Modulation of Motor Learning Capacity by Transcranial Alternating Current Stimulation

Triangular Wave tACS Improves Working Memory Performance by Enhancing Brain Activity in the Early Stage of Encoding

Working memory is an executive memory process that includes encoding, maintenance, and retrieval. These processes can be modulated by transcranial alternating current stimulation (tACS) with sinusoidal waves. However, little is known about the impact of the rate of current change on working memory. In this study, we aimed to investigate the effects of two types of tACS with different rates of current change on working memory performance and brain activity. We applied a randomized, single-blind design and divided 81 young participants who received triangular wave tACS, sinusoidal wave tACS, or sham stimulation into three groups. Participants performed n-back tasks, and electroencephalograms were recorded before, during, and after active or sham stimulation. Compared to the baseline, working memory performance (accuracy and response time) improved after stimulation under all stimulation conditions. According to drift-diffusion model analysis, triangular wave tACS significantly increased the efficiency of non-target information processing. In addition, compared with sham conditions, triangular wave tACS reduced alpha power oscillations in the occipital lobe throughout the encoding period, while sinusoidal wave tACS increased theta power in the central frontal region only during the later encoding period. The brain network connectivity results showed that triangular wave tACS improved the clustering coefficient, local efficiency, and node degree intensity in the early encoding stage, and these parameters were positively correlated with the non-target drift rate and decision starting point. Our findings on how tACS modulates working memory indicate that triangular wave tACS significantly enhances brain network connectivity during the early encoding stage, demonstrating an improvement in the efficiency of working memory processing. In contrast, sinusoidal wave tACS increased the theta power during the later encoding stage, suggesting its potential critical role in late-stage information processing. These findings provide valuable insights into the potential mechanisms by which tACS modulates working memory.

The Influence of Transcranial Alternating Current Stimulation on the Excitability of the Unstimulated Contralateral Primary Motor Cortex

OBJECTIVES

Transcranial alternating current stimulation (tACS) can enhance primary motor cortex (M1) excitability and improve motor skill when delivered unilaterally to the dominant hemisphere. However, the impact of tACS on contralateral M1 excitability both during and after application has not been studied. The purpose of this study was to examine the effects of tACS delivered to the dominant left M1 on the excitability of the unstimulated contralateral non-dominant right M1.

METHODS

This study implemented a double-blind, randomized, SHAM-controlled, within-subjects, crossover experimental design. Eighteen young adults completed a tACS condition and a SHAM condition on two different days in counterbalanced order with a week washout period between days. Transcranial magnetic stimulation (TMS) was utilized to assess excitability of the contralateral right M1 while tACS was delivered to the left M1. TMS was administered in five test blocks (termed Pre, D5, D10, D15, and Post) relative to a 20 min application of tACS (70 Hz, 1 mA current strength). The Pre and Post TMS test blocks were conducted before and immediately after tACS was applied to the left M1, whereas the TMS test blocks performed during tACS were completed at time points starting at the 5, 10, and 15 min marks of the 20 min stimulation period. The primary dependent variable was the 1 mV motor evoked potential (MEP) amplitude. MEP data were analyzed with a 2 condition (tACS, SHAM) × 5 test (Pre, D5, D10, D15, Post) within-subjects ANOVA.

RESULTS

The main effect for condition (p = 0.704) and condition × test interaction (p = 0.349) were both non-statistically significant. There was a significant main effect for test (p = 0.003); however, post hoc analysis indicated that none of the pairwise comparisons were statistically significant.

CONCLUSIONS

Overall, the findings indicate that tACS applied to the left M1 does not significantly modulate contralateral right M1 excitability during or immediately after stimulation, at least when utilizing the present tACS parameters.

Enhancement of beta rebound elicited by proprioceptive stimulation in the sensorimotor cortex by transcranial alternating current stimulation matched to the dominant beta frequency

Transcranial alternating current stimulation (tACS) can modulate endogenous brain oscillations in a frequency-specific manner. Previous studies have reported that beta tACS modulates the excitability of primary motor cortex and improves task performance. Tactile and proprioceptive stimuli also elicit event-related synchronization of the beta rhythm in contralateral sensorimotor cortex, termed beta rebound, and a strong correlation was reported between proprioception-induced rebound strength and clinical recovery in stroke patients. We investigated the effects of tACS matched to the dominant beta frequency on the strength of proprioception-induced beta rebound.We recorded the beta rebound from 14 healthy young adults in response to passive index finger movement by electroencephalography to determine individual peak beta frequency. Electroencephalograms (EEG) were recorded during passive movements before and after active or sham tACS. We recorded beta rebound of all participants to determine their individual peak frequency of beta rebound prior to this experiment. Active tACS at individually matched frequencies increased beta rebound strength during subsequent passive movement compared to sham tACS in the majority of participants, while the remaining participants demonstrated no significant change or a decrease. These findings on healthy participants provide an essential foundation for further studies on the effects of beta frequency-matched tACS for stroke patient rehabilitation.

Frequency-specific modulation of motor cortical excitability by transcranial alternating current stimulation

BACKGROUND

Transcranial alternating current stimulation (tACS) is a non-invasive technique that modulates neural oscillations, yet its specific effects on cortical excitability are not well-understood. This study investigated the effects of tACS on neuroplasticity in the primary motor cortex (M1) across different frequencies.

METHODS

In this randomized, sham-controlled, crossover study, 18 healthy young adults received β-tACS γ-tACS, and sham stimulation over the M1. Neurophysiological responses were assessed using motor evoked potentials (MEPs), electroencephalograms (EEG), and transcranial evoked potentials (TEPs) to determine the frequency-specific effects of tACS on cortical excitability and neuroplasticity.

RESULTS

γ-tACS significantly enhanced cortical excitability, as reflected by larger MEP amplitudes compared to both β-tACS and sham stimulation. In addition, γ-tACS resulted in significantly smaller M1-P15 amplitudes in TEP than other stimulation conditions. In contrast, β-tACS did not produce significant changes in either MEPs or TEPs compared to sham stimulation.

CONCLUSION

These findings provide evidence that tACS induces frequency-dependent effects on cortical excitability and neuroplasticity within the M1. This selective modulation of cortical excitability with γ-tACS suggests its potential as a therapeutic intervention for optimizing motor function and rehabilitation.

TRIAL REGISTRATION

This study was registered in the Chinese Clinical Trial Registry (ChiCTR2300074898, date of registration: 2023/08/18).

Determining the effects of transcranial alternating current stimulation on corticomotor excitability and motor performance: A sham-controlled comparison of four frequencies

Transcranial alternating current stimulation (tACS) modulates brain oscillations and corticomotor plasticity. We examined the effects of four tACS frequencies (20 Hz, 40 Hz, 60 Hz, and 80 Hz) on motor cortex (M1) excitability and motor performance. In a randomised crossover design, 12 adults received 20-minute tACS sessions, with Sham as control. Corticomotor and intracortical excitability was measured up to 60-minutes post-tACS. Motor performance was evaluated using the Grooved Pegboard Test (GPT) and sensorimotor assessments. Our findings demonstrated frequency-dependent modulation of corticomotor excitability based on MEP amplitude. 20 Hz and 40 Hz tACS reduced MEPs, while 60 Hz and 80 Hz increased MEPs. Inhibition (cortical silent period, SP) was reduced across all tACS frequencies compared to Sham, with 20 Hz and 40 Hz showing consistent reductions, 60 Hz showing effects at post-0 and post-30, and 80 Hz at post-60. Furthermore, 60 Hz tACS decreased intracortical inhibition at post-0, while intracortical facilitation increased with 20 Hz and 60 Hz at post-0, and 40 Hz at post-60. Motor performance remained unaffected across frequencies. Regression analyses revealed that shorter SP at 60 min post 60 Hz tACS predicted faster reaction times, while greater MEP amplitudes at 60 min following 80 Hz tACS predicted improved hand dexterity. Overall, beta and gamma tACS frequencies modulate M1 excitability, with consistent effects on SP, suggesting potential use in conditions involving SP elongation, such as stroke and Huntington's disease. These findings highlight 60 Hz tACS as a potential tool for motor rehabilitation therapies.

