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Claaß LV, Hedrich A, Reinelt J, Sehm B, Villringer A, Schlagenhauf F, Kaminski J. Influence of noninvasive brain stimulation on connectivity and local activation: a combined tDCS and fMRI study. Eur Arch Psychiatry Clin Neurosci 2024; 274:827-835. [PMID: 37597023 PMCID: PMC11127864 DOI: 10.1007/s00406-023-01666-y] [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: 12/09/2022] [Accepted: 07/31/2023] [Indexed: 08/21/2023]
Abstract
The effect of transcranial direct current stimulation (tDCS) on neurobiological mechanisms underlying executive function in the human brain remains elusive. This study aims at examining the effect of anodal and cathodal tDCS over the left dorsolateral prefrontal cortex (DLPFC) in comparison with sham stimulation on resting-state connectivity as well as functional activation and working memory performance. We hypothesized perturbed fronto-parietal resting-state connectivity during stimulation and altered working memory performance combined with modified functional working memory-related activation. We applied tDCS with 1 mA for 21 min over the DLPFC inside an fMRI scanner. During stimulation, resting-state fMRI was acquired and task-dependent fMRI during working memory task performance was acquired directly after stimulation. N = 36 healthy subjects were studied in a within-subject design with three different experimental conditions (anodal, cathodal and sham) in a double-blind design. Seed-based functional connectivity analyses and dynamic causal modeling were conducted for the resting-state fMRI data. We found a significant stimulation by region interaction in the seed-based ROI-to-ROI resting-state connectivity, but no effect on effective connectivity. We also did not find an effect of stimulation on task-dependent signal alterations in working memory activation in our regions of interest and no effect on working memory performance parameters. We found effects on measures of seed-based resting-state connectivity, while measures of effective connectivity and task-based connectivity did not show any stimulation effect. We could not replicate previous findings of tDCS stimulation effects on behavioral outcomes. We critically discuss possible methodological limitations and implications for future studies.
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Affiliation(s)
- Luise Victoria Claaß
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Annika Hedrich
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Janis Reinelt
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
| | - Bernhard Sehm
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Neurology, Martin Luther University of Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Germany
| | - Arno Villringer
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Day Clinic for Cognitive Neurology, University Hospital at the University of Leipzig, Liebigstraße 16, 04103, Leipzig, Germany
- Berlin School of Mind and Brain, MindBrainBody Institute, Humboldt-Universität zu Berlin, Unter den Linden 6, 10999, Berlin, Germany
| | - Florian Schlagenhauf
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Jakob Kaminski
- Department of Neurology, Max-Planck Institute for Human Cognitive and Brain Sciences, Stephanstraße 1, 04103, Leipzig, Germany.
- Department of Psychiatry and Neurosciences CCM, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
- Bernstein Center for Computational Neuroscience, Humboldt-Universität zu Berlin, Unter den Linden 6, 10099, Berlin, Germany.
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany.
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Latrèche C, Mancini V, Rochas V, Maeder J, Cantonas LM, Férat V, Schneider M, Michel CM, Eliez S. Using transcranial alternating current stimulation to enhance working memory skills in youths with 22q11.2 deletion syndrome: A randomized double-blind sham-controlled study. Psychiatry Res 2024; 335:115835. [PMID: 38460352 DOI: 10.1016/j.psychres.2024.115835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 02/29/2024] [Accepted: 03/02/2024] [Indexed: 03/11/2024]
Abstract
Abnormal cognitive development, particularly working memory (WM) deficits, is among the first apparent manifestations of psychosis. Yet, cognitive impairment only shows limited response to current pharmacological treatment. Alternative interventions to target cognition are highly needed in individuals at high risk for psychosis, like carriers of 22q11.2 deletion syndrome (22q11.2DS). Here we applied theta-tuned transcranial alternating current stimulation (tACS) between frontal and temporal regions during a visual WM task in 34 deletion carriers. We conducted a double-blind sham-controlled study over three consecutive days. The stimulation parameters were derived from individual structural MRI scan and HD-EEG data acquired at baseline (Day 1) to model current intensity and individual preferential theta peak. Participants were randomized to either sham or tACS (Days 2 and 3) and then completed a visual WM task and a control task. Our findings reveal that tACS was safe and well-tolerated among participants. We found a significantly increased accuracy in the visual WM but not the control task following tACS. Moreover, this enhancement in WM accuracy was greater after tACS than during tACS, indicating stronger offline effects than online effects. Our study therefore supports the application of repeated sessions of brain stimulation in 22q11.2DS.
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Affiliation(s)
- Caren Latrèche
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland.
| | - Valentina Mancini
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland
| | - Vincent Rochas
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland; Human Neuroscience Platform, Fondation Campus Biotech Geneva, Geneva, Switzerland
| | - Johanna Maeder
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland
| | - Lucia M Cantonas
- Autism Brain and Behavior Laboratory, Department of Psychiatry, University of Geneva School of Medicine, Geneva, Switzerland
| | - Victor Férat
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland
| | - Maude Schneider
- Clinical Psychology Unit for Developmental and Intellectual Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland
| | - Christoph M Michel
- Functional Brain Mapping Laboratory, Department of Basic Neurosciences, University of Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, University of Geneva School of Medicine, Switzerland; Department of Genetic Medicine and Development, University of Geneva School of Medicine, Switzerland
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3
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Di Rosa E, Masina F, Pastorino A, Galletti E, Gambarota F, Altoè G, Edelstyn N, Mapelli D. Mood moderates the effects of prefrontal tDCS on executive functions: A meta-analysis testing the affective state-dependency hypothesis. J Affect Disord 2024; 351:920-930. [PMID: 38341155 DOI: 10.1016/j.jad.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/19/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND In recent decades, numerous studies have investigated the effects of transcranial direct current stimulation (tDCS) on cognitive functioning. However, results of these studies frequently display inconsistency and pose challenges regarding replicability. The present work aimed at testing the hypothesis of mood as potential moderator of prefrontal tDCS effects on executive functions (EF). This hypothesis refers to the relationship between mood and EF, as well as to the association of mood with the dorsolateral prefrontal cortex (dlPFC) activity. METHODS We conducted a meta-analysis of 11 articles where the dlPFC was stimulated with anodal tDCS, EF were measured, and mood was assessed prior to the stimulation. We then conducted a meta-regression to examine whether mood moderated the tDCS effects on EF. RESULTS While no significant effect of tDCS on EF emerged from the meta-analysis, the meta-regression indicated that mood plays a significant role as moderator, with greater tDCS effects on EF in individuals with higher depressive symptoms. LIMITATIONS The limited number of studies included, the heterogeneous samples considered, and the limited generalizability to other non-invasive brain stimulation techniques and affective states. CONCLUSIONS Findings suggest that evaluating mood prior to stimulation could increase the sensitivity and specificity of tDCS application, and provide the first meta-analytic evidence in favor of the affective state-dependency hypothesis.
