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Simis M, Thibaut A, Imamura M, Battistella LR, Fregni F. Neurophysiological biomarkers of motor improvement from Constraint-Induced Movement Therapy and Robot-Assisted Therapy in participants with stroke. Front Hum Neurosci 2023; 17:1188806. [PMID: 37780964 PMCID: PMC10540307 DOI: 10.3389/fnhum.2023.1188806] [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: 03/17/2023] [Accepted: 08/29/2023] [Indexed: 10/03/2023] Open
Abstract
Background The mechanism of stroke recovery is related to the reorganization of cerebral activity that can be enhanced by rehabilitation therapy. Two well established treatments are Robot-Assisted Therapy (RT) and Constraint-Induced Movement Therapy (CIMT), however, it is unknown whether there is a difference in the neuroplastic changes induced by these therapies, and if the modifications are related to motor improvement. Therefore, this study aims to identify neurophysiological biomarkers related to motor improvement of participants with chronic stroke that received RT or CIMT, and to test whether there is a difference in neuronal changes induced by these two therapies. Methods This study included participants with chronic stroke that took part in a pilot experiment to compare CIMT vs. RT. Neurophysiological evaluations were performed with electroencephalography (EEG) and transcranial magnetic stimulation (TMS), pre and post rehabilitation therapy. Motor function was measured by the Wolf Motor Function Test (WMFT) and Fugl-Meyer Assessment Upper Limb (FMA-UL). Results Twenty-seven participants with chronic stroke completed the present study [mean age of 58.8 years (SD ± 13.6), mean time since stroke of 18.2 months (SD ± 9.6)]. We found that changes in motor threshold (MT) and motor evoked potential (MEP) in the lesioned hemisphere have a positive and negative correlation with WMFT improvement, respectively. The absolute change in alpha peak in the unlesioned hemisphere and the absolute change of the alpha ratio (unlesioned/lesioned hemisphere) is negatively correlated with WMFT improvement. The decrease of EEG power ratio (increase in the lesioned hemisphere and decrease in the unlesioned hemisphere) for high alpha bandwidths is correlated with better improvement in WMFT. The variable "type of treatment (RT or CIMT)" was not significant in the models. Conclusion Our results suggest that distinct treatments (RT and CIMT) have similar neuroplastic mechanisms of recovery. Moreover, motor improvements in participants with chronic stroke are related to decreases of cortical excitability in the lesioned hemisphere measured with TMS. Furthermore, the balance of both EEG power and EEG alpha peak frequency in the lesioned hemisphere is related to motor improvement.
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Affiliation(s)
- Marcel Simis
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Aurore Thibaut
- Coma Science Group, GIGA-Consciousness, University of Liege, Liege, Belgium
| | - Marta Imamura
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Linamara Rizzo Battistella
- Instituto de Medicina Fisica e Reabilitacao, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Felipe Fregni
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
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Xiao S, Shen B, Zhang C, Xu Z, Li J, Fu W, Jin J. Effects of tDCS on Foot Biomechanics: A Narrative Review and Clinical Applications. Bioengineering (Basel) 2023; 10:1029. [PMID: 37760131 PMCID: PMC10525503 DOI: 10.3390/bioengineering10091029] [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: 06/30/2023] [Revised: 08/13/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
In recent years, neuro-biomechanical enhancement techniques, such as transcranial direct current stimulation (tDCS), have been widely used to improve human physical performance, including foot biomechanical characteristics. This review aims to summarize research on the effects of tDCS on foot biomechanics and its clinical applications, and further analyze the underlying ergogenic mechanisms of tDCS. This review was performed for relevant papers until July 2023 in the following databases: Web of Science, PubMed, and EBSCO. The findings demonstrated that tDCS can improve foot biomechanical characteristics in healthy adults, including proprioception, muscle strength, reaction time, and joint range of motion. Additionally, tDCS can be effectively applied in the field of foot sports medicine; in particular, it can be combined with functional training to effectively improve foot biomechanical performance in individuals with chronic ankle instability (CAI). The possible mechanism is that tDCS may excite specific task-related neurons and regulate multiple neurons within the system, ultimately affecting foot biomechanical characteristics. However, the efficacy of tDCS applied to rehabilitate common musculoskeletal injuries (e.g., CAI and plantar fasciitis) still needs to be confirmed using a larger sample size. Future research should use multimodal neuroimaging technology to explore the intrinsic ergogenic mechanism of tDCS.
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Affiliation(s)
- Songlin Xiao
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Bin Shen
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Chuyi Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Zhen Xu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Jingjing Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
| | - Weijie Fu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (S.X.)
- Key Laboratory of Exercise and Health Sciences of Ministry of Education, Shanghai University of Sport, Shanghai 200438, China
| | - Jing Jin
- School of Psychology, Shanghai University of Sport, Shanghai 200438, China
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Kim H, Lee G, Lee J, Kim YH. Alterations in learning-related cortical activation and functional connectivity by high-definition transcranial direct current stimulation after stroke: an fNIRS study. Front Neurosci 2023; 17:1189420. [PMID: 37332855 PMCID: PMC10275383 DOI: 10.3389/fnins.2023.1189420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 05/04/2023] [Indexed: 06/20/2023] Open
Abstract
Introduction Motor learning is a key component of stroke neurorehabilitation. High-definition transcranial direct current stimulation (HD-tDCS) was recently developed as a tDCS technique that increases the accuracy of current delivery to the brain using arrays of small electrodes. The purpose of this study was to investigate whether HD-tDCS alters learning-related cortical activation and functional connectivity in stroke patients using functional near-infrared spectroscopy (fNIRS). Methods Using a sham-controlled crossover study design, 16 chronic stroke patients were randomly assigned to one of two intervention conditions. Both groups performed the sequential finger tapping task (SFTT) on five consecutive days, either with (a) real HD-tDCS or (b) with sham HD-tDCS. HD-tDCS (1 mA for 20 min, 4 × 1) was administered to C3 or C4 (according to lesion side). fNIRS signals were measured during the SFTT with the affected hand before (baseline) and after each intervention using fNIRS measurement system. Cortical activation and functional connectivity of NIRS signals were analyzed using a statistical parametric mapping open-source software package (NIRS-SPM), OptoNet II®. Results In the real HD-tDCS condition, oxyHb concentration increased significantly in the ipsilesional primary motor cortex (M1). Connectivity between the ipsilesional M1 and the premotor cortex (PM) was noticeably strengthened after real HD-tDCS compared with baseline. Motor performance also significantly improved, as shown in response time during the SFTT. In the sham HD-tDCS condition, functional connectivity between contralesional M1 and sensory cortex was enhanced compared with baseline. There was tendency toward improvement in SFTT response time, but without significance. Discussion The results of this study indicated that HD-tDCS could modulate learning-related cortical activity and functional connectivity within motor networks to enhance motor learning performance. HD-tDCS can be used as an additional tool for enhancing motor learning during hand rehabilitation for chronic stroke patients.
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Affiliation(s)
- Heegoo Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Gihyoun Lee
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Jungsoo Lee
- Department of Rehabilitation Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Yun-Hee Kim
- Department of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center, Seoul, Republic of Korea
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
- Department of Physical and Rehabilitation Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
- Haeundae Sharing and Happiness Hospital, Pusan, Republic of Korea
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Guimarães AN, Porto AB, Marcori AJ, Lage GM, Altimari LR, Alves Okazaki VH. Motor learning and tDCS: A systematic review on the dependency of the stimulation effect on motor task characteristics or tDCS assembly specifications. Neuropsychologia 2023; 179:108463. [PMID: 36567006 DOI: 10.1016/j.neuropsychologia.2022.108463] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 11/21/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022]
Abstract
TDCS is one of the most commonly used methods among studies with transcranial electrical stimulation and motor skills learning. Differences between study results suggest that the effect of tDCS on motor learning is dependent on the motor task performed or on the tDCS assembly specification used in the learning process. This systematic review aimed to analyze the tDCS effect on motor learning and verify whether this effect is dependent on the task or tDCS assembly specifications. Searches were performed in PubMed, SciELO, LILACS, Web of Science, CINAHL, Scopus, SPORTDiscus, Cochrane Central Register of Controlled Trials (CENTRAL), Embase, and PsycINFO. Articles were included that analyzed the effect of tDCS on motor learning through pre-practice, post-practice, retention, and/or transfer tests (period ≥24 h). The tDCS was most frequently applied to the primary motor cortex (M1) or the cerebellar cortex (CC) and the majority of studies found significant stimulation effects. Studies that analyzed identical or similar motor tasks show divergent results for the tDCS effect, even when the assembly specifications are the same. The tDCS effect is not dependent on motor task characteristics or tDCS assembly specifications alone but is dependent on the interaction between these factors. This interaction occurs between uni and bimanual tasks with anodal uni and bihemispheric (bilateral) stimulations at M1 or with anodal unihemispheric stimulations (unilateral and centrally) at CC, and between tasks of greater or lesser difficulty with single or multiple tDCS sessions. Movement time seems to be more sensitive than errors to indicate the effects of tDCS on motor learning, and a sufficient amount of motor practice to reach the "learning plateau" also seems to determine the effect of tDCS on motor learning.
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Affiliation(s)
- Anderson Nascimento Guimarães
- State University of Londrina, Londrina. Rodovia Celso Garcia Cid - Pr 445, Km 380, Cx. Postal 10.011, CEP 86057-970, Campus Universitário, Londrina, PR, Brazil.
| | - Alessandra Beggiato Porto
- State University of Londrina, Londrina. Rodovia Celso Garcia Cid - Pr 445, Km 380, Cx. Postal 10.011, CEP 86057-970, Campus Universitário, Londrina, PR, Brazil.
| | - Alexandre Jehan Marcori
- University of São Paulo, Av. Professor Mello Moraes 65, CEP 05508-030, Vila Universitaria, São Paulo, SP, Brazil.
| | - Guilherme Menezes Lage
- Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, CEP 31270-901, Belo Horizonte, MG, Brazil.
| | - Leandro Ricardo Altimari
- State University of Londrina, Londrina. Rodovia Celso Garcia Cid - Pr 445, Km 380, Cx. Postal 10.011, CEP 86057-970, Campus Universitário, Londrina, PR, Brazil.
| | - Victor Hugo Alves Okazaki
- State University of Londrina, Londrina. Rodovia Celso Garcia Cid - Pr 445, Km 380, Cx. Postal 10.011, CEP 86057-970, Campus Universitário, Londrina, PR, Brazil.
