Direct effects of transcranial electric stimulation on brain circuits in rats and humans

Neural substrates, dynamics and thresholds of galvanic vestibular stimulation in the behaving primate

Galvanic vestibular stimulation (GVS) uses the external application of electrical current to selectively target the vestibular system in humans. Despite its recent popularity for the assessment/treatment of clinical conditions, exactly how this non-invasive tool activates the vestibular system remains an open question. Here we directly investigate single vestibular afferent responses to GVS applied to the mastoid processes of awake-behaving monkeys. Transmastoid GVS produces robust and parallel activation of both canal and otolith afferents. Notably, afferent activation increases with intrinsic neuronal variability resulting in constant GVS-evoked neuronal detection thresholds across all afferents. Additionally, afferent tuning differs for GVS versus natural self-motion stimulation. Using a stochastic model of repetitive activity in afferents, we largely explain the main features of GVS-evoked vestibular afferent dynamics. Taken together, our results reveal the neural substrate underlying transmastoid GVS-evoked perceptual, ocular and postural responses-information that is essential to advance GVS applicability for biomedical uses in humans.

Double transcranial direct current stimulation of the brain increases cerebral energy levels and systemic glucose tolerance in men

Transcranial direct current stimulation (tDCS) is a neuromodulatory method that has been tested experimentally and has already been used as an adjuvant therapeutic option to treat a number of neurological disorders and neuropsychiatric diseases. Beyond its well known local effects within the brain, tDCS also transiently promotes systemic glucose uptake and reduces the activity of the neurohormonal stress axes. We aimed to test whether the effects of a single tDCS application could be replicated upon double stimulation to persistently improve systemic glucose tolerance and stress axes activity in humans. In a single-blinded cross-over study, we examined 15 healthy male volunteers. Anodal tDCS vs sham was applied twice in series. Systemic glucose tolerance was investigated by the standard hyperinsulinaemic-euglycaemic glucose clamp procedure, and parameters of neurohormonal stress axes activity were measured. Because tDCS-induced brain energy consumption has been shown to be part of the mechanism underlying the assumed effects, we monitored the cerebral high-energy phosphates ATP and phosphocreatine by ³¹ phosphorus magnetic resonance spectroscopy. As hypothesised, analyses revealed that double anodal tDCS persistently increases glucose tolerance compared to sham. Moreover, we observed a significant rise in cerebral high-energy phosphate content upon double tDCS. Accordingly, the activity of the neurohormonal stress axes was reduced upon tDCS compared to sham. Our data demonstrate that double tDCS promotes systemic glucose uptake and reduces stress axes activity in healthy humans. These effects suggest that repetitive tDCS may be a future non-pharmacological option for combating glucose intolerance in type 2 diabetes patients.

Capacitive technologies for highly controlled and personalized electrical stimulation by implantable biomedical systems

Cosurface electrode architectures are able to deliver personalized electric stimuli to target tissues. As such, this technology holds potential for a variety of innovative biomedical devices. However, to date, no detailed analyses have been conducted to evaluate the impact of stimulator architecture and geometry on stimuli features. This work characterizes, for the first time, the electric stimuli delivered to bone cellular tissues during in vitro experiments, when using three capacitive architectures: stripped, interdigitated and circular patterns. Computational models are presented that predict the influence of cell confluence, cosurface architecture, electrodes geometry, gap size between electrodes and power excitation on the stimuli delivered to cellular layers. The results demonstrate that these stimulators are able to deliver osteoconductive stimuli. Significant differences in stimuli distributions were observed for different stimulator designs and different external excitations. The thickness specification was found to be of utmost importance. In vitro experiments using an osteoblastic cell line highlight that cosurface stimulation at a low frequency can enhance osteoconductive responses, with some electrode-specific differences being found. A major feature of this type of work is that it enables future detailed analyses of stimuli distribution throughout more complex biological structures, such as tissues and organs, towards sophisticated biodevice personalization.

Electromagnetic Brain Stimulation in Patients With Disorders of Consciousness

Severe brain injury is a common cause of coma. In some cases, despite vigilance improvement, disorders of consciousness (DoC) persist. Several states of impaired consciousness have been defined, according to whether the patient exhibits only reflexive behaviors as in the vegetative state/unresponsive wakefulness syndrome (VS/UWS) or purposeful behaviors distinct from reflexes as in the minimally conscious state (MCS). Recently, this clinical distinction has been enriched by electrophysiological and neuroimaging data resulting from a better understanding of the physiopathology of DoC. However, therapeutic options, especially pharmacological ones, remain very limited. In this context, electroceuticals, a new category of therapeutic agents which act by targeting the neural circuits with electromagnetic stimulations, started to develop in the field of DoC. We performed a systematic review of the studies evaluating therapeutics relying on the direct or indirect electro-magnetic stimulation of the brain in DoC patients. Current evidence seems to support the efficacy of deep brain stimulation (DBS) and non-invasive brain stimulation (NIBS) on consciousness in some of these patients. However, while the latter is non-invasive and well tolerated, the former is associated with potential major side effects. We propose that all chronic DoC patients should be given the possibility to benefit from NIBS, and that transcranial direct current stimulation (tDCS) should be preferred over repetitive transcranial magnetic stimulation (rTMS), based on the literature and its simple use. Surgical techniques less invasive than DBS, such as vagus nerve stimulation (VNS) might represent a good compromise between efficacy and invasiveness but still need to be further investigated.

Analytical bias accounts for some of the reported effects of tACS on auditory perception

BACKGROUND

Transcranial alternating current stimulation (tACS) has been shown to modulate auditory, visual, cognitive and motor function. However, tACS effects can often be small and difficult to reproduce. Thus, the establishment of robust experimental and analysis procedures is of high importance. We reviewed the analysis used in six studies that investigated if tACS can phase-modulate auditory perception. All studies used analytical methods that introduce bias and could produce false positive results. Four studies corrected for this bias but two did not.

OBJECTIVE

Our objectives were two-fold: 1) Use simulated null hypothesis datasets, where no tACS effect is present, to determine if uncorrected analytical bias could account for some of the reported effects on auditory perception. 2) Help establish best practices to correct for bias when analyzing tACS phase-effects on perception.

METHODS

We simulated null hypothesis datasets (i.e. no tACS effect) by drawing samples for all tACS and sham conditions from the same normal distribution. We then applied the reported analyses to the null hypothesis datasets.

RESULTS

Reported results from studies that did not correct for analytical bias could be reproduced from the null hypothesis datasets. However, results for studies that did correct for analytical bias could not be reproduced from the null hypothesis datasets.

CONCLUSION

True effects of tACS on auditory perception can be detected if analytical bias is accounted for by using correction procedures. However, to fully establish the effects of tACS on auditory perception a reanalysis of the data for the studies that used biased analysis without correction procedures is needed.