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Affiliation(s)
- Elisa Di Rosa
- Department of General Psychology, University of Padova, Italy.
| | | | | | | | - Filippo Gambarota
- Department of Developmental and Social Psychology - University of Padova, Italy
| | - Gianmarco Altoè
- Department of Developmental and Social Psychology - University of Padova, Italy
| | | | - Daniela Mapelli
- Department of General Psychology, University of Padova, Italy
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Molho W, Raymond N, Reinhart RMG, Trotti R, Grover S, Keshavan M, Lizano P. Lesion network guided delta frequency neuromodulation improves cognition in patients with psychosis spectrum disorders: A pilot study. Asian J Psychiatr 2024; 92:103887. [PMID: 38183737 DOI: 10.1016/j.ajp.2023.103887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/05/2023] [Accepted: 12/18/2023] [Indexed: 01/08/2024]
Abstract
BACKGROUND Transcranial electric stimulation (tES) may improve cognition in psychosis spectrum disorders. However, few studies have used novel tES approaches, such as high definition tES (HD-tES) to target specific brain circuits. Recently, the extrastriate visual cortex (V5/MT) has been causally linked to visual hallucinations through lesion network mapping and this may be a promising approach for improving cognition. OBJECTIVE We aim to determine if causal lesion network guided HD-tES to V5/MT improves cognitive performance as measured by the Brief Assessment of Cognition in Schizophrenia (BACS). METHODS A single-blind pilot study with a within-subjects crossover design was performed to characterize the effect of cathodal HD-transcranial direct current stimulation (tDCS) and 2 Hz HD-transcranial alternating current stimulation (tACS) on cognition. Enrolled patients received 20 mins of HD-tES twice daily for 5 consecutive days applied bilaterally to V5/MT with a washout between conditions. BACS assessments were performed at baseline, day-5, and 1-month. RESULTS 6 participants with psychosis spectrum disorder were enrolled. 6 individuals received cathodal HD-tDCS. 4 individuals received 2 Hz HD-tACS. HD-tACS resulted in significant (p < 0.1 baseline to 1-month improvements for Digit Sequencing, Verbal Fluency, and Tower of London. HD-tDCS did not result in significant improvement on any task. CONCLUSIONS HD-tACS targeting V5/MT may be a promising treatment to improve cognitive abilities in individuals with psychosis. By promoting delta oscillations, tACS may enhance cortico-cortico communications across brain networks to improve verbal working memory, processing speed, and executive function. Large-scale investigations are needed to replicate these results.
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Affiliation(s)
- Willa Molho
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Nicolas Raymond
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Robert M G Reinhart
- Department of Psychological and Brain Science, Boston University, Boston, MA, USA
| | - Rebekah Trotti
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Shrey Grover
- Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Division of Translational Neuroscience, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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Abul Hasan M, Shahid H, Ahmed Qazi S, Ejaz O, Danish Mujib M, Vuckovic A. Underpinning the neurological source of executive function following cross hemispheric tDCS stimulation. Int J Psychophysiol 2023; 185:1-10. [PMID: 36634750 DOI: 10.1016/j.ijpsycho.2023.01.004] [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: 05/08/2022] [Revised: 12/22/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a promising technique for enhancement of executive functions in healthy as well as neurologically disturbed patients. However, the evidence regarding the neuropsychological and behavioral change with neurophysiological shifts as well as the mechanism of tDCS action as evidenced by activation of neuronal sources important for executive functions have remained unaddressed. The study thereby endeavors to (1) determine the neuropsychological, behavioral, and neurophysiological change induced with five sessions of bilateral tDCS stimulation and (2) identify putative neuronal sources related to the executive functions responsible for neuropsychological and behavioral change. For this single blinded study, a total of 40 healthy participants, randomly allocated to active (n = 19) or sham (n = 21) groups completed five sessions of 2 mA tDCS stimulation administered over Dorso-Lateral Prefrontal Cortex (DLPFC) (F3 as anode, F4 as cathode). Repeated measure analysis was performed on neuropsychological (Everyday Memory Questionnaire and Mindful Attention Awareness Scale), and behavioral assessment (n-Back and Stroop tests) to investigate within and between group differences. Pre and post neurophysiological (Electroencephalogram) results showed that bilateral tDCS stimulation activates cortical regions responsible for executive functions including updation (working memory) and inhibition (interference control or attention). Multiple sessions of bilateral tDCS stimulation results in a significant increase in theta, alpha, and beta-band activity in the DLPFC, cingulate and parietal cortex. This study provides evidence that tDCS can be used for performance enhancement of executive functions in able-bodied people.
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Affiliation(s)
- Muhammad Abul Hasan
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan; Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan
| | - Hira Shahid
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan; Research Centre for Intelligent Healthcare, Coventry University, Coventry, United Kingdom.
