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Niemann F, Riemann S, Hubert AK, Antonenko D, Thielscher A, Martin AK, Unger N, Flöel A, Meinzer M. Electrode positioning errors reduce current dose for focal tDCS set-ups: Evidence from individualized electric field mapping. Clin Neurophysiol 2024; 162:201-209. [PMID: 38643613 DOI: 10.1016/j.clinph.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 01/29/2024] [Accepted: 03/26/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVE Electrode positioning errors contribute to variability of transcranial direct current stimulation (tDCS) effects. We investigated the impact of electrode positioning errors on current flow for tDCS set-ups with different focality. METHODS Deviations from planned electrode positions were determined using data acquired in an experimental study (N = 240 datasets) that administered conventional and focal tDCS during magnetic resonance imaging (MRI). Comparison of individualized electric field modeling for planned and empirically derived "actual" electrode positions was conducted to quantify the impact of positioning errors on the electric field dose in target regions for tDCS. RESULTS Planned electrode positions resulted in higher current dose in the target regions for focal compared to conventional montages (7-12%). Deviations from planned positions significantly reduced current flow in the target regions, selectively for focal set-ups (26-30%). Dose reductions were significantly larger for focal compared to conventional set-ups (29-43%). CONCLUSIONS Precise positioning is crucial when using focal tDCS set-ups to avoid significant reductions of current dose in the intended target regions. SIGNIFICANCE Our results highlight the urgent need to routinely implement methods for improving electrode positioning, minimization of electrode drift, verification of electrode positions before and/or after tDCS and also to consider positioning errors when investigating dose-response relationships, especially for focal set-ups.
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Affiliation(s)
- Filip Niemann
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
| | - Steffen Riemann
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
| | - Ann-Kathrin Hubert
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
| | - Daria Antonenko
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark; Technical University of Denmark, Department of Health Technology, Kongens Lyngby, Denmark
| | - Andrew K Martin
- Kent University, School of Psychology, Canterbury, United Kingdom
| | - Nina Unger
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany
| | - Agnes Flöel
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany; German Center for Neurodegenerative Diseases (DZNE Site Greifswald), Greifswald, Germany
| | - Marcus Meinzer
- University Medicine Greifswald, Department of Neurology, Greifswald, Germany.
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Unger N, Stahl B, Darkow R, Scholz V, Weinmar I, Schmidt J, Breitenstein C, Meinzer M, Grewe T, Flöel A. [Transcranial direct current stimulation to enhance training effectiveness in chronic poststroke aphasia-A challenge for recruiting participants]. Nervenarzt 2024; 95:368-375. [PMID: 38175228 PMCID: PMC11014807 DOI: 10.1007/s00115-023-01572-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION/BACKGROUND DC_TRAIN_APHASIA is an ongoing multicenter, randomized controlled trial, conducted since November 2019 under the lead of the University Medicine Greifswald (ClinicalTrials.gov Identifier: NCT03930121). The study seeks to determine whether adjuvant transcranial direct current stimulation (tDCS) can increase the effectiveness of a 3‑week treatment with intensive speech-language therapy in chronic post-stroke aphasia. MATERIAL AND METHOD Until the end of 2024, a total of 130 patients are to be included in Germany. Recruitment has been a challenge throughout the study and substantial efforts went into devising innovative recruiting approaches. Standard recruitment strategies were used, such as directly approaching people with aphasia in clinical settings, inpatient and outpatient language rehabilitation facilities, and patient support and advocacy groups, alongside more innovative techniques including radio commercials, dissemination of study information via national television and social media platforms. PROVISIONAL RESULTS Up until now, 110 patients have been included into the study. The largest short-term response was achieved via television and radio. The largest long-term response was obtained through recruitment via logopaedic and neurological facilities, patient support groups, and social media. Participants served as "testimonials", expressing that they were satisfied with the therapy and the tDCS application. DISCUSSION The multicenter study DC_TRAIN_APHASIA aims to provide evidence on tDCS as an adjuvant application to increase the effect size of intensive speech-language therapy in chronic post-stroke aphasia. The present review may guide future studies in recruiting samples that involve people with impaired communicative abilities.
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Affiliation(s)
- Nina Unger
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland.