Challenges of P300 Modulation Using Transcranial Alternating Current Stimulation (tACS)

The P300 component of the event-related potential (ERP) is a well investigated phenomenon in the human electroencephalogram (EEG) and has been related to stimulus processing and attentional mechanisms. Event-related oscillations (ERO) represent a potential mechanism responsible for generating the ERP. In particular, oscillatory activity in the delta and theta frequency range has been associated with the generation of the P300 component. Transcranial Alternating Current Stimulation (tACS) is capable of modulating oscillatory brain activity in a frequency-specific manner. In this study, we aimed to modulate P300 amplitude using tACS by stimulating the individual ERO involved in the generation of the P300 component. TACS was applied precisely in time to the target P300 occurring in a visual oddball task. In order to achieve an appropriate current distribution, we designed an electrode configuration consisting of two clusters of stimulation electrodes on central-parietal locations. We could not demonstrate a group difference in P300 amplitude after applying tACS in the stimulation condition (N = 17) vs. the sham condition (N = 11). TACS condition and sham condition did not differ regarding their reaction times in response to target stimuli or their event-related spectral perturbation (ERSP) at stimulation frequency. Although a significant influence of stimulation could not yet be revealed on a statistical level, we suggest that the proposed method of using tACS for modulating EROs merits further investigation. Modulation of the P300 component in the ERP could help to gain further insights in the role of EROs generating ERPs and the functional relevance of the P300 component. In this study, we propose a novel approach of applying tACS and provide advice on using tACS for the modulation of EROs.

Transcranial alternating current stimulation entrains single-neuron activity in the primate brain

Spike timing is thought to play a critical role in neural computation and communication. Methods for adjusting spike timing are therefore of great interest to researchers and clinicians alike. Transcranial electrical stimulation (tES) is a noninvasive technique that uses weak electric fields to manipulate brain activity. Early results have suggested that this technique can improve subjects' behavioral performance on a wide range of tasks and ameliorate some clinical conditions. Nevertheless, considerable skepticism remains about its efficacy, especially because the electric fields reaching the brain during tES are small, whereas the likelihood of indirect effects is large. Our understanding of its effects in humans is largely based on extrapolations from simple model systems and indirect measures of neural activity. As a result, fundamental questions remain about whether and how tES can influence neuronal activity in the human brain. Here, we demonstrate that tES, as typically applied to humans, affects the firing patterns of individual neurons in alert nonhuman primates, which are the best available animal model for the human brain. Specifically, tES consistently influences the timing, but not the rate, of spiking activity within the targeted brain region. Such effects are frequency- and location-specific and can reach deep brain structures; control experiments show that they cannot be explained by sensory stimulation or other indirect influences. These data thus provide a strong mechanistic rationale for the use of tES in humans and will help guide the development of future tES applications.

Can Transcranial Electrical Stimulation Localize Brain Function?

Transcranial electrical stimulation (TES) uses constant (TDCS) or alternating currents (TACS) to modulate brain activity. Most TES studies apply low-intensity currents through scalp electrodes (≤2 mA) using bipolar electrode arrangements, producing weak electrical fields in the brain (<1 V/m). Low-intensity TES has been employed in humans to induce changes in task performance during or after stimulation. In analogy to focal transcranial magnetic stimulation, TES-induced behavioral effects have often been taken as evidence for a causal involvement of the brain region underlying one of the two stimulation electrodes, often referred to as the active electrode. Here, we critically review the utility of bipolar low-intensity TES to localize human brain function. We summarize physiological substrates that constitute peripheral targets for TES and may mediate subliminal or overtly perceived peripheral stimulation during TES. We argue that peripheral co-stimulation may contribute to the behavioral effects of TES and should be controlled for by "sham" TES. We discuss biophysical properties of TES, which need to be considered, if one wishes to make realistic assumptions about which brain regions were preferentially targeted by TES. Using results from electric field calculations, we evaluate the validity of different strategies that have been used for selective spatial targeting. Finally, we comment on the challenge of adjusting the dose of TES considering dose-response relationships between the weak tissue currents and the physiological effects in targeted cortical areas. These considerations call for caution when attributing behavioral effects during or after low-intensity TES studies to a specific brain region and may facilitate the selection of best practices for future TES studies.

Transcranial direct current stimulation (tDCS) over the left prefrontal cortex does not affect time-trial self-paced cycling performance: Evidence from oscillatory brain activity and power output

Objectives

To test the hypothesis that transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) influences performance in a 20-min time-trial self-paced exercise and electroencephalographic (EEG) oscillatory brain activity in a group of trained male cyclists.

Design

The study consisted of a pre-registered (https://osf.io/rf95j/), randomised, sham-controlled, single-blind, within-subject design experiment.

Methods

36 trained male cyclists, age 27 (6.8) years, weight 70.1 (9.5) Kg; VO_2max: 54 (6.13) ml.min^-1.kg^-1, Maximal Power output: 4.77 (0.6) W/kg completed a 20-min time-trial self-paced exercise in three separate sessions, corresponding to three stimulation conditions: anodal, cathodal and sham. tDCS was administered before each test during 20-min at a current intensity of 2.0 mA. The anode electrode was placed over the DLPFC and the cathode in the contralateral shoulder. In each session, power output, heart rate, sRPE and EEG (at baseline and during exercise) was measured.

Results

There were no differences (F = 0.31, p > 0.05) in power output between the stimulation conditions: anodal (235 W [95%CI 222–249 W]; cathodal (235 W [95%CI 222–248 W] and sham (234 W [95%CI 220–248 W]. Neither heart rate, sRPE nor EEG activity were affected by tDCS (all Ps > 0.05).

Conclusion

tDCS over the left DLFC did not affect self-paced exercise performance in trained cyclists. Moreover, tDCS did not elicit any change on oscillatory brain activity either at baseline or during exercise. Our data suggest that the effects of tDCS on endurance performance should be taken with caution.

Transcranial Current Stimulation During Sleep Facilitates Insight into Temporal Rules, but does not Consolidate Memories of Individual Sequential Experiences

Slow-wave sleep (SWS) is known to contribute to memory consolidation, likely through the reactivation of previously encoded waking experiences. Contemporary studies demonstrate that when auditory or olfactory stimulation is administered during memory encoding and then reapplied during SWS, memory consolidation can be enhanced, an effect that is believed to rely on targeted memory reactivation (TMR) induced by the sensory stimulation. Here, we show that transcranial current stimulations (tCS) during sleep can also be used to induce TMR, resulting in the facilitation of high-level cognitive processes. Participants were exposed to repeating sequences in a realistic 3D immersive environment while being stimulated with particular tCS patterns. A subset of these tCS patterns was then reapplied during sleep stages N2 and SWS coupled to slow oscillations in a closed-loop manner. We found that in contrast to our initial hypothesis, performance for the sequences corresponding to the reapplied tCS patterns was no better than for other sequences that received stimulations only during wake or not at all. In contrast, we found that the more stimulations participants received overnight, the more likely they were to detect temporal regularities governing the learned sequences the following morning, with tCS-induced beta power modulations during sleep mediating this effect.

