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Sousani M, Seydnejad SR, Ghahramani M. Insights from a model based study on optimizing non invasive brain electrical stimulation for Parkinson's disease. Sci Rep 2024; 14:2447. [PMID: 38291112 PMCID: PMC10828384 DOI: 10.1038/s41598-024-52355-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
Parkinson's Disease (PD) is a disorder in the central nervous system which includes symptoms such as tremor, rigidity, and Bradykinesia. Deep brain stimulation (DBS) is the most effective method to treat PD motor symptoms especially when the patient is not responsive to other treatments. However, its invasiveness and high risk, involving electrode implantation in the Basal Ganglia (BG), prompt recent research to emphasize non-invasive Transcranial Electrical Stimulation (TES). TES proves to be effective in treating some PD symptoms with inherent safety and no associated risks. This study explores the potential of using TES, to modify the firing pattern of cells in BG that are responsible for motor symptoms in PD. The research employs a mathematical model of the BG to examine the impact of applying TES to the brain. This is conducted using a realistic head model incorporating the Finite Element Method (FEM). According to our findings, the firing pattern associated with Parkinson's disease shifted towards a healthier firing pattern through the use of tACS. Employing an adaptive algorithm that continually monitored the behavior of BG cells (specifically, Globus Pallidus Pars externa (GPe)), we determined the optimal electrode number and placement to concentrate the current within the intended region. This resulted in a peak induced electric field of 1.9 v/m at the BG area. Our mathematical modeling together with precise finite element simulation of the brain and BG suggests that proposed method effectively mitigates Parkinsonian behavior in the BG cells. Furthermore, this approach ensures an improvement in the condition while adhering to all safety constraints associated with the current injection into the brain.
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Affiliation(s)
- Maryam Sousani
- Faculty of Science and Technology, University of Canberra, Bruce, Canberra, 2617, ACT, Australia.
| | - Saeid R Seydnejad
- Department of Electrical Engineering, Shahid Bahonar University of Kerman, Pajoohesh Sq., Kerman, Kerman, Iran
| | - Maryam Ghahramani
- Faculty of Science and Technology, University of Canberra, Bruce, Canberra, 2617, ACT, Australia
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Maggio MG, Billeri L, Cardile D, Quartarone A, Calabrò RS. The Role of Innovation Technology in the Rehabilitation of Patients Affected by Huntington's Disease: A Scoping Review. Biomedicines 2023; 12:39. [PMID: 38255146 PMCID: PMC10813604 DOI: 10.3390/biomedicines12010039] [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: 11/22/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/24/2024] Open
Abstract
Huntington's disease is an autosomal dominant neurodegenerative disease caused by the repetition of cytosine, adenine, and guanine trinucleotides on the short arm of chromosome 4p16.3 within the Huntingtin gene. In this study, we aim to examine and map the existing evidence on the use of innovations in the rehabilitation of Huntington's disease. A scoping review was conducted on innovative rehabilitative treatments performed on patients with Huntington's disease. A search was performed on PubMed, Embase, Web of Science, and Cochrane databases to screen references of included studies and review articles for additional citations. Of an initial 1117 articles, only 20 met the search criteria. These findings showed that available evidence is still limited and that studies generally had small sample sizes and a high risk of bias. Regarding cognitive rehabilitation, it has emerged that VR- and PC-based methods as well as NIBS techniques are feasible and may have promising effects in individuals with Huntington's disease. On the other hand, scarce evidence was found for cognitive and motor training that might have a slight impact on overall cognitive function in individuals with Huntington's disease. Data show that further investigation is needed to explore the effects of innovative rehabilitation tools on cognition, especially considering that cognitive and psychiatric symptoms can precede the onset of motor symptoms by many years.
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Affiliation(s)
| | | | - Davide Cardile
- IRCCS Centro Neurolesi Bonino-Pulejo, S.S. 113 Via Palermo, C. da Casazza, 98124 Messina, Italy; (M.G.M.); (L.B.)
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Cheng XP, Yu WH, Liu X, Lin W, Wang ZD, Wang XC, Ni J, Cai NQ, Chen XY. Transcranial Alternating Current Stimulation in a Patient with Ataxia-Ocular Apraxia 2: a Case Report. CEREBELLUM (LONDON, ENGLAND) 2023:10.1007/s12311-023-01637-y. [PMID: 37993636 DOI: 10.1007/s12311-023-01637-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 11/24/2023]
Abstract
Ataxia-ocular apraxia 2 (AOA2) is a rare neurodegenerative autosomal recessive disorder with no effective treatment. In this study, we present the case of a patient diagnosed with AOA2, who experienced walking instability and uncoordinated movement. The patient underwent transcranial alternating current stimulation (tACS) treatment for 4 weeks with follow-up after 1 month. The effectiveness of the treatment was evaluated using the International Cooperative Ataxia Rating Scale (ICARS), the Scale for the Assessment and Rating of Ataxia (SARA), the 9-Hole Peg Test (9HPT), and functional near-infrared spectroscopy (fNIRS). Following treatment, the patient's ataxia symptoms showed significant improvement and continued to be alleviated during the follow-up period, suggesting a lasting effect of tACS treatment. Our findings from this case study provide compelling evidence for the potential of tACS as a treatment option for AOA2.
