1
|
Sveva V, Guerra A, Mangone M, Agostini F, Bernetti A, Berardelli A, Paoloni M, Bologna M. Effects of cerebellar transcranial alternating current stimulation on balance and gait in healthy subjects. Clin Neurophysiol 2025:S1388-2457(25)00453-5. [PMID: 40180842 DOI: 10.1016/j.clinph.2025.03.033] [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: 03/11/2024] [Revised: 02/24/2025] [Accepted: 03/24/2025] [Indexed: 04/05/2025]
Abstract
BACKGROUND Transcranial Alternating Current Stimulation (tACS) is a non-invasive brain stimulation technique that modulates cortical oscillations and influences behavior. OBJECTIVES This study aimed to explore the effects of cerebellar theta (5 Hz) and gamma (50 Hz) tACS on human balance and gait through kinematic analysis. MATERIALS AND METHODS Nineteen right-handed healthy subjects participated in three randomized motor tasks: postural standing (PS), gait initiation (GI), and gait cycle (GC). Participants underwent theta-, gamma-, or sham-tACS over the cerebellum while kinematic data were collected using a force platform and an 8-camera optoelectronic system. RESULTS Theta-tACS significantly influenced motor behavior during PS and GC, but not GI. Specifically, it reduced the Maximum Radius, Total Trace Length, Longitudinal Range, and Area during PS, and decreased Stride Width during GC. In contrast, cerebellar gamma-tACS had no significant effect on any kinematic parameters across the tasks. CONCLUSIONS Cerebellar theta-tACS may enhance postural stability and gait control in healthy individuals. We hypothesize that theta-tACS may entrain theta-resonant neurons in the cerebellar cortex, affecting motor control networks involved in balance and gait. SIGNIFICANCE This study highlights tACS's potential as a non-invasive treatment for balance and gait disorders associated with cerebellar dysfunction.
Collapse
Affiliation(s)
- Valerio Sveva
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy; Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy
| | - Andrea Guerra
- Parkinson and Movement Disorders Unit, Study Center for Neurodegeneration (CESNE), Department of Neuroscience, University of Padua, Via Giustiniani 2, 35128 Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Via Giuseppe Orus, 2, 35131 Padua, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Andrea Bernetti
- Department of Science and Biological and Ambient Technologies, University of Salento, Via Lecce-Monteroni, 73100 Lecce, LE, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Matteo Bologna
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS Neuromed, Via Atinense 18, 86077 Pozzilli, IS, Italy.
| |
Collapse
|
2
|
Cruciani A, Pellegrino G, Todisco A, Motolese F, Sferruzzi M, Norata D, Santoro F, Musumeci G, Rossi M, Pilato F, Di Lazzaro V, Capone F. High-frequency transcranial alternating current stimulation matching individual frequency of somatosensory evoked high-frequency oscillations can modulate the somatosensory system through thalamocortical pathway. Cereb Cortex 2024; 34:bhad481. [PMID: 38100323 DOI: 10.1093/cercor/bhad481] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/22/2023] [Indexed: 12/17/2023] Open
Abstract
tACS (transcranial alternating current stimulation) is a technique for modulating brain activity through electrical current. Its effects depend on cortical entrainment, which is most effective when transcranial alternating current stimulation matches the brain's natural rhythm. High-frequency oscillations produced by external stimuli are useful for studying the somatosensory pathway. Our study aims to explore transcranial alternating current stimulation's impact on the somatosensory system when synchronized with individual high-frequency oscillation frequencies. We conducted a randomized, sham-controlled study with 14 healthy participants. The study had three phases: Individualized transcranial alternating current stimulation (matching the individual's high-frequency oscillation rhythm), Standard transcranial alternating current stimulation (600 Hz), and sham stimulation. We measured early and late HFO components after median nerve electrical stimulation at three time points: before (T0), immediately after (T1), and 10 min after transcranial alternating current stimulation (T2). Compared to Sham and Standard stimulation Individualized transcranial alternating current stimulation significantly enhanced high-frequency oscillations, especially the early component, immediately after stimulation and for at least 15 min. No other effects were observed for other high-frequency oscillation measures. In summary, our study provides initial evidence that transcranial alternating current stimulation synchronized with an individual's high-frequency oscillation frequency can precisely and time-specifically modulate thalamocortical activity. These insights may pave the way for innovative, personalized neuromodulation methods for the somatosensory system.