Internal ion-gated organic electrochemical transistor: A building block for integrated bioelectronics

Real-time processing and manipulation of biological signals require bioelectronic devices with integrated components capable of signal amplification, processing, and stimulation. Transistors form the backbone of such circuits, but numerous criteria must be met for efficient and safe operation in biological environments. Here, we introduce an internal ion-gated organic electrochemical transistor (IGT) that uses contained mobile ions within the conducting polymer channel to permit both volumetric capacitance and shortened ionic transit time. The IGT has high transconductance, fast speed, and can be independently gated to create scalable conformable integrated circuits. We demonstrate the ability of the IGT to provide a miniaturized, comfortable interface with human skin using local amplification to record high-quality brain neurophysiological activity. The IGT is an effective transistor architecture for enabling integrated, real-time sensing and stimulation of signals from living organisms.

Effects of transcranial direct current stimulation on the cognitive control of negative stimuli in borderline personality disorder

Borderline personality disorder (BPD) is characterized by impairments in the cognitive control of negative information. These impairments in cognitive control are presumably due to blunted activity of the dorsolateral prefrontal cortex (dlPFC) along with enhanced activations of the limbic system. However, the impact of an excitatory stimulation of the dlPFC still needs to be elucidated. In the present study, we therefore assigned 50 patients with BPD and 50 healthy controls to receive either anodal or sham stimulation of the right dlPFC in a double-blind, randomized, between-subjects design. Participants performed a delayed working memory task with a distracter period during which a grey background screen, or neutral, or negative stimuli were presented. This experimental paradigm was first evaluated in a pilot study with 18 patients with BPD and 19 healthy controls. In both studies, patients with BPD showed an impairment of cognitive control when negative distracters were presented in the delay period of a working memory task. However, excitatory stimulation of the right dlPFC did not ameliorate cognitive control of negative stimuli in BPD, which raises questions about the specific role of the right dlPFC for the understanding of BPD psychopathology. Methodological limitations are discussed.

Stimulating Self-Regulation: A Review of Non-invasive Brain Stimulation Studies of Goal-Directed Behavior

Self-regulation enables individuals to guide their thoughts, feelings, and behaviors in a purposeful manner. Self-regulation is thus crucial for goal-directed behavior and contributes to many consequential outcomes in life including physical health, psychological well-being, ethical decision making, and strong interpersonal relationships. Neuroscientific research has revealed that the prefrontal cortex plays a central role in self-regulation, specifically by exerting top-down control over subcortical regions involved in reward (e.g., striatum) and emotion (e.g., amygdala). To orient readers, we first offer a methodological overview of tDCS and then review experiments using non-invasive brain stimulation techniques (especially transcranial direct current stimulation) to target prefrontal brain regions implicated in self-regulation. We focus on brain stimulation studies of self-regulatory behavior across three broad domains of response: persistence, delay behavior, and impulse control. We suggest that stimulating the prefrontal cortex promotes successful self-regulation by altering the balance in activity between the prefrontal cortex and subcortical regions involved in emotion and reward processing.

tACS motor system effects can be caused by transcutaneous stimulation of peripheral nerves

Transcranial alternating current stimulation (tACS) is a noninvasive neuromodulation method which has been shown to modulate hearing, motor, cognitive and memory function. However, the mechanisms underpinning these findings are controversial, as studies show that the current reaching the cortex may not be strong enough to entrain neural activity. Here, we propose a new hypothesis to reconcile these opposing results: tACS effects are caused by transcutaneous stimulation of peripheral nerves in the skin and not transcranial stimulation of cortical neurons. Rhythmic activity from peripheral nerves then entrains cortical neurons. A series of experiments in rats and humans isolated the transcranial and transcutaneous mechanisms and showed that the reported effects of tACS on the motor system can be caused by transcutaneous stimulation of peripheral nerves. Whether or not the transcutaneous mechanism will generalize to tACS effects on other systems is debatable but should be investigated.

Transcranial alternating current stimulation (tACS) uses weak electrical currents, applied to the head, to modulate brain activity. Here, the authors show that contrary to previous assumptions, the effects of tACS on the brain may be mediated by its effect on peripheral nerves in the skin, not direct.

Electrical fields induced inside the rat brain with skin, skull, and dural placements of the current injection electrode

Transcranial electrical stimulation (tES) is rapidly becoming an indispensable clinical tool with its different forms. Animal data are crucially needed for better understanding of the underlying mechanisms of tES. For reproducibility of results in animal experiments, the electric fields (E-Fields) inside the brain parenchyma induced by the injected currents need to be predicted accurately. In this study, we measured the electrical fields in the rat brain perpendicular to the brain surface, i.e. vertical electric field (VE-field), when the stimulation electrode was placed over the skin, skull, or dura mater through a craniotomy hole. The E-field attenuation through the skin was a few times larger than that of the skull and the presence of skin substantially reduced the VE-field peak at the cortical surface near the electrode. The VE-field declined much quicker in the gray matter underneath the pial surface than it did in the white matter, and thus the large VE-fields were contained mostly in the gray matter. The transition at the gray/white matter border caused a significant peak in the VE-field, as well as at other local inhomogeneties. A conductivity value of 0.57 S/m is predicted as a global value for the whole brain by matching our VE-field measurements to the field profile given by analytical equations for volume conductors. Finally, insertion of the current return electrode into the shoulder, submandibular, and hind leg muscles had virtually no effects on the measured E-field amplitudes in the cortex underneath the epidural electrodes.

Examining the Interactions Between Expectations and tDCS Effects on Motor and Cognitive Performance

Background: Despite a growing literature and commercial market, the effectiveness of transcranial direct current stimulation (tDCS) remains questionable. Notably, studies rarely examine factors such as expectations of outcomes, which may influence tDCS response through placebo-like effects. Here we sought to determine whether expectations could influence the behavioral outcomes of a tDCS intervention. Methods: Through an initial study and self-replication, we recruited 121 naïve young adults 18-34 years of age (M = 21.14, SD = 3.58; 88 women). We evaluated expectations of tDCS and of motor and cognitive performance at three times: (i) at baseline; (ii) after being primed to have High or Low expectations of outcomes; and (iii) after a single session of sham-controlled anodal tDCS over the left or right motor cortex. Before and after stimulation, participants performed the Grooved Pegboard Test and a choice reaction time task as measures of motor dexterity, response time, and response inhibition. Results: Repeated measures ANOVA revealed that participants had varying, largely uncertain, expectations regarding tDCS effectiveness at baseline. Expectation ratings significantly increased or decreased in response to High or Low priming, respectively, and decreased following the intervention. Response times and accuracy on motor and cognitive measures were largely unaffected by expectation or stimulation conditions. Overall, our analysis revealed no effect attributable to baseline expectations, belief of group assignment, or experimental condition on behavioral outcomes. Subjective experience did not differ based on expectation or stimulation condition. Conclusions: Our results suggest no clear effects of tDCS or of expectations on our performance measures, highlighting the need for further investigations of such stimulation methods.