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Ghasemian-Shirvan E, Ungureanu R, Melo L, van Dun K, Kuo MF, Nitsche MA, Meesen RLJ. Optimizing the Effect of tDCS on Motor Sequence Learning in the Elderly. Brain Sci 2023; 13:brainsci13010137. [PMID: 36672118 PMCID: PMC9857096 DOI: 10.3390/brainsci13010137] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023] Open
Abstract
One of the most visible effects of aging, even in healthy, normal aging, is a decline in motor performance. The range of strategies applicable to counteract this deterioration has increased. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique that can promote neuroplasticity, has recently gained attention. However, knowledge about optimized tDCS parameters in the elderly is limited. Therefore, in this study, we investigated the effect of different anodal tDCS intensities on motor sequence learning in the elderly. Over the course of four sessions, 25 healthy older adults (over 65 years old) completed the Serial Reaction Time Task (SRTT) while receiving 1, 2, or 3 mA of anodal or sham stimulation over the primary motor cortex (M1). Additionally, 24 h after stimulation, motor memory consolidation was assessed. The results confirmed that motor sequence learning in all tDCS conditions was maintained the following day. While increased anodal stimulation intensity over M1 showed longer lasting excitability enhancement in the elderly in a prior study, the combination of higher intensity stimulation with an implicit motor learning task showed no significant effect. Future research should focus on the reason behind this lack of effect and probe alternative stimulation protocols.
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Affiliation(s)
- Ensiyeh Ghasemian-Shirvan
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
- International Graduate School of Neuroscience, Ruhr-University Bochum, 44780 Bochum, Germany
- Neuroplasticity and Movement Control Research Group, REVAL Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Ruxandra Ungureanu
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
- Institute of Cognitive Neuroscience, Ruhr-University Bochum, 44801 Bochum, Germany
| | - Lorena Melo
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
- International Graduate School of Neuroscience, Ruhr-University Bochum, 44780 Bochum, Germany
| | - Kim van Dun
- Neuroplasticity and Movement Control Research Group, REVAL Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Min-Fang Kuo
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
| | - Michael A. Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Center for Working Environment and Human Factors, 44139 Dortmund, Germany
- University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Protestant Hospital of Bethel Foundation, University Hospital OWL, Bielefeld University, 33617 Bielefeld, Germany
| | - Raf L. J. Meesen
- Neuroplasticity and Movement Control Research Group, REVAL Rehabilitation Research Center, REVAL, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Movement Control and Neuroplasticity Research Group, Department of Movement Sciences, Group Biomedical Sciences, KU Leuven, 3001 Leuven, Belgium
- Correspondence:
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Schwell G, Kozol Z, Tarshansky D, Einat M, Frenkel-Toledo S. The effect of action observation combined with high-definition transcranial direct current stimulation on motor performance in healthy adults: A randomized controlled trial. Front Hum Neurosci 2023; 17:1126510. [PMID: 36936614 PMCID: PMC10014919 DOI: 10.3389/fnhum.2023.1126510] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 02/14/2023] [Indexed: 03/05/2023] Open
Abstract
Action observation (AO) can improve motor performance in humans, probably via the human mirror neuron system. In addition, there is some evidence that transcranial direct current stimulation (tDCS) can improve motor performance. However, it is yet to be determined whether AO combined with tDCS has an enhanced effect on motor performance. We investigated the effect of AO combined with high-definition tDCS (HD-tDCS) targeting the inferior parietal lobe (IPL) and inferior frontal gyrus (IFG), the main aggregates of the human mirror neuron system, on motor performance in healthy adults and compared the immediate vs. 24-h retention test effects (anodal electrodes were placed over these regions of interest). Sixty participants were randomly divided into three groups that received one of the following single-session interventions: (1) observation of a video clip that presented reaching movement sequences toward five lighted units + active HD-tDCS stimulation (AO + active HD-tDCS group); (2) observation of a video clip that presented the same reaching movement sequences + sham HD-tDCS stimulation (AO + sham HD-tDCS group); and (3) observation of a video clip that presented neutral movie while receiving sham stimulation (NM + sham HD-tDCS group). Subjects' reaching performance was tested before and immediately after each intervention and following 24 h. Subjects performed reaching movements toward units that were activated in the same order as the observed sequence during pretest, posttest, and retest. Occasionally, the sequence order was changed by beginning the sequence unexpectedly with a different activated unit. Outcome measures included mean Reaching Time and difference between the Reaching Time of the unexpected and expected reaching movements (Delta). In the posttest and retest, Reaching Time and Delta improved in the AO + sham HD-tDCS group compared to the NM + HD-sham tDCS group. In addition, at posttest, Delta improved in the AO + active HD-tDCS group compared to the NM + sham HD-tDCS group. It appears that combining a montage of active HD-tDCS, which targets the IPL and IFG, with AO interferes with the positive effects of AO alone on the performance of reaching movement sequences.
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Affiliation(s)
- Gidon Schwell
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Zvi Kozol
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - David Tarshansky
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
| | - Moshe Einat
- Department of Electrical and Electronic Engineering, Ariel University, Ariel, Israel
| | - Silvi Frenkel-Toledo
- Department of Physical Therapy, School of Health Sciences, Ariel University, Ariel, Israel
- Department of Neurological Rehabilitation, Loewenstein Rehabilitation Medical Center, Ra’anana, Israel
- *Correspondence: Silvi Frenkel-Toledo,
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Kaminski E, Maudrich T, Bassler P, Ordnung M, Villringer A, Ragert P. tDCS over the primary motor cortex contralateral to the trained hand enhances cross-limb transfer in older adults. Front Aging Neurosci 2022; 14:935781. [PMID: 36204550 PMCID: PMC9530461 DOI: 10.3389/fnagi.2022.935781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 08/29/2022] [Indexed: 11/17/2022] Open
Abstract
Transferring a unimanual motor skill to the untrained hand, a phenomenon known as cross-limb transfer, was shown to deteriorate as a function of age. While transcranial direct current stimulation (tDCS) ipsilateral to the trained hand facilitated cross-limb transfer in older adults, little is known about the contribution of the contralateral hemisphere to cross-limb transfer. In the present study, we investigated whether tDCS facilitates cross-limb transfer in older adults when applied over the motor cortex (M1) contralateral to the trained hand. Furthermore, the study aimed at investigating short-term recovery of tDCS-associated cross-limb transfer. In a randomized, double-blinded, sham-controlled setting, 30 older adults (67.0 ± 4.6 years, 15 female) performed a short grooved-pegboard training using their left hand, while anodal (a-tDCS) or sham-tDCS (s-tDCS) was applied over right M1 for 20 min. Left (LHtrained) - and right-hand (RHuntrained) performance was tested before and after training and in three recovery measures 15, 30 and 45 min after training. LHtrained performance improved during both a-tDCS and s-tDCS and improvements persisted during recovery measures for at least 45 min. RHuntrained performance improved only following a-tDCS but not after s-tDCS and outlasted the stimulation period for at least 45 min. Together, these data indicate that tDCS over the M1 contralateral to the trained limb is capable of enhancing cross-limb transfer in older adults, thus showing that cross-limb transfer is mediated not only by increased bi-hemispheric activation.
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Affiliation(s)
- Elisabeth Kaminski
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- *Correspondence: Elisabeth Kaminski,
| | - Tom Maudrich
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Pauline Bassler
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Madeleine Ordnung
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Arno Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
- Charité-Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Patrick Ragert
- Department of Movement Neuroscience, Faculty of Sport Science, Leipzig University, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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The effects of concurrent bilateral anodal tDCS of primary motor cortex and cerebellum on corticospinal excitability: a randomized, double-blind sham-controlled study. Brain Struct Funct 2022; 227:2395-2408. [PMID: 35984496 PMCID: PMC9418272 DOI: 10.1007/s00429-022-02533-7] [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: 06/28/2021] [Accepted: 06/30/2022] [Indexed: 11/11/2022]
Abstract
Transcranial direct current stimulation (tDCS) applied to the primary motor cortex (M1), and cerebellum (CB) can change the level of M1 corticospinal excitability (CSE). A randomized double-blinded crossover, the sham-controlled study design was used to investigate the effects of concurrent bilateral anodal tDCS of M1 and CB (concurrent bilateral a-tDCSM1+CB) on the CSE. Twenty-one healthy participants were recruited in this study. Each participant received anodal-tDCS (a-tDCS) of 2 mA, 20 min in four pseudo-randomized, counterbalanced sessions, separated by at least 7 days (7.11 days ± 0.65). These sessions were bilateral M1 stimulation (bilateral a-tDCSM1), bilateral cerebellar stimulation (bilateral a-tDCSCB), concurrent bilateral a-tDCSM1+CB, and sham stimulation (bilateral a-tDCSSham). Transcranial magnetic stimulation (TMS) was delivered over the left M1, and motor evoked potentials (MEPs) of a contralateral hand muscle were recorded before and immediately after the intervention to measure CSE changes. Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long interval intracortical inhibition (LICI) were assessed with paired-pulse TMS protocols. Anodal-tDCS significantly increased CSE after concurrent bilateral a-tDCSM1+CB and bilateral a-tDCSCB. Interestingly, CSE was decreased after bilateral a-tDCSM1. Respective alterations in SICI, LICI, and ICF were seen, including increased SICI and decreased ICF, which indicate the involvement of glutamatergic and GABAergic systems in these effects. These results confirm that the concurrent bilateral a-tDCSM1+CB have a facilitatory effect on CSE, whereas bilateral a-tDCSM1 exert some inhibitory effects. Moreover, the effects of the 2 mA, 20 min a-tDCS on the CB were consistent with its effects on the M1.
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Van der Cruijsen J, Jonker ZD, Andrinopoulou ER, Wijngaarden JE, Tangkau DA, Tulen JHM, Frens MA, Ribbers GM, Selles RW. Transcranial Direct Current Stimulation Targeting the Entire Motor Network Does Not Increase Corticospinal Excitability. Front Hum Neurosci 2022; 16:842954. [PMID: 35601898 PMCID: PMC9114302 DOI: 10.3389/fnhum.2022.842954] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/11/2022] [Indexed: 11/21/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) over the contralateral primary motor cortex of the target muscle (conventional tDCS) has been described to enhance corticospinal excitability, as measured with transcranial magnetic stimulation. Recently, tDCS targeting the brain regions functionally connected to the contralateral primary motor cortex (motor network tDCS) was reported to enhance corticospinal excitability more than conventional tDCS. We compared the effects of motor network tDCS, 2 mA conventional tDCS, and sham tDCS on corticospinal excitability in 21 healthy participants in a randomized, single-blind within-subject study design. We applied tDCS for 12 min and measured corticospinal excitability with TMS before tDCS and at 0, 15, 30, 45, and 60 min after tDCS. Statistical analysis showed that neither motor network tDCS nor conventional tDCS significantly increased corticospinal excitability relative to sham stimulation. Furthermore, the results did not provide evidence for superiority of motor network tDCS over conventional tDCS. Motor network tDCS seems equally susceptible to the sources of intersubject and intrasubject variability previously observed in response to conventional tDCS.