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Affiliation(s)
- Xiao-Ping Cheng
- Department of Rehabilitation Medicine of First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Wen-Hui Yu
- The School of Health, Fujian Medical University, Fuzhou, 350122, China
| | - Xia Liu
- Department of Rehabilitation Medicine of First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Wei Lin
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China
| | - Zhao-Di Wang
- Department of Rehabilitation Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, 215008, China
| | - Xi-Chen Wang
- Department of Rehabilitation Medicine of First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Jun Ni
- Department of Rehabilitation Medicine of First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China
| | - Nai-Qing Cai
- Department of Neurology and Institute of Neurology of First Affiliated Hospital, Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, 350005, China.
| | - Xin-Yuan Chen
- Department of Rehabilitation Medicine of First Affiliated Hospital, Fujian Medical University, Fuzhou, 350005, China.
- Department of Rehabilitation Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, 350212, China.
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Ganguly J, Kumar H. COVID-19 and De Novo Movement Disorders: Lessons Learned So Far. Ann Indian Acad Neurol 2023; 26:621-622. [PMID: 38022433 PMCID: PMC10666859 DOI: 10.4103/aian.aian_824_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/22/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Jacky Ganguly
- Movement Disorder Centre, Institute of Neurosciences Kolkata, 185, Acharya Jagadish Chandra Bose Rd., Elgin, Kolkata, West Bengal, India
| | - Hrishikesh Kumar
- Movement Disorder Centre, Institute of Neurosciences Kolkata, 185, Acharya Jagadish Chandra Bose Rd., Elgin, Kolkata, West Bengal, India
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Blagovechtchenski E, Kostromina S, Shaboltas A. Using a Pulse Protocol to Fix the Individual Dosage of Transcranial and Transspinal Direct Current Electrical Stimulation. Life (Basel) 2023; 13:1376. [PMID: 37374158 DOI: 10.3390/life13061376] [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: 05/09/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
The non-invasive current stimulation protocol differs significantly between the brain and spinal cord, such that when comparing the two, there is a clear predominance of protocols using transcranial direct current stimulation (tDCS) for the brain and of protocols using pulsed stimulation for the spinal cord (psSC). These protocols differ in their effects on the central nervous system and in such important parameters as stimulation intensity. In most cases, tDCS has a fixed amplitude for all subjects/patients, while psSC is usually chosen on a case-by-case basis, according to the thresholds of muscle responses. In our opinion, it is possible to use the experience of identifying thresholds during psSC to adjust the dose of the direct current for transcranial and transspinal electrical stimulation, an approach that may provide more homogeneous tDCS data.
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Affiliation(s)
- Evgeny Blagovechtchenski
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Svetlana Kostromina
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Alla Shaboltas
- Laboratory of Behavioural Neurodynamics, St. Petersburg State University, St. Petersburg 199034, Russia
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Non-Invasive Neuromodulation Methods to Alleviate Symptoms of Huntington's Disease: A Systematic Review of the Literature. J Clin Med 2023; 12:jcm12052002. [PMID: 36902788 PMCID: PMC10004225 DOI: 10.3390/jcm12052002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/23/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
Huntington's disease (HD) is a progressive and debilitating neurodegenerative disease. There is growing evidence for non-invasive neuromodulation tools as therapeutic strategies in neurodegenerative diseases. This systematic review aims to investigate the effectiveness of noninvasive neuromodulation in HD-associated motor, cognitive, and behavioral symptoms. A comprehensive literature search was conducted in Ovid MEDLINE, Cochrane Central Register of Clinical Trials, Embase, and PsycINFO from inception to 13 July 2021. Case reports, case series, and clinical trials were included while screening/diagnostic tests involving non-invasive neuromodulation, review papers, experimental studies on animal models, other systematic reviews, and meta-analyses were excluded. We have identified 19 studies in the literature investigating the use of ECT, TMS, and tDCS in the treatment of HD. Quality assessments were performed using Joanna Briggs Institute's (JBI's) critical appraisal tools. Eighteen studies showed improvement of HD symptoms, but the results were very heterogeneous considering different intervention techniques and protocols, and domains of symptoms. The most noticeable improvement involved depression and psychosis after ECT protocols. The impact on cognitive and motor symptoms is more controversial. Further investigations are required to determine the therapeutic role of distinct neuromodulation techniques for HD-related symptoms.