The effect of expectation on transcranial direct current stimulation (tDCS) to suppress food craving and eating in individuals with overweight and obesity

Transcranial direct current stimulation (tDCS) is a neuromodulation technique with potential to treat eating disorders and obesity. As for any potential treatment, it is important to assess the degree to which expectation effects contribute to its reported efficacy. This study assessed the effect of tDCS on amount of food craving and eating while tightly controlling treatment expectation. N = 74 adults with overweight or obesity were informed of the known effects of tDCS to suppress craving and eating. Once electrodes were on the head, half of the participants were told they were receiving real, and the other half sham tDCS. Within these groups, approximately half actually received real and the other half sham tDCS. Stimulation parameters used were those previously found to reduce craving and eating, including in our lab: 2 mA, anode right/cathode left targeting the dorsolateral prefrontal cortex for 20 min (real), or only for the first and last minute (sham). Analyses controlled for demographics, hunger, trait impulsiveness, eating motives, dieting, binge eating, suggestibility, and baseline craving and eating. Participants told they were receiving real tDCS craved and ate less than participants told they were receiving sham tDCS (both p < 0.01), regardless of tDCS condition administered. There was no main effect of real vs. sham tDCS on craving or eating or an interaction between tDCS condition and expectation. The scientific validation of tDCS as a treatment for eating-related conditions hinges on controlling for the powerful effects of expectation. This can include the type of information provided on consent forms and participants' ability to guess real from sham conditions.

Can transcranial electric stimulation with multiple electrodes reach deep targets?

To reach a deep target in the brain with transcranial electric stimulation (TES), currents have to pass also through the cortical surface. Thus, it is generally thought that TES cannot achieve focal deep brain stimulation. Recent efforts with interfering waveforms and pulsed stimulation have argued that one can achieve deeper or more intense stimulation in the brain. Here we argue that conventional transcranial stimulation with multiple current sources is just as effective as these new approaches. The conventional multi-electrode approach can be numerically optimized to maximize intensity or focality at a desired target location. Using such optimal electrode configurations we find in a detailed and realistic head model that deep targets may in fact be strongly stimulated, with cerebro-spinal fluid guiding currents deep into the brain.

When and How to Interpret Null Results in NIBS: A Taxonomy Based on Prior Expectations and Experimental Design

Experiments often challenge the null hypothesis that an intervention, for instance application of non-invasive brain stimulation (NIBS), has no effect on an outcome measure. In conventional statistics, a positive result rejects that hypothesis, but a null result is meaningless. Informally, however, researchers often do find null results meaningful to a greater or lesser extent. We present a model to guide interpretation of null results in NIBS research. Along a "gradient of surprise," from Replication nulls through Exploration nulls to Hypothesized nulls, null results can be less or more surprising in the context of prior expectations, research, and theory. This influences to what extent we should credit a null result in this greater context. Orthogonal to this, experimental design choices create a "gradient of interpretability," along which null results of an experiment, considered in isolation, become more informative. This is determined by target localization procedure, neural efficacy checks, and power and effect size evaluations. Along the latter gradient, we concretely propose three "levels of null evidence." With caveats, these proposed levels C, B, and A, classify how informative an empirical null result is along concrete criteria. Lastly, to further inform, and help formalize, the inferences drawn from null results, Bayesian statistics can be employed. We discuss how this increasingly common alternative to traditional frequentist inference does allow quantification of the support for the null hypothesis, relative to support for the alternative hypothesis. It is our hope that these considerations can contribute to the ongoing effort to disseminate null findings alongside positive results to promote transparency and reduce publication bias.

The effects of transcranial direct current stimulation on objective and subjective indexes of exercise performance: A systematic review and meta-analysis

OBJECTIVE

To examine the effects of transcranial direct current stimulation (tDCS) on objective and subjective indexes of exercise performance.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

A systematic literature search of electronic databases (PubMed, Web of Science, Scopus, Google Scholar) and reference lists of included articles up to June 2018.

ELIGIBILITY CRITERIA

Published articles in journals or in repositories with raw data available, randomized sham-controlled trial comparing anodal stimulation with a sham condition providing data on objective (e.g. time to exhaustion or time-trial performance) or subjective (e.g. rate of perceived exertion) indexes of exercise performance.

RESULTS

The initial search provided 420 articles of which 31 were assessed for eligibility. Finally, the analysis of effect sizes comprised 24 studies with 386 participants. The analysis indicated that anodal tDCS had a small but positive effect on performance g = 0.34, 95% CI [0.12, 0.52], z = 3.24, p = .0012. Effects were not significantly moderated by type of outcome, electrode placement, muscles involved, number of sessions, or intensity and duration of the stimulation. Importantly, the funnel plot showed that, overall, effect sizes tended to be larger in studies with lower sample size and high standard error.

SUMMARY

The results suggest that tDCS may have a positive impact on exercise performance. However, the effect is probably small and most likely biased by low quality studies and the selective publication of significant results. Therefore, the current evidence does not provide strong support to the conclusion that tDCS is an effective means to improve exercise performance.

Methods to Compare Predicted and Observed Phosphene Experience in tACS Subjects

Background

Phosphene generation is an objective physical measure of potential transcranial alternating current stimulation (tACS) biological side effects. Interpretations from phosphene analysis can serve as a first step in understanding underlying mechanisms of tACS in healthy human subjects and assist validation of computational models.

Objective/Hypothesis

This preliminary study introduces and tests methods to analyze predicted phosphene occurrence using computational head models constructed from tACS recipients against verbal testimonies of phosphene sensations. Predicted current densities in the eyes and the occipital lobe were also verified against previously published threshold values for phosphenes.

Methods

Six healthy subjects underwent 10 Hz tACS while being imaged in an MRI scanner. Two different electrode montages, T7-T8 and Fpz-Oz, were used. Subject ratings of phosphene experience were collected during tACS and compared against current density distributions predicted in eye and occipital lobe regions of interest (ROIs) determined for each subject. Calculated median current densities in each ROI were compared to minimum thresholds for phosphene generation.