| | - Saad Ahmed Qazi
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan; Department of Electrical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Osama Ejaz
- Neurocomputation Laboratory, National Center of Artificial Intelligence, Karachi, Pakistan
| | - Muhammad Danish Mujib
- Department of Biomedical Engineering, NED University of Engineering & Technology, Karachi, Pakistan
| | - Aleksandra Vuckovic
- Biomedical Engineering Division, University of Glasgow, Glasgow, United Kingdom
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Orlov ND, Muqtadir SA, Oroojeni H, Averbeck B, Rothwell J, Shergill SS. Stimulating learning: A functional MRI and behavioral investigation of the effects of transcranial direct current stimulation on stochastic learning in schizophrenia. Psychiatry Res 2022; 317:114908. [PMID: 37732853 DOI: 10.1016/j.psychres.2022.114908] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 04/19/2022] [Accepted: 10/13/2022] [Indexed: 11/25/2022]
Abstract
Transcranial direct current stimulation (tDCS) of the medial prefrontal cortex (mPFC) is under clinical investigation as a treatment for cognitive deficits. We investigate the effects of tDCS over the mPFC on performance SSLT in individuals with schizophrenia, and the underlying neurophysiological effect in regions associated with learning values and stimulus-outcome relationships. In this parallel-design double-blind pilot study, 49 individuals with schizophrenia, of whom 28 completed a fMRI, were randomized into active or sham tDCS stimulation groups. Subjects participated in 4 days of SSLT training (days 1, 2, 14, 56) with tDCS applied at day-1, and during a concurrent MRI scan at day-14. The SSLT demonstrated a significant mean difference in performance in the tDCS treatment group: at day-2 and at day-56. Active tDCS was associated with increased insular activity, and reduced amygdala activation. tDCS may offer an important novel approach to modulating brain networks to ameliorate cognitive deficits in schizophrenia, with this study being the first to show a longer-term effect on SSLT.
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Affiliation(s)
- Natasza D Orlov
- Cognition Schizophrenia Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Liu Lab, Athinoula A. Martinos Center for Biomedical Imaging Center, Massachusetts General Hospital, Charlestown, MA, USA; Lab of Precision Brain Imaging, Department of Neuroscience, Medical University of South Carolina, Charleston, SC, USA.
| | - Syed Ali Muqtadir
- Cognition Schizophrenia Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Lahore University of Management and Sciences, Lon, Lahore, Pakistan
| | - Hooman Oroojeni
- Department of Computing, Goldsmiths College, London, United Kingdom
| | - Bruno Averbeck
- Laboratory for Neuropsychology Section on Learning and Decision Making, National Institute of Mental Health Research, Bethesda, MD, United States
| | - John Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - Sukhi S Shergill
- Cognition Schizophrenia Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Kent and Medway Medical School, Canterbury, United Kingdom
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Pross B, Strube W, Papazova I, Güler D, Häckert J, Keeser D, Padberg F, Siamouli M, Falkai P, Hasan A. Anodal transcranial direct current stimulation sustainably increases
EEG
alpha activity in patients with schizophrenia. Neuropsychopharmacol Rep 2022; 42:323-332. [PMID: 35716122 PMCID: PMC9515721 DOI: 10.1002/npr2.12274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 05/11/2022] [Accepted: 05/14/2022] [Indexed: 11/20/2022] Open
Abstract
Aims Transcranial direct current stimulation (tDCS) applied to the prefrontal cortex has been frequently used to elicit behavioral changes in patients with schizophrenia. However, the interaction between prefrontal tDCS and electrophysiological changes remains largely uncharted. The present study aimed to investigate cortical electrophysiological changes induced by tDCS in frontal areas by means of repeated electroencephalography (EEG) in patients with schizophrenia. Methods In total, 20 patients with schizophrenia received 13 minutes of anodal tDCS (1 mA) applied to the left dorsolateral prefrontal cortex (DLPFC). Repeated resting EEG was recorded before (once) and following (at five follow‐up time‐bins) tDCS to trace post‐tDCS effects. We used sLORETA for source reconstruction to preserve the localization of brain signals with a low variance and to analyze frequency changes. Results We observed significant changes after the stimulation in areas highly connected with the stimulated DLPFC areas. The alpha 1 (8.5‐10.0 Hz) activity showed a highly significant, long‐lasting, increase for up to 1 hour after the stimulation in the postcentral gyrus (Brodmann area 2, 3, and 40). Significant yet unstable changes were also seen in the alpha‐2 frequency band precentral at 10 minutes, in the beta‐1 frequency band occipital at 20 minutes, and in the beta‐3 frequency band temporal at 40 minutes. Conclusion We were able to show that anodal tDCS can induce stable EEG changes in patients with schizophrenia. The results underline the potential of tDCS to induce long‐lasting neurophysiological changes in patients with schizophrenia showing the possibility to induce brain excitability changes in this population.
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Affiliation(s)
- Benjamin Pross
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg, BKH Augsburg Augsburg Germany
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
| | - Wolfgang Strube
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg, BKH Augsburg Augsburg Germany
| | - Irina Papazova
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg, BKH Augsburg Augsburg Germany
| | - Duygu Güler
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
| | - Jan Häckert
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg, BKH Augsburg Augsburg Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
| | - Melina Siamouli
- 3rd Department of Psychiatry, School of Medicine Aristotle University of Thessaloniki Thessaloniki Greece
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty University of Augsburg, BKH Augsburg Augsburg Germany
- Department of Psychiatry and Psychotherapy LMU University Hospital Munich Germany
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Hasbollah NN, Abu Bakar AK, Shuib N, Jamil AT, Razali S, Md Som S. Maintaining functional working memory through job activities: A study among patients with schizophrenia enrolled in a supported employment program. JOURNAL OF VOCATIONAL REHABILITATION 2022. [DOI: 10.3233/jvr-221205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Employment is crucial in rehabilitation of patients with schizophrenia. It may have positive effects on cognitive function, including working memory. OBJECTIVE: The objective of this study was to look for evidence to confirm continuous job activities could maintain functional working memory in patients with schizophrenia. METHODS: This was a cross-sectional study involving patients with schizophrenia enrolled in supported employment (SE) program. Informed consent was obtained. Socio-demographic, employment, and clinical data were acquired from interview and clinical notes. Mini International Neuropsychiatric Inventory (M.I.N.I) was used to confirm the diagnosis of schizophrenia. Working memory was evaluated using Weschler Memory Scale Third Edition -Letter-Number Span and Spatial Span. RESULTS: 118 patients were recruited with a mean age of 43.76 years old (SD = 8.96). Most were male, Malays, Muslims, single, and received at least secondary education. There was a significant association between working memory and employment outcome (χ 2 = 20.835, p < .001), and past work history (χ 2 = 10.077, p = 0.002). Multiple logistic regression indicated that the employment outcome (adjusted OR: 12.50; 95% CI: 2.55–61.21; p = 0.002) and past work history (adjusted OR: 3.36; 95% CI: 1.05–10.70; p = 0.041) were significant predictors of working memory among patients with schizophrenia in SE program. CONCLUSION: This study indicated that continuous job activities could maintain functional working memory in patients with schizophrenia.