| | - Benjamin Stahl
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
- Fakultät Naturwissenschaften, Medical School Berlin, Berlin, Deutschland
- Max-Planck-Institut für Kognitions- und Neurowissenschaften, Leipzig, Deutschland
| | | | - Veronika Scholz
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Isabel Weinmar
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Johanna Schmidt
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Caterina Breitenstein
- Klinik für Neurologie mit Institut für Translationale Neurologie, Universität Münster, Münster, Deutschland
| | - Marcus Meinzer
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
| | - Tanja Grewe
- Abt. Technik & Gesundheit für Menschen, Studiengang Logopädie, Jade Hochschule, Oldenburg, Deutschland
| | - Agnes Flöel
- Klinik und Poliklinik für Neurologie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
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Roheger M, Grothe L, Hasselberg L, Grothe M, Meinzer M. A systematic review and meta-analysis of socio-cognitive impairments in multiple sclerose. Sci Rep 2024; 14:7096. [PMID: 38528009 PMCID: PMC10963773 DOI: 10.1038/s41598-024-53750-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 02/05/2024] [Indexed: 03/27/2024] Open
Abstract
Socio-cognitive impairment is frequent in multiple sclerosis (MS). However, little is known about the relationship between other potentially relevant clinical symptoms (i.e., cognition, depression, fatigue) and the degree of socio-cognitive impairment, and neural mechanisms underlying socio-cognitive deficits in MS. Therefore, we meta-analytically quantified socio-cognitive impairment in MS. A systematic literature search in MEDLINE Ovid, Web of Science Core Collection, CENTRAL, and PsycInfo was conducted until December 2022. Studies investigating affective or cognitive theory of mind (a/cToM), visual perspective taking (VPT) and social decision making (SDM) in MS patients relative to healthy controls were included. Risk-of-bias (RoB) was assessed using the CLARITY group "Tool for Assessing RoB in Cohort Studies". Mediation analysis investigated the contribution of clinical symptoms to socio-cognitive impairment. In total, n = 8534 studies were screened, 58 were included in the systematic review, 27 in the meta-analyses. Most studies were rated with a moderate RoB. Meta-analyses confirmed impairment of both aToM and cToM in MS patients, with larger effect sizes for aToM. Mediation analysis demonstrated that higher levels of fatigue selectively predicted the degree of cToM impairment. There was insufficient data available to quantify impairment in other socio-cognitive domains. Fourteen structural and functional imaging studies were identified and characterized by substantial heterogeneity. Summarized, this study confirmed substantial socio-cognitive impairment in MS and highlights the potential exacerbating role of comorbid clinical symptoms. We identify several evidence gaps that need to be addressed in future large-scale studies using comprehensive and coordinated assessments of socio-cognitive parameters, potential mediators, and neural correlates.Trial registration: The pre-registered review protocol can be assessed at www.crd.york.ac.uk/PROSPERO/ (ID: CRD42020206225).
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Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
- Ambulatory Assessment in Psychology, Department of Psychology, Carl Von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Lydia Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Laura Hasselberg
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
| | - Matthias Grothe
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany.
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Walther Rathenau Str. 49, 17489, Greifswald, Germany
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Kim J, Rose ML, Pierce JE, Nickels L, Copland DA, Togher L, Godecke E, Meinzer M, Rai T, Hurley M, Foster A, Carragher M, Wilcox C, Cadilhac DA. High-Intensity Aphasia Therapy Is Cost-Effective in People With Poststroke Aphasia: Evidence From the COMPARE Trial. Stroke 2024; 55:705-714. [PMID: 38328930 DOI: 10.1161/strokeaha.123.045183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Evidence from systematic reviews confirms that speech and language interventions for people with aphasia during the chronic phase after stroke (>6 months) improve word retrieval, functional communication, and communication-related quality of life. However, there is limited evidence of their cost-effectiveness. We aimed to estimate the cost per quality-adjusted life year gained from 2 speech and language therapies compared with usual care in people with aphasia during the chronic phase (median, 2.9 years) after stroke. METHODS A 3-arm, randomized controlled trial compared constraint-induced aphasia therapy plus (CIAT-Plus) and multimodality aphasia therapy (M-MAT) with usual care in 216 people with chronic aphasia. Participants were administered a standardized questionnaire before intervention and at 12 weeks after the 2-week intervention/control period to ascertain health service utilization, employment changes, and informal caregiver burden. Unit prices from Australian sources were used to estimate costs in 2020. Quality-adjusted life years were estimated using responses to the EuroQol-5 Dimension-3 Level questionnaire. To test uncertainty around the differences in costs and outcomes between groups, bootstrapping was used with the cohorts resampled 1000 times. RESULTS Overall 201/216 participants were included (mean age, 63 years, 29% moderate or severe aphasia, 61 usual care, 70 CIAT-Plus, 70 M-MAT). There were no statistically significant differences in mean total costs ($13 797 usual care, $17 478 CIAT-Plus, $11 113 M-MAT) and quality-adjusted life years (0.19 usual care, 0.20 CIAT-Plus, 0.20 M-MAT) between groups. In bootstrapped analysis of CIAT-Plus, 21.5% of iterations were likely to result in better outcomes and be cost saving (dominant) compared with usual care. In contrast, 72.4% of iterations were more favorable for M-MAT than usual care. CONCLUSIONS We observed that both treatments, but especially M-MAT, may result in better outcomes at an acceptable additional cost, or potentially with cost savings. These findings are relevant in advocating for the use of these therapies for chronic aphasia after stroke.
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Affiliation(s)
- Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia (J.K., D.A. Cadilhac)
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (J.K., D.A. Cadilhac)
| | - Miranda L Rose
- School of Allied Health, Human Services and Sport (M.L.R., J.E.P., A.M., M.C., C.W.), Melbourne, Victoria, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
| | - John E Pierce
- School of Allied Health, Human Services and Sport (M.L.R., J.E.P., A.M., M.C., C.W.), Melbourne, Victoria, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia (L.N.)
| | - David A Copland
- Queensland Aphasia Research Centre, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia (D.A. Copland)
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Australia (D.A. Copland)
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, New South Wales, Australia (L.T.)
| | - Erin Godecke
- Edith Cowan University, Joondalup, Western Australia (E.G.)