Main Results

All subjects reported phosphenes, and predicted median current densities in ROIs exceeded minimum thresholds for phosphenes found in the literature. Higher current densities in the eyes were consistently associated with decreased phosphene generation for the Fpz-Oz montage. There was an overall positive association between phosphene perceptions and current densities in the occipital lobe.

Conclusions

These methods may have promise for predicting phosphene generation using data collected during in-scanner tACS sessions and may enable better understanding of phosphene origin. Additional empirical data in a larger cohort is required to fully test the robustness of the proposed methods. Future studies should include additional montages that could dissociate retinal and occipital stimulation.

Biophysically realistic neuron models for simulation of cortical stimulation

OBJECTIVE

We implemented computational models of human and rat cortical neurons for simulating the neural response to cortical stimulation with electromagnetic fields.

APPROACH

We adapted model neurons from the library of Blue Brain models to reflect biophysical and geometric properties of both adult rat and human cortical neurons and coupled the model neurons to exogenous electric fields (E-fields). The models included 3D reconstructed axonal and dendritic arbors, experimentally-validated electrophysiological behaviors, and multiple, morphological variants within cell types. Using these models, we characterized the single-cell responses to intracortical microstimulation (ICMS) and uniform E-field with dc as well as pulsed currents.

MAIN RESULTS

The strength-duration and current-distance characteristics of the model neurons to ICMS agreed with published experimental results, as did the subthreshold polarization of cell bodies and axon terminals by uniform dc E-fields. For all forms of stimulation, the lowest threshold elements were terminals of the axon collaterals, and the dependence of threshold and polarization on spatial and temporal stimulation parameters was strongly affected by morphological features of the axonal arbor, including myelination, diameter, and branching.

SIGNIFICANCE

These results provide key insights into the mechanisms of cortical stimulation. The presented models can be used to study various cortical stimulation modalities while incorporating detailed spatial and temporal features of the applied E-field.

Immediate neurophysiological effects of transcranial electrical stimulation

Noninvasive brain stimulation techniques are used in experimental and clinical fields for their potential effects on brain network dynamics and behavior. Transcranial electrical stimulation (TES), including transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS), has gained popularity because of its convenience and potential as a chronic therapy. However, a mechanistic understanding of TES has lagged behind its widespread adoption. Here, we review data and modelling on the immediate neurophysiological effects of TES in vitro as well as in vivo in both humans and other animals. While it remains unclear how typical TES protocols affect neural activity, we propose that validated models of current flow should inform study design and artifacts should be carefully excluded during signal recording and analysis. Potential indirect effects of TES (e.g., peripheral stimulation) should be investigated in more detail and further explored in experimental designs. We also consider how novel technologies may stimulate the next generation of TES experiments and devices, thus enhancing validity, specificity, and reproducibility.

Evidence for Cognitive Placebo and Nocebo Effects in Healthy Individuals

Inactive interventions can have significant effects on cognitive performance. Understanding the generation of these cognitive placebo/nocebo effects is crucial for evaluating the cognitive impacts of interventional methods, such as non-invasive brain stimulation (NIBS). We report both cognitive placebo and nocebo effects on reward-based learning performance induced using an active sham NIBS protocol, verbal suggestions and conditioning in 80 healthy participants. Whereas our placebo manipulation increased both expected and perceived cognitive performance, nocebo had a detrimental effect on both. Model-based analysis suggests manipulation-specific strategic adjustments in learning-rates: Participants in the placebo group showed stronger learning from losses and reduced behavioral noise, participants in the nocebo group showed stronger learning from gains and increased behavioral noise. We conclude that experimentally induced expectancy can impact cognitive functions of healthy adult participants. This has important implications for the use of double-blind study designs that can effectively maintain blinding in NIBS studies.

A Prospective Study of the Impact of Transcranial Alternating Current Stimulation on EEG Correlates of Somatosensory Perception

The (8-12 Hz) neocortical alpha rhythm is associated with shifts in attention across sensory systems, and is thought to represent a sensory gating mechanism for the inhibitory control of cortical processing. The present preliminary study sought to explore whether alpha frequency transcranial alternating current stimulation (tACS) could modulate endogenous alpha power in the somatosensory system, and whether the hypothesized modulation would causally impact perception of tactile stimuli at perceptual threshold. We combined electroencephalography (EEG) with simultaneous brief and intermittent tACS applied over primary somatosensory cortex at individuals' endogenous alpha frequency during a tactile detection task (n = 12 for EEG, n = 20 for behavior). EEG-measured pre-stimulus alpha power was higher on non-perceived than perceived trials, and analogous perceptual correlates emerged in early components of the tactile evoked response. Further, baseline normalized tactile detection performance was significantly lower during alpha than sham tACS, but the effect did not last into the post-tACS time period. Pre- to post-tACS changes in alpha power were linearly dependent upon baseline state, such that alpha power tended to increase when pre-tACS alpha power was low, and decrease when it was high. However, these observations were comparable in both groups, and not associated with evidence of tACS-induced alpha power modulation. Nevertheless, the tactile stimulus evoked response potential (ERP) revealed a potentially lasting impact of alpha tACS on circuit dynamics. The post-tACS ERP was marked by the emergence of a prominent peak ∼70 ms post-stimulus, which was not discernible post-sham, or in either pre-stimulation condition. Computational neural modeling designed to simulate macroscale EEG signals supported the hypothesis that the emergence of this peak could reflect synaptic plasticity mechanisms induced by tACS. The primary lesson learned in this study, which commanded a small sample size, was that while our experimental paradigm provided some evidence of an influence of tACS on behavior and circuit dynamics, it was not sufficient to induce observable causal effects of tACS on EEG-measured alpha oscillations. We discuss limitations and suggest improvements that may help further delineate a causal influence of tACS on cortical dynamics and perception in future studies.

Using tDCS to facilitate motor learning in speech production: The role of timing

There exists debate regarding the extent to which transcranial direct current stimulation (tDCS) can affect or enhance human behavior. Here, we examined a previously unexplored domain: speech motor learning. We investigated whether speech motor learning in unimpaired participants can be enhanced using a single-session tDCS experiment, and investigated whether the timing of tDCS relative to a behavioral task affected performance. Participants (N = 80) performed a twenty minute learning task with nonwords containing non-native consonant clusters (e.g., GDEEVOO), and were assigned to groups receiving either sham or active tDCS either immediately before or during the task. Both accuracy and properties of errors were examined throughout the course of the practice task, and then practice was compared to a retention period 30 min later (R1) and two days later (R2). For cluster and whole-(non)word accuracy measures, acquisition was observed for all groups during the practice session. Compared to the beginning of practice, the tDCS-Before group showed significantly greater improvement than both the sham group and the tDCS-During group at R1. An effect was also observed for vowel duration in errors (/gdivu/ → [gədivu]), with the tDCS-Before group showing significant shortening of vowel errors throughout practice. Overall, the findings suggest that tDCS can improve speech motor learning, and that the improvement may be greater when tDCS is applied immediately before practice, warranting further exploration of this new domain for tDCS research.