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Affiliation(s)
- Joris Van der Cruijsen
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Zeb D. Jonker
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Rijndam Rehabilitation Centre, Rotterdam, Netherlands
| | - Eleni-Rosalina Andrinopoulou
- Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Jessica E. Wijngaarden
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Biomechanical Engineering, Delft University of Technology, Delft, Netherlands
| | - Ditte A. Tangkau
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Joke H. M. Tulen
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Maarten A. Frens
- Department of Neuroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Gerard M. Ribbers
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Rijndam Rehabilitation Centre, Rotterdam, Netherlands
| | - Ruud W. Selles
- Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
- Department of Plastic and Reconstructive Surgery and Hand Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, Netherlands
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10
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Klomjai W, Aneksan B. A randomized sham-controlled trial on the effects of dual-tDCS "during" physical therapy on lower limb performance in sub-acute stroke and a comparison to the previous study using a "before" stimulation protocol. BMC Sports Sci Med Rehabil 2022; 14:68. [PMID: 35428346 PMCID: PMC9013129 DOI: 10.1186/s13102-022-00463-9] [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: 10/13/2021] [Accepted: 04/04/2022] [Indexed: 11/26/2022] Open
Abstract
Background Dual-transcranial direct current stimulation (tDCS) has been used to rebalance the cortical excitability of both hemispheres following unilateral-stroke. Our previous study showed a positive effect from a single-session of dual-tDCS applied before physical therapy (PT) on lower limb performance. However, it is still undetermined if other timings of brain stimulation (i.e., during motor practice) induce better effects. The objective of this study was to examine the effect of a single-session of dual-tDCS “during” PT on lower limb performance in sub-acute stroke and then compare the results with our previous data using a “before” stimulation paradigm. Method For the current “during” protocol, 19 participants were participated in a randomized sham-controlled crossover trial. Dual-tDCS over the M1 of both cortices (2 mA) was applied during the first 20 min of PT. The Timed Up and Go and Five-Times-Sit-To-Stand tests were assessed at pre- and post-intervention and 1-week follow-up. Then, data from the current study were compared with those of the previous “before” study performed in a different group of 19 subjects. Both studies were compared by the difference of mean changes from the baseline. Results Dual-tDCS “during” PT and the sham group did not significantly improve lower limb performance. By comparing with the previous data, performance in the “before” group was significantly greater than in the “during” and sham groups at post-intervention, while at follow-up the “before” group had better improvement than sham, but not greater than the “during” group. Conclusion A single-session of dual-tDCS during PT induced no additional advantage on lower limb performance. The “before” group seemed to induce better acute effects; however, the benefits of the after-effects on motor learning for both stimulation protocols were probably not different. Trial registration Current randomized controlled trials was prospectively registered at the clinicaltrials.gov, registration number: NCT04051671. The date of registration was 09/08/2019.
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Affiliation(s)
- Wanalee Klomjai
- Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, 73170, Thailand.,Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand
| | - Benchaporn Aneksan
- Neuro Electrical Stimulation Laboratory (NeuE), Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, 73170, Thailand. .,Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
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11
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Rivera-Urbina GN, Molero-Chamizo A, Nitsche MA. Discernible effects of tDCS over the primary motor and posterior parietal cortex on different stages of motor learning. Brain Struct Funct 2022; 227:1115-1131. [PMID: 35037127 DOI: 10.1007/s00429-021-02451-0] [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: 11/03/2020] [Accepted: 12/29/2021] [Indexed: 11/28/2022]
Abstract
Implicit motor learning and memory involve complex cortical and subcortical networks. The induction of plasticity in these network components via non-invasive brain stimulation, including transcranial direct current stimulation (tDCS), has shown to improve motor learning. However, studies showing these effects are mostly restricted to stimulation of the primary motor cortex (M1) during the early stage of learning. Because of this, we aimed to explore the efficacy of anodal tDCS applied over the posterior parietal cortex (PPC), which is involved in memory processes, on serial reaction time task (SRTT) performance. Specifically, to evaluate the involvement of both motor learning network components, we compared the effects of tDCS applied over regions corresponding to M1 and PPC during the early and late stages of learning. The results revealed a selective improvement of reaction time (RT) during anodal stimulation over the PPC in the late stage of learning. These findings support the assumption that the PPC is relevant during specific phases of learning, at least for SRTT performance. The results also indicate that not only the target area (i.e., PPC), but also timing is crucial for achieving the effects of stimulation on motor learning.
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Affiliation(s)
- Guadalupe Nathzidy Rivera-Urbina
- Autonomous University of Baja California, Blvd Juan A Zertuche y Blvd de los Lagos s/n Fracc, Valle Dorado, C.P. 22890, Ensenada, Baja California, México.
| | | | - Michael A Nitsche
- Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.,Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
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12
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Simis M, Fregni F, Battistella LR. Transcranial direct current stimulation combined with robotic training in incomplete spinal cord injury: a randomized, sham-controlled clinical trial. Spinal Cord Ser Cases 2021; 7:87. [PMID: 34580282 DOI: 10.1038/s41394-021-00448-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN A randomized, sham-controlled clinical trial. OBJECTIVE To test the effects of tDCS, combined with robotic training, on gait disability in SCI. Our hypothesis was that participants who received active tDCS would experience greater walking gains, as indexed by the WISCI-II, than those who received sham tDCS. SETTING University of São Paulo, Brazil. METHODS This randomized, double-blind study comprised 43 participants with incomplete SCI who underwent 30 sessions of active (n = 21) or sham (n = 22) tDCS (20 min, 2 mA) before every Lokomat session of 30 min (3 times a week over 12 weeks or 5 times a week over 6 weeks). The main outcome was the improvement in WISCI-II. Participants were assessed at baseline, after 15 and 30 sessions of Lokomat, and after three months of treatment. RESULTS There was a significant difference in the percentage of participants that improved in WISCI-II at the 30-session, compared with baseline: 33.3% in the sham group and 70.0% in the active group (p = 0.046; OR: 3.7; 95% CI: 1.0-13.5). At the follow-up, the improvement compared with baseline in the sham group was 35.0% vs. 68.4% for the active group (p = 0.046; OR: 3.7; 95% CI: 1.0-13.5). There was no significant difference at the 15-session. CONCLUSION Thirty sessions of active tDCS is associated with a significant improvement in walking, compared to sham. Moreover, 15 sessions had no significant effect. The improvement in WISCI-II can be related to different aspects of motor learning, including motor recovery and compensation.
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Affiliation(s)
- Marcel Simis
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.
| | - Felipe Fregni
- Institute of Physical and Rehabilitation Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Linamara R Battistella
- Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
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13
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Age-related changes in motor cortex plasticity assessed with non-invasive brain stimulation: an update and new perspectives. Exp Brain Res 2021; 239:2661-2678. [PMID: 34269850 DOI: 10.1007/s00221-021-06163-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 06/22/2021] [Indexed: 12/24/2022]
Abstract
It is commonly accepted that the brains capacity to change, known as plasticity, declines into old age. Recent studies have used a variety of non-invasive brain stimulation (NIBS) techniques to examine this age-related decline in plasticity in the primary motor cortex (M1), but the effects seem inconsistent and difficult to unravel. The purpose of this review is to provide an update on studies that have used different NIBS techniques to assess M1 plasticity with advancing age and offer some new perspective on NIBS strategies to boost plasticity in the ageing brain. We find that early studies show clear differences in M1 plasticity between young and older adults, but many recent studies with motor training show no decline in use-dependent M1 plasticity with age. For NIBS-induced plasticity in M1, some protocols show more convincing differences with advancing age than others. Therefore, our view from the NIBS literature is that it should not be automatically assumed that M1 plasticity declines with age. Instead, the effects of age are likely to depend on how M1 plasticity is measured, and the characteristics of the elderly population tested. We also suggest that NIBS performed concurrently with motor training is likely to be most effective at producing improvements in M1 plasticity and motor skill learning in older adults. Proposed NIBS techniques for future studies include combining multiple NIBS protocols in a co-stimulation approach, or NIBS strategies to modulate intracortical inhibitory mechanisms, in an effort to more effectively boost M1 plasticity and improve motor skill learning in older adults.
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14
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Nakashima S, Koeda M, Ikeda Y, Hama T, Funayama T, Akiyama T, Arakawa R, Tateno A, Suzuki H, Okubo Y. Effects of anodal transcranial direct current stimulation on implicit motor learning and language-related brain function: An fMRI study. Psychiatry Clin Neurosci 2021; 75:200-207. [PMID: 33576537 DOI: 10.1111/pcn.13208] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/09/2021] [Accepted: 02/01/2021] [Indexed: 12/22/2022]
Abstract
AIM Anodal transcranial direct current stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) is known as a useful application for improving depressive symptoms or cognitive performance. Antidepressive effects by anodal tDCS over the left DLPFC are expected, but the neural mechanisms of these effects are still unclear. Further, in depression, reduced performance and left prefrontal hypofunction during the verbal fluency task (VFT) are generally known. However, few studies have examined the effect of tDCS on the language-related cerebral network. We aimed to investigate whether anodal tDCS at the left DLPFC affects cognitive performance and the neural basis of verbal fluency. METHODS Nineteen healthy volunteers participated in this study. The effects of tDCS on cognitive behavior and cerebral function were evaluated by (i) performance and accuracy of implicit/explicit motor learning task (serial reaction time task/sequential finger-tapping task), and (ii) cerebral activation while the subjects were performing the VFT by using a functional MRI protocol of a randomized sham-controlled, within-subjects crossover design. RESULTS Reaction times of the implicit motor learning task were significantly faster with tDCS in comparison with the sham. Further, language-related left prefrontal-parahippocampal-parietal activation was significantly less with tDCS compared with the sham. Significant correlation was observed between shortened response time in serial reaction time task and decreased cerebral activation during VFT with tDCS. CONCLUSION Anodal tDCS over the left DLPFC could improve cognitive behavior of implicit motor learning by improving brain function of the frontoparietal-parahippocampal region related to motor learning, as well as language-related regions.
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Affiliation(s)
- Soichiro Nakashima
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Michihiko Koeda
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yumiko Ikeda
- Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Tomoko Hama
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan.,Faculty of Health Science Technology, Bunkyo Gakuin University, Tokyo, Japan
| | - Takuya Funayama
- Anesthesiology and Clinical Physiology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tomomi Akiyama
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Ryosuke Arakawa
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Amane Tateno
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Hidenori Suzuki
- Department of Pharmacology, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
| | - Yoshiro Okubo
- Department of Neuropsychiatry, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan
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15
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Small Enhancement of Bimanual Typing Performance after 20 Sessions of tDCS in Healthy Young Adults. Neuroscience 2021; 466:26-35. [PMID: 33974964 DOI: 10.1016/j.neuroscience.2021.05.001] [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] [Received: 10/28/2020] [Revised: 03/04/2021] [Accepted: 05/02/2021] [Indexed: 01/10/2023]
Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that may improve motor learning. However, the long-term effects of tDCS have not been explored, and the ecological validity of the evaluated tasks was limited. To determine whether 20 sessions of tDCS over the primary motor cortex (M1) would enhance the performance of a complex life motor skill, i.e., typing, in healthy young adults. Healthy young adults (n = 60) were semi-randomly assigned to three groups: the tDCS group (n = 20) received anodal tDCS over M1; the SHAM group (n = 20) received sham tDCS, both while performing a typing task; and the Control group (CON, n = 20) only performed the typing task. Typing speed and errors at maximum (mTT) and submaximal (iTT) speeds were measured before training, and after 10 and 20 sessions of tDCS. Every subject increased maximum typing speed after 10 and 20 tDCS sessions, with no significant differences (p > 0.05) between the groups. The number of errors at submaximal rates decreased significantly (p < 0.05) by 4% after 10 tDCS sessions compared with the 3% increase in the SHAM and the 2% increase in the CON groups. Between the 10th and 20th tDCS sessions, the number of typing errors increased significantly in all groups. While anodal tDCS reduced typing errors marginally, such performance-enhancing effects plateaued after 10 sessions without any further improvements in typing speed. These findings suggest that long-term tDCS may not have functionally relevant effects on healthy young adults' typing performance.