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Germany (M.M.)
| | - Tapan Rai
- University of Technology Sydney, New South Wales, Australia (T.R.)
| | - Melanie Hurley
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
| | - Abby Foster
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia (A.F.)
- School of Primary & Allied Health Care, Monash University, Frankston, Victoria, Australia (A.F.)
| | - Marcella Carragher
- School of Allied Health, Human Services and Sport (M.L.R., J.E.P., A.M., M.C., C.W.), Melbourne, Victoria, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
| | - Cassie Wilcox
- School of Allied Health, Human Services and Sport (M.L.R., J.E.P., A.M., M.C., C.W.), Melbourne, Victoria, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Victoria, Australia (J.K., D.A. Cadilhac)
- Stroke Division, Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia (J.K., D.A. Cadilhac)
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University (M.L.R., J.E.P., M.H., A.F., M.C., C.W., D.A. Cadilhac), Melbourne, Victoria, Australia
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Pierce JE, OHalloran R, Togher L, Nickels L, Copland D, Godecke E, Meinzer M, Rai T, Cadilhac DA, Kim J, Hurley M, Foster A, Carragher M, Wilcox C, Steel G, Rose ML. Acceptability, feasibility and preliminary efficacy of low-moderate intensity Constraint Induced Aphasia Therapy and Multi-Modality Aphasia Therapy in chronic aphasia after stroke. Top Stroke Rehabil 2024; 31:44-56. [PMID: 37036031 DOI: 10.1080/10749357.2023.2196765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/24/2023] [Indexed: 04/11/2023]
Abstract
BACKGROUND High-intensity Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) and Multi-Modality Aphasia Therapy (M-MAT) are effective interventions for chronic post-stroke aphasia but challenging to provide in clinical practice. Providing these interventions may be more feasible at lower intensities, but comparative evidence is lacking. We therefore explored feasibility, acceptability, and preliminary efficacy of the treatments at a lower intensity. METHODS A multisite, single-blinded, randomized Phase II trial was conducted within the Phase III COMPARE trial. Groups of participants with chronic aphasia from the usual care arm of the COMPARE trial were randomized to M-MAT or CIAT-Plus, delivered at the same dose as the COMPARE trial but at lower intensity (6 hours/week × 5 weeks rather than 15 hours/week × 2 weeks). Blinded assessors measured aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient), word retrieval, connected speech, multimodal communication, functional communication, and quality of life immediately post interventions and after 12 weeks. Feasibility and acceptability were explored. RESULTS Of 70 eligible participants, 77% consented to the trial; 78% of randomized participants completed intervention and 98% of assessment visits were conducted. Fatigue and distress ratings were low with no related withdrawals. Adverse events related to the trial (n = 4) were mild in severity. Statistically significant treatment effects were demonstrated on word retrieval and functional communication and both interventions were equally effective. CONCLUSIONS Low-moderateintensity CIAT-Plus and M-MAT were feasible and acceptable. Both interventions show preliminary efficacy at a low-moderate intensity. These results support a powered trial investigating these interventions at a low-moderate intensity.
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Affiliation(s)
- John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Robyn OHalloran
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - David Copland
- Queensland Aphasia Research Centre, The University of Queensland, Herston, Queensland, Australia
- Surgical Treatment and Rehabilitation Service Education and Research Allience, Metro North Health, Herston, Queensland, Australia
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Western, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- Graduate Research School, University of Technology Sydney, New South Wales, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
| | - Melanie Hurley
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Abby Foster
- Speech Pathology, Monash Health, Clayton, Victoria, Australia
- School of Allied Health, Human Service & Sport, La Trobe University, Victoria, Australia
- School of Primary & Allied Health Care, Monash University, Victoria, Australia
| | - Marcella Carragher
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Cassie Wilcox
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Gillian Steel
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
| | - Miranda L Rose
- CRE Aphasia Recovery and Rehabilitation, La Trobe University, Bundoora, Australia
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Antonenko D, Fromm AE, Thams F, Grittner U, Meinzer M, Flöel A. Microstructural and functional plasticity following repeated brain stimulation during cognitive training in older adults. Nat Commun 2023; 14:3184. [PMID: 37268628 DOI: 10.1038/s41467-023-38910-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023] Open
Abstract
The combination of repeated behavioral training with transcranial direct current stimulation (tDCS) holds promise to exert beneficial effects on brain function beyond the trained task. However, little is known about the underlying mechanisms. We performed a monocenter, single-blind randomized, placebo-controlled trial comparing cognitive training to concurrent anodal tDCS (target intervention) with cognitive training to concurrent sham tDCS (control intervention), registered at ClinicalTrial.gov (Identifier NCT03838211). The primary outcome (performance in trained task) and secondary behavioral outcomes (performance on transfer tasks) were reported elsewhere. Here, underlying mechanisms were addressed by pre-specified analyses of multimodal magnetic resonance imaging before and after a three-week executive function training with prefrontal anodal tDCS in 48 older adults. Results demonstrate that training combined with active tDCS modulated prefrontal white matter microstructure which predicted individual transfer task performance gain. Training-plus-tDCS also resulted in microstructural grey matter alterations at the stimulation site, and increased prefrontal functional connectivity. We provide insight into the mechanisms underlying neuromodulatory interventions, suggesting tDCS-induced changes in fiber organization and myelin formation, glia-related and synaptic processes in the target region, and synchronization within targeted functional networks. These findings advance the mechanistic understanding of neural tDCS effects, thereby contributing to more targeted neural network modulation in future experimental and translation tDCS applications.