Noninvasive Ultrasonic Drug Uncaging Maps Whole-Brain Functional Networks

Being able to noninvasively modulate brain activity, where and when an experimenter desires, with an immediate path toward human translation is a long-standing goal for neuroscience. To enable robust perturbation of brain activity while leveraging the ability of focused ultrasound to deliver energy to any point of the brain noninvasively, we have developed biocompatible and clinically translatable nanoparticles that allow ultrasound-induced uncaging of neuromodulatory drugs. Utilizing the anesthetic propofol, together with electrophysiological and imaging assays, we show that the neuromodulatory effect of ultrasonic drug uncaging is limited spatially and temporally by the size of the ultrasound focus, the sonication timing, and the pharmacokinetics of the uncaged drug. Moreover, we see secondary effects in brain regions anatomically distinct from and functionally connected to the sonicated region, indicating that ultrasonic drug uncaging could noninvasively map the changes in functional network connectivity associated with pharmacologic action at a particular brain target.

GABA, not BOLD, reveals dissociable learning-dependent plasticity mechanisms in the human brain

Experience and training have been shown to facilitate our ability to extract and discriminate meaningful patterns from cluttered environments. Yet, the human brain mechanisms that mediate our ability to learn by suppressing noisy and irrelevant signals remain largely unknown. To test the role of suppression in perceptual learning, we combine fMRI with MR Spectroscopy measurements of GABA, as fMRI alone does not allow us to discern inhibitory vs. excitatory mechanisms. Our results demonstrate that task-dependent GABAergic inhibition relates to functional brain plasticity and behavioral improvement. Specifically, GABAergic inhibition in the occipito-temporal cortex relates to dissociable learning mechanisms: decreased GABA for noise filtering, while increased GABA for feature template retuning. Perturbing cortical excitability during training with tDCs alters performance in a task-specific manner, providing evidence for a direct link between suppression and behavioral improvement. Our findings propose dissociable GABAergic mechanisms that optimize our ability to make perceptual decisions through training.

When searching for a friend in the crowd or telling identical twins apart, your visual system must solve a complex puzzle. It must ignore all irrelevant information (e.g., unfamiliar faces in the crowd) and focus on key features (e.g., your friend’s familiar face) that will allow you to make a decision. We become better at solving complex visual discriminations with practice. But exactly how the brain achieves this improved performance is unclear.

To answer this question, Frangou et al. trained healthy volunteers on two such visual tasks. The first (target detection task) involved locating a target (e.g. circular shape made of dots among randomly distributed dots in the background), a task similar to identifying a friend in the crowd. The second (feature discrimination task) involved assigning highly alike shapes in two different categories, similar to telling apart identical twins. To solve this problem, volunteers had to identify distinct features that allowed them to distinguishthese shapes. During training on this task, they updated and refined the representation of these distinct features in their brain. This enabled them to make finer discriminations and assign each image correctly to one of the two categories.

While the volunteers trained on the tasks, Frangou et al. measured levels of a chemical called GABA in brain areas that process visual information. GABA is the brain's main inhibitory molecule and controls the activity of neurons. As the volunteers learned the two tasks, their brains showed opposite changes in GABA levels. In the first, target detection task, individuals did better if their GABA decreased during training. In the second, feature discrimination task, they achieved more if their GABA increased during training. To confirm these findings, Frangou et al. used a second technique to activate or suppress processing in visual areas of the brain. Activating visual areas enhanced performance on the target detection task. Suppressing them enhanced performance on the fine discrimination task. These changes are thus consistent with those seen in GABA levels.

As well as revealing how we learn to make decisions based on the information from our eyes, these findings suggest that adjusting brain activity could help patients regain skills lost as a result of eye-related or neurological conditions. Understanding the role of GABA in brain plasticity is also relevant to conditions like autism and psychosis, which have been shown to relate to changes in brain inhibition.

Physiological effects of low-magnitude electric fields on brain activity: advances from in vitro, in vivo and in silico models

While electrical stimulation of brain tissue has been thoroughly investigated over the last decades, ongoing questions remain regarding the neurophysiological effects of low-level electric fields (on the order of 1 V/m) on brain activity. Electric fields at such levels are, for example, induced by transcranial direct/alternating current stimulation (tDCS/tACS). Action potentials can be indeed elicited when applied (supra-threshold) electric fields are in the 10-100 V/m range, while lower (subthreshold) electric fields result in more limited and subtler membrane polarization effects. In this review, we address the question of the mechanisms underlying the immediate effects (also referred to as acute, concurrent or short-term) and the lasting effects (also referred to as long-term or aftereffects) of low-level electric fields on brain tissue. We review recent evidence at the in vitro and in vivo (animal and human) level, and also present mechanistic insights gained from in silico models, which are still few but have received increased attention over the recent past years. We highlight the convergent evidence towards potential mechanisms, and also discuss discrepancies between in vitro studies and human tDCS/tACS studies that require further investigation to bridge the gap between the single-cell and large-scale network level. Possible novel avenues of research are discussed.

Low-frequency alternating current stimulation rhythmically suppresses gamma-band oscillations and impairs perceptual performance

Low frequency oscillations such as alpha (8-12 Hz) are hypothesized to rhythmically gate sensory processing, reflected by 40-100 Hz gamma band activity, via the mechanism of pulsed inhibition. We applied transcranial alternating current stimulation (TACS) at individual alpha frequency (IAF) and flanking frequencies (IAF-4 Hz, IAF+4 Hz) to the occipital cortex of healthy human volunteers during concurrent magnetoencephalography (MEG), while participants performed a visual detection task inducing strong gamma-band responses. Occipital (but not retinal) TACS phasically suppressed stimulus-induced gamma oscillations in the visual cortex and impaired target detection, with stronger phase-to-amplitude coupling predicting behavioral impairments. Retinal control TACS ruled out retino-thalamo-cortical entrainment resulting from (subthreshold) retinal stimulation. All TACS frequencies tested were effective, suggesting that visual gamma-band responses can be modulated by a range of low frequency oscillations. We propose that TACS-induced membrane potential modulations mimic the rhythmic change in cortical excitability by which spontaneous low frequency oscillations may eventually exert their impact when gating sensory processing via pulsed inhibition.