Human cortical high-gamma power scales with movement rate in healthy participants and stroke survivors

Motor cortical high-gamma oscillations (60-90 Hz) occur at movement onset and are spatially focused over the contralateral primary motor cortex. Although high-gamma oscillations are widely recognized for their significance in human motor control, their precise function on a cortical level remains elusive. Importantly, their relevance in human stroke pathophysiology is unknown. Because motor deficits are fundamental determinants of symptom burden after stroke, understanding the neurophysiological processes of motor coding could be an important step in improving stroke rehabilitation. We recorded magnetoencephalography data during a thumb movement rate task in 14 chronic stroke survivors, 15 age-matched control participants and 29 healthy young participants. Motor cortical high-gamma oscillations showed a strong relation with movement rate as trials with higher movement rate were associated with greater high-gamma power. Although stroke survivors showed reduced cortical high-gamma power, this reduction primarily reflected the scaling of high-gamma power with movement rate, yet after matching movement rate in stroke survivors and age-matched controls, the reduction of high-gamma power exceeded the effect of their decreased movement rate alone. Even though motor skill acquisition was evident in all three groups, it was not linked to high-gamma power. Our study quantifies high-gamma oscillations after stroke, revealing a reduction in movement-related high-gamma power. Moreover, we provide strong evidence for a pivotal role of motor cortical high-gamma oscillations in encoding movement rate. KEY POINTS: Neural oscillations in the high-gamma frequency range (60-90 Hz) emerge in the human motor cortex during movement. The precise function of these oscillations in motor control remains unclear, and they have never been characterized in stroke survivors. In a magnetoencephalography study, we demonstrate that high-gamma oscillations in motor cortical areas scale with movement rate, and we further explore their temporal and spatial characteristics. Stroke survivors exhibit lower high-gamma power during movement than age-matched control participants, even after matching for movement rate. The results contribute to the understanding of the role of high-gamma oscillations in motor control and have important implications for neuromodulation in stroke rehabilitation.

The Modulatory Effects of Transcranial Alternating Current Stimulation on Brain Oscillatory Patterns in the Beta Band in Healthy Older Adults

Background: In the last few years, transcranial alternating current stimulation (tACS) has attracted attention as a promising approach to interact with ongoing oscillatory cortical activity and, consequently, to enhance cognitive and motor processes. While tACS findings are limited by high variability in young adults' responses, its effects on brain oscillations in older adults remain largely unexplored. In fact, the modulatory effects of tACS on cortical oscillations in healthy aging participants have not yet been investigated extensively, particularly during movement. This study aimed to examine the after-effects of 20 Hz and 70 Hz High-Definition tACS on beta oscillations both during rest and movement. Methods: We recorded resting state EEG signals and during a handgrip task in 15 healthy older participants. We applied 10 min of 20 Hz HD-tACS, 70 Hz HD-tACS or Sham stimulation for 10 min. We extracted resting-state beta power and movement-related beta desynchronization (MRBD) values to compare between stimulation frequencies and across time. Results: We found that 20 Hz HD-tACS induced a significant reduction in beta power for electrodes C3 and CP3, while 70 Hz did not have any significant effects. With regards to MRBD, 20 Hz HD-tACS led to more negative values, while 70 Hz HD-tACS resulted in more positive ones for electrodes C3 and FC3. Conclusions: These findings suggest that HD-tACS can modulate beta brain oscillations with frequency specificity. They also highlight the focal impact of HD-tACS, which elicits effects on the cortical region situated directly beneath the stimulation electrode.

Aging, brain plasticity, and motor learning

Motor skill learning, the process of acquiring new motor skills, is critically important across the lifespan, from early development through adulthood and into older age, as well as in pathological conditions (i.e., rehabilitation). Extensive research has demonstrated that motor skill acquisition in young adults is accompanied by significant neuroplastic changes, including alterations in brain structure (gray and white matter), function (i.e., activity and connectivity), and neurochemistry (i.e., levels of neurotransmitters). In the aging population, motor performance typically declines, characterized by slower and less accurate movements. However, despite these age-related changes, older adults maintain the capacity for skill improvement through training. In this review, we explore the extent to which the aging brain retains the ability to adapt in response to motor learning, specifically whether skill acquisition is accompanied by neural changes. Furthermore, we discuss the associations between inter-individual variability in brain structure and function and the potential for future learning in older adults. Finally, we consider the use of non-invasive brain stimulation techniques aimed at optimizing motor learning in this population. Our review provides insights into the neurobiological underpinnings of motor learning in older adults and emphasizes strategies to enhance their motor skill acquisition.

Advances in non-invasive brain stimulation: enhancing sports performance function and insights into exercise science

The cerebral cortex, as the pinnacle of human complexity, poses formidable challenges to contemporary neuroscience. Recent advancements in non-invasive brain stimulation have been pivotal in enhancing human locomotor functions, a burgeoning area of interest in exercise science. Techniques such as transcranial direct current stimulation, transcranial alternating current stimulation, transcranial random noise stimulation, and transcranial magnetic stimulation are widely recognized for their neuromodulator capabilities. Despite their broad applications, these methods are not without limitations, notably in spatial and temporal resolution and their inability to target deep brain structures effectively. The advent of innovative non-invasive brain stimulation modalities, including transcranial focused ultrasound stimulation and temporal interference stimulation technology, heralds a new era in neuromodulation. These approaches offer superior spatial and temporal precision, promising to elevate athletic performance, accelerate sport science research, and enhance recovery from sports-related injuries and neurological conditions. This comprehensive review delves into the principles, applications, and future prospects of non-invasive brain stimulation in the realm of exercise science. By elucidating the mechanisms of action and potential benefits, this study aims to arm researchers with the tools necessary to modulate targeted brain regions, thereby deepening our understanding of the intricate interplay between brain function and human behavior.

The role of the somatosensory system in the feeling of emotions: a neurostimulation study

Emotional experiences deeply impact our bodily states, such as when we feel 'anger', our fists close and our face burns. Recent studies have shown that emotions can be mapped onto specific body areas, suggesting a possible role of the primary somatosensory system (S1) in emotion processing. To date, however, the causal role of S1 in emotion generation remains unclear. To address this question, we applied transcranial alternating current stimulation (tACS) on the S1 at different frequencies (beta, theta, and sham) while participants saw emotional stimuli with different degrees of pleasantness and levels of arousal. Results showed that modulation of S1 influenced subjective emotional ratings as a function of the frequency applied. While theta and beta-tACS made participants rate the emotional images as more pleasant (higher valence), only theta-tACS lowered the subjective arousal ratings (more calming). Skin conductance responses recorded throughout the experiment confirmed a different arousal for pleasant versus unpleasant stimuli. Our study revealed that S1 has a causal role in the feeling of emotions, adding new insight into the embodied nature of emotions. Importantly, we provided causal evidence that beta and theta frequencies contribute differently to the modulation of two dimensions of emotions-arousal and valence-corroborating the view of a dissociation between these two dimensions of emotions.

Differential online and offline effects of theta-tACS on memory encoding and retrieval

Theta oscillations support memory formation, but their exact contribution to the communication between prefrontal cortex (PFC) and the hippocampus is unknown. We tested the functional relevance of theta oscillations as a communication link between both areas for memory formation using transcranial alternating current stimulation (tACS). Healthy, young participants learned two lists of Dutch-German word pairs and retrieved them immediately and with a 30-min delay. In the encoding group (N = 30), tACS was applied during the encoding of list 1. List 2 was used to test stimulation aftereffects. In the retrieval group (N = 23), we stimulated during the delayed recall. In both groups, we applied tACS bilaterally at prefrontal and tempo-parietal sites, using either individualized theta frequency or 15 Hz (as control), according to a within-subject design. Stimulation with theta-tACS did not alter overall learning performance. An exploratory analysis revealed that immediate recall improved when word-pairs were learned after theta-tACS (list 2). Applying theta-tACS during retrieval had detrimental effects on memory. No changes in the power of the respective frequency bands were observed. Our results do not support the notion that impacting the communication between PFC and the hippocampus during a task by bilateral tACS improves memory. However, we do find evidence that direct stimulation had a trend for negatively interfering effects during immediate and delayed recall. Hints for beneficial effects on memory only occurred with aftereffects of the stimulation. Future studies need to further examine the effects during and after stimulation on memory formation.