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Affiliation(s)
- Nurul Nadia Hasbollah
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
- Department of Psychiatry and Mental Health, Hospital Sultan Ismail, Johore, Malaysia
| | | | - Norley Shuib
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Ahmad Taufik Jamil
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
| | - Salmi Razali
- Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
- Maternofetal and Embryo Research Group (MatE), Faculty of Medicine, Universiti TeknologiMARA (UiTM), Sungai Buloh, Selangor, Malaysia Institute for Pathology, Laboratory and Forensic Medicine (I-PPerForM), Faculty ofMedicine, Universiti Teknologi MARA (UiTM), Sungai Buloh, Selangor, Malaysia
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Olgiati E, Malhotra PA. Using non-invasive transcranial direct current stimulation for neglect and associated attentional deficits following stroke. Neuropsychol Rehabil 2022; 32:732-763. [PMID: 32892712 DOI: 10.1080/09602011.2020.1805335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Neglect is a disabling neuropsychological syndrome that is frequently observed following right-hemispheric stroke. Affected individuals often present with multiple attentional deficits, ranging from reduced orienting towards contralesional space to a generalized impairment in maintaining attention over time. Although a degree of spontaneous recovery occurs in most patients, in some individuals this condition can be treatment-resistant with prominent ongoing non-spatial deficits. Further, there is a large inter-individual variability in response to different therapeutic approaches. Given its potential to alter neuronal excitability and affect neuroplasticity, non-invasive brain stimulation is a promising tool that could potentially be utilized to facilitate recovery. However, there are many outstanding questions regarding its implementation in this heterogeneous patient group. Here we provide a critical overview of the available evidence on the use of non-invasive electrical brain stimulation, focussing on transcranial direct current stimulation (tDCS), to improve neglect and associated attentional deficits after right-hemispheric stroke. At present, there is insufficient robust evidence supporting the clinical use of tDCS to alleviate symptoms of neglect. Future research would benefit from careful study design, enhanced precision of electrical montages, multi-modal approaches exploring predictors of response, tailored dose-control applications and increased efforts to evaluate standalone tDCS versus its incorporation into combination therapy.
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Affiliation(s)
- Elena Olgiati
- Department of Brain Sciences, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Paresh A Malhotra
- Department of Brain Sciences, Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK.,UK Dementia Research Institute, Care Research & Technology Centre, Imperial College London and University of Surrey, London, UK
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Caulfield KA, Indahlastari A, Nissim NR, Lopez JW, Fleischmann HH, Woods AJ, George MS. Electric Field Strength From Prefrontal Transcranial Direct Current Stimulation Determines Degree of Working Memory Response: A Potential Application of Reverse-Calculation Modeling? Neuromodulation 2022; 25:578-587. [PMID: 35670064 DOI: 10.1111/ner.13342] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/24/2020] [Accepted: 11/30/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) for working memory is an enticing treatment, but there is mixed evidence to date. OBJECTIVES We tested the effects of electric field strength from uniform 2 mA dosing on working memory change from prestimulation to poststimulation. Second, we statistically evaluated a reverse-calculation method of individualizing tDCS dose and its effect on normalizing electric field at the cortex. MATERIALS AND METHODS We performed electric field modeling on a data set of 28 healthy older adults (15 women, mean age = 73.7, SD = 7.3) who received ten sessions of active 2 mA tDCS (N = 14) or sham tDCS (N = 14) applied over bilateral dorsolateral prefrontal cortices (DLPFC) in a triple-blind design. We evaluated the relationship between electric field strength and working memory change on an N-back task in conditions of above-median, high electric field from active 2 mA (N = 7), below-median, low electric field from active 2 mA (N = 7), and sham (N = 14) at regions of interest (ROI) at the left and right DLPFC. We then determined the individualized reverse-calculation dose to produce the group average electric field and measured the electric field variance between uniform 2 mA doses vs individualized reverse-calculation doses at the same ROIs. RESULTS Working memory improvements from pre- to post-tDCS were significant for the above-median electric field from active 2 mA condition at the left DLPFC (mixed ANOVA, p = 0.013). Furthermore, reverse-calculation modeling significantly reduced electric field variance at both ROIs (Levene's test; p < 0.001). CONCLUSIONS Higher electric fields at the left DLPFC from uniform 2 mA doses appear to drive working memory improvements from tDCS. Individualized doses from reverse-calculation modeling significantly reduce electric field variance at the cortex. Taken together, using reverse-calculation modeling to produce the same, high electric fields at the cortex across participants may produce more effective future tDCS treatments for working memory.
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Affiliation(s)
- Kevin A Caulfield
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA.