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Affiliation(s)
- Daria Antonenko
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany.
| | | | - Friederike Thams
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health (BIH), Berlin, Germany
- Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Biometry and Clinical Epidemiology, Berlin, Germany
| | - Marcus Meinzer
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, Universitätsmedizin Greifswald, Greifswald, Germany
- German Centre for Neurodegenerative Diseases (DZNE) Standort Greifswald, Greifswald, Germany
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Sihvonen AJ, Vadinova V, Garden KL, Meinzer M, Roxbury T, O'Brien K, Copland D, McMahon KL, Brownsett SLE. Right hemispheric structural connectivity and poststroke language recovery. Hum Brain Mapp 2023; 44:2897-2904. [PMID: 36852658 PMCID: PMC10089089 DOI: 10.1002/hbm.26252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 03/01/2023] Open
Abstract
Poststroke aphasia typically results from brain damage to the left-lateralized language network. The contribution of the right-lateralized homologues in aphasia recovery remains equivocal. In this longitudinal observational study, we specifically investigated the role of right hemisphere structural connectome in aphasia recovery. Twenty-two patients with aphasia after a left hemispheric stroke underwent comprehensive language assessment at the early subacute and chronic stages. A novel structural connectometry approach, using multi-shell diffusion-weighted MRI data collected at the early subacute stage, was used to evaluate the relationship between right hemisphere white matter connectome and language production and comprehension abilities at early subacute stage. Moreover, we evaluated the relationship between early subacute right hemisphere white matter connectome and longitudinal change in language production and comprehension abilities. All results were corrected for multiple comparisons. Connectometry analyses revealed negative associations between early subacute stage right hemisphere structural connectivity and language production, both cross-sectionally and longitudinally (pFDR < .0125). In turn, only positive associations between right hemisphere structural connectivity and language comprehension were observed, both cross-sectionally and longitudinally (pFDR < .0125). Interhemispheric connectivity was highly associated with comprehension scores. Our results shed light on the discordant interpretations of previous findings, by providing evidence that while some right hemisphere white matter pathways may make a maladaptive contribution to the recovery of language, other pathways support the recovery of language, especially comprehension abilities.
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Affiliation(s)
- Aleksi J Sihvonen
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia.,Cognitive Brain Research Unit (CBRU), University of Helsinki, Helsinki, Finland.,Centre of Excellence in Music, Mind, Body and Brain, University of Helsinki, Helsinki, Finland
| | - Veronika Vadinova
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Kimberley L Garden
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tracy Roxbury
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia
| | - Kate O'Brien
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia
| | - David Copland
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Katie L McMahon
- School of Clinical Sciences, Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia
| | - Sonia L E Brownsett
- Queensland Aphasia Research Centre, University of Queensland, Herston, Australia.,School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia.,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
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Brady MC, Ali M, VandenBerg K, Williams LJ, Williams LR, Abo M, Becker F, Bowen A, Brandenburg C, Breitenstein C, Bruehl S, Copland DA, Cranfill TB, Pietro-Bachmann MD, Enderby P, Fillingham J, Lucia Galli F, Gandolfi M, Glize B, Godecke E, Hawkins N, Hilari K, Hinckley J, Horton S, Howard D, Jaecks P, Jefferies E, Jesus LMT, Kambanaros M, Kyoung Kang E, Khedr EM, Pak-Hin Kong A, Kukkonen T, Laganaro M, Lambon Ralph MA, Charlotte Laska A, Leemann B, Leff AP, Lima RR, Lorenz A, MacWhinney B, Shisler Marshall R, Mattioli F, Maviş İ, Meinzer M, Nilipour R, Noé E, Paik NJ, Palmer R, Papathanasiou I, Patricio B, Pavão Martins I, Price C, Prizl Jakovac T, Rochon E, Rose ML, Rosso C, Rubi-Fessen I, Ruiter MB, Snell C, Stahl B, Szaflarski JP, Thomas SA, van de Sandt-Koenderman M, van der Meulen I, Visch-Brink E, Worrall L, Harris Wright H. Precision rehabilitation for aphasia by patient age, sex, aphasia severity, and time since stroke? A prespecified, systematic review-based, individual participant data, network, subgroup meta-analysis. Int J Stroke 2022; 17:1067-1077. [PMID: 35422175 PMCID: PMC9679795 DOI: 10.1177/17474930221097477] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 03/01/2022] [Indexed: 09/19/2023]
Abstract
BACKGROUND Stroke rehabilitation interventions are routinely personalized to address individuals' needs, goals, and challenges based on evidence from aggregated randomized controlled trials (RCT) data and meta-syntheses. Individual participant data (IPD) meta-analyses may better inform the development of precision rehabilitation approaches, quantifying treatment responses while adjusting for confounders and reducing ecological bias. AIM We explored associations between speech and language therapy (SLT) interventions frequency (days/week), intensity (h/week), and dosage (total SLT-hours) and language outcomes for different age, sex, aphasia severity, and chronicity subgroups by undertaking prespecified subgroup network meta-analyses of the RELEASE database. METHODS MEDLINE, EMBASE, and trial registrations were systematically searched (inception-Sept2015) for RCTs, including ⩾ 10 IPD on stroke-related aphasia. We extracted demographic, stroke, aphasia, SLT, and risk of bias data. Overall-language ability, auditory comprehension, and functional communication outcomes were standardized. A one-stage, random effects, network meta-analysis approach filtered IPD into a single optimal model, examining SLT regimen and language recovery from baseline to first post-intervention follow-up, adjusting for covariates identified a-priori. Data were dichotomized