke that have emerged from the assessment of networks. Thereby, it is shown that neurological deficits do not only arise from focal tissue damage but also from local and remote changes in white-matter tracts and in neural interactions among wide-spread networks. Similarly, plasticity and clinical improvements are associated with specific compensatory structural and functional patterns of neural network interactions. Innovative treatment approaches have started to target such network patterns to enhance recovery. Network assessments to predict treatment response and to individualize rehabilitation is a promising way to enhance specific treatment effects and overall outcome after stroke.
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Affiliation(s)
- Adrian G Guggisberg
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospital Geneva, Switzerland.
| | - Philipp J Koch
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202 Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology Valais (EPFL Valais), Clinique Romande de Réadaptation, 1951 Sion, Switzerland; Department of Clinical Neuroscience, University Hospital Geneva, 1202 Geneva, Switzerland
| | - Cathrin M Buetefisch
- Depts of Neurology, Rehabilitation Medicine, Radiology, Emory University, Atlanta, GA, USA
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Roberts BM, Clarke A, Addante RJ, Ranganath C. Entrainment enhances theta oscillations and improves episodic memory. Cogn Neurosci 2019; 9:181-193. [PMID: 30198823 DOI: 10.1080/17588928.2018.1521386] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Neural oscillations in the theta band have been linked to episodic memory, but it is unclear whether activity patterns that give rise to theta play a causal role in episodic retrieval. Here, we used rhythmic auditory and visual stimulation to entrain neural oscillations to assess whether theta activity contributes to successful memory retrieval. In two separate experiments, human subjects studied words and were subsequently tested on memory for the words ('item recognition') and the context in which each had been previously studied ('source memory'). Between study and test, subjects in the entrainment groups were exposed to audiovisual stimuli designed to enhance activity at 5.5 Hz, whereas subjects in the control groups were exposed to white noise (Expt. 1) or 14 Hz entrainment (Expt. 2). Theta entrainment selectively increased source memory performance in both studies. Electroencephalography (EEG) data in Expt. 2 revealed that theta entrainment resulted in band-specific enhancement of theta power during the entrainment period and during post-entrainment memory retrieval. These results demonstrate a direct link between theta activity and episodic memory retrieval. Targeted manipulation of theta activity could be a promising new approach to enhance theta activity and memory performance in healthy individuals and in patients with memory disorders.
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Affiliation(s)
- Brooke M Roberts
- a Department of Psychology , University of California at Davis , Davis , CA , USA
| | - Alex Clarke
- b Department of Psychology , University of Cambridge , Cambridge , UK.,c Department of Psychology , Anglia Ruskin University , Cambridge , UK
| | - Richard J Addante
- d Department of Psychology , California State University , San Bernardino , CA , USA
| | - Charan Ranganath
- a Department of Psychology , University of California at Davis , Davis , CA , USA.,e Center for Neuroscience , University of California at Davis , Davis , CA , USA
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40
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Modulating Subjective Time Perception with Transcranial Random Noise Stimulation (tRNS). JOURNAL OF COGNITIVE ENHANCEMENT 2019. [DOI: 10.1007/s41465-019-00128-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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41
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Changes in recruitment of motor cortex excitation and inhibition in patients with drug-induced tardive syndromes. Neurophysiol Clin 2018; 49:33-40. [PMID: 30366858 DOI: 10.1016/j.neucli.2018.10.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/22/2018] [Accepted: 10/03/2018] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES It has recently been suggested that drug-induced tardive syndromes (TS) might be due to maladaptive plasticity, which increases motor excitability in cerebral cortex and basal ganglia. In order to test this hypothesis, we performed the first measurements of cortical excitability in TS. METHODS Motor cortex excitability was examined using transcranial magnetic stimulation (TMS) in 22 TS patients and compared with that in 20 age and sex-matched healthy individuals. Resting and active motor threshold (RMT, AMT) and input-output curves (I/O curves) assessed corticospinal excitability. The duration of the contralateral silent period (cSP) at a range of stimulation intensities and ipsilateral silent period (iSP) were used as measures of inhibition. RESULTS There were no significant differences in RMT and AMT between patients and controls, although the input-output curves were significantly steeper in patients. The cSP (at different stimulus intensities) and iSP were both longer in the patients compared to the control group. However, most of this difference could be accounted for by increased recruitment of motor evoked potentials (MEPs) in patients. CONCLUSION TS is characterized by hyperexcitability of corticospinal output that might contribute to the lack of selectivity in muscle recruitment and contribute to excess involuntary movement. The findings are opposite to those in naturally-occurring hyperkinesia such as Sydenham's and Huntington's chorea, suggesting a fundamental difference in the pathophysiology.