Collapse
Affiliation(s)
- Alessandro Cruciani
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Giovanni Pellegrino
- Epilepsy Program, Schulich School of Medicine and Dentistry, Western University, London, ON N6A 3K7, Canada
| | - Antonio Todisco
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Francesco Motolese
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Marco Sferruzzi
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Davide Norata
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
- Neurological Clinic, Department of Experimental and Clinical Medicine (DIMSC), Marche Polytechnic University, 60121 Ancona, Italy
| | - Francesca Santoro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Gabriella Musumeci
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Mariagrazia Rossi
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Fabio Pilato
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Vincenzo Di Lazzaro
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| | - Fioravante Capone
- Department of Medicine and Surgery, Unit of Neurology, Neurophysiology, Neurobiology, and Psychiatry, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, Roma 21-00128, Italy
- Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo Roma 200-00128, Italy
| |
Collapse
|
3
|
Abstract
Noninvasive brain stimulation (NIBS) techniques are widely used tools for the study and rehabilitation of cognitive functions. Different NIBS approaches aim to enhance or impair different cognitive processes. The methodological focus for achieving this has been on stimulation protocols that are considered either inhibitory or facilitatory. However, despite more than three decades of use, their application is based on incomplete and overly simplistic conceptualizations of mechanisms of action. Such misconception limits the usefulness of these approaches in the basic science and clinical domains. In this review, we challenge this view by arguing that stimulation protocols themselves are neither inhibitory nor facilitatory. Instead, we suggest that all induced effects reflect complex interactions of internal and external factors. Given these considerations, we present a novel model in which we conceptualize NIBS effects as an interaction between brain activity and the characteristics of the external stimulus. This interactive model can explain various phenomena in the brain stimulation literature that have been considered unexpected or paradoxical. We argue that these effects no longer seem paradoxical when considered from the viewpoint of state dependency.
Collapse
Affiliation(s)
- Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Juha Silvanto
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| |
Collapse
|
4
|
Sawai S, Murata S, Fujikawa S, Yamamoto R, Nakano H. Effects of θ High Definition-Transcranial Alternating Current Stimulation in the Anterior Cingulate Cortex on the Dominance of Attention Focus in Standing Postural Control. Behav Sci (Basel) 2023; 13:477. [PMID: 37366728 DOI: 10.3390/bs13060477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/26/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
Attention focus affects performance in postural control while standing, and it is divided into internal focus (IF) and external focus (EF). Each individual has a predominant attention focus, and research has revealed that the dominance of attention focus may be an acquired trait. However, the impact of non-invasive brain stimulation on attention-focus dominance remains unexplored in the current literature. Here, we examined the effect of high-definition transcranial alternating current stimulation (HD-tACS) on θ waves in the anterior cingulate cortex (ACC) on standing postural control tasks in an EF condition for IF- and EF-dominant groups. The effect of θ HD-tACS on the ACC differed between IF- and EF-dominant groups, and θ HD-tACS in the IF-dominant group decreased the performance of standing postural control under the EF condition. The forced activation of the ACC with θ HD-tACS may have conversely reduced the activity of brain regions normally activated by the IF-dominant group. Additionally, the activation of ACC prioritized visual information processing and suppressed the superficial sensory processing that is normally potentially prioritized by the IF-dominant group. These results highlight the importance of changing the type of rehabilitation and sports training tasks to account for the individual's dominance of attention focus.
Collapse
Affiliation(s)
- Shun Sawai
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Rehabilitation, Kyoto Kuno Hospital, Kyoto 607-0981, Japan
| | - Shin Murata
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| | - Shoya Fujikawa
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Rehabilitation, Kyoto Kuno Hospital, Kyoto 607-0981, Japan
| | - Ryosuke Yamamoto
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Rehabilitation, Tesseikai Neurosurgical Hospital, Osaka 575-8511, Japan
| | - Hideki Nakano
- Graduate School of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan
| |
Collapse
|
5
|
Lyzhko E, Peter SE, Nees F, Siniatchkin M, Moliadze V. Offline 20 Hz transcranial alternating current stimulation over the right inferior frontal gyrus increases theta activity during a motor response inhibition task. Neurophysiol Clin 2023; 53:102887. [PMID: 37355398 DOI: 10.1016/j.neucli.2023.102887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/17/2023] [Accepted: 05/17/2023] [Indexed: 06/26/2023] Open
Abstract
OBJECTIVES Previous studies have shown that the right inferior frontal gyrus (rIFG) and the pre-supplementary motor area (preSMA) play an important role in motor inhibitory control. The aim of the study was to use theta frequency transcranial alternating current stimulation (tACS) to modulate brain activity in the rIFG and preSMA and to test the effects of stimulation using a motor response inhibition task. METHODS In four sessions, 20 healthy participants received tACS at 6 Hz over preSMA or rIFG, or 20 Hz over rIFG (to test frequency specificity), or sham stimulation before task processing. After each type of stimulation, the participants performed the Go/NoGo task with simultaneous electroencephalogram (EEG) recording. RESULTS By stimulating rIFG and preSMA with 6 Hz tACS, we were not able to modulate either behavioral performance nor the EEG correlate. Interestingly, 20 Hz tACS over the rIFG significantly increased theta activity, however without behavioral effects. This increased theta activity did not coincide with the stimulation area and was localized in the fronto-central and centro-parietal areas. CONCLUSIONS The inclusion of a control frequency is crucial to test for frequency specificity. Our findings are in accordance with previous studies showing that after effects of tACS are not restricted to the stimulation frequency but can also occur in other frequency bands.