by age (⩽/> 65 years), aphasia severity (mild-moderate/ moderate-severe based on language outcomes' median value), chronicity (⩽/> 3 months), and sex subgroups. We reported estimates of means and 95% confidence intervals. Where relative variance was high (> 50%), results were reported for completeness. RESULTS 959 IPD (25 RCTs) were analyzed. For working-age participants, greatest language gains from baseline occurred alongside moderate to high-intensity SLT (functional communication 3-to-4 h/week; overall-language and comprehension > 9 h/week); older participants' greatest gains occurred alongside low-intensity SLT (⩽ 2 h/week) except for auditory comprehension (> 9 h/week). For both age-groups, SLT-frequency and dosage associated with best language gains were similar. Participants ⩽ 3 months post-onset demonstrated greatest overall-language gains for SLT at low intensity/moderate dosage (⩽ 2 SLT-h/week; 20-to-50 h); for those > 3 months, post-stroke greatest gains were associated with moderate-intensity/high-dosage SLT (3-4 SLT-h/week; ⩾ 50 hours). For moderate-severe participants, 4 SLT-days/week conferred the greatest language gains across outcomes, with auditory comprehension gains only observed for ⩾ 4 SLT-days/week; mild-moderate participants' greatest functional communication gains were associated with similar frequency (⩾ 4 SLT-days/week) and greatest overall-language gains with higher frequency SLT (⩾ 6 days/weekly). Males' greatest gains were associated with SLT of moderate (functional communication; 3-to-4 h/weekly) or high intensity (overall-language and auditory comprehension; (> 9 h/weekly) compared to females for whom the greatest gains were associated with lower-intensity SLT (< 2 SLT-h/weekly). Consistencies across subgroups were also evident; greatest overall-language gains were associated with 20-to-50 SLT-h in total; auditory comprehension gains were generally observed when SLT > 9 h over ⩾ 4 days/week. CONCLUSIONS We observed a treatment response in most subgroups' overall-language, auditory comprehension, and functional communication language gains. For some, the maximum treatment response varied in association with different SLT-frequency, intensity, and dosage. Where differences were observed, working-aged, chronic, mild-moderate, and male subgroups experienced their greatest language gains alongside high-frequency/intensity SLT. In contrast, older, moderate-severely impaired, and female subgroups within 3 months of aphasia onset made their greatest gains for lower-intensity SLT. The acceptability, clinical, and cost effectiveness of precision aphasia rehabilitation approaches based on age, sex, aphasia severity, and chronicity should be evaluated in future clinical RCTs.
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Affiliation(s)
| | - Marian C Brady
- Marian C Brady, NMAHP Research Unit, Glasgow Caledonian University, Cowcaddens Road, Glasgow G4 0BA, UK.
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9
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Antonenko D, Rocke M, Thams F, Hummel FC, Maceira-Elvira P, Meinzer M, Flöel A. Complementary practical considerations to home-based, remotely-controlled and independently self-applied tES combined with cognitive training. Brain Stimul 2022; 15:1351-1353. [PMID: 36191808 DOI: 10.1016/j.brs.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 09/16/2022] [Accepted: 09/21/2022] [Indexed: 12/30/2022] Open
Affiliation(s)
- Daria Antonenko
- University Medicine Greifswald, Department of Neurology, 17475, Greifswald, Germany.
| | - Merle Rocke
- University Medicine Greifswald, Department of Neurology, 17475, Greifswald, Germany
| | - Friederike Thams
- University Medicine Greifswald, Department of Neurology, 17475, Greifswald, Germany
| | - Friedhelm C Hummel
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202, Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, 1951, Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, 1202, Geneva, Switzerland
| | - Pablo Maceira-Elvira
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL), 1202, Geneva, Switzerland; Defitech Chair of Clinical Neuroengineering, Neuro-X Institute (INX) and Brain Mind Institute (BMI), Swiss Federal Institute of Technology (EPFL Valais), Clinique Romande de Réadaptation, 1951, Sion, Switzerland; Clinical Neuroscience, University of Geneva Medical School, 1202, Geneva, Switzerland
| | - Marcus Meinzer
- University Medicine Greifswald, Department of Neurology, 17475, Greifswald, Germany
| | - Agnes Flöel
- University Medicine Greifswald, Department of Neurology, 17475, Greifswald, Germany
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10
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Roheger M, Brenning J, Riemann S, Martin AK, Flöel A, Meinzer M. Progression of socio-cognitive impairment from healthy aging to Alzheimer's Dementia: A systematic Review and Meta-Analysis. Neurosci Biobehav Rev 2022; 140:104796. [PMID: 35905800 DOI: 10.1016/j.neubiorev.2022.104796] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 06/16/2022] [Accepted: 07/23/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Trajectories of decline across different socio-cognitive domains in healthy older adults and in pathological aging conditions have not been investigated. This was addressed in the present systematic review and meta-analysis. METHODS MEDLINE, Web of Science Core Collection, CENTRAL, and PsycInfo were searched for studies investigating social cognition across four domains (Theory of Mind, ToM; emotion recognition, ER; Social-decision making, SD; visual perspective taking, VPT) in healthy older individuals, individuals with subjective and mild cognitive impairment (SCD, MCI) and Alzheimer's disease (AD). Random-effects meta-analyses were conducted. RESULTS Of 8,137 screened studies, 132 studies were included in the review. ToM and ER showed a clear progression of impairment from normal aging to AD. Differential patterns of decline were identified for different types of ToM and ER. CONCLUSION This systematic review identified progression of impairment of specific socio-cognitive abilities, which is the necessary pre-requisite for developing targeted interventions. We identified a lack of research on socio-cognitive decline in different populations (e.g., middle age, SCD and MCI-subtypes) and domains (SDM, VPT). REGISTRATION CRD42020191607, https://www.crd.york.ac.uk/prospero/.