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16
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Aloi D, della Rocchetta AI, Ditchfield A, Coulborn S, Fernández-Espejo D. Therapeutic Use of Transcranial Direct Current Stimulation in the Rehabilitation of Prolonged Disorders of Consciousness. Front Neurol 2021; 12:632572. [PMID: 33897592 PMCID: PMC8058460 DOI: 10.3389/fneur.2021.632572] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/09/2021] [Indexed: 12/20/2022] Open
Abstract
Patients with Prolonged Disorders of Consciousness (PDOC) have catastrophic disabilities and very complex needs for care. Therapeutic options are very limited, and patients often show little functional improvement over time. Neuroimaging studies have demonstrated that a significant number of PDOC patients retain a high level of cognitive functioning, and in some cases even awareness, and are simply unable to show this with their external behavior - a condition known as cognitive-motor dissociation (CMD). Despite vast implications for diagnosis, the discovery of covert cognition in PDOC patients is not typically associated with a more favorable prognosis, and the majority of patients will remain in a permanent state of low responsiveness. Recently, transcranial direct current stimulation (tDCS) has attracted attention as a potential therapeutic tool in PDOC. Research to date suggests that tDCS can lead to clinical improvements in patients with a minimally conscious state (MCS), especially when administered over multiple sessions. While promising, the outcomes of these studies have been highly inconsistent, partially due to small sample sizes, heterogeneous methodologies (in terms of both tDCS parameters and outcome measures), and limitations related to electrode placement and heterogeneity of brain damage inherent to PDOC. In addition, we argue that neuroimaging and electrophysiological assessments may serve as more sensitive biomarkers to identify changes after tDCS that are not yet apparent behaviorally. Finally, given the evidence that concurrent brain stimulation and physical therapy can enhance motor rehabilitation, we argue that future studies should focus on the integration of tDCS with conventional rehabilitation programmes from the subacute phase of care onwards, to ascertain whether any synergies exist.
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Affiliation(s)
- Davide Aloi
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | | | - Alice Ditchfield
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Sean Coulborn
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Davinia Fernández-Espejo
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
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17
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Karabanov AN, Shindo K, Shindo Y, Raffin E, Siebner HR. Multimodal Assessment of Precentral Anodal TDCS: Individual Rise in Supplementary Motor Activity Scales With Increase in Corticospinal Excitability. Front Hum Neurosci 2021; 15:639274. [PMID: 33762917 PMCID: PMC7982814 DOI: 10.3389/fnhum.2021.639274] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/01/2021] [Indexed: 11/29/2022] Open
Abstract
Background Transcranial direct current stimulation (TDCS) targeting the primary motor hand area (M1-HAND) may induce lasting shifts in corticospinal excitability, but after-effects show substantial inter-individual variability. Functional magnetic resonance imaging (fMRI) can probe after-effects of TDCS on regional neural activity on a whole-brain level. Objective Using a double-blinded cross-over design, we investigated whether the individual change in corticospinal excitability after TDCS of M1-HAND is associated with changes in task-related regional activity in cortical motor areas. Methods Seventeen healthy volunteers (10 women) received 20 min of real (0.75 mA) or sham TDCS on separate days in randomized order. Real and sham TDCS used the classic bipolar set-up with the anode placed over right M1-HAND. Before and after each TDCS session, we recorded motor evoked potentials (MEP) from the relaxed left first dorsal interosseus muscle after single-pulse transcranial magnetic stimulation(TMS) of left M1-HAND and performed whole-brain fMRI at 3 Tesla while participants completed a visuomotor tracking task with their left hand. We also assessed the difference in MEP latency when applying anterior-posterior and latero-medial TMS pulses to the precentral hand knob (AP-LM MEP latency). Results Real TDCS had no consistent aftereffects on mean MEP amplitude, task-related activity or motor performance. Individual changes in MEP amplitude, measured directly after real TDCS showed a positive linear relationship with individual changes in task-related activity in the supplementary motor area and AP-LM MEP latency. Conclusion Functional aftereffects of classical bipolar anodal TDCS of M1-HAND on the motor system vary substantially across individuals. Physiological features upstream from the primary motor cortex may determine how anodal TDCS changes corticospinal excitability.
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Affiliation(s)
- Anke Ninija Karabanov
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Nutrition, Exercise and Sports, University of Copenhagen, Copenhagen, Denmark
| | - Keiichiro Shindo
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjyuku-ku, Japan
| | - Yuko Shindo
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Department of Rehabilitation Medicine, Keio University School of Medicine, Shinjyuku-ku, Japan
| | - Estelle Raffin
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Center for Neuroprosthetics and Brain Mind Institute, Swiss Federal Institute of Technology, Geneva, Switzerland
| | - Hartwig Roman Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark.,Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
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18
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Gregoret L, Zamorano AM, Graven‐Nielsen T. Effects of multifocal transcranial direct current stimulation targeting the motor network during prolonged experimental pain. Eur J Pain 2021; 25:1241-1253. [DOI: 10.1002/ejp.1743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Luisina Gregoret
- Center for Neuroplasticity and Pain (CNAP) Department of Health Science and Technology Faculty of Medicine Aalborg University Aalborg Denmark
| | - Anna M. Zamorano
- Center for Neuroplasticity and Pain (CNAP) Department of Health Science and Technology Faculty of Medicine Aalborg University Aalborg Denmark
| | - Thomas Graven‐Nielsen
- Center for Neuroplasticity and Pain (CNAP) Department of Health Science and Technology Faculty of Medicine Aalborg University Aalborg Denmark
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19
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Sánchez-León CA, Cordones I, Ammann C, Ausín JM, Gómez-Climent MA, Carretero-Guillén A, Sánchez-Garrido Campos G, Gruart A, Delgado-García JM, Cheron G, Medina JF, Márquez-Ruiz J. Immediate and after effects of transcranial direct-current stimulation in the mouse primary somatosensory cortex. Sci Rep 2021; 11:3123. [PMID: 33542338 PMCID: PMC7862679 DOI: 10.1038/s41598-021-82364-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/24/2020] [Indexed: 01/30/2023] Open
Abstract
Transcranial direct-current stimulation (tDCS) is a non-invasive brain stimulation technique consisting in the application of weak electric currents on the scalp. Although previous studies have demonstrated the clinical value of tDCS for modulating sensory, motor, and cognitive functions, there are still huge gaps in the knowledge of the underlying physiological mechanisms. To define the immediate impact as well as the after effects of tDCS on sensory processing, we first performed electrophysiological recordings in primary somatosensory cortex (S1) of alert mice during and after administration of S1-tDCS, and followed up with immunohistochemical analysis of the stimulated brain regions. During the application of cathodal and anodal transcranial currents we observed polarity-specific bidirectional changes in the N1 component of the sensory-evoked potentials (SEPs) and associated gamma oscillations. On the other hand, 20 min of cathodal stimulation produced significant after-effects including a decreased SEP amplitude for up to 30 min, a power reduction in the 20-80 Hz range and a decrease in gamma event related synchronization (ERS). In contrast, no significant changes in SEP amplitude or power analysis were observed after anodal stimulation except for a significant increase in gamma ERS after tDCS cessation. The polarity-specific differences of these after effects were corroborated by immunohistochemical analysis, which revealed an unbalance of GAD 65-67 immunoreactivity between the stimulated versus non-stimulated S1 region only after cathodal tDCS. These results highlight the differences between immediate and after effects of tDCS, as well as the asymmetric after effects induced by anodal and cathodal stimulation.
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Affiliation(s)
- Carlos A. Sánchez-León
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Isabel Cordones
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Claudia Ammann
- grid.428486.40000 0004 5894 9315HM CINAC, Hospital Universitario HM Puerta del Sur, HM Hospitales, Madrid, Spain
| | - José M. Ausín
- grid.157927.f0000 0004 1770 5832Instituto de Investigación E Innovación en Bioingeniería, Universidad Politécnica de Valencia, Valencia, Spain
| | - María A. Gómez-Climent
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Alejandro Carretero-Guillén
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Guillermo Sánchez-Garrido Campos
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Agnès Gruart
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - José M. Delgado-García
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
| | - Guy Cheron
- grid.8364.90000 0001 2184 581XLaboratory of Electrophysiology, Université de Mons, Mons, Belgium ,grid.4989.c0000 0001 2348 0746Laboratory of Neurophysiology and Movement Biomechanics, ULB Neuroscience Institute, Université Libre de Bruxelles, Brussels, Belgium
| | - Javier F. Medina
- grid.39382.330000 0001 2160 926XDepartment of Neuroscience, Baylor College of Medicine, Houston, TX USA
| | - Javier Márquez-Ruiz
- grid.15449.3d0000 0001 2200 2355Department of Physiology, Anatomy and Cell Biology, Pablo de Olavide University, Ctra. de Utrera, km. 1, 41013 Seville, Spain
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20
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Khanmohammadi R, Sheikh M, Bagherzadeh F, Hoomanian D, Khajavi D, Shaw I. Effect Of Cognitive And Exercise Rehabilitation On Gait In Male Schizophrenic Patients Suffering From Depression Disorder. RUSSIAN OPEN MEDICAL JOURNAL 2020. [DOI: 10.15275/rusomj.2020.0409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective ― The purpose of this study was to investigate the effect of cognitive and exercise rehabilitation training, and non-invasive brain stimulation on the gait of schizophrenic patients suffering from depression disorder. Methods ― Fifty-five male schizophrenic patients suffering from depression disorder aged 24 to 66 years were assigned to either a control group (n=10), cognitive rehabilitation group (n=10), exercise rehabilitation training group (n=13), transcranial direct current stimulation (tDCS) group (n=11) or multimodal intervention group (n=11). Gait was measured using a 10-meter gait speed test under normal, in dual-task cognitive-gait, and in dual task motor-gait conditions. Results ― Gait speed during the 10-meter walk test under normal conditions was significantly (P≤0.05) different from pre- to post-test in the exercise rehabilitation training, and cognitive rehabilitation multimodal intervention. Gait speed during the dual task motor-gait condition was significantly different from pre- to post-test in the exercise rehabilitation training, cognitive rehabilitation and, multimodal intervention groups (P≤0.05). Gait speed during the dual task cognitive-gait condition significantly changed from pre- to post-test following exercise rehabilitation training, cognitive rehabilitation, tDCS and the multimodal intervention group (P≤0.05). Conclusion ― This study’s findings demonstrate that exercise rehabilitation training, cognitive rehabilitation, and multimodal interventions could assist with preventing falls within Schizophrenic patients suffering from depression and thereby improve their functional independence.