| | - Aprinda Indahlastari
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Nicole R Nissim
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - James W Lopez
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Holly H Fleischmann
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory Clinical Translational Research, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Mark S George
- Brain Stimulation Laboratory, Department of Psychiatry, Medical University of South Carolina, Charleston, SC, USA; Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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11
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Schwippel T, Schroeder PA, Hasan A, Plewnia C. Implicit measures of alcohol approach and drinking identity in alcohol use disorder: A preregistered double‐blind randomized trial with cathodal transcranial direct current stimulation (tDCS). Addict Biol 2022; 27:e13180. [DOI: 10.1111/adb.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 03/18/2022] [Accepted: 04/20/2022] [Indexed: 12/01/2022]
Affiliation(s)
- Tobias Schwippel
- Department of Psychiatry and Psychotherapy, Brain Stimulation Center, Tübingen Center for Mental Health (TüCMH) University of Tübingen Tübingen Germany
| | - Philipp A. Schroeder
- Department of Psychology, Clinical Psychology & Psychotherapy University of Tübingen Tübingen Germany
| | - Arafat Hasan
- Department of Psychiatry and Psychotherapy, Brain Stimulation Center, Tübingen Center for Mental Health (TüCMH) University of Tübingen Tübingen Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Brain Stimulation Center, Tübingen Center for Mental Health (TüCMH) University of Tübingen Tübingen Germany
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12
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Giel KE, Schag K, Martus P, Max SM, Plewnia C. Ameliorating cognitive control in patients with binge eating disorder by electrical brain stimulation: study protocol of the randomized controlled ACCElect pilot trial. J Eat Disord 2022; 10:26. [PMID: 35183261 PMCID: PMC8857741 DOI: 10.1186/s40337-022-00544-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/27/2022] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The current first-line treatment for binge eating disorder (BED), which is psychotherapy, is moderately effective in terms of abstinence from binge-eating. Neurobiological evidence suggests that people affected by BED show difficulties along the spectrum of impulsivity, including inhibitory control impairments and highlights the potential of novel treatment approaches directly targeting inhibitory control, including cognitive training approaches and non-invasive brain stimulation. METHODS ACCElect is a prospective, randomized controlled pilot trial investigating a novel, food-related inhibitory control training combined with transcranial direct current stimulation (tDCS). 40 patients with BED will be randomly assigned to receive the training either combined with verum or with sham stimulation (control condition). The inhibitory control training is based on principles of the antisaccade paradigm and comprises six training sessions over two weeks. Core aims are the investigation of feasibility and clinically relevant effects of a tDCS-enhanced inhibitory control training in BED patients and the establishment of a data basis for a larger efficacy trial. The primary clinical endpoint is binge-eating (BE) frequency in terms of changes in BE episodes four weeks after treatment termination as compared to baseline. Key secondary outcomes comprise ED pathology and general psychopathology, inhibitory control capacities, quality of life as well as acceptability and satisfaction with the intervention. DISCUSSION The results of the present trial will contribute to the development of novel neurobiologically informed treatment approaches for patients suffering from BED. Trial registration The ACCElect trial was prospectively registered on October 1, 2020, under the registration number NCT04572087 at ClinicalTrials.gov ( https://clinicaltrials.gov/ct2/show/NCT04572087 ).
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Affiliation(s)
- Katrin E Giel
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Eberhard Karls University Tübingen, Osianderstr. 5, 72076, Tübingen, Germany. .,Center of Excellence for Eating Disorders, Tübingen, Germany.
| | - Kathrin Schag
- Department of Psychosomatic Medicine and Psychotherapy, Medical University Hospital Tübingen, Eberhard Karls University Tübingen, Osianderstr. 5, 72076, Tübingen, Germany.,Center of Excellence for Eating Disorders, Tübingen, Germany
| | - Peter Martus
- Institute for Clinical Epidemiology and Applied Biostatistics, Medical Faculty, Eberhard Karls University Tübingen, Tübingen, Germany
| | - Sebastian M Max
- University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
| | - Christian Plewnia
- University Hospital of Psychiatry and Psychotherapy, Tübingen, Germany
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13
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Yang C, Zhang T, Huang K, Xiong M, Liu H, Wang P, Zhang Y. Increased both cortical activation and functional connectivity after transcranial direct current stimulation in patients with post-stroke: A functional near-infrared spectroscopy study. Front Psychiatry 2022; 13:1046849. [PMID: 36569623 PMCID: PMC9784914 DOI: 10.3389/fpsyt.2022.1046849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have shown that cognitive impairment is common after stroke. Transcranial direct current stimulation (tDCS) is a promising tool for rehabilitating cognitive impairment. This study aimed to investigate the effects of tDCS on the rehabilitation of cognitive impairment in patients with stroke. METHODS Twenty-two mild-moderate post-stroke patients with cognitive impairments were treated with 14 tDCS sessions. A total of 14 healthy individuals were included in the control group. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). Cortical activation was assessed using functional near-infrared spectroscopy (fNIRS) during the verbal fluency task (VFT). RESULTS The cognitive function of patients with stroke, as assessed by the MMSE and MoCA scores, was lower than that of healthy individuals but improved after tDCS. The cortical activation of patients with stroke was lower than that of healthy individuals in the left superior temporal cortex (lSTC), right superior temporal cortex (rSTC), right dorsolateral prefrontal cortex (rDLPFC), right ventrolateral prefrontal cortex (rVLPFC), and left ventrolateral prefrontal cortex (lVLPFC) cortical regions. Cortical activation increased in the lSTC cortex after tDCS. The functional connectivity (FC) between the cerebral hemispheres of patients with stroke was lower than that of healthy individuals but increased after tDCS. CONCLUSION The cognitive and brain functions of patients with mild-to-moderate stroke were damaged but recovered to a degree after tDCS. Increased cortical activation and increased FC between the bilateral cerebral hemispheres measured by fNIRS are promising biomarkers to assess the effectiveness of tDCS in stroke.
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Affiliation(s)
- Caihong Yang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.,School of Psychology, Central China Normal University, Wuhan, Hubei, China
| | - Tingyu Zhang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China
| | - Kaiqi Huang
- The Seventh Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Menghui Xiong
- Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Huiyu Liu
- Department of Rehabilitation Medicine, Yue Bei People's Hospital, Shaoguan, Guangdong, China
| | - Pu Wang
- Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, China.,Department of Rehabilitation Medicine, Tianyang District People's Hospital, Baise, Guangxi, China
| | - Yan Zhang
- School of Educational Science, Huazhong University of Science and Technology, Wuhan, Hubei, China
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14
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Effects of transcranial electrical stimulation on working memory in patients with schizophrenia: A systematic review and meta-analysis. Psychiatry Res 2021; 296:113656. [PMID: 33360429 DOI: 10.1016/j.psychres.2020.113656] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 12/09/2020] [Indexed: 01/12/2023]
Abstract
To investigate the immediate and lasting effects of transcranial electrical stimulation (tES) on working memory (WM) in schizophrenia. We performed a literature search to identify randomized controlled trials (RCTs) evaluating the ability of tES to ameliorate WM. Twelve studies were included: 215 patients in the active stimulation group and 214 in the sham stimulation group. Meta-analysis demonstrated a significant efficacy of tES on WM in follow up, a summary of one or more assessments weeks after the last tES session (standardized mean difference (SMD) 0.33, 95% confidence interval (CI) 0.04 to 0.62; p = 0.02; n = 190, 4 studies; I2 = 33%) compared to sham tES, while non-significant results were observed for WM assessed immediately after the last tES session (SMD 0.14, 95% CI -0.12 to 0.41; p = 0.30; n = 417, 11 studies; I2 = 41%) in schizophrenia. There was no significant difference between the two groups in tolerability and dropouts. Evidence of low quality indicates that effects of tES on WM in schizophrenia may appear a few weeks after the last tES session, but not always be present when tested immediately after the last tES session. Further large-scale RCTs with a parallel-group design, sample size estimation and a longer follow-up period are needed.