An overview of the effects and mechanisms of transcranial stimulation frequency on motor learning

Many studies over the recent decades have attempted the modulation of motor learning using brain stimulation. Alternating currents allow for researchers not only to electrically stimulate the brain, but to further investigate the effects of specific frequencies, in and beyond the context of their endogenous associations. Transcranial alternating current stimulation (tACS) has therefore been used during motor learning to modulate aspects of acquisition, consolidation and performance of a learned motor skill. Despite numerous reviews on the effects of tACS, and its role in motor learning, there are few studies which synthesize the numerous frequencies and their respective theoretical mechanisms as they relate to motor and perceptual processes. Here we provide a short overview of the main stimulation frequencies used in motor learning modulation (e.g., alpha, beta, and gamma), and discuss the effect and proposed mechanisms of these studies. We summarize with the current state of the field, the effectiveness and variability in motor learning modulation, and novel mechanistic proposals from other fields.

Differential effects of theta-gamma tACS on motor skill acquisition in young individuals and stroke survivors: A double-blind, randomized, sham-controlled study

BACKGROUND

Theta-gamma transcranial alternating current stimulation (tACS) was recently found to enhance thumb acceleration in young, healthy participants, suggesting a potential role in facilitating motor skill acquisition. Given the relevance of motor skill acquisition in stroke rehabilitation, theta-gamma tACS may hold potential for treating stroke survivors.

OBJECTIVE

We aimed to examine the effects of theta-gamma tACS on motor skill acquisition in young, healthy participants and stroke survivors.

METHODS

In a pre-registered, double-blind, randomized, sham-controlled study, 78 young, healthy participants received either theta-gamma peak-coupled (TGP) tACS, theta-gamma trough-coupled (TGT) tACS or sham stimulation. 20 individuals with a chronic stroke received either TGP or sham. TACS was applied over motor cortical areas while participants performed an acceleration-dependent thumb movement task. Stroke survivors were characterized using standardized testing, with a subgroup receiving additional structural brain imaging.

RESULTS

Neither TGP nor TGT tACS significantly modified general motor skill acquisition in the young, healthy cohort. In contrast, in the stroke cohort, TGP diminished motor skill acquisition compared to sham. Exploratory analyses revealed that, independent of general motor skill acquisition, healthy participants receiving TGP or TGT exhibited greater peak thumb acceleration than those receiving sham.

CONCLUSION

Although theta-gamma tACS increased thumb acceleration in young, healthy participants, consistent with previous reports, it did not enhance overall motor skill acquisition in a more complex motor task. Furthermore, it even had detrimental effects on motor skill acquisition in stroke survivors.

Motor Learning in a Complex Motor Task Is Unaffected by Three Consecutive Days of Transcranial Alternating Current Stimulation

Transcranial alternating current stimulation (tACS) delivered to the primary motor cortex (M1) can increase cortical excitability, entrain neuronal firing patterns, and increase motor skill acquisition in simple motor tasks. The primary aim of this study was to assess the impact of tACS applied to M1 over three consecutive days of practice on the motor learning of a challenging overhand throwing task in young adults. The secondary aim was to examine the influence of tACS on M1 excitability. This study implemented a double-blind, randomized, SHAM-controlled, between-subjects experimental design. A total of 24 healthy young adults were divided into tACS and SHAM groups and performed three identical experimental sessions that comprised blocks of overhand throwing trials of the right dominant arm concurrent with application of tACS to the left M1. Performance in the overhand throwing task was quantified as the endpoint error. Motor evoked potentials (MEPs) were assessed in the right first dorsal interosseus (FDI) muscle with transcranial magnetic stimulation (TMS) to quantify changes in M1 excitability. Endpoint error was significantly decreased in the post-tests compared with the pre-tests when averaged over the three days of practice (p = 0.046), but this decrease was not statistically significant between the tACS and SHAM groups (p = 0.474). MEP amplitudes increased from the pre-tests to the post-tests (p = 0.003), but these increases were also not different between groups (p = 0.409). Overall, the main findings indicated that tACS applied to M1 over multiple days does not enhance motor learning in a complex task to a greater degree than practice alone (SHAM).

Effects of transcranial alternating current stimulation to the supplementary motor area on motor learning

Transcranial alternating current stimulation (tACS) is a noninvasive method for brain stimulation that artificially modulates oscillatory brain activity in the cortical region directly beneath the electrodes by applying a weak alternating current. Beta (β) oscillatory activity in the supplementary motor area (SMA) is involved in motor planning and maintenance, whereas gamma (γ) oscillatory activity is involved in the updating of motor plans. However, the effect of applying tACS to the SMA on motor learning has not yet been investigated. This study assessed the effects of applying tACS to the SMA on motor learning. Forty-two right-handed healthy adults (age 20.6 ± 0.5 years, 24 men and 18 women) were included. Motor learning was assessed using a visuomotor tracking task with pinch tension of the right thumb and right forefinger. Each trial lasted 60 s, and the error rates were measured. Conductive rubber electrodes were attached to the SMA and the left shoulder for tACS. Stimulation was applied at an intensity of 1.0 mA and frequencies of 70 and 20 Hz in the γ-tACS and β-tACS treatment groups, respectively. The sham group was only administered a fade-in/out. The visuomotor tracking task was performed for 10 trials before tACS and 10 trials after tACS. Two trials were conducted on the following day to determine motor skill retention. The average deviation measured during 60 s was considered the error value. Pre-stimulation learning rate was calculated as the change in error rate. Post-stimulation learning rate and retention rate were calculated as the change in error rate after stimulation and on the day after stimulation, respectively. In both the stimulation groups, differences in pre-stimulation learning, post-stimulation learning, and retention rates were not significant. However, in the γ-tACS group, baseline performance and pre-stimulation learning rate were positively correlated with post-stimulation learning rate. Therefore, applying γ-tACS to the SMA can increase post-stimulation learning rate in participants exhibiting low baseline performance and high pre-stimulation learning rate. Our findings suggest that motor learning can be effectively enhanced by applying γ-tACS to the SMA based on an individual's motor and learning abilities.

Uncorking the limitation-improving dual tasking using transcranial electrical stimulation and task training in the elderly: a systematic review

Introduction

With aging, dual task (DT) ability declines and is more cognitively demanding than single tasks. Rapidly declining DT performance is regarded as a predictor of neurodegenerative disease. Task training and non-invasive transcranial electrical stimulation (tES) are methods applied to optimize the DT ability of the elderly.

Methods

A systematic search was carried out in the PUBMED, TDCS (transcranial direct current stimulation) databases, as well as Web of Science, and a qualitative analysis was conducted in 56 included studies. Aiming to summarize the results of studies that implemented tES, task training, or the combination for improving DT ability and related performance changes in healthy elderly and geriatric patients. For different approaches, the training procedures, parameters, as well as outcomes were discussed.

Results

Task training, particularly cognitive-motor DT training, has more notable effects on improving DT performance in the elderly when compared to the neuromodulation method.

Discussion

Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (L-DLPFC), or its combination with task training could be promising tools. However, additional evidence is required from aged healthy people and patients, as well as further exploration of electrode montage.

Transcranial alternating current stimulation does not affect microscale learning

A theory has been posited that microscale learning, which involves short intervals of a few seconds during explicit motor skill learning, considerably enhances performance. This phenomenon correlates with diminished beta-band activity in the frontal and parietal regions. However, there is a lack of neurophysiological studies regarding the relationship between microscale learning and implicit motor skill learning. In the present study, we aimed to determine the effects of transcranial alternating current stimulation (tACS) during short rest periods on microscale learning in an implicit motor task. We investigated the effects of 20-Hz β-tACS delivered during short rest periods while participants performed an implicit motor task. In Experiments 1 and 2, β-tACS targeted the right dorsolateral prefrontal cortex and the right frontoparietal network, respectively. The participants performed a finger-tapping task using their nondominant left hand, and microscale learning was separately analyzed for micro-online gains (MOnGs) and micro-offline gains (MOffGs). Contrary to our expectations, β-tACS exhibited no statistically significant effects on MOnGs or MOffGs in either Experiment 1 or Experiment 2. In addition, microscale learning during the performance of the implicit motor task was improved by MOffGs in the early learning phase and by MOnGs in the late learning phase. These results revealed that the stimulation protocol employed in this study did not affect microscale learning, indicating a novel aspect of microscale learning in implicit motor tasks. This is the first study to examine microscale learning in implicit motor tasks and may provide baseline information that will be useful in future studies.