Collapse
Affiliation(s)
- Ekaterina Lyzhko
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; Department of Neuropediatrics, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Stefanie E Peter
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany
| | - Michael Siniatchkin
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany; University Clinic of Child and Adolescent Psychiatry and Psychotherapy, University Hospital OWL, University of Bielefeld, Campus Bethel, Bielefeld, Germany
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig Holstein, Kiel University, Kiel, Germany.
| |
Collapse
|
6
|
Li T, Chang Y, Zhao S, Jones JA, Chen X, Gan C, Wu X, Dai G, Li J, Shen Y, Liu P, Liu H. The left inferior frontal gyrus is causally linked to vocal feedback control: evidence from high-definition transcranial alternating current stimulation. Cereb Cortex 2022; 33:5625-5635. [PMID: 36376991 DOI: 10.1093/cercor/bhac447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/16/2022] Open
Abstract
Abstract
Current models of speech motor control propose a role for the left inferior frontal gyrus (IFG) in feedforward control of speech production. There is evidence, however, that has implicated the functional relevance of the left IFG for the neuromotor processing of vocal feedback errors. The present event-related potential (ERP) study examined whether the left IFG is causally linked to auditory feedback control of vocal production with high-definition transcranial alternating current stimulation (HD-tACS). After receiving active or sham HD-tACS over the left IFG at 6 or 70 Hz, 20 healthy adults vocalized the vowel sounds while hearing their voice unexpectedly pitch-shifted by ±200 cents. The results showed that 6 or 70 Hz HD-tACS over the left IFG led to larger magnitudes and longer latencies of vocal compensations for pitch perturbations paralleled by larger ERP P2 responses than sham HD-tACS. Moreover, there was a lack of frequency specificity that showed no significant differences between 6 and 70 Hz HD-tACS. These findings provide first causal evidence linking the left IFG to vocal pitch regulation, suggesting that the left IFG is an important part of the feedback control network that mediates vocal compensations for auditory feedback errors.
Collapse
Affiliation(s)
- Tingni Li
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Yichen Chang
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Shuzhi Zhao
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Jeffery A Jones
- Wilfrid Laurier University Psychology Department and Laurier Centre for Cognitive Neuroscience, , Waterloo, Ontario N2L 3C5 , Canada
| | - Xi Chen
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Chu Gan
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Xiuqin Wu
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Guangyan Dai
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Jingting Li
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Ying Shen
- The First Affiliated Hospital of Nanjing Medical University Rehabilitation Medicine Center, , Nanjing 210029 , China
| | - Peng Liu
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
| | - Hanjun Liu
- The First Affiliated Hospital, Sun Yat-sen University Department of Rehabilitation Medicine, , Guangzhou 510080 , China
- Zhongshan School of Medicine, Sun Yat-sen University Guangdong Provincial Key Laboratory of Brain Function and Disease, , Guangzhou 510080 , China
| |
Collapse
|
7
|
No effects of prefrontal multichannel tACS at individual alpha frequency on phonological decisions. Clin Neurophysiol 2022; 142:96-108. [DOI: 10.1016/j.clinph.2022.07.494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 05/23/2022] [Accepted: 07/17/2022] [Indexed: 11/23/2022]
|
8
|
Fabbrini A, Guerra A, Giangrosso M, Manzo N, Leodori G, Pasqualetti P, Conte A, Di Lazzaro V, Berardelli A. Transcranial alternating current stimulation modulates cortical processing of somatosensory information in a frequency- and time-specific manner. Neuroimage 2022; 254:119119. [PMID: 35321858 DOI: 10.1016/j.neuroimage.2022.119119] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 02/16/2022] [Accepted: 03/19/2022] [Indexed: 10/18/2022] Open
Abstract