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42
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Ahn H, Suchting R, Woods AJ, Miao H, Green C, Cho RY, Choi E, Fillingim RB. Bayesian analysis of the effect of transcranial direct current stimulation on experimental pain sensitivity in older adults with knee osteoarthritis: randomized sham-controlled pilot clinical study. J Pain Res 2018; 11:2071-2082. [PMID: 30310309 PMCID: PMC6166765 DOI: 10.2147/jpr.s173080] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose Previous studies have indicated that transcranial direct current stimulation (tDCS) with the anode over the motor cortex and the cathode over the contralateral supraorbital region is effective in reducing clinical pain in patients with chronic pain, but these studies have not focused on experimental pain sensitivity. Therefore, the aim of this study was to examine the effect of tDCS on experimental pain sensitivity in older adults with knee osteoarthritis (OA). Patients and methods Forty community-dwelling participants aged 50–70 years with knee OA pain were randomly assigned to receive five daily sessions of 2 mA tDCS for 20 minutes (n = 20) or sham tDCS (n = 20) using a parallel group design. A multimodal quantitative sensory testing battery was completed, including heat pain, pressure pain threshold (PPT), punctate mechanical pain, and conditioned pain modulation (CPM). Results The active tDCS group showed greater increases in heat pain thresholds and tolerances, PPTs, and CPM, and reductions in punctate pain. In addition, beneficial changes in experimental pain measures were associated with reductions in clinical pain. Future studies are needed to extend these findings to better understand the underlying mechanisms of tDCS as well as to optimize treatment parameters including number and duration of stimulation sessions. Conclusion Our findings demonstrate that tDCS reduces experimental pain sensitivity, and these beneficial changes in experimental pain measures were associated with reductions in clinical pain.
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Affiliation(s)
- Hyochol Ahn
- Department of Nursing Research, University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, TX, USA,
| | - Robert Suchting
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center at Houston, Houston, TX; USA
| | - Adam J Woods
- Department of Clinical and Health Psychology, University of Florida Center for Cognitive Aging and Memory, McKnight Brain Institute, Gainesville, FL, USA
| | - Hongyu Miao
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, School of Public Health, Houston, TX, USA
| | - Charles Green
- Department of Pediatrics, University of Texas Health Science Center at Houston, Center for Clinical Research and Evidence-Based Medicine, Houston, TX, USA
| | - Raymond Y Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eunyoung Choi
- Department of Patient Care, Epic Health Services, Houston, TX, USA
| | - Roger B Fillingim
- Department of Community Dentistry and Behavioral Science, University of Florida Pain Research and Intervention Center of Excellence, Gainesville, FL, USA
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Abstract
Transcranial direct current stimulation (tDCS) is a neuromodulatory approach that is affordable, safe, and well tolerated. This review article summarizes the research and clinically relevant findings from meta-analyses and studies investigating the cognitive effects of tDCS in healthy and clinical populations. We recapitulate findings from recent studies where cognitive performance paired with tDCS was compared with performance under placebo (sham stimulation) in single sessions and longitudinal designs where cognitive effects were evaluated following repeated sessions. In summary, the tDCS literature currently indicates that the effects of tDCS on cognitive measures are less robust and less predictable compared with the more consistent effects on motor outcomes. There is also a notable difference in the consistency of single-session and longitudinal designs. In single-session tDCS designs, there are small effects amid high variability confounded by individual differences and potential sham stimulation effects. In contrast, longitudinal studies provide more consistent benefits in healthy and clinical populations, particularly when tDCS is paired with a concurrent task. Yet, these studies are few in number, thereby impeding design optimization. While there is good evidence that tDCS can modulate cognitive functioning and potentially produce longer-term benefits, a major challenge to widespread translation of tDCS is the absence of a complete mechanistic account for observed effects. Significant future work is needed to identify a priori responders from nonresponders for every cognitive task and tDCS protocol.