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Baharlouei H, Ali Salehinejad M, Talimkhani A, Nitsche MA. The Effect of Non-invasive Brain Stimulation on Gait in Healthy Young and Older Adults: A Systematic Review of the Literature. Neuroscience 2023; 516:125-140. [PMID: 36720301 DOI: 10.1016/j.neuroscience.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 12/26/2022] [Accepted: 01/21/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND AND OBJECTIVES Walking is an important function which requires coordinated activity of sensory-motor neural networks. Noninvasive brain stimulation (NIBS) is a safe neuromodulatory technique with motor function-improving effects. This study aimed to determine the effect of different types of NIBS interventions explored in randomized controlled trials on gait in healthy young and older adults. METHODS Based on the PRISMA approach, we conducted an electronic search in PubMed, Web of Science, Scopus, and PEDro for randomized clinical trials assessing the effect of NIBS on gait in healthy young and older adults and performed a narrative review. RESULTS Fourteen studies were included in this systematic review. According to the outcomes, transcranial direct current stimulation (tDCS) over the motor cortex and transcranial alternating current stimulation (tACS) over the cerebellum seem to be promising for improving gait characteristics such as speed, synchronization, and variability. Furthermore, tDCS over the dorsolateral prefrontal cortex (DLPFC) improved gait speed and reduced gait parameter variability under dual-task conditions. Only one repetitive transcranial magnetic stimulation was available, which showed no effects. No studies were available for transcranial random noise stimulation, and transcranial pulsed current stimulation. Moreover, the intervention parameters of the included studies were heterogeneous, and studies comparing directly specific intervention protocols were missing. CONCLUSION NIBS is a promising approach to improve gait in healthy young and older adults. Anodal tDCS over the motor areas and DLPFC, and tACS over the cerebellum have shown positive effects on gait.
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Affiliation(s)
- Hamzeh Baharlouei
- Musculoskeletal Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
| | - Ailin Talimkhani
- Department of Physical Therapy, School of Rehabilitation Sciences, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany; Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany.
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Guo B, Zhang M, Hao W, Wang Y, Zhang T, Liu C. Neuroinflammation mechanisms of neuromodulation therapies for anxiety and depression. Transl Psychiatry 2023; 13:5. [PMID: 36624089 PMCID: PMC9829236 DOI: 10.1038/s41398-022-02297-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Mood disorders are associated with elevated inflammation, and the reduction of symptoms after multiple treatments is often accompanied by pro-inflammation restoration. A variety of neuromodulation techniques that regulate regional brain activities have been used to treat refractory mood disorders. However, their efficacy varies from person to person and lack reliable indicator. This review summarizes clinical and animal studies on inflammation in neural circuits related to anxiety and depression and the evidence that neuromodulation therapies regulate neuroinflammation in the treatment of neurological diseases. Neuromodulation therapies, including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), electroconvulsive therapy (ECT), photobiomodulation (PBM), transcranial ultrasound stimulation (TUS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS), all have been reported to attenuate neuroinflammation and reduce the release of pro-inflammatory factors, which may be one of the reasons for mood improvement. This review provides a better understanding of the effective mechanism of neuromodulation therapies and indicates that inflammatory biomarkers may serve as a reference for the assessment of pathological conditions and treatment options in anxiety and depression.
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Affiliation(s)
- Bingqi Guo
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Neuromodulation, Beijing, 100053 China
| | - Mengyao Zhang
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Neuromodulation, Beijing, 100053 China
| | - Wensi Hao
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Neuromodulation, Beijing, 100053 China
| | - Yuping Wang
- grid.413259.80000 0004 0632 3337Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XBeijing Key Laboratory of Neuromodulation, Beijing, 100053 China ,grid.24696.3f0000 0004 0369 153XInstitute of sleep and consciousness disorders, Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing, 100069 China
| | - Tingting Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. .,Beijing Key Laboratory of Neuromodulation, Beijing, 100053, China.
| | - Chunyan Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. .,Beijing Key Laboratory of Neuromodulation, Beijing, 100053, China.
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Bu J, Huang H. Editorial: Non-invasive neuromodulation for movement and emotional disorders. Front Psychol 2022; 13:1079531. [PMID: 36506997 PMCID: PMC9728098 DOI: 10.3389/fpsyg.2022.1079531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/09/2022] [Indexed: 11/24/2022] Open
Affiliation(s)
- Junjie Bu
- School of Biomedical Engineering, Anhui Medical University, Hefei, China,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China,*Correspondence: Junjie Bu
| | - Huijing Huang
- School of Biomedical Engineering, Anhui Medical University, Hefei, China,School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
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Neuroprotection and Non-Invasive Brain Stimulation: Facts or Fiction? Int J Mol Sci 2022; 23:ijms232213775. [PMID: 36430251 PMCID: PMC9692544 DOI: 10.3390/ijms232213775] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 11/11/2022] Open
Abstract
Non-Invasive Brain Stimulation (NIBS) techniques, such as transcranial Direct Current Stimulation (tDCS) and repetitive Magnetic Transcranial Stimulation (rTMS), are well-known non-pharmacological approaches to improve both motor and non-motor symptoms in patients with neurodegenerative disorders. Their use is of particular interest especially for the treatment of cognitive impairment in Alzheimer's Disease (AD), as well as axial disturbances in Parkinson's (PD), where conventional pharmacological therapies show very mild and short-lasting effects. However, their ability to interfere with disease progression over time is not well understood; recent evidence suggests that NIBS may have a neuroprotective effect, thus slowing disease progression and modulating the aggregation state of pathological proteins. In this narrative review, we gather current knowledge about neuroprotection and NIBS in neurodegenerative diseases (i.e., PD and AD), just mentioning the few results related to stroke. As further matter of debate, we discuss similarities and differences with Deep Brain Stimulation (DBS)-induced neuroprotective effects, and highlight possible future directions for ongoing clinical studies.