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15
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Lu H, Gong Y, Huang P, Zhang Y, Guo Z, Zhu X, You X. Effect of Repeated Anodal HD-tDCS on Executive Functions: Evidence From a Pilot and Single-Blinded fNIRS Study. Front Hum Neurosci 2021; 14:583730. [PMID: 33536886 PMCID: PMC7847848 DOI: 10.3389/fnhum.2020.583730] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/17/2020] [Indexed: 12/01/2022] Open
Abstract
Executive functions are of vital importance in the process of active cognition, which is thought to be associated with the dorsolateral prefrontal cortex (DLPFC). As a valid brain stimulation technology, high-definition transcranial direct current stimulation (HD-tDCS) has been used to optimize cognitive function in healthy adults. Substantial evidence indicates that short-term or single anodal tDCS sessions over the left DLPFC will enhance the performance of executive functions. However, the changes in performance and cortical activation of executive functions after modulation by repeated anodal HD-tDCS is as yet unexplored. This study aims to examine changes in three core components of executive functions (inhibitory control, working memory, and cognitive flexibility) produced by nine HD-tDCS sessions (1.5 mA, over left DLPFC, 20 min per session), and to use functional near-infrared spectroscopy (fNIRS) to bilaterally record DLPFC neural activity. A total of 43 participants were divided randomly into two study groups (anodal group vs. sham group) to complete nine interventions. Our results demonstrate that the enhancement of cognitive flexibility in the anodal group was significantly better than that in the sham group. Additionally, a Stroop effect-related decrease in oxygenated hemoglobin (HbO) concentration in the DLPFC was observed in the anodal group but not the sham group. In conclusion, our study found that repeated anodal HD-tDCS sessions can significantly promote cognitive flexibility, one of the core components of executive function, and that alterations in DLPFC activation can enhance our understanding of the neuroplastic modifications modulated by HD-tDCS.
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Affiliation(s)
- Hongliang Lu
- Faculty of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yue Gong
- School of Psychology, Shaanxi Normal University, Xi’an, China
| | - Peng Huang
- Faculty of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Yajuan Zhang
- Faculty of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Zhihua Guo
- Faculty of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xia Zhu
- Faculty of Medical Psychology, Air Force Medical University, Xi’an, China
| | - Xuqun You
- School of Psychology, Shaanxi Normal University, Xi’an, China
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16
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Cheng JX, Zhao X, Qiu J, Jiang Y, Ren J, Sun S, Wang R, Su C. Effects of transcranial direct current stimulation on performance and recovery sleep during acute sleep deprivation: a pilot study. Sleep Med 2021; 79:124-133. [PMID: 33524838 DOI: 10.1016/j.sleep.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/06/2021] [Accepted: 01/08/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND Previous studies claimed that transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) improves cognition in neuropsychiatric patients with cognitive impairment, schizophrenia, organic hypersomnia, etc, but few studies evaluated the effects of tDCS on cognitive improvement following sleep deprivation. The objective of this study was to determine whether tDCS (anode on the left DLPFC and cathode on the right DLPFC with a 2-mA current for 30 min) improves cognition following sleep deprivation. METHODS Seven participants received active tDCS and eight participants received sham tDCS when their cognition declined during at least 30 h of sleep deprivation. All participants completed the psychomotor vigilance task, Trail Making Tests A and B, digit cancellation test, Stroop color word test, the Brief Visuospatial Memory Test-Revised and a procedural game every 2 h during the sleep deprivation and after recovery sleep. RESULTS Compared to the sham stimulation, active tDCS (anode on the left DLPFC and cathode on the right DLPFC at a 2-mA current for 30 min) had beneficial effects on attention, memory, executive function, processing speed, and the ability to inhibit cognitive interference, and improved in subjective drowsiness and fatigue following sleep deprivation. The lasting effect of a single tDCS on cognition during sleep deprivation was greater than 2 h. In all participants, tDCS did not disturb recovery sleep, and cognitive performance recovered to the baseline levels after recovery sleep. CONCLUSIONS The study results indicate that tDCS can improve cognition following sleep deprivation and does not disturb recovery sleep or cognitive performance after recovery sleep. The possible pathophysiological mechanisms might be related to the modulation of the corticothalamic pathway. We believe that tDCS can be applied in the treatment of sleep disorders involving sleepiness. TRIAL REGISTRATION NUMBER ChiCTR2000029420. DATE OF REGISTRATION 2020-1-31.
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Affiliation(s)
- Jin-Xiang Cheng
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
| | - Xianchao Zhao
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Jian Qiu
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Yingcong Jiang
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Jiafeng Ren
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Shuyu Sun
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Rong Wang
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China
| | - Changjun Su
- Department of Neurology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi Province, China.
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17
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Abbasi S, Nasehi M, Ebrahimi-Ghiri M, Zarrindast MR. Anodal tDCS applied to the left frontal cortex abrogates scopolamine-induced fear memory deficit via the dopaminergic system. Acta Neurobiol Exp (Wars) 2021. [DOI: 10.21307/ane-2021-016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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18
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Efficacy of transcranial direct current stimulation in ameliorating negative symptoms and cognitive impairments in schizophrenia: A systematic review and meta-analysis. Schizophr Res 2020; 224:2-10. [PMID: 33129639 DOI: 10.1016/j.schres.2020.10.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 05/08/2020] [Accepted: 10/17/2020] [Indexed: 12/29/2022]
Abstract
AIMS Negative symptoms and cognitive impairments in schizophrenia patients are associated with the patients' functional outcomes and quality of life. However, pharmacotherapy has little effect on such symptoms. This study aimed to systematically evaluate the efficacy of transcranial direct current stimulation (tDCS) in ameliorating negative symptoms and cognitive impairments in schizophrenia patients. METHODS A literature search was performed in the PubMed, Embase, PsycINFO and Cochrane Library databases through March 23, 2020. Studies were included if they met all the following criteria: (1) subjects were exclusively patients with schizophrenia, schizoaffective disorder or psychosis, (2) active tDCS and shame stimulation were conducted in two parallel groups, (3) sufficient data were present, and (4) the study design was based on a randomized controlled trial. Two authors conducted the search strategy, publication assessment and data extraction independently, and a third person was consulted when any disagreement emerged. RESULTS A total of 14 studies were included (12 studies included negative symptoms and 7 studies included cognitive impairments). The overall meta-analysis showed no significant difference between active and sham tDCS in ameliorating negative symptoms in schizophrenia patients (SMD: -0.14, 95% CI: -0.33- 0.05). Subgroup analysis including studies with a high stimulation frequency, twice daily, revealed a significant difference in therapeutic effects between active tDCS and sham stimulation (SMD: -0.31, 95% CI: -0.58 to -0.05). With respect to cognitive impairments, there was a trend indicating that active tDCS might improve cognitive impairment (SMD: -0.21, 95% CI: -0.46- 0.04), but the overall meta-analysis failed to obtain statistically significant results. CONCLUSION Our meta-analysis indicates that tDCS is a potential strategy for improving negative symptoms, but the therapeutic benefit for negative symptoms requires a high stimulation frequency (twice a day).