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Abstract
Transcranial direct current stimulation (tDCS) modulates spontaneous neuronal activity that can generate long-term neuroplastic changes. It has been used in numerous therapeutic trials showing significant clinical effects especially when combined with other behavioral therapies. One area of intensive tDCS research is chronic pain. Since the initial tDCS trials for chronic pain treatment using current parameters of stimulation, more than 60 clinical trials have been published testing its effects in different pain syndromes. However, as the field moves in the direction of clinical application, several aspects need to be taken into consideration regarding tDCS effectiveness and parameters of stimulation. In this article, we reviewed the evidence of tDCS effects for the treatment of chronic pain and critically analyzed the literature pertaining its safety and efficacy, and how to optimize tDCS clinical effects in a therapeutic setting. We discuss optimization of tDCS effects in 3 different domains: (i) parameters of stimulation, (ii) combination therapies, and (iii) subject selection. This article aims to provide insights for the development of future tDCS clinical trials.
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Affiliation(s)
- Camila Bonin Pinto
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Beatriz Teixeira Costa
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Dante Duarte
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Felipe Fregni
- Laboratory of Neuromodulation & Center for Clinical Research Learning, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, Boston, MA, USA
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Sandrini M, Caronni A, Corbo M. Modulating Reconsolidation With Non-invasive Brain Stimulation-Where We Stand and Future Directions. Front Psychol 2018; 9:1430. [PMID: 30150956 PMCID: PMC6099108 DOI: 10.3389/fpsyg.2018.01430] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 07/23/2018] [Indexed: 11/25/2022] Open
Affiliation(s)
- Marco Sandrini
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy.,Department of Psychology, University of Roehampton, London, United Kingdom
| | - Antonio Caronni
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa Cura Policlinico, Milan, Italy
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46
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Ghin F, Pavan A, Contillo A, Mather G. The effects of high-frequency transcranial random noise stimulation (hf-tRNS) on global motion processing: An equivalent noise approach. Brain Stimul 2018; 11:1263-1275. [PMID: 30078542 DOI: 10.1016/j.brs.2018.07.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 07/13/2018] [Accepted: 07/17/2018] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND High frequency transcranial random noise stimulation (hf-tRNS) facilitates performance in several perceptual and cognitive tasks, however, little is known about the underlying modulatory mechanisms. OBJECTIVE In this study we compared the effects of hf-tRNS to those of anodal and cathodal tDCS in a global motion direction discrimination task. An equivalent noise (EN) paradigm was used to assess how hf-tRNS modulates the mechanisms underlying local and global motion processing. METHOD Motion coherence threshold and slope of the psychometric function were estimated using an 8AFC task in which observers had to discriminate the motion direction of a random dot kinematogram presented either in the left or right visual hemi-field. During the task hf-tRNS, anodal and cathodal tDCS were delivered over the left hMT+. In a subsequent experiment we implemented an EN paradigm in order to investigate the effects of hf-tRNS on the mechanisms involved in visual motion integration (i.e., internal noise and sampling). RESULTS hf-tRNS reduced the motion coherence threshold but did not affect the slope of the psychometric function, suggesting no modulation of stimulus discriminability. Anodal and cathodal tDCS did not produce any modulatory effects. EN analysis in the last experiment found that hf-tRNS modulates sampling but not internal noise, suggesting that hf-tRNS modulates the integration of local motion cues. CONCLUSION hf-tRNS interacts with the output neurons tuned to directions near to the directional signal, incrementing the signal-to-noise ratio and the pooling of local motion cues and thus increasing the sensitivity for global moving stimuli.
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Affiliation(s)
- Filippo Ghin
- University of Lincoln, School of Psychology, Brayford Wharf East, Lincoln LN5 7AY, United Kingdom.
| | - Andrea Pavan
- University of Lincoln, School of Psychology, Brayford Wharf East, Lincoln LN5 7AY, United Kingdom
| | - Adriano Contillo
- University of Ferrara, Dipartimento di Fisica e Scienze della Terra, Via Saragat 1, 44122 Ferrara, Italy
| | - George Mather
- University of Lincoln, School of Psychology, Brayford Wharf East, Lincoln LN5 7AY, United Kingdom
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47
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Hanlon CA, Dowdle LT, Henderson JS. Modulating Neural Circuits with Transcranial Magnetic Stimulation: Implications for Addiction Treatment Development. Pharmacol Rev 2018; 70:661-683. [PMID: 29945899 PMCID: PMC6020107 DOI: 10.1124/pr.116.013649] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Although the last 50 years of clinical and preclinical research have demonstrated that addiction is a brain disease, we still have no neural circuit-based treatments for substance dependence or cue reactivity at large. Now, for the first time, it appears that a noninvasive brain stimulation technique known as transcranial magnetic stimulation (TMS), which is Food and Drug Administration approved to treat depression, may be the first tool available to fill this critical void in addiction treatment development. The goals of this review are to 1) introduce TMS as a tool to induce causal change in behavior, cortical excitability, and frontal-striatal activity; 2) describe repetitive TMS (rTMS) as an interventional tool; 3) provide an overview of the studies that have evaluated rTMS as a therapeutic tool for alcohol and drug use disorders; and 4) outline a conceptual framework for target selection when designing future rTMS clinical trials in substance use disorders. The manuscript concludes with some suggestions for methodological innovation, specifically with regard to combining rTMS with pharmacotherapy as well as cognitive behavioral training paradigms. We have attempted to create a comprehensive manuscript that provides the reader with a basic set of knowledge and an introduction to the primary experimental questions that will likely drive the field of TMS treatment development forward for the next several years.