Exploring new transcranial electrical stimulation strategies to modulate brain function in animal models

Transcranial electrical stimulation (tES) refers to a group of non-invasive brain stimulation techniques to induce changes in the excitability of cortical neurons in humans. In recent years, studies in animal models have been shown to be essential for disentangling the neuromodulatory effects of tES, defining safety limits, and exploring potential therapeutic applications in neurological and neuropsychiatric disorders. Testing in animal models is valuable for the development of new unconventional protocols intended to improve tES administration and optimize the desired effects by increasing its focality and enabling deep-brain stimulation. Successful and controlled application of tES in humans relies on the knowledge acquired from studies meticulously performed in animal models.

No Evidence That Frontal Eye Field tDCS Affects Latency or Accuracy of Prosaccades

Transcranial direct current stimulation (tDCS) may be used to directly affect neural activity from outside of the skull. However, its exact physiological mechanisms remain elusive, particularly when applied to new brain areas. The frontal eye field (FEF) has rarely been targeted with tDCS, even though it plays a crucial role in control of overt and covert spatial attention. Here, we investigate whether tDCS over the FEF can affect the latency and accuracy of saccadic eye movements. Twenty-six participants performed a prosaccade task in which they made eye movements to a sudden-onset eccentric visual target (lateral saccades). After each lateral saccade, they made an eye movement back to the center (center saccades). The task was administered before, during, and after anodal or cathodal tDCS over the FEF, in a randomized, double-blind, within-subject design. One previous study (Kanai et al., 2012) found that anodal tDCS over the FEF decreased the latency of saccades contralateral to the stimulated hemisphere. We did not find the same effect: neither anodal nor cathodal tDCS influenced the latency of lateral saccades. tDCS also did not affect accuracy of lateral saccades (saccade endpoint deviation and saccade endpoint variability). For center saccades, we found some differences between the anodal and cathodal sessions, but these were not consistent across analyses (latency, endpoint variability), or were already present before tDCS onset (endpoint deviation). We tried to improve on the design of Kanai et al. (2012) in several ways, including the tDCS duration and electrode montage, which could explain the discrepant results. Our findings add to a growing number of null results, which have sparked concerns that tDCS outcomes are highly variable. Future studies should aim to establish the boundary conditions for FEF-tDCS to be effective, in addition to increasing sample size and adding additional controls such as a sham condition. At present, we conclude that it is unclear whether eye movements or other aspects of spatial attention can be affected through tDCS of the frontal eye fields.

The Future of Brain Stimulation Treatments

Trends in brain stimulation include becoming less invasive, more focal, and more durable with less toxicity. Several of the more interesting new potentially disruptive technologies that are just making their way through basic and sometimes clinical research studies include low-intensity focused ultrasound and temporally interfering electric fields. It is possible, and even likely, that noninvasive brain stimulation may become the dominant form of brain treatments over the next 20 years. The future of brain stimulation therapeutics is bright.

Physics of Transcranial Direct Current Stimulation Devices and Their History

Transcranial direct current stimulation (tDCS) devices apply direct current through electrodes on the scalp with the intention to modulate brain function for experimental or clinical purposes. All tDCS devices include a current controlled stimulator, electrodes that include a disposable electrolyte, and headgear to position the electrodes on the scalp. Transcranial direct current stimulation dose can be defined by the size and position of electrodes and the duration and intensity of current applied across electrodes. Electrode design and preparation are important for reproducibility and tolerability. High-definition tDCS uses smaller electrodes that can be arranged in arrays to optimize brain current flow. When intended to be used at home, tDCS devices require specific device design considerations. Computational models of current flow have been validated and support optimization and hypothesis testing. Consensus on the safety and tolerability of tDCS is protocol specific, but medical-grade tDCS devices minimize risk.

Modulation of negative emotions through anodal tDCS over the right ventrolateral prefrontal cortex

Increasing evidence suggests that the right ventrolateral prefrontal cortex (rVLPFC) plays a critical role in emotion regulation, in particular concerning negative feelings. In the present research, we applied anodal transcranial direct current stimulation (tDCS) over the rVLPFC with a twofold purpose. First, we aimed at exploring the feasibility of modulating the subjective experience of emotions through tDCS in healthy participants. Second, we wanted to assess which specific emotion can be regulated (and which cannot) with this brain stimulation approach. We designed a double-blind, between-subjects, sham-controlled study in which 96 participants watched short video clips eliciting different emotions during anodal or sham tDCS over the rVLPFC. Emotional reactions to each video clip were assessed with self-report scales measuring eight basic emotions. Results showed that, in contrast to the sham condition, tDCS over the rVLPFC reduced the perceived extent of specific negative emotions, namely, fear, anxiety, and sadness, compared to other negative or positive feelings. Overall, these results support the role of rVLPFC in regulating negative emotions, mostly associated with the prevention of dangerous situations (i.e., fear, anxiety, and sadness).

Transcranial electrical stimulation (tES) mechanisms and its effects on cortical excitability and connectivity

In this review, we describe transcranial electrical stimulation (tES) techniques currently being used in neuroscientific research, including transcranial direct current (tDCS), alternating current (tACS) and random noise (tRNS) stimulation techniques. We explain how these techniques are used and summarise the proposed mechanisms of action for each technique. We continue by describing how each method has been used to alter endogenous neuronal oscillations and connectivity between brain regions, and we conclude by highlighting the varying effects of stimulation and discussing the future direction of these stimulation techniques in research.

Effects of Transcranial Alternating Current Stimulation on Repetitive Finger Movements in Healthy Humans

Transcranial alternating current stimulation (tACS) is a noninvasive neurophysiological technique that can entrain brain oscillations. Only few studies have investigated the effects of tACS on voluntary movements. We aimed to verify whether tACS, delivered over M1 at beta and gamma frequencies, has any effect on repetitive finger tapping as assessed by means of kinematic analysis. Eighteen healthy subjects were enrolled. Objective measurements of repetitive finger tapping were obtained by using a motion analysis system. M1 excitability was assessed by using single-pulse TMS and measuring the amplitude of motor-evoked potentials (MEPs). Movement kinematic measures and MEPs were collected during beta, gamma, and sham tACS and when the stimulation was off. Beta tACS led to an amplitude decrement (i.e., progressive reduction in amplitude) across the first ten movements of the motor sequence while gamma tACS had the opposite effect. The results did not reveal any significant effect of tACS on other movement parameters, nor any changes in MEPs. These findings demonstrate that tACS modulates finger tapping in a frequency-dependent manner with no concurrent changes in corticospinal excitability. The results suggest that cortical beta and gamma oscillations are involved in the motor control of repetitive finger movements.