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Khatoun A, Asamoah B, Boogers A, Mc Laughlin M. Epicranial Direct Current Stimulation Suppresses Harmaline Tremor in Rats. Neuromodulation 2022:S1094-7159(22)01223-5. [DOI: 10.1016/j.neurom.2022.08.448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/19/2022] [Accepted: 08/01/2022] [Indexed: 10/14/2022]
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Efficacy of Transcranial Direct Current Stimulation (tDCS) on Balance and Gait in Multiple Sclerosis Patients: A Machine Learning Approach. J Clin Med 2022; 11:jcm11123505. [PMID: 35743575 PMCID: PMC9224780 DOI: 10.3390/jcm11123505] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 06/05/2022] [Accepted: 06/15/2022] [Indexed: 02/06/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) has emerged as an appealing rehabilitative approach to improve brain function, with promising data on gait and balance in people with multiple sclerosis (MS). However, single variable weights have not yet been adequately assessed. Hence, the aim of this pilot randomized controlled trial was to evaluate the tDCS effects on balance and gait in patients with MS through a machine learning approach. In this pilot randomized controlled trial (RCT), we included people with relapsing−remitting MS and an Expanded Disability Status Scale >1 and <5 that were randomly allocated to two groups—a study group, undergoing a 10-session anodal motor cortex tDCS, and a control group, undergoing a sham treatment. Both groups underwent a specific balance and gait rehabilitative program. We assessed as outcome measures the Berg Balance Scale (BBS), Fall Risk Index and timed up-and-go and 6-min-walking tests at baseline (T0), the end of intervention (T1) and 4 (T2) and 6 weeks after the intervention (T3) with an inertial motion unit. At each time point, we performed a multiple factor analysis through a machine learning approach to allow the analysis of the influence of the balance and gait variables, grouping the participants based on the results. Seventeen MS patients (aged 40.6 ± 14.4 years), 9 in the study group and 8 in the sham group, were included. We reported a significant repeated measures difference between groups for distances covered (6MWT (meters), p < 0.03). At T1, we showed a significant increase in distance (m) with a mean difference (MD) of 37.0 [−59.0, 17.0] (p = 0.003), and in BBS with a MD of 2.0 [−4.0, 3.0] (p = 0.03). At T2, these improvements did not seem to be significantly maintained; however, considering the machine learning analysis, the Silhouette Index of 0.34, with a low cluster overlap trend, confirmed the possible short-term effects (T2), even at 6 weeks. Therefore, this pilot RCT showed that tDCS may provide non-sustained improvements in gait and balance in MS patients. In this scenario, machine learning could suggest evidence of prolonged beneficial effects.
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Mai AS, Yong JH, Lim OZH, Tan EK. Non-Invasive Electrical Stimulation in Patients with Neurodegenerative Ataxia and Spasticity: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Eur J Neurol 2022; 29:2842-2850. [PMID: 35666142 DOI: 10.1111/ene.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are limited treatment options for patients with neurodegenerative ataxia and spasticity. Non-invasive electrostimulation (NES) is receiving increasing interest because of its ease of implementation, cost-effectiveness, and safety. We conducted a meta-analysis to evaluate the efficacy of NES. METHODS We screened Medline and Embase for studies using NES in ataxias and spasticity. Key outcome measurements of effectiveness included changes in: (1) Modified Ashworth Scale (MAS) scores, (2) cerebellar brain inhibition (CBI), (3) 9-hole peg test (9HPT), (4) 8-meter walking time (8MWT), (5) International Cooperative Ataxia Rating Scale (ICARS) scores, (6) Scale for Assessment and Rating of Ataxia (SARA) scores. RESULTS Seven randomised controlled trials (RCTs) involving 203 patients were included. There were significant improvements in MAS (MD -0.42, 95% CI -0.76 to -0.08, P=0.015), CBI (MD -0.35%, 95% CI -0.42 to -0.28, P<0.001), 8MWT (MD -1.88 seconds, 95% CI -3.26 to -0.49, P=0.008), ICARS (MD -7.84, 95% CI -11.90 to -3.78, P<0.001), and SARA (MD -3.01, 95% CI -4.74 to -1.28, P<0.001). There was almost no heterogeneity across all outcomes except for CBI (I2 =79%). No significant changes in 9HPT were observed when comparing NES to a sham procedure (MD -3.52 seconds, 95% CI -9.15 to 2.10, P=0.220). Most included studies were at low risk of bias, and no severe adverse effects were reported. CONCLUSION We demonstrated that NES is an effective treatment for improving coordination and balance, and increased exercise capacity in patients with ataxia and spasticity. There was also a significant modulation of CBI in ataxic patients.