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Affiliation(s)
- Colleen A Hanlon
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
| | - Logan T Dowdle
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
| | - J Scott Henderson
- Departments of Psychiatry (C.A.H., L.T.D., J.S.H.) and Neurosciences (C.A.H., L.T.D.), Medical University of South Carolina, Charleston, South Carolina; and Ralph Johnson VA Medical Center, Charleston, South Carolina (C.A.H.)
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Riggs A, Patel V, Paneri B, Portenoy RK, Bikson M, Knotkova H. At-Home Transcranial Direct Current Stimulation (tDCS) With Telehealth Support for Symptom Control in Chronically-Ill Patients With Multiple Symptoms. Front Behav Neurosci 2018; 12:93. [PMID: 29872381 PMCID: PMC5972211 DOI: 10.3389/fnbeh.2018.00093] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 04/23/2018] [Indexed: 11/13/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) delivered in multiple sessions can reduce symptom burden, but access of chronically ill patients to tDCS studies is constrained by the burden of office-based tDCS administration. Expanded access to this therapy can be accomplished through the development of interventions that allow at-home tDCS applications. Objective: We describe the development and initial feasibility assessment of a novel intervention for the chronically ill that combines at-home tDCS with telehealth support. Methods: In the developmental phase, the tDCS procedure was adjusted for easy application by patients or their informal caregivers at home, and a tDCS protocol with specific elements for enhanced safety and remote adherence monitoring was created. Lay language instructional materials were written and revised based on expert feedback. The materials were loaded onto a tablet allowing for secure video-conferencing. The telehealth tablet was paired with an at-home tDCS device that allowed for remote dose control via electronic codes dispensed to patients prior to each session. tDCS was delivered in two phases: once daily on 10 consecutive days, followed by an as needed regimen for 20 days. Initial feasibility of this tDCS-telehealth system was evaluated in four patients with advanced chronic illness and multiple symptoms. Change in symptom burden and patient satisfaction were assessed with the Condensed Memorial Symptom Assessment Scale (CMSAS) and a tDCS user survey. Results: The telehealth-tDCS protocol includes one home visit and has seven patient-tailored elements and six elements enhancing safety monitoring. Replicable electrode placement at home without 10–20 EEG measurement is achieved via a headband that holds electrodes in a pre-determined position. There were no difficulties with patients’ training, protocol adherence, or tolerability. A total of 60 tDCS sessions were applied. No session required discontinuation, and there were no adverse events. Data collection was feasible and there were no missing data. Satisfaction with the tDCS-telehealth procedure was high and the patients were comfortable using the system. Conclusion: At-home tDCS with telehealth support appears to be a feasible approach for the management of symptom burden in patients with chronic illness. Further studies to evaluate and optimize the protocol effectiveness for symptom-control outcomes are warranted.