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21
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Kim T, Kim H, Wright DL. Improving consolidation by applying anodal transcranial direct current stimulation at primary motor cortex during repetitive practice. Neurobiol Learn Mem 2020; 178:107365. [PMID: 33348047 DOI: 10.1016/j.nlm.2020.107365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/22/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022]
Abstract
Engagement of primary motor cortex (M1) is important for successful consolidation of motor skills. Recruitment of M1 has been reported to be more extensive during interleaved compared to repetitive practice and this differential recruitment has been proposed to contribute to the long-term retention benefit associated with interleaved practice. The present study administered anodal direct current stimulation (tDCS) during repetitive practice in an attempt to increase M1 activity throughout repetitive practice with the goal to improve the retention performance of individuals exposed to this training format. Fifty-four participants were assigned to one of three experimental groups that included: interleaved-sham, repetitive-sham, and repetitive-anodal tDCS. Real or sham stimulation at M1 was administered during practice of three motor sequences for approximately 20-min. Performance in the absence of any stimulation was evaluated prior to practice, immediately after practice as well as at 6-hr, and 24-h after practice was complete. As expected, for the sham conditions, interleaved as opposed repetitive practice resulted in superior offline gain. This was manifest as more rapid stabilization of performance after 6-h as well as an enhancement in performance with a period of overnight sleep. Administration of anodal stimulation at M1 during repetitive practice improved offline gains assessed at both 6-h and 24-h tests compared to the repetitive practice sham group. These data are consistent with the claims that reduced activation at M1 during repetitive practice impedes offline gain relative to interleaved practice and that M1 plays an important role in early consolidation of novel motor skills even in the context of the simultaneous acquisition of multiple new skills. Moreover, these findings highlight a possible role for M1 during sleep-related consolidation, possibly as part of a network including the dorsal premotor region, which supports delayed performance enhancement.
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Affiliation(s)
- Taewon Kim
- Division of Stroke and Vascular Neurology, Department of Neurology, Duke University Medical Center, Durham, NC, USA.
| | - Hakjoo Kim
- Non-Invasive Brain Stimulation Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
| | - David L Wright
- Non-Invasive Brain Stimulation Laboratory, Department of Health and Kinesiology, Texas A&M University, College Station, TX, USA.
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Baptista AF, Baltar A, Okano AH, Moreira A, Campos ACP, Fernandes AM, Brunoni AR, Badran BW, Tanaka C, de Andrade DC, da Silva Machado DG, Morya E, Trujillo E, Swami JK, Camprodon JA, Monte-Silva K, Sá KN, Nunes I, Goulardins JB, Bikson M, Sudbrack-Oliveira P, de Carvalho P, Duarte-Moreira RJ, Pagano RL, Shinjo SK, Zana Y. Applications of Non-invasive Neuromodulation for the Management of Disorders Related to COVID-19. Front Neurol 2020; 11:573718. [PMID: 33324324 PMCID: PMC7724108 DOI: 10.3389/fneur.2020.573718] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/11/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Novel coronavirus disease (COVID-19) morbidity is not restricted to the respiratory system, but also affects the nervous system. Non-invasive neuromodulation may be useful in the treatment of the disorders associated with COVID-19. Objective: To describe the rationale and empirical basis of the use of non-invasive neuromodulation in the management of patients with COVID-10 and related disorders. Methods: We summarize COVID-19 pathophysiology with emphasis of direct neuroinvasiveness, neuroimmune response and inflammation, autonomic balance and neurological, musculoskeletal and neuropsychiatric sequela. This supports the development of a framework for advancing applications of non-invasive neuromodulation in the management COVID-19 and related disorders. Results: Non-invasive neuromodulation may manage disorders associated with COVID-19 through four pathways: (1) Direct infection mitigation through the stimulation of regions involved in the regulation of systemic anti-inflammatory responses and/or autonomic responses and prevention of neuroinflammation and recovery of respiration; (2) Amelioration of COVID-19 symptoms of musculoskeletal pain and systemic fatigue; (3) Augmenting cognitive and physical rehabilitation following critical illness; and (4) Treating outbreak-related mental distress including neurological and psychiatric disorders exacerbated by surrounding psychosocial stressors related to COVID-19. The selection of the appropriate techniques will depend on the identified target treatment pathway. Conclusion: COVID-19 infection results in a myriad of acute and chronic symptoms, both directly associated with respiratory distress (e.g., rehabilitation) or of yet-to-be-determined etiology (e.g., fatigue). Non-invasive neuromodulation is a toolbox of techniques that based on targeted pathways and empirical evidence (largely in non-COVID-19 patients) can be investigated in the management of patients with COVID-19.
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Affiliation(s)
- Abrahão Fontes Baptista
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Brazilian Institute of Neuroscience and Neurotechnology Centros de Pesquisa, Investigação e Difusão - Fundação de Amparo à Pesquisa do Estado de São Paulo (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, Brazil
- Laboratory of Medical Investigations 54 (LIM-54), São Paulo University, São Paulo, Brazil
| | - Adriana Baltar
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Specialized Neuromodulation Center—Neuromod, Recife, Brazil
| | - Alexandre Hideki Okano
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Brazilian Institute of Neuroscience and Neurotechnology Centros de Pesquisa, Investigação e Difusão - Fundação de Amparo à Pesquisa do Estado de São Paulo (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, Brazil
- Graduate Program in Physical Education, State University of Londrina, Londrina, Brazil
| | - Alexandre Moreira
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | | | - Ana Mércia Fernandes
- Centro de Dor, LIM-62, Departamento de Neurologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - André Russowsky Brunoni
- Serviço Interdisciplinar de Neuromodulação, Laboratório de Neurociências (LIM-27), Instituto Nacional de Biomarcadores em Neuropsiquiatria, São Paulo, Brazil
- Instituto de Psiquiatria, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Bashar W. Badran
- Department of Psychiatry, Medical University of South Carolina, Charleston, SC, United States
| | - Clarice Tanaka
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Laboratory of Medical Investigations 54 (LIM-54), São Paulo University, São Paulo, Brazil
- Instituto Central, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Daniel Ciampi de Andrade
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Centro de Dor, LIM-62, Departamento de Neurologia, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | | | - Edgard Morya
- Edmond and Lily Safra International Neuroscience Institute, Santos Dumont Institute, Macaiba, Brazil
| | - Eduardo Trujillo
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
| | - Jaiti K. Swami
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, United States
| | - Joan A. Camprodon
- Laboratory for Neuropsychiatry and Neuromodulation, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Katia Monte-Silva
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Applied Neuroscience Laboratory, Universidade Federal de Pernambuco, Recife, Brazil
| | - Katia Nunes Sá
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Brazil
| | - Isadora Nunes
- Department of Physiotherapy, Pontifícia Universidade Católica de Minas Gerais, Betim, Brazil
| | - Juliana Barbosa Goulardins
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
- Laboratory of Medical Investigations 54 (LIM-54), São Paulo University, São Paulo, Brazil
- School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Universidade Cruzeiro do Sul (UNICSUL), São Paulo, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, United States
| | | | - Priscila de Carvalho
- Instituto Central, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Rafael Jardim Duarte-Moreira
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
- NAPeN Network (Rede de Núcleos de Assistência e Pesquisa em Neuromodulação), Brazil
| | | | - Samuel Katsuyuki Shinjo
- Division of Rheumatology, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Yossi Zana
- Center for Mathematics, Computation and Cognition, Federal University of ABC, São Bernardo do Campo, Brazil
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23
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Gold J, Ciorciari J. A Review on the Role of the Neuroscience of Flow States in the Modern World. Behav Sci (Basel) 2020; 10:E137. [PMID: 32916878 PMCID: PMC7551835 DOI: 10.3390/bs10090137] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/31/2020] [Accepted: 09/01/2020] [Indexed: 11/18/2022] Open
Abstract
Flow states have been shown to help people reach peak performance, yet this elusive state is not easily attained. The review describes the current state of literature on flow by addressing the environmental influences as well as the cognitive and neurocognitive elements that underlie the experience. In particular, the research focusses on the transition of cognitive control from an explicit to an implicit process. This is further expanded upon to look at the current, yet related neurocognitive research of high performance associated with the implicit process of automaticity. Finally, the review focusses on transcranial direct current stimulation (tDCS) as a novel method to facilitates an induction of flow states. Implications are aimed at a general technique to improve on skill acquisition and overall performance.
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Affiliation(s)
- Joshua Gold
- Centre for Mental Health, Swinburne Neuroimaging (SNI), Swinburne University of Technology, P.O. Box 218, Hawthorn, Melbourne, VIC 3122, Australia;
| | - Joseph Ciorciari
- Centre for Mental Health, Swinburne Neuroimaging (SNI), Swinburne University of Technology, P.O. Box 218, Hawthorn, Melbourne, VIC 3122, Australia;
- Department of Psychological Sciences, Swinburne University of Technology, P.O. Box 218, Hawthorn, Melbourne, VIC 3122, Australia
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24
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Different Effects of Transcranial Direct Current Stimulation on Leg Muscle Glucose Uptake Asymmetry in Two Women with Multiple Sclerosis. Brain Sci 2020; 10:brainsci10080549. [PMID: 32823504 PMCID: PMC7465960 DOI: 10.3390/brainsci10080549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/17/2022] Open
Abstract
Asymmetrical lower limb strength is a significant contributor to impaired walking abilities in people with multiple sclerosis (PwMS). Transcranial direct current stimulation (tDCS) may be an effective technique to enhance cortical excitability and increase neural drive to more-affected lower limbs. A sham-controlled, randomized, cross-over design was employed. Two women with MS underwent two 20 min sessions of either 3 mA tDCS or Sham before 20 min of treadmill walking at a self-selected speed. During walking, the participants were injected with the glucose analogue, [18F] fluorodeoxyglucose (FDG). Participants were then imaged to examine glucose metabolism and uptake asymmetries in the legs. Standardized uptake values (SUVs) were compared between the legs and asymmetry indices were calculated. Subject 2 was considered physically active (self-reported participating in at least 30 min of moderate-intensity physical activity on at least three days of the week for the last three months), while Subject 1 was physically inactive. In Subject 1, there was a decrease in SUVs at the left knee flexors, left upper leg, left and right plantar flexors, and left and right lower legs and SUVs in the knee extensors and dorsiflexors were considered symmetric after tDCS compared to Sham. Subject 2 showed an increase in SUVs at the left and right upper legs, right plantar flexors, and right lower leg with no muscle group changing asymmetry status. This study demonstrates that tDCS may increase neural drive to leg muscles and decrease glucose uptake during walking in PwMS with low physical activity levels.
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25
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Spampinato D, Celnik P. Multiple Motor Learning Processes in Humans: Defining Their Neurophysiological Bases. Neuroscientist 2020; 27:246-267. [PMID: 32713291 PMCID: PMC8151555 DOI: 10.1177/1073858420939552] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Learning new motor behaviors or adjusting previously learned actions to account for dynamic changes in our environment requires the operation of multiple distinct motor learning processes, which rely on different neuronal substrates. For instance, humans are capable of acquiring new motor patterns via the formation of internal model representations of the movement dynamics and through positive reinforcement. In this review, we will discuss how changes in human physiological markers, assessed with noninvasive brain stimulation techniques from distinct brain regions, can be utilized to provide insights toward the distinct learning processes underlying motor learning. We will summarize the findings from several behavioral and neurophysiological studies that have made efforts to understand how distinct processes contribute to and interact when learning new motor behaviors. In particular, we will extensively review two types of behavioral processes described in human sensorimotor learning: (1) a recalibration process of a previously learned movement and (2) acquiring an entirely new motor control policy, such as learning to play an instrument. The selected studies will demonstrate in-detail how distinct physiological mechanisms contributions change depending on the time course of learning and the type of behaviors being learned.