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19
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Non-Invasive Brain Stimulation Does Not Improve Working Memory in Schizophrenia: A Meta-Analysis of Randomised Controlled Trials. Neuropsychol Rev 2020; 31:115-138. [PMID: 32918254 DOI: 10.1007/s11065-020-09454-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 08/26/2020] [Indexed: 10/23/2022]
Abstract
Poor working memory functioning is commonly found in schizophrenia. A number of studies have now tested whether non-invasive brain stimulation can improve this aspect of cognitive functioning. This report used meta-analysis to synthesise the results of these studies to examine whether transcranial electrical stimulation (tES) or repetitive transcranial magnetic stimulation (rTMS) can improve working memory in schizophrenia. The studies included in this meta-analysis were sham-controlled, randomised controlled trials that utilised either tES or rTMS to treat working memory problems in schizophrenia. A total of 22 studies were included in the review. Nine studies administered rTMS and 13 administered tES. Meta-analysis revealed that compared to sham/placebo stimulation, neither TMS nor tES significantly improved working memory. This was found when working memory was measured with respect to the accuracy on working memory tasks (TMS studies: Hedges' g = 0.112, CI95: -0.082, 0.305, p = .257; tES studies Hedges' g = 0.080, CI95: -0.117, 0.277, p = .427) or the speed working memory tasks were completed (rTMS studies: Hedges' g = 0.233, CI95: -0.212, 0.678, p = .305; tES studies Hedges' g = -0.016, CI95: -0.204, 0.173, p = .871). For tES studies, meta-regression analysis found that studies with a larger number of stimulation sessions were associated with larger treatment effects. This association was not found for TMS studies. At present, rTMS and tES is not associated with a reliable improvement in working memory for individuals with schizophrenia.
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20
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Enhancing cognitive control training with transcranial direct current stimulation: a systematic parameter study. Brain Stimul 2020; 13:1358-1369. [DOI: 10.1016/j.brs.2020.07.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 06/18/2020] [Accepted: 07/13/2020] [Indexed: 12/31/2022] Open
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21
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Ciullo V, Spalletta G, Caltagirone C, Banaj N, Vecchio D, Piras F, Piras F. Transcranial Direct Current Stimulation and Cognition in Neuropsychiatric Disorders: Systematic Review of the Evidence and Future Directions. Neuroscientist 2020; 27:285-309. [PMID: 32644874 DOI: 10.1177/1073858420936167] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been implemented in neuropsychiatric disorders characterized by cognitive impairment. However, methodological heterogeneity challenges conclusive remarks. Through a critical analysis of previous conflicting findings and in the light of current neurobiological models of pathophysiology, we qualitatively assessed the effects of tDCS in neuropsychiatric disorders that share neurobiological underpinnings, as to evaluate whether stimulation can improve cognitive deficits in patients' cohorts. We performed a systematic review of tDCS studies targeting cognitive functions in mental disorders and pathological cognitive aging. Data from 41 studies, comprising patients with diagnosis of mood disorders, schizophrenia-spectrum disorders, Alzheimer's disease (AD), and mild cognitive impairment (MCI), were included. Results indicate that tDCS has the capacity to enhance processing speed, working memory, and executive functions in patients with mood and schizophrenia-spectrum disorders. The evidence of a positive effect on general cognitive functioning and memory is either inconclusive in AD, or weak in MCI. Future directions are discussed for developing standardized stimulation protocols and for translating the technique therapeutic potential into effective clinical practice.
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Affiliation(s)
- Valentina Ciullo
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Gianfranco Spalletta
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy.,Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Carlo Caltagirone
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Nerisa Banaj
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Daniela Vecchio
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Fabrizio Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Federica Piras
- Neuropsychiatry Laboratory, Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
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22
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Papazova I, Strube W, Wienert A, Henning B, Schwippel T, Fallgatter AJ, Padberg F, Falkai P, Plewnia C, Hasan A. Effects of 1 mA and 2 mA transcranial direct current stimulation on working memory performance in healthy participants. Conscious Cogn 2020; 83:102959. [PMID: 32502908 DOI: 10.1016/j.concog.2020.102959] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/25/2022]
Abstract
Anodal transcranial current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to enhance working memory (WM) in neuropsychiatric patients. In healthy populations, however, tDCS obtains inconclusive results, mostly due to heterogeneous study and stimulation protocols. Here, we approached these issues by investigating effects of tDCS intensity on simultaneous WM performance with three cognitive loads by directly comparing findings of two double-blind, cross-over, sham-controlled experiments. TDCS was administrated to the left DLPFC at intensity of 1 mA (Experiment 1) or 2 mA (Experiment 2), while participants completed a verbal n-back paradigm (1-, 2-, 3-back). Analysis showed no overall effects of tDCS on WM, but a significant interaction with cognitive load. The present study suggests that cognitive load rather than tDCS intensity could be a decisive factor for effects on WM. Moreover, it emphasizes the need of thorough investigation on study parameters to develop more efficient stimulation protocols.