Evidence of transcranial direct current stimulation-generated electric fields at subthalamic level in human brain in vivo

BACKGROUND

Transcranial direct current stimulation (tDCS) is a promising brain modulation technique for several disease conditions. With this technique, some portion of the current penetrates through the scalp to the cortex and modulates cortical excitability, but a recent human cadaver study questions the amount. This insufficient intracerebral penetration of currents may partially explain the inconsistent and mixed results in tDCS studies to date. Experimental validation of a transcranial alternating current stimulation-generated electric field (EF) in vivo has been performed on the cortical (using electrocorticography, ECoG, electrodes), subcortical (using stereo electroencephalography, SEEG, electrodes) and deeper thalamic/subthalamic levels (using DBS electrodes). However, tDCS-generated EF measurements have never been attempted.

OBJECTIVE

We aimed to demonstrate that tDCS generates biologically relevant EF as deep as the subthalamic level in vivo.

METHODS

Patients with movement disorders who have implanted deep brain stimulation (DBS) electrodes serve as a natural experimental model for thalamic/subthalamic recordings of tDCS-generated EF. We measured voltage changes from DBS electrodes and body resistance from tDCS electrodes in three subjects while applying direct current to the scalp at 2 mA and 4 mA over two tDCS montages.

RESULTS

Voltage changes at the level of deep nuclei changed proportionally with the level of applied current and varied with different tDCS montages.

CONCLUSIONS

Our findings suggest that scalp-applied tDCS generates biologically relevant EF. Incorporation of these experimental results may improve finite element analysis (FEA)-based models.

Multi-Electrode Alpha tACS During Varying Background Tasks Fails to Modulate Subsequent Alpha Power

Transcranial alternating-current stimulation (tACS) for entraining alpha activity holds potential for influencing mental function, both in laboratory and clinical settings. While initial results of alpha entrainment are promising, questions remain regarding its translational potential—namely if tACS alpha entrainment is sufficiently robust to context and to what extent it can be upscaled to multi-electrode arrangements needed to direct currents into precise brain loci. We set out to explore these questions by administering alternating current through a multi-electrode montage (mtACS), while varying background task. A multi-electrode analog of previously employed anterior/posterior stimulation failed to replicate the reported alpha entrainment, suggesting that further work is required to understand the scope of applicability of tACS alpha entrainment.

Control of Spreading Depression with Electrical Fields

Spreading depression or depolarization is a large-scale pathological brain phenomenon related to migraine, stroke, hemorrhage and traumatic brain injury. Once initiated, spreading depression propagates across gray matter extruding potassium and other active molecules, collapsing the resting membrane electro-chemical gradient of cells leading to spike inactivation and cellular swelling, and propagates independently of synaptic transmission. We demonstrate the modulation, suppression and prevention of spreading depression utilizing applied transcortical DC electric fields in brain slices, measured with intrinsic optical imaging and potassium dye epifluorescence. We experimentally observe a surface-positive electric field induced forcing of spreading depression propagation to locations in cortex deeper than the unmodulated propagation path, whereby further propagation is confined and arrested even after field termination. The opposite surface-negative electric field polarity produces an increase in propagation velocity and a confinement of the wave to more superficial layers of cortex than the unmodulated propagation path. These field polarities are of opposite sign to the polarity that blocks neuronal spiking and seizures, and are consistent with biophysical models of spreading depression. The results demonstrate the potential feasibility of electrical control and prevention of spreading depression.

Non-invasive Brain Stimulation: A Paradigm Shift in Understanding Brain Oscillations

Cognitive neuroscience set out to understand the neural mechanisms underlying cognition. One central question is how oscillatory brain activity relates to cognitive processes. Up to now, most of the evidence supporting this relationship was correlative in nature. This situation changed dramatically with the recent development of non-invasive brain stimulation (NIBS) techniques, which open up new vistas for neuroscience by allowing researchers for the first time to validate their correlational theories by manipulating brain functioning directly. In this review, we focus on transcranial alternating current stimulation (tACS), an electrical brain stimulation method that applies sinusoidal currents to the intact scalp of human individuals to directly interfere with ongoing brain oscillations. We outline how tACS can impact human brain oscillations by employing different levels of observation from non-invasive tACS application in healthy volunteers and intracranial recordings in patients to animal studies demonstrating the effectiveness of alternating electric fields on neurons in vitro and in vivo. These findings likely translate to humans as comparable effects can be observed in human and animal studies. Neural entrainment and plasticity are suggested to mediate the behavioral effects of tACS. Furthermore, we focus on mechanistic theories about the relationship between certain cognitive functions and specific parameters of brain oscillaitons such as its amplitude, frequency, phase and phase coherence. For each of these parameters we present the current state of testing its functional relevance by means of tACS. Recent developments in the field of tACS are outlined which include the stimulation with physiologically inspired non-sinusoidal waveforms, stimulation protocols which allow for the observation of online-effects, and closed loop applications of tACS.

Opposite effects of lateralised transcranial alpha versus gamma stimulation on auditory spatial attention

BACKGROUND

Spatial attention relatively increases the power of neural 10-Hz alpha oscillations in the hemisphere ipsilateral to attention, and decreases alpha power in the contralateral hemisphere. For gamma oscillations (>40 Hz), the opposite effect has been observed. The functional roles of lateralised oscillations for attention are currently unclear.

HYPOTHESIS

If lateralised oscillations are functionally relevant for attention, transcranial stimulation of alpha versus gamma oscillations in one hemisphere should differentially modulate the accuracy of spatial attention to the ipsi-versus contralateral side.

METHODS

20 human participants performed a dichotic listening task under continuous transcranial alternating current stimulation (tACS, vs sham) at alpha (10 Hz) or gamma (47 Hz) frequency. On each trial, participants attended to four spoken numbers on the left or right ear, while ignoring numbers on the other ear. In order to stimulate a left temporo-parietal cortex region, which is known to show marked modulations of alpha power during auditory spatial attention, tACS (1 mA peak-to-peak amplitude) was applied at electrode positions TP7 and FC5 over the left hemisphere.

RESULTS

As predicted, unihemispheric alpha-tACS relatively decreased the recall of targets contralateral to stimulation, but increased recall of ipsilateral targets. Importantly, this spatial pattern of results was reversed for gamma-tACS.

CONCLUSIONS

Results provide a proof of concept that transcranially stimulated oscillations can enhance spatial attention and facilitate attentional selection of speech. Furthermore, opposite effects of alpha versus gamma stimulation support the view that states of high alpha are incommensurate with active neural processing as reflected by states of high gamma.

On ways to overcome the magical capacity limit of working memory

The ability to simultaneously process and maintain multiple pieces of information is limited. Over the past 50 years, observational methods have provided a large amount of insight regarding the neural mechanisms that underpin the mental capacity that we refer to as "working memory." More than 20 years ago, a neural coding scheme was proposed for working memory. As a result of technological developments, we can now not only observe but can also influence brain rhythms in humans. Building on these novel developments, we have begun to externally control brain oscillations in order to extend the limits of working memory.