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26
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Pollok B, Keitel A, Foerster M, Moshiri G, Otto K, Krause V. The posterior parietal cortex mediates early offline-rather than online-motor sequence learning. Neuropsychologia 2020; 146:107555. [PMID: 32653440 DOI: 10.1016/j.neuropsychologia.2020.107555] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 06/23/2020] [Accepted: 07/04/2020] [Indexed: 12/13/2022]
Abstract
Learning of new motor skills occurs particularly during training on a task (i.e. online) but has been observed between training-blocks lasting up to days after the end of the training (i.e. offline). Offline-learning occurs as further improvement in task performance indicated by increased accuracy and/or faster responses as well as less interference with respect to a distracting condition. Successful motor learning requires the functional interplay between cortical as well as subcortical brain areas. While the involvement of the primary motor cortex in online-as well as early offline-learning is well established, the functional significance of the posterior parietal cortex (PPC) is less clear. Since the PPC may act as sensory-motor interface, a causal involvement in motor learning is conceivable. In order to characterize the functional significance of the left PPC for motor sequence learning, transcranial direct current stimulation (tDCS) was applied either immediately prior to, during or immediately after training on a serial reaction time task (SRTT) in a total of 54 healthy volunteers. While the analysis did not provide evidence for a significant modulation of reaction times during SRTT training (i.e. online-learning), cathodal tDCS decelerated reaction times of the learned sequences as compared to anodal and sham stimulation 30 min after the end of training. The findings suggest that cathodal tDCS over the left parietal cortex interferes with the reproduction of learned sequences.
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Affiliation(s)
- Bettina Pollok
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany.
| | - Ariane Keitel
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany
| | - Maike Foerster
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany
| | - Geraldine Moshiri
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany
| | - Katharina Otto
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany
| | - Vanessa Krause
- Heinrich-Heine University Duesseldorf, Medical Faculty, Institute of Clinical Neuroscience and Medical Psychology, Germany; Mauritius Hospital Meerbusch, Department of Neuropsychology, Germany
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27
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Alsultan F, Alaboudi M, Almousa A, Alajaji R, Bashir S. Effects of transcranial direct current stimulation over frontal, parietal and cerebellar cortex for cognitive function during fasting in healthy adults. IBRO Rep 2020; 8:129-135. [PMID: 32435717 PMCID: PMC7231976 DOI: 10.1016/j.ibror.2020.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 03/19/2020] [Indexed: 11/30/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is a neuromodulation tool used to modify the cognitive function in subjects. There is a paucity of data on tDCS' effect on cognitive function during Ramadan fasting. This paper aims to assess the effect of tDCS of three brain areas, including the right dorsolateral prefrontal cortex (DLPFC), posterior parietal cortex (PPC), and cerebellum on cognitive function, and obtain safety data in healthy adults during Ramadan fasting. Methods and material A total of 42 healthy, right-handed participants were randomly assigned to one of the 6 stimulation groups: active (anodal)-tDCS of right DLPFC, PPC, and cerebellum; or sham for DLPFC, PPC, and cerebellum after 8 h of fasting for Ramadan. Safety data and cognitive function, such as attention-switching tasks (AST), were obtained by employing the Cambridge Neuropsychological Test Automated Battery (CANTAB) before and after each tDCS session. The cognitive function outcome variables were the response time and the percentage of correct answers in AST. For sham stimulation, the placement of the electrodes was the same as for the active stimulation. Results An improvement in performance time in attention tasks was observed; however, it did not reach a significant level after anodal stimulation of the DLPFC, PPC, and cerebellum. Overall, there were no statistically significant differences between the active and sham tDCS groups in cognitive function. There were no significant side effects of tDCS during fasting for any group. Conclusions Our data suggest that there are variable effects of tDCS on attention tasks during Ramadan fasting. TDCS appears to be safe, well-tolerated and adhered to the international standard of safety in the local population during Ramadan fasting. Further large sample size studies should be conducted to validate the current study findings and reach better conclusions.
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Affiliation(s)
- Fahad Alsultan
- Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia.,Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Malak Alaboudi
- Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Abdullah Almousa
- Department of Medicine, King Saud Medical City, Riyadh, Saudi Arabia
| | - Reema Alajaji
- Department of radiology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
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28
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Transcranial Direct Current Stimulation of Supplementary Motor Region Impacts the Effectiveness of Interleaved and Repetitive Practice Schedules for Retention of Motor Skills. Neuroscience 2020; 435:58-72. [DOI: 10.1016/j.neuroscience.2020.03.043] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 03/25/2020] [Accepted: 03/26/2020] [Indexed: 12/31/2022]
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29
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Transcranial Direct Current Stimulation at 4 mA Induces Greater Leg Muscle Fatigability in Women Compared to Men. Brain Sci 2020; 10:brainsci10040244. [PMID: 32326236 PMCID: PMC7226364 DOI: 10.3390/brainsci10040244] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 04/17/2020] [Accepted: 04/19/2020] [Indexed: 12/12/2022] Open
Abstract
Transcranial direct current stimulation (tDCS) has previously shown different cortical excitability and neuropsychological effects between women and men. However, the sex-specific effects of tDCS on leg muscle fatigability has not been investigated. The purpose of this study was to determine the effects of a single session of 2 mA and 4 mA primary motor cortex tDCS on leg muscle fatigability in healthy young men and women in a crossover design. Twenty participants (women = 10) completed isokinetic fatigue testing (40 maximal reps, 120°/s) of the knee extensors and flexors in conjunction with sham, 2 mA, and 4 mA tDCS in a double-blind, randomized design. The fatigue index from each condition was calculated. Women had significantly greater knee extensor fatigability in the 4 mA condition compared to men (57.8 ± 6.8% versus 44.1 ± 18.4%; p = 0.041, d = 0.99). This study provides additional evidence that responses to tDCS may be sex-specific and highlights the necessity of accounting and powering for sex differences in future investigations.
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30
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Seidel-Marzi O, Ragert P. Neurodiagnostics in Sports: Investigating the Athlete's Brain to Augment Performance and Sport-Specific Skills. Front Hum Neurosci 2020; 14:133. [PMID: 32327988 PMCID: PMC7160821 DOI: 10.3389/fnhum.2020.00133] [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: 01/15/2020] [Accepted: 03/23/2020] [Indexed: 12/22/2022] Open
Abstract
Enhancing performance levels of athletes during training and competition is a desired goal in sports. Quantifying training success is typically accompanied by performance diagnostics including the assessment of sports-relevant behavioral and physiological parameters. Even though optimal brain processing is a key factor for augmented motor performance and skill learning, neurodiagnostics is typically not implemented in performance diagnostics of athletes. We propose, that neurodiagnostics via non-invasive brain imaging techniques such as functional near-infrared spectroscopy (fNIRS) will offer novel perspectives to quantify training-induced neuroplasticity and its relation to motor behavior. A better understanding of such a brain-behavior relationship during the execution of sport-specific movements might help to guide training processes and to optimize training outcomes. Furthermore, targeted non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) might help to further enhance training outcomes by modulating brain areas that show training-induced neuroplasticity. However, we strongly suggest that ethical aspects in the use of non-invasive brain stimulation during training and/or competition need to be addressed before neuromodulation can be considered as a performance enhancer in sports.
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Affiliation(s)
- Oliver Seidel-Marzi
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Patrick Ragert
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany.,Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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31
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Workman CD, Kamholz J, Rudroff T. Increased leg muscle fatigability during 2 mA and 4 mA transcranial direct current stimulation over the left motor cortex. Exp Brain Res 2020; 238:333-343. [PMID: 31919540 DOI: 10.1007/s00221-019-05721-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022]
Abstract
Transcranial direct current stimulation (tDCS) using intensities ≤ 2 mA on physical and cognitive outcomes has been extensively investigated. Studies comparing the effects of different intensities of tDCS have yielded mixed results and little is known about how higher intensities (> 2 mA) affect outcomes. This study examined the effects of tDCS at 2 mA and 4 mA on leg muscle fatigability. This was a double-blind, randomized, sham-controlled study. Sixteen healthy young adults underwent tDCS at three randomly ordered intensities (sham, 2 mA, 4 mA). Leg muscle fatigability of both legs was assessed via isokinetic fatigue testing (40 maximal reps, 120°/s). Torque- and work-derived fatigue indices (FI-T and FI-W, respectively), as well as total work performed (TW), were calculated. FI-T of the right knee extensors indicated increased fatigability in 2 mA and 4 mA compared with sham (p = 0.01, d = 0.73 and p < 0.001, d = 1.61, respectively). FI-W of the right knee extensors also indicated increased fatigability in 2 mA and 4 mA compared to sham (p = 0.01, d = 0.57 and p < 0.001, d = 1.12, respectively) and 4 mA compared with 2 mA (p = 0.034, d = 0.37). tDCS intensity did not affect TW performed. The 2 mA and 4 mA tDCS intensities increased the fatigability of the right knee extensors in young, healthy participants, potentially from altered motor unit recruitment/discharge rate or cortical hyperexcitability. Despite this increase in fatigability, the TW performed in both these conditions was not different from sham.
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Affiliation(s)
- Craig D Workman
- Department of Health and Human Physiology, University of Iowa, E432 Field House, Iowa City, IA, 52242, USA
| | - John Kamholz
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, E432 Field House, Iowa City, IA, 52242, USA.
- Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
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32
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Workman CD, Kamholz J, Rudroff T. Transcranial Direct Current Stimulation (tDCS) to Improve Gait in Multiple Sclerosis: A Timing Window Comparison. Front Hum Neurosci 2019; 13:420. [PMID: 31849628 PMCID: PMC6893177 DOI: 10.3389/fnhum.2019.00420] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 11/13/2019] [Indexed: 12/18/2022] Open
Abstract
Unilateral weakness of the lower limb is a hallmark of multiple sclerosis (MS) and a significant contributor to the progressive worsening of walking ability. There are currently no effective rehabilitation strategies targeting strength asymmetries and/or gait impairments in people with MS (PwMS). Transcranial direct current stimulation (tDCS) has improved motor outcomes in various populations, but the effect of tDCS on gait in PwMS and the ideal timing window of tDCS application are still unknown. This study investigated the effects of tDCS, either before or during a 6 min walk test (6MWT), on the distance walked and gait characteristics in PwMS. Twelve participants were recruited and randomly assigned into BEFORE or DURING groups (both n = 6). The BEFORE group received stimulation before performing a 6MWT (sham/2 mA, 13 min). The DURING group received stimulation only during a 6MWT (sham/2 mA, 6 min). Stimulation was over the more MS-affected primary motor cortex (M1). Distance walked and gait characteristics of the walk were the primary and secondary outcomes. The results indicated a significant decrease in distance walked in the DURING group (p = 0.026) and a significant increase in gait velocity in the BEFORE group (p = 0.04). These changes were accompanied by trends (p < 0.1) in distance walked, gait velocity, and stride length. Overall, the results of this study suggest that tDCS performed before a 6MWT might be more effective than tDCS during a 6MWT and that a single session of tDCS may not be sufficient to influence gait. Clinical Trial Registration: www.ClinicalTrials.gov, identifier #NCT03757819.