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Affiliation(s)
- Irina Papazova
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany.
| | - Wolfgang Strube
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany
| | - Aida Wienert
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany
| | - Bettina Henning
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany
| | - Tobias Schwippel
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany
| | - Christian Plewnia
- Department of Psychiatry and Psychotherapy, Neurophysiology & Interventional Neuropsychiatry, University of Tübingen, Germany
| | - Alkomiet Hasan
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilians University, München, Germany; Department of Psychiatry, Psychotherapy and Psychosomatics, BKH Augsburg, Medical Faculty, University of Augsburg, Germany
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Kostova R, Cecere R, Thut G, Uhlhaas PJ. Targeting cognition in schizophrenia through transcranial direct current stimulation: A systematic review and perspective. Schizophr Res 2020; 220:300-310. [PMID: 32204971 DOI: 10.1016/j.schres.2020.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 02/28/2020] [Accepted: 03/02/2020] [Indexed: 01/03/2023]
Abstract
Cognitive deficits are a fundamental feature of schizophrenia for which currently no effective treatments exist. This paper examines the possibility to use transcranial direct current stimulation (tDCS) to target cognitive deficits in schizophrenia as evidence from studies in healthy participants suggests that tDCS may improve cognitive functions and associated neural processes. We carried out a systematic review with the following search terms: 'tDCS', 'electric brain stimulation', 'schizophrenia', 'cognitive', 'cognition' until March 2019. 659 records were identified initially, 612 of which were excluded after abstract screening. The remaining 47 articles were assessed for eligibility based on our criteria and 26 studies were excluded. In addition, we compared several variables, such as online vs. offline-stimulation protocols, stimulation type and intensity on mediating positive vs. negative study outcomes. The majority of studies (n = 21) identified significant behavioural and neural effects on a range of cognitive functions (versus n = 11 with null results), including working memory, attention and social cognition. However, we could not identify tDCS parameters (electrode montage, stimulation protocol, type and intensity) that clearly mediated effects on cognitive deficits. There is preliminary evidence for the possibility that tDCS may improve cognitive deficits in schizophrenia. We discuss the rationale and strength of evidence for using tDCS for targeting cognitive deficits in schizophrenia as well as methodological issues and potential mechanisms of action.
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Affiliation(s)
- R Kostova
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - R Cecere
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - G Thut
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK; Department of Child and Adolescent Psychiatry, Charite Universitätsmedizin Berlin, Berlin, Germany.
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Translating preclinical findings in clinically relevant new antipsychotic targets: focus on the glutamatergic postsynaptic density. Implications for treatment resistant schizophrenia. Neurosci Biobehav Rev 2019; 107:795-827. [DOI: 10.1016/j.neubiorev.2019.08.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 07/20/2019] [Accepted: 08/22/2019] [Indexed: 02/07/2023]
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25
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Weickert TW, Salimuddin H, Lenroot RK, Bruggemann J, Loo C, Vercammen A, Kindler J, Weickert CS. Preliminary findings of four-week, task-based anodal prefrontal cortex transcranial direct current stimulation transferring to other cognitive improvements in schizophrenia. Psychiatry Res 2019; 280:112487. [PMID: 31376788 DOI: 10.1016/j.psychres.2019.112487] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 07/16/2019] [Accepted: 07/17/2019] [Indexed: 02/07/2023]
Abstract
Most transcranial Direct Current Stimulation (tDCS) trials of schizophrenia administer few sessions and do not assess transfer effects to other cognitive domains. In a randomized, double-blind, sham-controlled, parallel groups trial, we determined the extent to which 4-weeks of 2 mA tDCS at 20 min/day totalling 20 tDCS sessions administered during a spatial working memory test, with anodal right dorsolateral prefrontal cortex (DLPFC) and cathodal left tempo-parietal junction (TPJ) placement, as an adjunct to antipsychotics reduced auditory hallucinations and improved cognition in 12 outpatients with schizophrenia. Anodal tDCS significantly improved language-based working memory after 2 weeks and verbal fluency after 2 and 4 weeks. Thus, four weeks of tDCS appears to be safe and elicits transfer benefits to other prefrontal-dependent cognitive abilities in schizophrenia.
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Affiliation(s)
- T W Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia.
| | - H Salimuddin
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - R K Lenroot
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, USA
| | - J Bruggemann
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - C Loo
- School of Psychiatry, University of New South Wales, Sydney, Australia; Black Dog Institute, Sydney, Australia
| | - A Vercammen
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; Faculty of Natural Sciences, Imperial College London, London, UK
| | - J Kindler
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - C S Weickert
- School of Psychiatry, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
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26
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Moon SY, Kim M, Hwang WJ, Lee TY, Kwon JS. A pilot study investigating the effect of transcranial direct current stimulation on the electrophysiological correlates of working memory in patients with schizophrenia. Psychiatry Res Neuroimaging 2019; 284:9-12. [PMID: 30622048 DOI: 10.1016/j.pscychresns.2018.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/14/2018] [Accepted: 12/29/2018] [Indexed: 12/23/2022]
Abstract
Transcranial direct current stimulation (tDCS) exerts pro-cognitive effects in various populations. We evaluated the effect of tDCS on cognitive performance and its electrophysiological correlates in schizophrenia patients. Ten participants received 10 sessions of tDCS and performed cognitive performance tasks; error-related negativity and correct response negativity (CRN) were measured before and after tDCS. Verbal performance was improved by tDCS and strongly correlated with a reduced CRN amplitude. Despite the lack of sham control design and possible practice effects of cognitive tasks, we might conclude that CRN could be a modifiable electrophysiological correlate of cognitive improvement by tDCS.
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Affiliation(s)
- Sun-Young Moon
- Department of Psychiatry, College of Medicine, Seoul National University, 101 Daehak-no, Chongno-gu, 03080 Seoul, Republic of Korea
| | - Minah Kim
- Department of Psychiatry, College of Medicine, Seoul National University, 101 Daehak-no, Chongno-gu, 03080 Seoul, Republic of Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Science, College of Natural Science, Seoul National University Seoul, Republic of Korea
| | - Tae Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun Soo Kwon
- Department of Psychiatry, College of Medicine, Seoul National University, 101 Daehak-no, Chongno-gu, 03080 Seoul, Republic of Korea; Department of Brain and Cognitive Science, College of Natural Science, Seoul National University Seoul, Republic of Korea; Department of Brain and Cognitive Science, College of Natural Science, Seoul National University, Seoul, Republic of Korea.
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