Neural oscillations can be modulated by non-invasive brain stimulation techniques, including transcranial alternating current stimulation (tACS). However, direct evidence of tACS effects at the cortical level in humans is still limited. In a tACS-electroencephalography co-registration setup, we investigated the ability of tACS to modulate cortical somatosensory information processing as assessed by somatosensory-evoked potentials (SEPs). To better elucidate the neural substrates of possible tACS effects we also recorded peripheral and spinal SEPs components, high-frequency oscillations (HFOs), and long-latency reflexes (LLRs). Finally, we studied whether changes were limited to the stimulation period or persisted thereafter. SEPs, HFOs, and LLRs were recorded during tACS applied at individual mu and beta frequencies and at the theta frequency over the primary somatosensory cortex (S1). Sham-tACS was used as a control condition. In a separate experiment, we assessed the time course of mu-tACS effects by recording SEPs before (T0), during (T1), and 1 min (T2) and 10 min (T3) after stimulation. Mu-tACS increased the amplitude of the N20 component of SEPs compared to both sham and theta-tACS. No differences were found between sham, beta-, and theta-tACS conditions. Also, peripheral and spinal SEPs, P25, HFOs, and LLRs did not change during tACS. Finally, mu-tACS-induced modulation of N20 amplitude specifically occurred during stimulation (T1) and vanished afterwards (i.e., at T2 and T3). Our findings suggest that TACS applied at the individual mu frequency is able to modulate early somatosensory information processing at the S1 level and the effect is limited to the stimulation period.
Collapse
Affiliation(s)
- Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy
| | - Andrea Guerra
- IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Margherita Giangrosso
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy
| | - Nicoletta Manzo
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS San Camillo Hospital, Via Alberoni 70, Venice 30126, Italy
| | - Giorgio Leodori
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Patrizio Pasqualetti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Viale dell'Università 30, Rome 00185, Italy
| | - Antonella Conte
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy
| | - Vincenzo Di Lazzaro
- Unit of Neurology, Neurophysiology, Neurobiology, Department of Medicine, University Campus Bio-Medico, Via Álvaro Del Portillo 21, Rome 00128, Italy
| | - Alfredo Berardelli
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, Rome, 00185, Italy; IRCCS Neuromed, Via Atinense 18, Pozzilli, IS 86077, Italy.
| |
Collapse
|
9
|
Kandić M, Moliadze V, Andoh J, Flor H, Nees F. Brain Circuits Involved in the Development of Chronic Musculoskeletal Pain: Evidence From Non-invasive Brain Stimulation. Front Neurol 2021; 12:732034. [PMID: 34531819 PMCID: PMC8438114 DOI: 10.3389/fneur.2021.732034] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 08/06/2021] [Indexed: 12/03/2022] Open
Abstract
It has been well-documented that the brain changes in states of chronic pain. Less is known about changes in the brain that predict the transition from acute to chronic pain. Evidence from neuroimaging studies suggests a shift from brain regions involved in nociceptive processing to corticostriatal brain regions that are instrumental in the processing of reward and emotional learning in the transition to the chronic state. In addition, dysfunction in descending pain modulatory circuits encompassing the periaqueductal gray and the rostral anterior cingulate cortex may also be a key risk factor for pain chronicity. Although longitudinal imaging studies have revealed potential predictors of pain chronicity, their causal role has not yet been determined. Here we review evidence from studies that involve non-invasive brain stimulation to elucidate to what extent they may help to elucidate the brain circuits involved in pain chronicity. Especially, we focus on studies using non-invasive brain stimulation techniques [e.g., transcranial magnetic stimulation (TMS), particularly its repetitive form (rTMS), transcranial alternating current stimulation (tACS), and transcranial direct current stimulation (tDCS)] in the context of musculoskeletal pain chronicity. We focus on the role of the motor cortex because of its known contribution to sensory components of pain via thalamic inhibition, and the role of the dorsolateral prefrontal cortex because of its role on cognitive and affective processing of pain. We will also discuss findings from studies using experimentally induced prolonged pain and studies implicating the DLPFC, which may shed light on the earliest transition phase to chronicity. We propose that combined brain stimulation and imaging studies might further advance mechanistic models of the chronicity process and involved brain circuits. Implications and challenges for translating the research on mechanistic models of the development of chronic pain to clinical practice will also be addressed.
Collapse
Affiliation(s)
- Mina Kandić
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Vera Moliadze
- Institute of Medical Psychology and Medical Sociology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Jamila Andoh
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany
| | - Herta Flor
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Frauke Nees
- Institute of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Institute of Medical Psychology and Medical Sociology, University Hospital Schleswig-Holstein, Kiel University, Kiel, Germany
| |
Collapse
|