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Affiliation(s)
- Craig D Workman
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States
| | - John Kamholz
- Department of Neurology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
| | - Thorsten Rudroff
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA, United States.,Department of Neurology, Carver College of Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA, United States
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Morya E, Monte-Silva K, Bikson M, Esmaeilpour Z, Biazoli CE, Fonseca A, Bocci T, Farzan F, Chatterjee R, Hausdorff JM, da Silva Machado DG, Brunoni AR, Mezger E, Moscaleski LA, Pegado R, Sato JR, Caetano MS, Sá KN, Tanaka C, Li LM, Baptista AF, Okano AH. Beyond the target area: an integrative view of tDCS-induced motor cortex modulation in patients and athletes. J Neuroeng Rehabil 2019; 16:141. [PMID: 31730494 PMCID: PMC6858746 DOI: 10.1186/s12984-019-0581-1] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 08/19/2019] [Indexed: 02/07/2023] Open
Abstract
Transcranial Direct Current Stimulation (tDCS) is a non-invasive technique used to modulate neural tissue. Neuromodulation apparently improves cognitive functions in several neurologic diseases treatment and sports performance. In this study, we present a comprehensive, integrative review of tDCS for motor rehabilitation and motor learning in healthy individuals, athletes and multiple neurologic and neuropsychiatric conditions. We also report on neuromodulation mechanisms, main applications, current knowledge including areas such as language, embodied cognition, functional and social aspects, and future directions. We present the use and perspectives of new developments in tDCS technology, namely high-definition tDCS (HD-tDCS) which promises to overcome one of the main tDCS limitation (i.e., low focality) and its application for neurological disease, pain relief, and motor learning/rehabilitation. Finally, we provided information regarding the Transcutaneous Spinal Direct Current Stimulation (tsDCS) in clinical applications, Cerebellar tDCS (ctDCS) and its influence on motor learning, and TMS combined with electroencephalography (EEG) as a tool to evaluate tDCS effects on brain function.
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Affiliation(s)
- Edgard Morya
- Edmond and Lily Safra International Institute of Neuroscience, Santos Dumont Institute, Macaíba, Rio Grande do Norte Brazil
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Kátia Monte-Silva
- Universidade Federal de Pernambuco, Recife, Pernambuco Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY USA
| | - Zeinab Esmaeilpour
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY USA
| | - Claudinei Eduardo Biazoli
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Andre Fonseca
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Tommaso Bocci
- Aldo Ravelli Center for Neurotechnology and Experimental Brain Therapeutics, Department of Health Sciences, International Medical School, University of Milan, Milan, Italy
| | - Faranak Farzan
- School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia Canada
| | - Raaj Chatterjee
- School of Mechatronic Systems Engineering, Simon Fraser University, Surrey, British Columbia Canada
| | - Jeffrey M. Hausdorff
- Department of Physical Therapy, Sackler Faculty of Medicine and Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | | | | | - Eva Mezger
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Luciane Aparecida Moscaleski
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Rodrigo Pegado
- Graduate Program in Rehabilitation Science, Universidade Federal do Rio Grande do Norte, Santa Cruz, Rio Grande do Norte Brazil
| | - João Ricardo Sato
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Marcelo Salvador Caetano
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
| | - Kátia Nunes Sá
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia Brazil
| | - Clarice Tanaka
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Laboratório de Investigações Médicas-54, Universidade de São Paulo, São Paulo, São Paulo Brazil
| | - Li Min Li
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
| | - Abrahão Fontes Baptista
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
- Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia Brazil
- Laboratório de Investigações Médicas-54, Universidade de São Paulo, São Paulo, São Paulo Brazil
| | - Alexandre Hideki Okano
- Brazilian Institute of Neuroscience and Neurotechnology (BRAINN/CEPID-FAPESP), University of Campinas, Campinas, São Paulo, Brazil
- Núcleo de Assistência e Pesquisa em Neuromodulação (NAPeN), Universidade Federal do ABC (UFABC)/Universidade de São Paulo (USP)/Universidade Cidade de São Paulo (UNICID)/Universidade Federal de Pernambuco (UFPE), Escola Bahiana de Medicina e Saúde Pública (EBMSP), Santo André, Brazil
- Center of Mathematics, Computing and Cognition (CMCC), Universidade Federal do ABC (UFABC), Alameda da Universidade, 3 - Anchieta, Bloco Delta – Sala 257, São Bernardo do Campo, SP CEP 09606-070 Brazil
- Graduate Program in Physical Education. State University of Londrina, Londrina, Paraná, Brazil
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Kumari N, Taylor D, Signal N. The Effect of Cerebellar Transcranial Direct Current Stimulation on Motor Learning: A Systematic Review of Randomized Controlled Trials. Front Hum Neurosci 2019; 13:328. [PMID: 31636552 PMCID: PMC6788395 DOI: 10.3389/fnhum.2019.00328] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 09/06/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Cerebellar transcranial direct current stimulation (ctDCS) appears to modulate motor performance in both adaptation and motor skill tasks; however, whether the gains are long-lasting is unclear. Objectives: This systematic review aims to evaluate the effect of ctDCS with respect to different time scales of motor learning. Methods: Ten electronic databases (CINAHL, MEDLINE, SPORT Discus, Scopus, Web of Science, Cochrane via OVID, Evidence-Based Reviews (EBM) via OVID, AMED: Allied and Complementary Medicine, PsycINFO, and PEDro) were systematically searched. Studies evaluating the effect of ctDCS compared to sham ctDCS on motor learning in healthy individuals were selected and reviewed. Two authors independently reviewed the quality of the included studies using the revised Cochrane's risk-of-bias tool. The results were extracted with respect to the time scale in which changes in motor performance were evaluated. Results: Seventeen randomized controlled trials met the eligibility criteria of which 65% of the studies had a “high” risk-of-bias, and 35% had “some concerns.” These studies included data from 629 healthy participants. Of the studies that evaluated the effect of anodal ctDCS during and immediately after the stimulation, four found enhanced, three found impaired, and ten found no effect on gains in motor performance. Of the studies that evaluated the effect of anodal ctDCS after a break of 24 h or more, seven found enhanced, two found impaired, and one found no effect on gains in motor performance. Of the studies that evaluated the effect of cathodal ctDCS across a range of time scales, five found impaired, one found enhanced, and five found no effect on gains in motor performance. Conclusions: In healthy individuals, anodal ctDCS appears to improve short to longer-term motor skill learning, whereas it appears to have no effect on gains in motor performance during and immediate after the stimulation. ctDCS may have potential to improve motor performance beyond the training period. The challenge of the motor task and its characteristics, and the stimulation parameters are likely to influence the effect of ctDCS on motor learning.
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Affiliation(s)
- Nitika Kumari
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Denise Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
| | - Nada Signal
- Health and Rehabilitation Research Institute, Auckland University of Technology, Auckland, New Zealand
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Ljubisavljevic MR, Oommen J, Filipovic S, Bjekic J, Szolics M, Nagelkerke N. Effects of tDCS of Dorsolateral Prefrontal Cortex on Dual-Task Performance Involving Manual Dexterity and Cognitive Task in Healthy Older Adults. Front Aging Neurosci 2019; 11:144. [PMID: 31275139 PMCID: PMC6592113 DOI: 10.3389/fnagi.2019.00144] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 05/31/2019] [Indexed: 01/29/2023] Open
Abstract
Healthy aging limits the activities of daily living and personal independence. Furthermore, cognitive-motor interference in dual-task (e.g., walking while talking) appears to be more pronounced in the elderly. Transcranial direct current stimulation (tDCS), a form of the non-invasive brain stimulation technique, is known to modify cortical excitability and has been investigated as a tool for enhancing motor and cognitive performance in health and disease. The present study examined whether tDCS targeting the dorsolateral prefrontal cortex (DLPFC) could improve dual-task performance in healthy older adults. The effects of tDCS, among other factors, depend on stimulation polarity (anodal vs. cathodal), electrode setup (unilateral vs. bilateral) and the time of application (off-line vs. on-line). We therefore explored the effects of unilateral and simultaneous bilateral tDCS (anodal and cathodal) of left DLPFC while performing (on-line) the Grooved Pegboard Test (GPT) and Serial Seven Subtraction Test (SSST) alone or together (dual-tasking). The number of pegs and the number of correct subtractions were recorded before, during and 30 min after tDCS. The dual-task performance was measured as the percent change from single- to the dual-task condition (dual-task cost DTC). Only bilateral, anode left tDCS, induced a significant increase in subtracted numbers while dual-tasking, i.e., it reduced the DTC of manual dexterity (GPT) to a cognitive task. Significant changes 30 min after the stimulation were only present after bilateral anode right (BAR) tDCS on GPT dual-task costs. These findings suggest that anodal tDCS applied on-line interacts with a dual-task performance involving demanding cognitive and manual dexterity tasks. The results support the potential use of non-invasive brain stimulation for improvement of cognitive functioning in daily activities in older individuals.
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Affiliation(s)
- Milos R Ljubisavljevic
- Department of Physiology, College of Medicine and Health Sciences (CMHS), UAE University, Al Ain, United Arab Emirates
| | - Joji Oommen
- Department of Physiology, College of Medicine and Health Sciences (CMHS), UAE University, Al Ain, United Arab Emirates
| | - Sasa Filipovic
- Department of Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Jovana Bjekic
- Department of Neuroscience, Institute for Medical Research, University of Belgrade, Belgrade, Serbia
| | - Miklos Szolics
- Department of Internal Medicine, Neurology Section, Tawam Hospital, Al Ain, United Arab Emirates
| | - Nico Nagelkerke
- Institute of Public Health, College of Medicine and Health Sciences (CMHS), UAE University, Al Ain, United Arab Emirates
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Spampinato DA, Satar Z, Rothwell JC. Combining reward and M1 transcranial direct current stimulation enhances the retention of newly learnt sensorimotor mappings. Brain Stimul 2019; 12:1205-1212. [PMID: 31133478 PMCID: PMC6709642 DOI: 10.1016/j.brs.2019.05.015] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 03/27/2019] [Accepted: 05/16/2019] [Indexed: 12/17/2022] Open
Abstract
Background Reward-based feedback given during motor learning has been shown to improve the retention of the behaviour being acquired. Interestingly, applying transcranial direct current stimulation (tDCS) during learning over the primary motor cortex (M1), an area associated with motor retention, also results in enhanced retention of the newly formed motor memories. However, it remains unknown whether combining these distinct interventions result in an additive benefit of motor retention. Methods We investigated whether combining both interventions while participants learned to account for a visuomotor transformation results in enhanced motor retention (total n = 56; each group n = 14). To determine whether these interventions share common physiological mechanisms underpinning learning, we assessed motor cortical excitability and inhibition (i.e. SICI) on a hand muscle before and after all participants learned the visuomotor rotation using their entire arm and hand. Results We found that both the Reward-Stim (i.e. reward + tDCS) and Reward-Sham (i.e. reward-only) groups had increased retention at the beginning of the retention phase, indicating an immediate effect of reward on behaviour. However, each intervention on their own did not enhance retention when compared to sham, but rather, only the combination of both reward and tDCS demonstrated prolonged retention. We also found that only the Reward-Stim group had a significant reduction in SICI after exposure to the perturbation. Conclusions We show that combining both interventions are additive in providing stronger retention of motor adaptation. These results indicate that the reliability and validity of using tDCS within a clinical context may depend on the type of feedback individuals receive when learning a new motor pattern. Concurrently administering reward and M1 tDCS during learning results in enhanced motor retention. The combination of these interventions also leads to a reduction in M1 inhibitory mechanisms. No benefits of motor retention were found when reward or M1 tDCS were given alone.