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Affiliation(s)
- Aaron Shengting Mai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jung Hahn Yong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Oliver Zi Hern Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eng-King Tan
- Department of Neurology, General Hospital Campus, National Neuroscience Institute, Singapore, Singapore.,Neuroscience and Behavioural Disorders, Duke-NUS Medical School, Singapore
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De Icco R, Putortì A, Allena M, Avenali M, Dagna C, Martinelli D, Cristina S, Grillo V, Fresia M, Bitetto V, Cosentino G, Valentino F, Alfonsi E, Sandrini G, Pisani A, Tassorelli C. Non-Invasive Neuromodulation in the Rehabilitation of Pisa Syndrome in Parkinson's Disease: A Randomized Controlled Trial. Front Neurol 2022; 13:849820. [PMID: 35493824 PMCID: PMC9046718 DOI: 10.3389/fneur.2022.849820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/14/2022] [Indexed: 11/24/2022] Open
Abstract
Background Pisa syndrome (PS) is a frequent postural complication of Parkinson's disease (PD). PS poorly responds to anti-parkinsonian drugs and the improvement achieved with neurorehabilitation tends to fade in 6 months or less. Transcranial direct current stimulation (t-DCS) is a non-invasive neuromodulation technique that showed promising results in improving specific symptoms in different movement disorders. Objectives This study aimed to evaluate the role of bi-hemispheric t-DCS as an add-on to a standardized hospital rehabilitation program in the management of PS in PD. Methods This study included 28 patients with PD and PS (21 men, aged 72.9 ± 5.1 years) who underwent a 4-week intensive neurorehabilitation treatment and were randomized to receive: i) t-DCS (t-DCS group, n = 13) for 5 daily sessions (20 min−2 mA) with bi-hemispheric stimulation over the primary motor cortex (M1), or ii) sham stimulation (sham group, n = 15) with the same duration and cadence. At baseline (T0), end of rehabilitation (T1), and 6 months later (T2) patients were evaluated with both trunk kinematic analysis and clinical scales, including UPDRS-III, Functional Independence Measure (FIM), and Numerical Rating Scale for lumbar pain. Results When compared to the sham group, the t-DCS group achieved a more pronounced improvement in several variables: overall posture (p = 0.014), lateral trunk inclination (p = 0.013) during upright standing position, total range of motion of the trunk (p = 0.012), FIM score (p = 0.048), and lumbar pain intensity (p = 0.017). Conclusions Our data support the use of neuromodulation with t-DCS as an add-on to neurorehabilitation for the treatment of patients affected by PS in PD.
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Affiliation(s)
- Roberto De Icco
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- *Correspondence: Roberto De Icco
| | - Alessia Putortì
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Marta Allena
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Micol Avenali
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Carlotta Dagna
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Daniele Martinelli
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Silvano Cristina
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Valentina Grillo
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Mauro Fresia
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Vito Bitetto
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giuseppe Cosentino
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Clinical Neurophysiology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Francesca Valentino
- Parkinson's Disease and Movement Disorders Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Enrico Alfonsi
- Clinical Neurophysiology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Giorgio Sandrini
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Antonio Pisani
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Cristina Tassorelli
- Movement Analysis Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
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15
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Ni R, Yuan Y, Yang L, Meng Q, Zhu Y, Zhong Y, Cao Z, Zhang S, Yao W, Lv D, Chen X, Chen X, Bu J. Novel Non-invasive Transcranial Electrical Stimulation for Parkinson's Disease. Front Aging Neurosci 2022; 14:880897. [PMID: 35493922 PMCID: PMC9039727 DOI: 10.3389/fnagi.2022.880897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
Abstract
Conventional transcranial electrical stimulation (tES) is a non-invasive method to modulate brain activity and has been extensively used in the treatment of Parkinson's disease (PD). Despite promising prospects, the efficacy of conventional tES in PD treatment is highly variable across different studies. Therefore, many have tried to optimize tES for an improved therapeutic efficacy by developing novel tES intervention strategies. Until now, these novel clinical interventions have not been discussed or reviewed in the context of PD therapy. In this review, we focused on the efficacy of these novel strategies in PD mitigation, classified them into three categories based on their distinct technical approach to circumvent conventional tES problems. The first category has novel stimulation modes to target different modulating mechanisms, expanding the rang of stimulation choices hence enabling the ability to modulate complex brain circuit or functional networks. The second category applies tES as a supplementary intervention for PD hence amplifies neurological or behavioral improvements. Lastly, the closed loop tES stimulation can provide self-adaptive individualized stimulation, which enables a more specialized intervention. In summary, these novel tES have validated potential in both alleviating PD symptoms and improving understanding of the pathophysiological mechanisms of PD. However, to assure wide clinical used of tES therapy for PD patients, further large-scale trials are required.