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Affiliation(s)
- Mandy Roheger
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.
| | - Jana Brenning
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Steffen Riemann
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Andrew K Martin
- Department of Psychology, University of Kent, Canterbury, United Kingdom CT2 7NP
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
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11
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Rose ML, Nickels L, Copland D, Togher L, Godecke E, Meinzer M, Rai T, Cadilhac DA, Kim J, Hurley M, Foster A, Carragher M, Wilcox C, Pierce JE, Steel G. Results of the COMPARE trial of Constraint-induced or Multimodality Aphasia Therapy compared with usual care in chronic post-stroke aphasia. J Neurol Neurosurg Psychiatry 2022; 93:573-581. [PMID: 35396340 PMCID: PMC9148985 DOI: 10.1136/jnnp-2021-328422] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 03/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND While meta-analyses confirm treatment for chronic post-stroke aphasia is effective, a lack of comparative evidence for different interventions limits prescription accuracy. We investigated whether Constraint-Induced Aphasia Therapy Plus (CIAT-plus) and/or Multimodality Aphasia Therapy (M-MAT) provided greater therapeutic benefit compared with usual community care and were differentially effective according to baseline aphasia severity. METHODS We conducted a three-arm, multicentre, parallel group, open-label, blinded endpoint, phase III, randomised-controlled trial. We stratified eligible participants by baseline aphasia on the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ). Groups of three participants were randomly assigned (1:1:1) to 30 hours of CIAT-Plus or M-MAT or to usual care (UC). Primary outcome was change in aphasia severity (WAB-R-AQ) from baseline to therapy completion analysed in the intention-to-treat population. Secondary outcomes included word retrieval, connected speech, functional communication, multimodal communication, quality of life and costs. RESULTS We analysed 201 participants (70 in CIAT-Plus, 70 in M-MAT and 61 in UC). Aphasia severity was not significantly different between groups at postintervention: 1.05 points (95% CI -0.78 to 2.88; p=0.36) UC group vs CIAT-Plus; 1.06 points (95% CI -0.78 to 2.89; p=0.36) UC group vs M-MAT; 0.004 points (95% CI -1.76 to 1.77; p=1.00) CIAT-Plus vs M-MAT. Word retrieval, functional communication and communication-related quality of life were significantly improved following CIAT-Plus and M-MAT. Word retrieval benefits were maintained at 12-week follow-up. CONCLUSIONS CIAT-Plus and M-MAT were effective for word retrieval, functional communication, and quality of life, while UC was not. Future studies should explore predictive characteristics of responders and impacts of maintenance doses. TRIAL REGISTRATION NUMBER ACTRN 2615000618550.
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Affiliation(s)
- Miranda L Rose
- Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia .,Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Lyndsey Nickels
- School of Psychological Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - David Copland
- Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.,Queensland Aphasia Rehabilitation Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Leanne Togher
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Erin Godecke
- Edith Cowan University, Joondalup, Western Australia, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Dominique A Cadilhac
- Stroke and Ageing Research, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Joosup Kim
- Stroke and Ageing Research, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Melanie Hurley
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Abby Foster
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia.,Monash Health, Clayton, Victoria, Australia
| | - Marcella Carragher
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Cassie Wilcox
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - John E Pierce
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
| | - Gillian Steel
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Victoria, Australia
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12
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Thams F, Antonenko D, Fleischmann R, Meinzer M, Grittner U, Schmidt S, Brakemeier EL, Steinmetz A, Flöel A. Neuromodulation through brain stimulation-assisted cognitive training in patients with post-COVID-19 cognitive impairment (Neuromod-COV): study protocol for a PROBE phase IIb trial. BMJ Open 2022; 12:e055038. [PMID: 35410927 PMCID: PMC9002255 DOI: 10.1136/bmjopen-2021-055038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION A substantial number of patients diagnosed with COVID-19 experience long-term persistent symptoms. First evidence suggests that long-term symptoms develop largely independently of disease severity and include, among others, cognitive impairment. For these symptoms, there are currently no validated therapeutic approaches available. Cognitive training interventions are a promising approach to counteract cognitive impairment. Combining training with concurrent transcranial direct current stimulation (tDCS) may further increase and sustain behavioural training effects. Here, we aim to examine the effects of cognitive training alone or in combination with tDCS on cognitive performance, quality of life and mental health in patients with post-COVID-19 subjective or objective cognitive impairments. METHODS AND ANALYSIS This study protocol describes a prospective randomised open endpoint-blinded trial. Patients with post-COVID-19 cognitive impairment will either participate in a 3-week cognitive training or in a defined muscle relaxation training (open-label interventions). Irrespective of their primary intervention, half of the cognitive training group will additionally receive anodal tDCS, all other patients will receive sham tDCS (double-blinded, secondary intervention). The primary outcome will be improvement of working memory performance, operationalised by an n-back task, at the postintervention assessment. Secondary outcomes will include performance on trained and untrained tasks and measures of health-related quality of life at postassessment and follow-up assessments (1 month after the end of the trainings). ETHICS AND DISSEMINATION Ethical approval was granted by the Ethics Committee of the University Medicine Greifswald (number: BB 066/21). Results will be available through publications in peer-reviewed journals and presentations at national and international conferences. TRIAL REGISTRATION NUMBER NCT04944147.