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Lefaucheur JP. Boosting physical exercise with cortical stimulation or brain doping using tDCS: Fact or myth? Neurophysiol Clin 2019; 49:95-98. [DOI: 10.1016/j.neucli.2019.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 01/08/2019] [Indexed: 11/26/2022] Open
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Viganò A, Toscano M, Puledda F, Di Piero V. Treating Chronic Migraine With Neuromodulation: The Role of Neurophysiological Abnormalities and Maladaptive Plasticity. Front Pharmacol 2019; 10:32. [PMID: 30804782 PMCID: PMC6370938 DOI: 10.3389/fphar.2019.00032] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 01/14/2019] [Indexed: 12/20/2022] Open
Abstract
Chronic migraine (CM) is the most disabling form of migraine, because pharmacological treatments have low efficacy and cumbersome side effects. New evidence has shown that migraine is primarily a disorder of brain plasticity and migraine chronification depends on a maladaptive process favoring the development of a brain state of hyperexcitability. Due to the ability to induce plastic changes in the brain, researchers started to look at Non-Invasive Brain Stimulation (NIBS) as a possible therapeutic option in migraine field. On one side, NIBS techniques induce changes of neural plasticity that outlast the period of the stimulation (a fundamental prerequisite of a prophylactic migraine treatment, concurrently they allow targeting neurophysiological abnormalities that contribute to the transition from episodic to CM. The action may thus influence not only the cortex but also brainstem and diencephalic structures. Plus, NIBS is not burdened by serious medication side effects and drug–drug interactions. Although the majority of the studies reported somewhat beneficial effects in migraine patients, no standard intervention has been defined. This may be due to methodological differences regarding the used techniques (e.g., transcranial magnetic stimulation, transcranial direct current stimulation), the brain regions chosen as targets, and the stimulation types (e.g., the use of inhibitory and excitatory stimulations on the basis of opposite rationales), and an intrinsic variability of stimulation effect. Hence, it is difficult to draw a conclusion on the real effect of neuromodulation in migraine. In this article, we first will review the definition and mechanisms of brain plasticity, some neurophysiological hallmarks of migraine, and migraine chronification-related (dys)plasticity. Secondly, we will review available results from therapeutic and physiological studies using neuromodulation in CM. Lastly we will discuss the results obtained in these preventive trials in the light of a possible effect on brain plasticity.
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Affiliation(s)
- Alessandro Viganò
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Molecular and Cellular Networks Lab, Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Toscano
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,Department of Neurology, Fatebenefratelli Hospital, Rome, Italy
| | - Francesca Puledda
- Headache Group, Department of Basic and Clinical Neuroscience, King's College Hospital, King's College London, London, United Kingdom
| | - Vittorio Di Piero
- Headache Research Centre and Neurocritical Care Unit, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy.,University Consortium for Adaptive Disorders and Head Pain - UCADH, Pavia, Italy
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Transcranial Direct Current Stimulation (tDCS) Paired with Occupation-Centered Bimanual Training in Children with Unilateral Cerebral Palsy: A Preliminary Study. Neural Plast 2018; 2018:9610812. [PMID: 30627151 PMCID: PMC6304908 DOI: 10.1155/2018/9610812] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/18/2018] [Accepted: 08/27/2018] [Indexed: 12/19/2022] Open
Abstract
Objective We investigated the preliminary efficacy of cathodal transcranial direct current stimulation (tDCS) combined with bimanual training in children and young adults with unilateral cerebral palsy based on the principle of exaggerated interhemispheric inhibition (IHI). Methods Eight participants with corticospinal tract (CST) connectivity from the lesioned hemisphere participated in an open-label study of 10 sessions of cathodal tDCS to the nonlesioned hemisphere (20 minutes) concurrently with bimanual, goal-directed training (120 minutes). We measured the frequency of adverse events and intervention efficacy with performance (bimanual-Assisting Hand Assessment (AHA)-and unimanual-Box and Blocks), self-report (Canadian Occupational Performance Measure (COPM), ABILHAND), and neurophysiologic (motor-evoked potential amplitude, cortical silent period (CSP) duration, and motor mapping) assessments. Results All participants completed the study with no serious adverse events. Three of 8 participants showed gains on the AHA, and 4 of 8 participants showed gains in Box and Blocks (more affected hand). Nonlesioned CSP duration decreased in 6 of 6 participants with analyzable data. Cortical representation of the first dorsal interosseous expanded in the nonlesioned hemisphere in 4 of 6 participants and decreased in the lesioned hemisphere in 3 of 4 participants with analyzable data. Conclusions While goal achievement was observed, objective measures of hand function showed inconsistent gains. Neurophysiologic data suggests nonlinear responses to cathodal stimulation of the nonlesioned hemisphere. Future studies examining the contributions of activity-dependent competition and cortical excitability imbalances are indicated.
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Sánchez-León CA, Ammann C, Medina JF, Márquez-Ruiz J. Using animal models to improve the design and application of transcranial electrical stimulation in humans. Curr Behav Neurosci Rep 2018; 5:125-135. [PMID: 30013890 DOI: 10.1007/s40473-018-0149-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Purpose of Review Transcranial electrical stimulation (tES) is a non-invasive stimulation technique used for modulating brain function in humans. To help tES reach its full therapeutic potential, it is necessary to address a number of critical gaps in our knowledge. Here, we review studies that have taken advantage of animal models to provide invaluable insight about the basic science behind tES. Recent Findings Animal studies are playing a key role in elucidating the mechanisms implicated in tES, defining safety limits, validating computational models, inspiring new stimulation protocols, enhancing brain function and exploring new therapeutic applications. Summary Animal models provide a wealth of information that can facilitate the successful utilization of tES for clinical interventions in human subjects. To this end, tES experiments in animals should be carefully designed to maximize opportunities for applying discoveries to the treatment of human disease.
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Affiliation(s)
| | - Claudia Ammann
- CINAC, University Hospital HM Puerta del Sur, CEU - San Pablo University, 28938-Móstoles, Madrid, Spain
| | - Javier F Medina
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - Javier Márquez-Ruiz
- Division of Neurosciences, Pablo de Olavide University, 41013-Seville, Spain
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Anodal tDCS over Primary Motor Cortex Provides No Advantage to Learning Motor Sequences via Observation. Neural Plast 2018; 2018:1237962. [PMID: 29796014 PMCID: PMC5896271 DOI: 10.1155/2018/1237962] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 12/28/2017] [Indexed: 11/18/2022] Open
Abstract
When learning a new motor skill, we benefit from watching others. It has been suggested that observation of others' actions can build a motor representation in the observer, and as such, physical and observational learning might share a similar neural basis. If physical and observational learning share a similar neural basis, then motor cortex stimulation during observational practice should similarly enhance learning by observation as it does through physical practice. Here, we used transcranial direct-current stimulation (tDCS) to address whether anodal stimulation to M1 during observational training facilitates skill acquisition. Participants learned keypress sequences across four consecutive days of observational practice while receiving active or sham stimulation over M1. The results demonstrated that active stimulation provided no advantage to skill learning over sham stimulation. Further, Bayesian analyses revealed evidence in favour of the null hypothesis across our dependent measures. Our findings therefore provide no support for the hypothesis that excitatory M1 stimulation can enhance observational learning in a similar manner to physical learning. More generally, the results add to a growing literature that suggests that the effects of tDCS tend to be small, inconsistent, and hard to replicate. Future tDCS research should consider these factors when designing experimental procedures.
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Simonsmeier BA, Grabner RH, Hein J, Krenz U, Schneider M. Electrical brain stimulation (tES) improves learning more than performance: A meta-analysis. Neurosci Biobehav Rev 2018; 84:171-181. [DOI: 10.1016/j.neubiorev.2017.11.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 09/16/2017] [Accepted: 11/02/2017] [Indexed: 01/12/2023]
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Hashemirad F, Fitzgerald PB, Zoghi M, Jaberzadeh S. Single-Session Anodal tDCS with Small-Size Stimulating Electrodes Over Frontoparietal Superficial Sites Does Not Affect Motor Sequence Learning. Front Hum Neurosci 2017; 11:153. [PMID: 28420970 PMCID: PMC5376552 DOI: 10.3389/fnhum.2017.00153] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 03/15/2017] [Indexed: 12/12/2022] Open
Abstract
Due to the potential of anodal transcranial direct current stimulation (a-tDCS) for enhancement of fine sequenced movements and increasing interest in achieving high level of fine movements in the trained and untrained hands especially at initial stage of learning, we designed this study to investigate whether the application of single-session a-tDCS with small-size stimulating electrodes over FPN sites, such as dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1) or posterior parietal cortex (PPC) could enhance sequence learning with the trained hand and these effects are transferred into the untrained hand or not. A total of 51 right-handed healthy participants were randomly assigned to one of the four stimulation groups: a-tDCS of left M1, DLPFC, PPC, or sham. Stimulation was applied for 20 min during a sequential visual isometric pinch task (SVIPT). Eight blocks of training using SVIPT were completed with the right hand during stimulation. Two blocks of sequence training with each hand were performed by participants as assessment blocks at three time points: baseline, 15 min and one day following the intervention. Behavioral outcomes including movement time, error rate and skill were assessed in all assessment blocks across three time points. We also measured corticospinal excitability, short-interval intracortical inhibition, and intracortical facilitation using single- and paired-pulse transcranial magnetic stimulation. The results indicated that the behavioral outcomes were significantly improved with the right trained hand, but this learning effect was not modulated by a-tDCS with small-size stimulating electrodes over the FPN. Transfer of learning into the untrained hand was observed in all four groups for movement time but not for the error rate or skill. Our results suggest that sequential learning in SVIPT and its transfer into the untrained hand were not sensitive to a single-session a-tDCS with small-size stimulating electrodes over left M1, DLPFC or PPC in young healthy participants.
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Affiliation(s)
- Fahimeh Hashemirad
- Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, MelbourneVIC, Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre, the Alfred and Monash University Central Clinical School, MelbourneVIC, Australia
| | - Maryam Zoghi
- Department of Medicine at Royal Melbourne Hospital, the University of Melbourne, MelbourneVIC, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, MelbourneVIC, Australia
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