Functional connectivity via the dorsolateral prefrontal cortex in the late phase of rest periods predicts offline learning

The relationship between offline learning gains and functional connectivity (FC) has been investigated in several studies. They have focused on average motor task performance and resting-state FC across subjects. Generally, individual differences are seen in both offline learning gain and neurophysiological profiles in resting-state FC. However, few studies have focused on the relationship between individual differences in offline learning gain and temporal characteristics of resting-state FC. The present study aimed to clarify this relationship between the two profiles. Thirty-four healthy right-handed participants performed a force-controlled motor task. Electroencephalography was performed during the 15-minute wakeful rest period between tasks. The results revealed a significant correlation between offline learning gain and FC between the contralateral dorsolateral prefrontal cortex (DLPFC) and contralateral primary motor cortex (M1), and ipsilateral primary somatosensory cortex (S1) during late phase of the rest interval. These results are consistent with the findings of previous studies showing the FC between M1, which is necessary for awake offline learning, and DLPFC, which is related to motor control. Additionally, sensory feedback related to force control may be caused by the interaction between contralateral DLPFC and ipsilateral S1. Our study shed light on the temporal profiles of resting-state FC associated with individual differences in offline learning.

Theta-tACS modulates cerebellar-related motor functions and cerebellar-cortical connectivity

OBJECTIVE

To evaluate the effects of cerebellar transcranial alternating current stimulation (tACS) delivered at cerebellar-resonant frequencies, i.e., theta (θ) and gamma (γ), on upper limb motor performance and cerebellum-primary motor cortex (M1) connectivity, as assessed by cerebellar-brain inhibition (CBI), in healthy subjects.

METHODS

Participants underwent cerebellar-tACS while performing three cerebellar-dependent motor tasks: (i) rhythmic finger-tapping, (ii) arm reaching-to-grasp ('grasping') and (iii) arm reaching-to-point ('pointing') an object. Also, we evaluated possible changes in CBI during cerebellar-tACS.

RESULTS

θ-tACS decreased movement regularity during the tapping task and increased the duration of the pointing task compared to sham- and γ-tACS. Additionally, θ-tACS increased the CBI effectiveness (greater inhibition). The effect of θ-tACS on movement rhythm correlated with CBI changes and less tapping regularity corresponded to greater CBI.

CONCLUSIONS

Cerebellar-tACS delivered at the θ frequency modulates cerebellar-related motor behavior and this effect is, at least in part, mediated by changes in the cerebellar inhibitory output onto M1. The effects of θ-tACS may be due to the modulation of cerebellar neurons that resonate to the θ rhythm.

SIGNIFICANCE

These findings contribute to a better understanding of the physiological mechanisms of motor control and provide new evidence on cerebellar non-invasive brain stimulation.

Does 20 Hz Transcranial Alternating Current Stimulation over the Human Primary Motor Cortex Modulate Beta Rebound Following Voluntary Movement?

Beta frequency oscillations originating from the primary motor cortex increase in amplitude following the initiation of voluntary movement, a process termed beta rebound. The strength of beta rebound has been reported to predict the recovery of motor function following stroke, suggesting therapeutic applications of beta rebound modulation. The present study examined the effect of 20 Hz transcranial alternating current stimulation (tACS) on the beta rebound induced by self-paced voluntary movement. Electroencephalograms (EEGs) and electromyograms (EMGs) were recorded from 16 healthy adults during voluntary movements performed before and after active or sham tACS. There was no significant change in average beta rebound after active tACS. However, the beta rebound amplitude was significantly enhanced in a subset of participants, and the magnitude of the increase across all participants was negatively correlated with the difference between individual peak beta frequency and tACS frequency. Thus, matching the stimulus frequency of tACS with individual beta frequency may facilitate therapeutic enhancement for motor rehabilitation.

Cerebellar Transcranial Direct Current Stimulation Applied over Multiple Days Does Not Enhance Motor Learning of a Complex Overhand Throwing Task in Young Adults

Cerebellar transcranial direct current stimulation (tDCS) enhances motor skill and learning in relatively simple motor tasks, but it is unclear if c-tDCS can improve motor performance in complex motor tasks. The purpose of this study was to determine the influence of c-tDCS applied over multiple days on motor learning in a complex overhand throwing task. In a double-blind, randomized, between-subjects, SHAM-controlled, experimental design, 30 young adults were assigned to either a c-tDCS or a SHAM group. Participants completed three identical experiments on consecutive days that involved overhand throwing in a pre-test block, five practice blocks with concurrent c-tDCS, and a post-test block. Overhand throwing endpoint accuracy was quantified as the endpoint error. The first dorsal interosseous muscle motor evoked potential (MEP) amplitude elicited by transcranial magnetic stimulation was used to quantify primary motor cortex (M1) excitability modulations via c-tDCS. Endpoint error significantly decreased over the 3 days of practice, but the magnitude of decrease was not significantly different between the c-tDCS and SHAM group. Similarly, MEP amplitude slightly increased from the pre-tests to the post-tests, but these increases did not differ between groups. These results indicate that multi-day c-tDCS does not improve motor learning in an overhand throwing task or increase M1 excitability.

Determining the corticospinal, intracortical and motor function responses to transcranial alternating current stimulation of the motor cortex in healthy adults: A systematic review and meta-analysis

BACKGROUND

Transcranial Alternating Current Stimulation (tACS) employs low-intensity sinusoidal currents to influence cortical plasticity and motor function. Despite extensive research, inconsistent results require a comprehensive review of tACS efficacy.

OBJECTIVE

This study systematically assesses tACS effects on corticospinal and intracortical excitability, and motor function over the motor cortex (M1), focusing on alpha, beta, and gamma frequencies.

METHODS

Relevant studies were identified through database searches and citations were tracked until July 10, 2023. The methodological quality of the included studies (29) was evaluated by Downs and Black. Data synthesis involved meta-analysis (n = 25) and best evidence synthesis (n = 5).

RESULTS

Meta-analysis revealed that alpha and beta tACS with intensities > 1 mA and tACS with individualized alpha frequency (IAF) increased corticospinal excitability (CSE). tACS over M1 improved motor function, irrespective of stimulation frequency and intensity. Sub-analysis showed that alpha and beta tACS with an intensity ≤ 1 mA led to improved motor function, while gamma tACS at 2 mA enhanced motor function. Additionally, beta tACS at a fixed frequency of 20 Hz, as well as both low gamma (30-55) and high gamma (55-80) tACS, resulted in improved motor function. A stimulation duration of 20 min led to improvements in both CSE and motor function, and tACS with electrode sizes smaller than 35 cm2 and an electrode montage over M1-supraorbital region (SOR) were found to enhance motor function. Notably, both online and offline tACS improved motor function, regardless of stimulation factors.

CONCLUSION

tACS modulates CSE and improves motor function, with outcomes dependent on stimulation parameters and timing.

The Influence of Transcranial Alternating Current Stimulation on Fatigue Resistance

Previous research has shown that some forms of non-invasive brain stimulation can increase fatigue resistance. The purpose of this study is to determine the influence of transcranial alternating current stimulation (tACS) on the time to task failure (TTF) of a precision grip task. The study utilized a randomized, double-blind, SHAM-controlled, within-subjects design. Twenty-six young adults completed two experimental sessions (tACS and SHAM) with a 7-day washout period between sessions. Each session involved a fatiguing isometric contraction of the right hand with a precision grip with either a tACS or SHAM stimulation applied to the primary motor cortex (M1) simultaneously. For the fatiguing contraction, the participants matched an isometric target force of 20% of the maximum voluntary contraction (MVC) force until task failure. Pre- and post-MVCs were performed to quantify the force decline due to fatigue. Accordingly, the dependent variables were the TTF and MVC force decline as well as the average EMG activity, force error, and standard deviation (SD) of force during the fatiguing contractions. The results indicate that there were no significant differences in any of the dependent variables between the tACS and SHAM conditions (p value range: 0.256-0.820). These findings suggest that tACS does not increase the TTF during fatiguing contractions in young adults.