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Affiliation(s)
- Friederike Thams
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Daria Antonenko
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Robert Fleischmann
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Ulrike Grittner
- Berlin Institute of Health, Berlin, Germany
- Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sein Schmidt
- Clinical Research Unit, Campus Mitte, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Eva-Lotta Brakemeier
- Department of Clinical Psychology and Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Anke Steinmetz
- Department of Physical and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
- German Center for Neurodegenerative Diseases Site Rostock/Greifswald, Rostock, Germany
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13
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Ekhtiari H, Ghobadi-Azbari P, Thielscher A, Antal A, Li LM, Shereen AD, Cabral-Calderin Y, Keeser D, Bergmann TO, Jamil A, Violante IR, Almeida J, Meinzer M, Siebner HR, Woods AJ, Stagg CJ, Abend R, Antonenko D, Auer T, Bächinger M, Baeken C, Barron HC, Chase HW, Crinion J, Datta A, Davis MH, Ebrahimi M, Esmaeilpour Z, Falcone B, Fiori V, Ghodratitoostani I, Gilam G, Grabner RH, Greenspan JD, Groen G, Hartwigsen G, Hauser TU, Herrmann CS, Juan CH, Krekelberg B, Lefebvre S, Liew SL, Madsen KH, Mahdavifar-Khayati R, Malmir N, Marangolo P, Martin AK, Meeker TJ, Ardabili HM, Moisa M, Momi D, Mulyana B, Opitz A, Orlov N, Ragert P, Ruff CC, Ruffini G, Ruttorf M, Sangchooli A, Schellhorn K, Schlaug G, Sehm B, Soleimani G, Tavakoli H, Thompson B, Timmann D, Tsuchiyagaito A, Ulrich M, Vosskuhl J, Weinrich CA, Zare-Bidoky M, Zhang X, Zoefel B, Nitsche MA, Bikson M. A checklist for assessing the methodological quality of concurrent tES-fMRI studies (ContES checklist): a consensus study and statement. Nat Protoc 2022; 17:596-617. [PMID: 35121855 PMCID: PMC7612687 DOI: 10.1038/s41596-021-00664-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 11/12/2021] [Indexed: 11/09/2022]
Abstract
Low-intensity transcranial electrical stimulation (tES), including alternating or direct current stimulation, applies weak electrical stimulation to modulate the activity of brain circuits. Integration of tES with concurrent functional MRI (fMRI) allows for the mapping of neural activity during neuromodulation, supporting causal studies of both brain function and tES effects. Methodological aspects of tES-fMRI studies underpin the results, and reporting them in appropriate detail is required for reproducibility and interpretability. Despite the growing number of published reports, there are no consensus-based checklists for disclosing methodological details of concurrent tES-fMRI studies. The objective of this work was to develop a consensus-based checklist of reporting standards for concurrent tES-fMRI studies to support methodological rigor, transparency and reproducibility (ContES checklist). A two-phase Delphi consensus process was conducted by a steering committee (SC) of 13 members and 49 expert panelists through the International Network of the tES-fMRI Consortium. The process began with a circulation of a preliminary checklist of essential items and additional recommendations, developed by the SC on the basis of a systematic review of 57 concurrent tES-fMRI studies. Contributors were then invited to suggest revisions or additions to the initial checklist. After the revision phase, contributors rated the importance of the 17 essential items and 42 additional recommendations in the final checklist. The state of methodological transparency within the 57 reviewed concurrent tES-fMRI studies was then assessed by using the checklist. Experts refined the checklist through the revision and rating phases, leading to a checklist with three categories of essential items and additional recommendations: (i) technological factors, (ii) safety and noise tests and (iii) methodological factors. The level of reporting of checklist items varied among the 57 concurrent tES-fMRI papers, ranging from 24% to 76%. On average, 53% of checklist items were reported in a given article. In conclusion, use of the ContES checklist is expected to enhance the methodological reporting quality of future concurrent tES-fMRI studies and increase methodological transparency and reproducibility.