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Affiliation(s)
- Rui Ni
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
- Department of Life Sciences, Imperial College London, London, United Kingdom
| | - Ye Yuan
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Li Yang
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Qiujian Meng
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Ying Zhu
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Yiya Zhong
- Department of Life Sciences, Imperial College London, London, United Kingdom
| | - Zhenqian Cao
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Shengzhao Zhang
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
| | - Wenjun Yao
- Department of Radiology, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Daping Lv
- Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xin Chen
- Department of Neurology, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xianwen Chen
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Junjie Bu
- Department of Intelligent Medical Engineering, School of Biomedical Engineering, Anhui Medical University, Hefei, China
- Department of Neurosurgery, The Fourth Affiliated Hospital of Anhui Medical University, Hefei, China
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16
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Nieuwhof F, Toni I, Buijink AW, van Rootselaar AF, van de Warrenburg BP, Helmich RC. Phase-locked transcranial electrical brain stimulation for tremor suppression in dystonic tremor syndromes. Clin Neurophysiol 2022; 140:239-250. [DOI: 10.1016/j.clinph.2022.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 12/19/2022]
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17
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Costa TDDC, Godeiro Júnior C, Silva RAE, dos Santos SF, Machado DGDS, Andrade SM. The Effects of Non-Invasive Brain Stimulation on Quantitative EEG in Patients With Parkinson's Disease: A Systematic Scoping Review. Front Neurol 2022; 13:758452. [PMID: 35309586 PMCID: PMC8924295 DOI: 10.3389/fneur.2022.758452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 01/14/2022] [Indexed: 11/13/2022] Open
Abstract
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms, aside from alterations in the electroencephalogram (EEG) already registered. Non-invasive brain stimulation (NIBS) techniques have been suggested as an alternative rehabilitative therapy, but the neurophysiological changes associated with these techniques are still unclear. We aimed to identify the nature and extent of research evidence on the effects of NIBS techniques in the cortical activity measured by EEG in patients with PD. A systematic scoping review was configured by gathering evidence on the following bases: PubMed (MEDLINE), PsycINFO, ScienceDirect, Web of Science, and cumulative index to nursing & allied health (CINAHL). We included clinical trials with patients with PD treated with NIBS and evaluated by EEG pre-intervention and post-intervention. We used the criteria of Downs and Black to evaluate the quality of the studies. Repetitive transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), electrical vestibular stimulation, and binaural beats (BBs) are non-invasive stimulation techniques used to treat cognitive and motor impairment in PD. This systematic scoping review found that the current evidence suggests that NIBS could change quantitative EEG in patients with PD. However, considering that the quality of the studies varied from poor to excellent, the low number of studies, variability in NIBS intervention, and quantitative EEG measures, we are not yet able to use the EEG outcomes to predict the cognitive and motor treatment response after brain stimulation. Based on our findings, we recommend additional research efforts to validate EEG as a biomarker in non-invasive brain stimulation trials in PD.
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Affiliation(s)
| | - Clécio Godeiro Júnior
- Division of Neurology, Hospital Universitario Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Rodrigo Alencar e Silva
- Division of Neurology, Hospital Universitario Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, Brazil
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18
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Suzuki M, Tanaka S, Gomez-Tames J, Okabe T, Cho K, Iso N, Hirata A. Nonequivalent After-Effects of Alternating Current Stimulation on Motor Cortex Oscillation and Inhibition: Simulation and Experimental Study. Brain Sci 2022; 12:brainsci12020195. [PMID: 35203958 PMCID: PMC8870173 DOI: 10.3390/brainsci12020195] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/28/2022] [Accepted: 01/28/2022] [Indexed: 02/01/2023] Open
Abstract
The effects of transcranial alternating current stimulation (tACS) frequency on brain oscillations and cortical excitability are still controversial. Therefore, this study investigated how different tACS frequencies differentially modulate cortical oscillation and inhibition. To do so, we first determined the optimal positioning of tACS electrodes through an electric field simulation constructed from magnetic resonance images. Seven electrode configurations were tested on the electric field of the precentral gyrus (hand motor area). We determined that the Cz-CP1 configuration was optimal, as it resulted in higher electric field values and minimized the intra-individual differences in the electric field. Therefore, tACS was delivered to the hand motor area through this arrangement at a fixed frequency of 10 Hz (alpha-tACS) or 20 Hz (beta-tACS) with a peak-to-peak amplitude of 0.6 mA for 20 min. We found that alpha- and beta-tACS resulted in larger alpha and beta oscillations, respectively, compared with the oscillations observed after sham-tACS. In addition, alpha- and beta-tACS decreased the amplitudes of conditioned motor evoked potentials and increased alpha and beta activity, respectively. Correspondingly, alpha- and beta-tACSs enhanced cortical inhibition. These results show that tACS frequency differentially affects motor cortex oscillation and inhibition.