Spectral specificity of gamma-frequency transcranial alternating current stimulation over motor cortex during sequential movements

Motor control requires the coordination of spatiotemporally precise neural oscillations in the beta and gamma range within the primary motor cortex (M1). Recent studies have shown that motor performance can be differentially modulated based on the spectral target of noninvasive transcranial alternating current stimulation (tACS), with gamma-frequency tACS improving motor performance. However, the spectral specificity for eliciting such improvements remains unknown. Herein, we derived the peak movement-related gamma frequency in 25 healthy adults using magnetoencephalography and a motor control paradigm. These individualized peak gamma frequencies were then used for personalized sessions of tACS. All participants completed 4 sessions of high-definition (HD)-tACS (sham, low-, peak-, and high-gamma frequency) over M1 for 20 min during the performance of sequential movements of varying complexity (e.g. tapping adjacent fingers or nonadjacent fingers). Our primary findings demonstrated that individualized tACS dosing over M1 leads to enhanced motor performance/learning (i.e. greatest reduction in time to complete motor sequences) compared to nonspecific gamma-tACS in humans, which suggests that personalized neuromodulation may be advantageous to optimize behavioral outcomes.

Effects of transcranial alternating current stimulation on motor performance and motor learning for healthy individuals: A systematic review and meta-analysis

Objective:Previous behavioral studies have reported the potential of transcranial alternating current stimulation in analyzing the causal relationship between neural activity and behavior. However, the efficacy of tACS on motor performance and learning in healthy individuals remains unclear. This systematic reviewexamines the effectiveness of tACS on motor performance and motor learning in healthy individuals. Methods: Literature was systematically searched through the Cochrane Library, PubMed, EMBASE, and Web of Science until 16 October 2022. Studies were eligible for review if they were randomized, parallel, or crossover experimental designs and reported the efficacy of tACS on motor performance and motor learning in healthy adults. Review Manager 5.3 was used to evaluate the methodological quality and analyze the combined effect. Results: Ten studies (270 participants) met all the inclusion criteria. The results showed that motor performance was not significantly greater than that with sham tACS stimulation [I2 = 44%, 95% CI (-0.01, 0.35), p = 0.06, standardized mean difference = 0.17], whereas motor learning ability improved significantly [I2 = 33%, 95% CI (-1.03, -0.31), p = 0.0002, SMD = -0.67]. Subgroup analysis found that gamma bend tACS could affect the changes in motor performance (I2 = 6%, 95% CI (0.05, 0.51), p = 0.02, SMD = 0.28), and online tACS did as well [I2 = 54%, 95% CI (0.12, 0.56), p = 0.002, SMD = 0.34]. Conclusion: The results showed that tACS effectively improves motor performance (gamma band and online mode) and motor learning in healthy individuals, which indicates that tACS may be a potential therapeutic tool to improve motor behavioral outcomes. However, further evidence is needed to support these promising results. Systematic Review Registration: PROSPERO, identifier CRD42022342884.

Motor training is improved by concurrent application of slow oscillating transcranial alternating current stimulation to motor cortex

Physical exercise and neurorehabilitation involve repetitive training that can induce changes in motor performance arising from neuroplasticity. Retention of these motor changes occurs via an encoding process, during which rapid neuroplastic changes occur in response to training. Previous studies show that transcranial alternating current stimulation (tACS), a form of non-invasive brain stimulation, can enhance encoding of a cognitive learning task during wakefulness. However, the effect of tACS on motor processes in the awake brain is unknown. In this study, forty-two healthy 18–35 year old participants received either 0.75 Hz (active) tACS (or sham stimulation) for 30 min during a ballistic thumb abduction motor training task. Training-related behavioural effects were quantified by assessing changes in thumb abduction acceleration, and neuroplastic changes were quantified by measuring motor evoked potential (MEP) amplitude of the abductor pollicis brevis muscle. These measures were reassessed immediately after the motor training task to quantify short-term changes, and then 24 h later to assess longer-term changes. Thumb abduction acceleration in both active and sham stimulation conditions increased immediately after the motor learning, consistent with effective training. Critically, participants in the active group maintained significantly higher thumb acceleration 24 h later (t₄₀ = 2.810, P = 0.044). There were no significant changes or inter-group differences in MEPs for both conditions. The results suggest that 0.75 Hz tACS applied during motor training enhances the effectiveness of motor training, which manifests as enhancement in longer-term task benefits.

Removal of Transcranial Alternating Current Stimulation EEG Artifacts Using Blind Source Separation and Wavelets

GOAL

Transcranial alternating current stimulation (tACS) is a non-invasive technology for modulating brain activity, with significant potential for improving motor and cognitive functions. To investigate the effects of tACS, many studies have used electroencephalographic (EEG) data recorded during brain stimulation. However, the large artifacts induced by tACS make the analysis of tACS-EEG recordings challenging, which in turn has prevented the implementation of closed-loop brain stimulation schemes. Here, we propose a novel combination of blind source separation (BSS) and wavelets to achieve removal of tACS-EEG artifacts with improved performance.

METHODS

We examined the performance of several BSS methods both applied individually, as well as combined with the empirical wavelet transform (EWT) in terms of denoising realistic simulated and experimental tACS-EEG data.

RESULTS

EWT combined with BSS yielded considerably improved performance compared to BSS alone for both simulated and experimental data. Overall, independent vector analysis (IVA) combined with EWT yielded the best performance.

SIGNIFICANCE

The proposed method yields promise for quantifying the effects of tACS on simultaneously recorded EEG data, which can in turn contribute towards understanding the effects of tACS on brain activity, as well as extracting reliable biomarkers that may be used to develop closed-loop tACS strategies for modulating the underlying brain activity in real time.

New tools for shaping plasticity to enhance recovery after stroke

Stroke is the second most common cause of death worldwide and its prevalence is projected to increase in the coming years in parallel with the increase of life expectancy. Despite the great improvements in the management of the acute phase of stroke, some residual disability persists in most patients thus requiring rehabilitation. One third of patients do not reach the maximal recovery potential and different approaches have been explored with the aim to boost up recovery. In this regard, noninvasive brain stimulation techniques have been widely used to induce neuroplasticity phenomena. Different protocols of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (tES) can induce short- and long-term changes of synaptic excitability and are promising tools for enhancing recovery in stroke patients. New options for neuromodulation are currently under investigation. They include: vagal nerve stimulation (VNS) that can be delivered invasively, with implanted stimulators and noninvasively with transcutaneous VNS (tVNS); and extremely low-frequency (1-300Hz) magnetic fields. This chapter will provide an overview on the new techniques that are used for neuroprotection and for enhancing recovery after stroke.

The effects of monophasic anodal transcranial pulsed current stimulation on corticospinal excitability and motor performance in healthy young adults: A randomized double-blind sham-controlled study

INTRODUCTION

Transcranial pulsed current stimulation (tPCS) could be used to deliver electrical pulses at different frequencies to entrain the cortical neurons of the brain. Frequency dependence of these pulses in the induction of changes in corticospinal excitability (CSE) has not been reported.

OBJECTIVE

We aimed to assess the effect of anodal tPCS (a-tPCS) at theta (4 Hz), and gamma (75 Hz) frequencies on CSE as assessed by the peak-to-peak amplitude of transcranial magnetic stimulation (TMS) induced motor evoked potentials (MEPs) and motor performance.

METHOD

In a randomized double-blinded sham-controlled cross over design study, seventeen healthy participants attended three experimental sessions and received either a-tPCS at 4 Hz, 75 Hz, or sham a-tPCS with 1.5 mA for 15 min. The amplitude of TMS induced resting MEPs and time for completion of the grooved pegboard test were recorded at baseline, immediately after, and 30-min after a-tPCS.

RESULTS

Both a-tPCS at 75 Hz and 4 Hz showed significantly increased CSE compared to sham. The a-tPCS at 75 Hz induced significantly higher CSE changes compared to 4 Hz. There was a significant increase in intracortical facilitation and a significant reduction in short-interval intra-cortical inhibition with both 4 and 75 Hz stimulation. However, the inhibition and facilitation did not correlate with CSE. Motor performance was unaffected by the interventions.

CONCLUSION

The high CSE changes in M1 in a-tPCS at 75 Hz provides an initial understanding of the frequency-specific effect of a-tPCS. More research is needed to establish this concept and to assess its behavioural relevance.