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Affiliation(s)
- Alexa Riggs
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States
| | - Vaishali Patel
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States
| | - Bhaskar Paneri
- Department of Biomedical Engineering, Grove School of Engineering, The City College of New York, New York, NY, United States
| | - Russell K Portenoy
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States.,MJHS Hospice and Palliative Care, New York, NY, United States.,Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY, United States.,The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, New York, NY, United States
| | - Marom Bikson
- Department of Biomedical Engineering, Grove School of Engineering, The City College of New York, New York, NY, United States
| | - Helena Knotkova
- MJHS Institute for Innovation in Palliative Care, New York, NY, United States.,Department of Family and Social Medicine, Albert Einstein College of Medicine, New York, NY, United States
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49
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Knotkova H, Riggs A, Berisha D, Borges H, Bernstein H, Patel V, Truong DQ, Unal G, Arce D, Datta A, Bikson M. Automatic M1‐SO Montage Headgear for Transcranial Direct Current Stimulation (TDCS) Suitable for Home and High‐Throughput In‐Clinic Applications. Neuromodulation 2018; 22:904-910. [DOI: 10.1111/ner.12786] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 03/05/2018] [Accepted: 03/09/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Helena Knotkova
- MJHS Institute for Innovation in Palliative Care New York, NY USA
- Department of Family and Social Medicine, Albert Einstein College of MedicineBronx NY, USA
| | - Alexa Riggs
- MJHS Institute for Innovation in Palliative Care New York, NY USA
| | - Destiny Berisha
- MJHS Institute for Innovation in Palliative Care New York, NY USA
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
| | - Helen Borges
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
| | - Henry Bernstein
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
| | - Vaishali Patel
- MJHS Institute for Innovation in Palliative Care New York, NY USA
| | - Dennis Q. Truong
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
| | - Gozde Unal
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
| | | | | | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY New York, NY USA
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50
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Varoli E, Pisoni A, Mattavelli GC, Vergallito A, Gallucci A, Mauro LD, Rosanova M, Bolognini N, Vallar G, Romero Lauro LJ. Tracking the Effect of Cathodal Transcranial Direct Current Stimulation on Cortical Excitability and Connectivity by Means of TMS-EEG. Front Neurosci 2018; 12:319. [PMID: 29867330 PMCID: PMC5962888 DOI: 10.3389/fnins.2018.00319] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/24/2018] [Indexed: 12/23/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) is increasingly used in both research and therapeutic settings, but its precise mechanisms remain largely unknown. At a neuronal level, tDCS modulates cortical excitability by shifting the resting membrane potential in a polarity-dependent way: anodal stimulation increases the spontaneous firing rate, while cathodal decreases it. However, the neurophysiological underpinnings of anodal/cathodal tDCS seem to be different, as well as their behavioral effect, in particular when high order areas are involved, compared to when motor or sensory brain areas are targeted. Previously, we investigated the effect of anodal tDCS on cortical excitability, by means of a combination of Transcranial Magnetic Stimulation (TMS) and Electroencephalography (EEG). Results showed a diffuse rise of cortical excitability in a bilateral fronto-parietal network. In the present study, we tested, with the same paradigm, the effect of cathodal tDCS. Single pulse TMS was delivered over the left posterior parietal cortex (PPC), before, during, and after 10 min of cathodal or sham tDCS over the right PPC, while recording HD-EEG. Indexes of global and local cortical excitability were obtained both at sensors and cortical sources level. At sensors, global and local mean field power (GMFP and LMFP) were computed for three temporal windows (0-50, 50-100, and 100-150 ms), on all channels (GMFP), and in four different clusters of electrodes (LMFP, left and right, in frontal and parietal regions). After source reconstruction, Significant Current Density was computed at the global level, and for four Broadmann's areas (left/right BA 6 and 7). Both sensors and cortical sources results converge in showing no differences during and after cathodal tDCS compared to pre-stimulation sessions, both at global and local level. The same holds for sham tDCS. These data highlight an asymmetric impact of anodal and cathodal stimulation on cortical excitability, with a diffuse effect of anodal and no effect of cathodal tDCS over the parietal cortex. These results are consistent with the current literature: while anodal-excitatory and cathodal-inhibitory effects are well-established in the sensory and motor domains, both at physiological and behavioral levels, results for cathodal stimulation are more controversial for modulation of exitability of higher order areas.
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Affiliation(s)
- Erica Varoli
- Ph.D. Program in Neuroscience, Department of Medicine and Surgery, University Milano-Bicocca, Monza, Italy.,NeuroMi - Milan Center of Neuroscience, Milan, Italy
| | - Alberto Pisoni
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Giulia C Mattavelli
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Alessandra Vergallito
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Alessia Gallucci
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Lilia D Mauro
- Department of Psychology, University of Milano-Bicocca, Milan, Italy
| | - Mario Rosanova
- Department of Biomedical and Clinical Sciences "L. Sacco", University of Milan, Milan, Italy.,Fondazione Europea per la Ricerca Biomedica Onlus, Milan, Italy
| | - Nadia Bolognini
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, IRCCS Istituto Auxologico, Milan, Italy
| | - Giuseppe Vallar
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy.,Laboratory of Neuropsychology, IRCCS Istituto Auxologico, Milan, Italy
| | - Leonor J Romero Lauro
- NeuroMi - Milan Center of Neuroscience, Milan, Italy.,Department of Psychology, University of Milano-Bicocca, Milan, Italy
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