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Affiliation(s)
- Makoto Suzuki
- Faculty of Health Sciences, Tokyo Kasei University, 2-15-1 Inariyama, Sayama 350-1398, Saitama, Japan; (T.O.); (K.C.); (N.I.)
- Correspondence: ; Tel.: +81-42-955-6074
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu 431-3192, Shizuoka, Japan;
| | - Jose Gomez-Tames
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Aichi, Japan; (J.G.-T.); (A.H.)
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Aichi, Japan
| | - Takuhiro Okabe
- Faculty of Health Sciences, Tokyo Kasei University, 2-15-1 Inariyama, Sayama 350-1398, Saitama, Japan; (T.O.); (K.C.); (N.I.)
| | - Kilchoon Cho
- Faculty of Health Sciences, Tokyo Kasei University, 2-15-1 Inariyama, Sayama 350-1398, Saitama, Japan; (T.O.); (K.C.); (N.I.)
| | - Naoki Iso
- Faculty of Health Sciences, Tokyo Kasei University, 2-15-1 Inariyama, Sayama 350-1398, Saitama, Japan; (T.O.); (K.C.); (N.I.)
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Aichi, Japan; (J.G.-T.); (A.H.)
- Center of Biomedical Physics and Information Technology, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya 466-8555, Aichi, Japan
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19
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Motolese F, Capone F, Di Lazzaro V. New tools for shaping plasticity to enhance recovery after stroke. HANDBOOK OF CLINICAL NEUROLOGY 2022; 184:299-315. [PMID: 35034743 DOI: 10.1016/b978-0-12-819410-2.00016-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Francesco Motolese
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Fioravante Capone
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Vincenzo Di Lazzaro
- Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.
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20
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Takeuchi N, Izumi SI. Motor Learning Based on Oscillatory Brain Activity Using Transcranial Alternating Current Stimulation: A Review. Brain Sci 2021; 11:1095. [PMID: 34439714 PMCID: PMC8392205 DOI: 10.3390/brainsci11081095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 12/15/2022] Open
Abstract
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.
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Affiliation(s)
- Naoyuki Takeuchi
- Department of Physical Therapy, Akita University Graduate School of Health Sciences 1-1-1, Hondo, Akita 010-8543, Japan
| | - Shin-Ichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
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21
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Ferrazzoli D, Ortelli P, Volpe D, Cucca A, Versace V, Nardone R, Saltuari L, Sebastianelli L. The Ties That Bind: Aberrant Plasticity and Networks Dysfunction in Movement Disorders-Implications for Rehabilitation. Brain Connect 2021; 11:278-296. [PMID: 33403893 DOI: 10.1089/brain.2020.0971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background: Movement disorders encompass various conditions affecting the nervous system. The pathological processes underlying movement disorders lead to aberrant synaptic plastic changes, which in turn alter the functioning of large-scale brain networks. Therefore, clinical phenomenology does not only entail motor symptoms but also cognitive and motivational disturbances. The result is the disruption of motor learning and motor behavior. Due to this complexity, the responsiveness to standard therapies could be disappointing. Specific forms of rehabilitation entailing goal-based practice, aerobic training, and the use of noninvasive brain stimulation techniques could "restore" neuroplasticity at motor-cognitive circuitries, leading to clinical gains. This is probably associated with modulations occurring at both molecular (synaptic) and circuitry levels (networks). Several gaps remain in our understanding of the relationships among plasticity and neural networks and how neurorehabilitation could promote clinical gains is still unclear. Purposes: In this review, we outline first the networks involved in motor learning and behavior and analyze which mechanisms link the pathological synaptic plastic changes with these networks' disruption in movement disorders. Therefore, we provide theoretical and practical bases to be applied for treatment in rehabilitation.
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Affiliation(s)
- Davide Ferrazzoli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Paola Ortelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Daniele Volpe
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy
| | - Alberto Cucca
- Fresco Parkinson Center, Villa Margherita, S. Stefano Riabilitazione, Vicenza, Italy.,Department of Neurology, The Marlene & Paolo Fresco Institute for Parkinson's & Movement Disorders, NYU School of Medicine, New York, New York, USA.,Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Viviana Versace
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Raffaele Nardone
- Department of Neurology, Franz Tappeiner Hospital (SABES-ASDAA), Merano-Meran, Italy.,Department of Neurology, Christian Doppler Medical Center, Paracelsus University Salzburg, Salzburg, Austria
| | - Leopold Saltuari
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
| | - Luca Sebastianelli
- Department of Neurorehabilitation, Hospital of Vipiteno (SABES-ASDAA), Vipiteno-Sterzing, Italy
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22
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New modalities and directions for dystonia care. J Neural Transm (Vienna) 2021; 128:559-565. [PMID: 33389184 DOI: 10.1007/s00702-020-02278-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/06/2020] [Indexed: 01/11/2023]
Abstract
Dystonia is an abnormal involuntary movement or posture owing to sustained or intermittent muscle contraction. Standard treatment for dystonia includes medications, such as levodopa, anticholinergic and antiepileptic drugs, botulinum toxin, and baclofen pump, and surgeries, such as lesioning surgery and deep-brain stimulation. New treatment modalities aimed toward improving dystonia care in the future are under investigation. There are two main axes to improve dystonia care; one is non-invasive neuromodulation, such as transcranial magnetic stimulation, transcranial electrical stimulation, and transcutaneous electrical nerve stimulation. The other is a quantitative evaluation of dystonia using a wearable device and motion-capturing system, which can be empowered by artificial intelligence. In this article, the current status of these axes will be reviewed.