No aftereffects of high current density 10 Hz and 20 Hz tACS on sensorimotor alpha and beta oscillations

Application of transcranial alternating current stimulation (tACS) is thought to modulate ongoing brain oscillations in a frequency-dependent manner. However, recent studies report various and sometimes inconsistent results regarding its capacity to induce changes in cortical activity beyond the stimulation period. Here, thirty healthy volunteers participated in a randomized, cross-over, sham-controlled, double-blind study using EEG to measure the offline effects of tACS on alpha and beta power. Sham and high current density tACS (1 mA; 10 Hz and 20 Hz; 0.32 mA/cm²) were applied for 20 min over bilateral sensorimotor areas and EEG was recorded at rest before and after stimulation for 20 min. Bilateral tACS was not associated with significant changes in local alpha and beta power frequencies at stimulation sites (C3 and C4 electrodes). Overall, the present results fail to provide evidence that bilateral tACS with high current density applied over sensorimotor regions at 10 and 20 Hz reliably modulates offline brain oscillation power at the stimulation site. These results may have implications for the design and implementation of future protocols aiming to induce sustained changes in brain activity, including in clinical populations.

Exploring parameters of gamma transcranial alternating current stimulation (tACS) and full-spectrum transcranial random noise stimulation (tRNS) on human pharyngeal cortical excitability

BACKGROUND

Transcranial alternating current stimulation (tACS) and transcranial random noise stimulation (tRNS) have been shown to have physiological and functional effects on brain excitability and motor behavior. Yet, little is known about their effects in the swallowing system.

AIM

To examine the effects and optimal stimulation parameters of tACS and tRNS for modulating excitability of human pharyngeal motor cortex.

METHODS

10 Hz (alpha), 20 Hz (beta), 70 Hz (gamma) tACS, 0.1-640 Hz (full-spectrum) tRNS, and sham were applied over pharyngeal motor cortices at 1.5 mA current intensity for 10 min in 15 healthy participants. Pharyngeal motor-evoked and thenar motor-evoked potentials (PMEPs and TMEPs) were assessed before and up to 2 h after stimulation with single-pulse transcranial magnetic stimulation. Averaged MEP amplitude and latency changes were analyzed using repeated measures ANOVA (rmANOVA).

KEY RESULTS

Two-way rmANOVA across all active interventions demonstrated a significant MEP interaction both in the stimulated pharyngeal cortex (F (4, 56) = 1.731, p = 0.038) and in the ipsilateral thenar cortex (F (4, 56) = 1.506, p = 0.048). Compared to sham, subsequent post hoc tests showed site-specific and sustained (60-120 min) increases in PMEPs with gamma tACS and tRNS (p = 0.005, p = 0.027, respectively) and for TMEPs with beta tACS (p = 0.006).

CONCLUSIONS AND INFERENCES

Our findings suggest that the effects of tACS and tRNS are frequency-dependent and cortical (representation) site-specific with both gamma tACS and full-spectrum tRNS enhancing human pharyngeal cortical excitability. These techniques hold promise as potential treatments for neurological dysphagia.

Motor Learning Based on Oscillatory Brain Activity Using Transcranial Alternating Current Stimulation: A Review

Developing effective tools and strategies to promote motor learning is a high-priority scientific and clinical goal. In particular, motor-related areas have been investigated as potential targets to facilitate motor learning by noninvasive brain stimulation (NIBS). In addition to shedding light on the relationship between motor function and oscillatory brain activity, transcranial alternating current stimulation (tACS), which can noninvasively entrain oscillatory brain activity and modulate oscillatory brain communication, has attracted attention as a possible technique to promote motor learning. This review focuses on the use of tACS to enhance motor learning through the manipulation of oscillatory brain activity and its potential clinical applications. We discuss a potential tACS-based approach to ameliorate motor deficits by correcting abnormal oscillatory brain activity and promoting appropriate oscillatory communication in patients after stroke or with Parkinson's disease. Interpersonal tACS approaches to manipulate intra- and inter-brain communication may result in pro-social effects and could promote the teaching-learning process during rehabilitation sessions with a therapist. The approach of re-establishing oscillatory brain communication through tACS could be effective for motor recovery and might eventually drive the design of new neurorehabilitation approaches based on motor learning.

Theta but not beta power is positively associated with better explicit motor task learning

Neurophysiologic correlates of motor learning that can be monitored during neurorehabilitation interventions can facilitate the development of more effective learning methods. Previous studies have focused on the role of the beta band (14-30 Hz) because of its clear response during motor activity. However, it is difficult to discriminate between beta activity related to learning a movement and performing the movement. In this study, we analysed differences in the electroencephalography (EEG) power spectra of complex and simple explicit sequential motor tasks in healthy young subjects. The complex motor task (CMT) allowed EEG measurement related to motor learning. In contrast, the simple motor task (SMT) made it possible to control for EEG activity associated with performing the movement without significant motor learning. Source reconstruction of the EEG revealed task-related activity from 5 clusters covering both primary motor cortices (M1) and 3 clusters localised to different parts of the cingulate cortex (CC). We found no association between M1 beta power and learning, but the CMT produced stronger bilateral beta suppression compared to the SMT. However, there was a positive association between contralateral M1 theta (5-8 Hz) and alpha (8-12 Hz) power and motor learning, and theta and alpha power in the posterior mid-CC and posterior CC were positively associated with greater motor learning. These findings suggest that the theta and alpha bands are more related to motor learning than the beta band, which might merely relate to the level of perceived difficulty during learning.

Sequential motor learning transfers from real to virtual environment

Background

Skill acquisition of motor learning between virtual environments (VEs) and real environments (REs) may be related. Although studies have previously examined the transfer of motor learning in VEs and REs through the same tasks, only a small number of studies have focused on studying the transfer of motor learning in VEs and REs by using different tasks. Thus, detailed effects of the transfer of motor skills between VEs and REs remain controversial. Here, we investigated the transfer of sequential motor learning between VEs and REs conditions.

Methods

Twenty-seven healthy volunteers performed two types of sequential motor learning tasks; a visually cued button-press task in RE (RE task) and a virtual reaching task in VE (VE task). Participants were randomly assigned to two groups in the task order; the first group was RE task followed by VE task and the second group was VE task followed by RE task. Subsequently, the response time in RE task and VE task was compared between the two groups respectively.

Results

The results showed that the sequential reaching task in VEs was facilitated after the sequential finger task in REs.

Conclusions

These findings suggested that the sequential reaching task in VEs can be facilitated by a motor learning task comprising the same sequential finger task in REs, even when a different task is applied.

Effects of transcranial direct current stimulation on brain network connectivity and complexity in motor imagery

Related experiments have shown that transcranial direct current stimulation (tDCS) anodal stimulation of the brain's primary motor cortex (M1) and supplementary motor area (SMA) can improve the motor control and clinical manifestations of stroke patients with aphasia and dyskinesia. In this study, to explore the different effects of tDCS on the M1 and SMA in motor imagery, 35 healthy volunteers participated in a double-blind randomized controlled experiment. Five subjects underwent sham stimulation (control), 15 subjects underwent tDCS anode stimulation of the M1, and the remaining 15 subjects underwent tDCS anode stimulation of the SMA. The electroencephalogram data of the subjects' left- and right-hand motor imagery under different stimulation paradigms were recorded. We used a functional brain network and sample entropy to examine the different complexities and functional connectivities in subjects undergoing sham-tDCS and the two stimulation paradigms. The results show that tDCS anodal stimulation of the SMA produces less obvious differences in the motor preparation phase, while tDCS anodal stimulation of the M1 produces significant differences during the motor imaging task execution phase. The effect of tDCS on the motor area of the brain is significant, especially in the M1.

Systemic Review on Transcranial Electrical Stimulation Parameters and EEG/fNIRS Features for Brain Diseases

Background

Brain disorders are gradually becoming the leading cause of death worldwide. However, the lack of knowledge of brain disease’s underlying mechanisms and ineffective neuropharmacological therapy have led to further exploration of optimal treatments and brain monitoring techniques.

Objective

This study aims to review the current state of brain disorders, which utilize transcranial electrical stimulation (tES) and daily usable noninvasive neuroimaging techniques. Furthermore, the second goal of this study is to highlight available gaps and provide a comprehensive guideline for further investigation.

Method

A systematic search was conducted of the PubMed and Web of Science databases from January 2000 to October 2020 using relevant keywords. Electroencephalography (EEG) and functional near-infrared spectroscopy were selected as noninvasive neuroimaging modalities. Nine brain disorders were investigated in this study, including Alzheimer’s disease, depression, autism spectrum disorder, attention-deficit hyperactivity disorder, epilepsy, Parkinson’s disease, stroke, schizophrenia, and traumatic brain injury.

Results

Sixty-seven studies (1,385 participants) were included for quantitative analysis. Most of the articles (82.6%) employed transcranial direct current stimulation as an intervention method with modulation parameters of 1 mA intensity (47.2%) for 16–20 min (69.0%) duration of stimulation in a single session (36.8%). The frontal cortex (46.4%) and the cerebral cortex (47.8%) were used as a neuroimaging modality, with the power spectrum (45.7%) commonly extracted as a quantitative EEG feature.

Conclusion

An appropriate stimulation protocol applying tES as a therapy could be an effective treatment for cognitive and neurological brain disorders. However, the optimal tES criteria have not been defined; they vary across persons and disease types. Therefore, future work needs to investigate a closed-loop tES with monitoring by neuroimaging techniques to achieve personalized therapy for brain disorders.

Enhancement of Event-Related Desynchronization in Motor Imagery Based on Transcranial Electrical Stimulation

Due to the individual differences controlling brain-computer interfaces (BCIs), the applicability and accuracy of BCIs based on motor imagery (MI-BCIs) are limited. To improve the performance of BCIs, this article examined the effect of transcranial electrical stimulation (tES) on brain activity during MI. This article designed an experimental paradigm that combines tES and MI and examined the effects of tES based on the measurements of electroencephalogram (EEG) features in MI processing, including the power spectral density (PSD) and dynamic event-related desynchronization (ERD). Finally, we investigated the effect of tES on the accuracy of MI classification using linear discriminant analysis (LDA). The results showed that the ERD of the μ and β rhythms in the left-hand MI task was enhanced after electrical stimulation with a significant effect in the tDCS group. The average classification accuracy of the transcranial alternating current stimulation (tACS) group and transcranial direct current stimulation (tDCS) group (88.19% and 89.93% respectively) were improved significantly compared to the pre-and pseudo stimulation groups. These findings indicated that tES can improve the performance and applicability of BCI and that tDCS was a potential approach in regulating brain activity and enhancing valid features during noninvasive MI-BCI processing.

Sensory capability and information integration independently explain the cognitive status of healthy older adults

While there is evidence that sensory processing and multisensory integration change with age, links between these alterations and their relation to cognitive status remain unclear. In this study, we assessed sensory thresholds and performance of healthy younger and older adults in a visuotactile delayed match-to-sample task. Using Bayesian structural equation modelling (BSEM), we explored the factors explaining cognitive status in the group of older adults. Additionally, we applied transcranial alternating current stimulation (tACS) to a parieto-central network found to underlie visuotactile interactions and working memory matching in our previous work. Response times and signal detection measures indicated enhanced multisensory integration and enhanced benefit from successful working memory matching in older adults. Further, tACS caused a frequency-specific speeding (20 Hz) and delaying (70 Hz) of responses. Data exploration suggested distinct underlying factors for sensory acuity and sensitivity d’ on the one side, and multisensory and working memory enhancement on the other side. Finally, BSEM showed that these two factors labelled ‘sensory capability’ and ‘information integration’ independently explained cognitive status. We conclude that sensory decline and enhanced information integration might relate to distinct processes of ageing and discuss a potential role of the parietal cortex in mediating augmented integration in older adults.

The Modulation of Cognitive Performance with Transcranial Alternating Current Stimulation: A Systematic Review of Frequency-Specific Effects

Transcranial alternating current stimulation (tACS) is a non-invasive brain stimulation technique that allows the manipulation of intrinsic brain oscillations. Numerous studies have applied tACS in the laboratory to enhance cognitive performance. With this systematic review, we aim to provide an overview of frequency-specific tACS effects on a range of cognitive functions in healthy adults. This may help to transfer stimulation protocols to real-world applications. We conducted a systematic literature search on PubMed and Cochrane databases and considered tACS studies in healthy adults (age > 18 years) that focused on cognitive performance. The search yielded n = 109 studies, of which n = 57 met the inclusion criteria. The results indicate that theta-tACS was beneficial for several cognitive functions, including working memory, executive functions, and declarative memory. Gamma-tACS enhanced performance in both auditory and visual perception but it did not change performance in tasks of executive functions. For attention, the results were less consistent but point to an improvement in performance with alpha- or gamma-tACS. We discuss these findings and point to important considerations that would precede a transfer to real-world applications.

The effects of a single-session cathodal transcranial pulsed current stimulation on corticospinal excitability: A randomized sham-controlled double-blinded study

Transcranial pulsed current stimulation (tPCS) of the human motor cortex has received much attention in recent years. Although the effect of anodal tPCS with different frequencies has been investigated, the effect of cathodal tPCS (c-tPCS) has not been explored yet. Therefore, the aim of the present study was to investigate the effect of c-tPCS at 4 and 75 Hz frequencies on corticospinal excitability (CSE) and motor performance. In a randomized sham-controlled crossover design, fifteen healthy participants attended three experimental sessions and received either c-tPCS at 75 Hz, 4 Hz or sham with 1.5 mA for 15 min. Transcranial magnetic stimulation and grooved pegboard test were performed before, immediately after and 30 min after the completion of stimulation at rest. The findings indicate that c-tPCS at both 4 and 75 Hz significantly increased CSE compared to sham. Both c-tPCS at 75 and 4 Hz showed a significant increase in intracortical facilitation compared to sham, whereas the effect on short-interval intracortical inhibition was not significant. The c-tPCS at 4 Hz but not 75 Hz induced modulation of intracortical facilitation correlated with the CSE. Motor performance did not show any significant changes. These results suggest that, compared with sham stimulation, c-tPCS at both 4 and 75 Hz induces an increase in CSE.

The Effect of Transcranial Pulsed Current Stimulation at 4 and 75 Hz on Electroencephalography Theta and High Gamma Band Power: A Pilot Study

Introduction: Transcranial pulsed current stimulation (tPCS) is an emerging noninvasive brain stimulation technique that has shown significant effects on cortical excitability. To date, electrophysiological measures of the efficiency of monophasic tPCS have not been reported. Objective: We aimed to explore the effects of monophasic anodal and cathodal-tPCS (a-tPCS/c-tPCS) at theta (4 Hz) and gamma (75 Hz) frequencies on theta and high gamma electroencephalography (EEG) oscillatory power. Methods: In a single-blind, randomized, sham-controlled crossover design, 15 healthy participants were randomly assigned into 5 experimental sessions in which they received a-PCS/c-tPCS at 4 and 75 Hz or sham stimulation over the left primary motor cortex (M1) for 15 min at an intensity of 1.5 mA. Changes in theta and high gamma oscillatory power were recorded at baseline, immediately after, and 30 min after stimulation using EEG at rest with eyes open. Results: a-tPCS at 4 Hz showed a significant increase in theta power compared with sham, whereas c-tPCS at 4 Hz had no significant effect on theta power. a-tPCS at 75 Hz produced no changes in high gamma power compared with sham. Importantly, c-tPCS at 75 Hz led to a significant reduction in high gamma power compared with baseline, as well as compared with c-tPCS at 4 Hz and sham stimulation. Conclusion: The results demonstrate the modulation of oscillatory brain activity by monophasic tPCS, and highlight the need for future studies on a larger scale to confirm these initial findings. Impact statement Transcranial pulsed current stimulation (tPCS) is a novel brain stimulation technique. Recently, tPCS has been introduced to directly modulate brain oscillations by applying pulsatile current over the target brain area. Using both anodal and cathodal monophasic tPCS at theta and gamma frequencies, we demonstrate the ability of the stimulation to modulate brain activity. The present findings are the first direct electroencephalography evidence of an interaction between tPCS and ongoing oscillatory activity in the human motor cortex. Our work recommends tPCS as a tool for investigating human brain oscillations and open more studies in this area.