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23
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Spetsieris PG, Eidelberg D. Spectral guided sparse inverse covariance estimation of metabolic networks in Parkinson's disease. Neuroimage 2020; 226:117568. [PMID: 33246128 PMCID: PMC8409106 DOI: 10.1016/j.neuroimage.2020.117568] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/23/2020] [Accepted: 11/12/2020] [Indexed: 01/21/2023] Open
Abstract
In neurodegenerative disorders, a clearer understanding of the underlying aberrant networks facilitates the search for effective therapeutic targets and potential cures. [18F]-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging data of brain metabolism reflects the distribution of glucose consumption known to be directly related to neural activity. In FDG PET resting-state metabolic data, characteristic disease-related patterns have been identified in group analysis of various neurodegenerative conditions using principal component analysis of multivariate spatial covariance. Notably, among several parkinsonian syndromes, the identified Parkinson’s disease-related pattern (PDRP) has been repeatedly validated as an imaging biomarker of PD in independent groups worldwide. Although the primary nodal associations of this network are known, its connectivity is not fully understood. Here, we describe a novel approach to elucidate functional principal component (PC) network connections by performing graph theoretical sparse network derivation directly within the disease relevant PC partition layer of the whole brain data rather than by searching for associations retrospectively in whole brain sparse representations. Using sparse inverse covariance estimation of each overlapping PC partition layer separately, a single coherent network is detected for each layer in contrast to more spatially modular segmentation in whole brain data analysis. Using this approach, the major nodal hubs of the PD disease network are identified and their characteristic functional pathways are clearly distinguished within the basal ganglia, midbrain and parietal areas. Network associations are further clarified using Laplacian spectral analysis of the adjacency matrices. In addition, the innate discriminative capacity of the eigenvector centrality of the graph derived networks in differentiating PD versus healthy external data provides evidence of their validity.
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Affiliation(s)
- Phoebe G Spetsieris
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA
| | - David Eidelberg
- Center for Neurosciences, The Feinstein Institutes for Medical Research, Manhasset, NY 11030, USA.
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24
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Pilloni G, Bikson M, Badran BW, George MS, Kautz SA, Okano AH, Baptista AF, Charvet LE. Update on the Use of Transcranial Electrical Brain Stimulation to Manage Acute and Chronic COVID-19 Symptoms. Front Hum Neurosci 2020; 14:595567. [PMID: 33281589 PMCID: PMC7689057 DOI: 10.3389/fnhum.2020.595567] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/20/2020] [Indexed: 12/18/2022] Open
Abstract
The coronavirus disease 19 (COVID-19) pandemic has resulted in the urgent need to develop and deploy treatment approaches that can minimize mortality and morbidity. As infection, resulting illness, and the often prolonged recovery period continue to be characterized, therapeutic roles for transcranial electrical stimulation (tES) have emerged as promising non-pharmacological interventions. tES techniques have established therapeutic potential for managing a range of conditions relevant to COVID-19 illness and recovery, and may further be relevant for the general management of increased mental health problems during this time. Furthermore, these tES techniques can be inexpensive, portable, and allow for trained self-administration. Here, we summarize the rationale for using tES techniques, specifically transcranial Direct Current Stimulation (tDCS), across the COVID-19 clinical course, and index ongoing efforts to evaluate the inclusion of tES optimal clinical care.
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Affiliation(s)
- Giuseppina Pilloni
- Department of Neurology, NYU Langone Health, New York, NY, United States
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York, New York, NY, United States
| | - Bashar W. Badran
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Mark S. George
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
- Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, United States
| | - Steven A. Kautz
- Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, United States
- Department of Health Sciences and Research, Medical University of South Carolina, Charleston, SC, United States
| | - Alexandre Hideki Okano
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil
- Brazilian Institute of Neuroscience and Neurothechnology 52 (BRAINN/CEPID53 FAPESP), University of Campinas, Campinas, Brazil
| | - Abrahão Fontes Baptista
- Center for Mathematics, Computation and Cognition, Universidade Federal do ABC, São Bernardo do Campo, Brazil
- Brazilian Institute of Neuroscience and Neurothechnology 52 (BRAINN/CEPID53 FAPESP), University of Campinas, Campinas, Brazil
- Laboratory of Medical Investigation 54 (LIM-54), São Paulo University, São Paulo, Brazil
| | - Leigh E. Charvet
- Department of Neurology, NYU Langone Health, New York, NY, United States
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