Off-line effects of alpha-frequency transcranial alternating current stimulation on a visuomotor learning task

INTRODUCTION

It has been suggested that transcranial alternating current stimulation (tACS) at both alpha and beta frequencies promotes motor function as well as motor learning. However, limited information exists on the aftereffects of tACS on motor learning and neurophysiological profiles such as entrainment and neural plasticity in parallel. Therefore, in the present study, we examined the effect of tACS on motor learning and neurophysiological profiles using an off-line tACS condition.

METHODS

Thirty-three healthy participants were randomly assigned to 10 Hz, 20 Hz, or the sham group. Participants performed visuomotor learning tasks consisting of a baseline task (preadaptation task) and training task (adaptation task) to reach a target with a lever-type controller. Electroencephalography was recorded from eight locations during the learning tasks. tACS was performed between the preadaptation task and adaptation task over the left primary motor cortex for 10 min at 1 mA.

RESULTS

As a result, 10 Hz tACS was shown to be effective for initial angular error correction in the visuomotor learning tasks. However, there were no significant differences in neural oscillatory activities among the three groups.

CONCLUSION

These results suggest that initial motor learning can be facilitated even when 10 Hz tACS is applied under off-line conditions. However, neurophysiological aftereffects were recently demonstrated to be induced by tACS at individual alpha frequencies rather than fixed alpha tACS, which suggests that the neurophysiological aftereffects by fixed frequency stimulation in the present study may have been insufficient to generate changes in oscillatory neural activity.

The Effects of Transcranial Electrical Stimulation on Human Motor Functions: A Comprehensive Review of Functional Neuroimaging Studies

Transcranial electrical stimulation (tES) is a promising tool to enhance human motor skills. However, the underlying physiological mechanisms are not fully understood. On the other hand, neuroimaging modalities provide powerful tools to map some of the neurophysiological biomarkers associated with tES. Here, a comprehensive review was undertaken to summarize the neuroimaging evidence of how tES affects human motor skills. A literature search has been done on the PubMed database, and 46 relative articles were selected. After reviewing these articles, we conclude that neuroimaging techniques are feasible to be coupled with tES and offer valuable information of cortical excitability, connectivity, and oscillations regarding the effects of tES on human motor behavior. The biomarkers derived from neuroimaging could also indicate the motor performance under tES conditions. This approach could advance the understanding of tES effects on motor skill and shed light on a new generation of adaptive stimulation models.

Targeting Gamma-Related Pathophysiology in Autism Spectrum Disorder Using Transcranial Electrical Stimulation: Opportunities and Challenges

A range of scalp electroencephalogram (EEG) abnormalities correlates with the core symptoms of autism spectrum disorder (ASD). Among these are alterations of brain oscillations in the gamma-frequency EEG band in adults and children with ASD, whose origin has been linked to dysfunctions of inhibitory interneuron signaling. While therapeutic interventions aimed to modulate gamma oscillations are being tested for neuropsychiatric disorders such as schizophrenia, Alzheimer's disease, and frontotemporal dementia, the prospects for therapeutic gamma modulation in ASD have not been extensively studied. Accordingly, we discuss gamma-related alterations in the setting of ASD pathophysiology, as well as potential interventions that can enhance gamma oscillations in patients with ASD. Ultimately, we argue that transcranial electrical stimulation modalities capable of entraining gamma oscillations, and thereby potentially modulating inhibitory interneuron circuitry, are promising methods to study and mitigate gamma alterations in ASD. Autism Res 2020, 13: 1051-1071. © 2020 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: Brain functions are mediated by various oscillatory waves of neuronal activity, ranging in amplitude and frequency. In certain neuropsychiatric disorders, such as schizophrenia and Alzheimer's disease, reduced high-frequency oscillations in the "gamma" band have been observed, and therapeutic interventions to enhance such activity are being explored. Here, we review and comment on evidence of reduced gamma activity in ASD, arguing that modalities used in other disorders may benefit individuals with ASD as well.

Neurophysiological aftereffects of 10 Hz and 20 Hz transcranial alternating current stimulation over bilateral sensorimotor cortex

Alpha (8-12 Hz) and beta (13-30 Hz) oscillations are believed to be involved in motor control. Their modulation with transcranial alternating current stimulation (tACS) has been shown to alter motor behavior and cortical excitability. The aim of the present study was to determine whether tACS applied bilaterally over sensorimotor cortex at 10 Hz and 20 Hz modulates interhemispheric interactions and corticospinal excitability. Thirty healthy volunteers participated in a randomized, cross-over, sham-controlled, double-blind protocol. Sham and active tACS (10 Hz, 20 Hz, 1 mA) were applied for 20 min over bilateral sensorimotor areas. The physiological effects of tACS on corticospinal excitability and interhemispheric inhibition were assessed with transcranial magnetic stimulation. Physiological mirror movements were assessed to measure the overflow of motor activity to the contralateral M1 during voluntary muscle contraction. Bilateral 10 Hz tACS reduced corticospinal excitability. There was no significant effect of tACS on physiological mirror movements and interhemispheric inhibition. Ten Hz tACS was associated with response patterns consistent with corticospinal inhibition in 57% of participants. The present results indicate that application of tACS at the alpha frequency can induce aftereffects in sensorimotor cortex of healthy individuals.

Current State and Future Prospects of EEG and fNIRS in Robot-Assisted Gait Rehabilitation: A Brief Review

Gait and balance impairments are frequently considered as the most significant concerns among individuals suffering from neurological diseases. Robot-assisted gait training (RAGT) has shown to be a promising neurorehabilitation intervention to improve gait recovery in patients following stroke or brain injury by potentially initiating neuroplastic changes. However, the neurophysiological processes underlying gait recovery through RAGT remain poorly understood. As non-invasive, portable neuroimaging techniques, electroencephalography (EEG) and functional near-infrared spectroscopy (fNIRS) provide new insights regarding the neurophysiological processes occurring during RAGT by measuring different perspectives of brain activity. Due to spatial information about changes in cortical activation patterns and the rapid temporal resolution of bioelectrical changes, more features correlated with brain activation and connectivity can be identified when using fused EEG-fNIRS, thus leading to a detailed understanding of neurophysiological mechanisms underlying motor behavior and impairments due to neurological diseases. Therefore, multi-modal integrations of EEG-fNIRS appear promising for the characterization of neurovascular coupling in brain network dynamics induced by RAGT. In this brief review, we surveyed neuroimaging studies focusing specifically on robotic gait rehabilitation. While previous studies have examined either EEG or fNIRS with respect to RAGT, a multi-modal integration of both approaches is lacking. Based on comparable studies using fused EEG-fNIRS integrations either for guiding non-invasive brain stimulation or as part of brain-machine interface paradigms, the potential of this methodologically combined approach in RAGT is discussed. Future research directions and perspectives for targeted, individualized gait recovery that optimize the outcome and efficiency of RAGT in neurorehabilitation were further derived.

Transcranial Alternating Current Stimulation Has Frequency-Dependent Effects on Motor Learning in Healthy Humans

It is well established that the primary motor cortex (M1) plays a significant role in motor learning in healthy humans. It is unclear, however, whether mechanisms of motor learning include M1 oscillatory activity. In this study, we aimed to test whether M1 oscillations, entrained by transcranial Alternating Current Stimulation (tACS) at motor resonant frequencies, have any effect on motor acquisition and retention during a rapid learning task, as assessed by kinematic analysis. We also tested whether the stimulation influenced the corticospinal excitability changes after motor learning. Sixteen healthy subjects were enrolled in the study. Participants performed the motor learning task in three experimental conditions: sham-tACS (baseline), β-tACS and γ-tACS. Corticospinal excitability was assessed with single-pulse TMS before the motor learning task and 5, 15, and 30 min thereafter. Motor retention was tested 30 min after the motor learning task. During training, acceleration of the practiced movement improved in the baseline condition and the enhanced performance was retained when tested 30 min later. The β-tACS delivered during training inhibited the acquisition of the motor learning task. Conversely, the γ-tACS slightly improved the acceleration of the practiced movement during training but it reduced motor retention. At the end of training, corticospinal excitability had similarly increased in the three sessions. The results are compatible with the hypothesis that entrainment of the two major motor resonant rhythms through tACS over M1 has different effects on motor learning in healthy humans. The effects, however, were unrelated to corticospinal excitability changes.