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Affiliation(s)
| | - Peyman Ghobadi-Azbari
- Department of Biomedical Engineering, Shahed University, Tehran, Iran
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Axel Thielscher
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Health Technology, Technical University of Denmark, Kongens Lyngby, Denmark
| | - Andrea Antal
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Lucia M Li
- Computational, Cognitive and Clinical Imaging Lab, Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK
- UK DRI Centre for Care Research and Technology, Imperial College London, London, UK
| | - A Duke Shereen
- Advanced Science Research Center, The Graduate Center, City University of New York, New York, NY, USA
| | - Yuranny Cabral-Calderin
- Research Group Neural and Environmental Rhythms, Max Planck Institute for Empirical Aesthetics, Frankfurt, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital LMU Munich, Munich, Germany
- Department of Radiology, University Hospital LMU Munich, Munich, Germany
- NeuroImaging Core Unit Munich (NICUM), University Hospital LMU Munich, Munich, Germany
| | - Til Ole Bergmann
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Neurology and Stroke and Hertie Institute for Clinical Brain Research, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - Asif Jamil
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Ines R Violante
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Jorge Almeida
- Proaction Lab, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
- CINEICC, Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Marcus Meinzer
- Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Queensland, Australia
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Hartwig R Siebner
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Neurology, Copenhagen University Hospital Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Charlotte J Stagg
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, UK
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Rany Abend
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Daria Antonenko
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tibor Auer
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Marc Bächinger
- Neural Control of Movement Lab, Department of Health Sciences and Technology, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich, Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - Chris Baeken
- Department of Psychiatry and Medical Psychology, University Hospital Ghent, Ghent, Belgium
- Department of Psychiatry, Vrije Universiteit Brussel, University Hospital Brussels, Brussels, Belgium
- Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Helen C Barron
- Wellcome Centre for Integrative Neuroimaging, University of Oxford, FMRIB, John Radcliffe Hospital, Oxford, UK
- Medical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Henry W Chase
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jenny Crinion
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Abhishek Datta
- Research and Development, Soterix Medical, New York, USA
- The City College of the City University of New York, New York, USA
| | - Matthew H Davis
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Mohsen Ebrahimi
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Esmaeilpour
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA
| | - Brian Falcone
- Northrop Grumman Company, Mission Systems, Falls Church, VA, USA
| | - Valentina Fiori
- Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory (NEL), Center for Engineering Applied to Health, Institute of Mathematics and Computer Science (ICMC), University of Sao Paulo, Sao Paulo, Brazil
| | - Gadi Gilam
- Systems Neuroscience and Pain Laboratory, Division of Pain Medicine, Department of Anesthesiology, Perioperative, and Pain Medicine, School of Medicine, Stanford University, Palo Alto, CA, USA
- The Institute of Biomedical and Oral Research, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Roland H Grabner
- Educational Neuroscience, Institute of Psychology, University of Graz, Graz, Austria
| | - Joel D Greenspan
- Department of Neural and Pain Sciences, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - Georg Groen
- Department of Psychiatry, University of Ulm, Ulm, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Tobias U Hauser
- Max Planck University College London Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, University College London, London, UK
| | - Christoph S Herrmann
- Experimental Psychology Lab, Cluster of Excellence "Hearing4all", European Medical School, University of Oldenburg, Oldenburg, Germany
- Neuroimaging Unit, European Medical School, University of Oldenburg, Oldenburg, Germany
- Research Centre Neurosensory Science, University of Oldenburg, Oldenburg, Germany
| | - Chi-Hung Juan
- Institute of Cognitive Neuroscience, National Central University, Taoyuan, Taiwan
- Cognitive Intelligence and Precision Healthcare Research Center, National Central University, Taoyuan, Taiwan
| | - Bart Krekelberg
- Center for Molecular and Behavioral Neuroscience, Rutgers University-Newark, Newark, NJ, USA
| | - Stephanie Lefebvre
- Translational Research Centre, University Hospital of Psychiatry, University of Bern, Bern, Switzerland
| | - Sook-Lei Liew
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
- USC Stevens Neuroimaging and Informatics Institute, Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Biomedical Engineering, University of Southern California, Los Angeles, CA, USA
- Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
| | - Kristoffer H Madsen
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Amager and Hvidovre, Hvidovre, Denmark
- Department of Applied Mathematics and Computer Science, Technical University of Denmark, K, Lyngby, Denmark
| | | | - Nastaran Malmir
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Paola Marangolo
- Department of Humanities Studies, University Federico II, Naples, Italy
- Aphasia Research Lab, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Andrew K Martin
- Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Queensland, Australia
- Department of Psychology, University of Kent, Canterbury, UK
| | - Timothy J Meeker
- Department of Neurosurgery, Johns Hopkins University, Baltimore, MD, USA
| | - Hossein Mohaddes Ardabili
- Psychiatry and Behavioral Sciences Research Center, Ibn-e-Sina Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Marius Moisa
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Davide Momi
- Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Beni Mulyana
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Alexander Opitz
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Natasza Orlov
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Boston, MA, USA
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Psychology, Jagiellonian University, Cracow, Poland
| | - Patrick Ragert
- Institute for General Kinesiology and Exercise Science, University of Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Christian C Ruff
- Zurich Center for Neuroeconomics, Department of Economics, University of Zurich, Zurich, Switzerland
| | - Giulio Ruffini
- Neuroelectrics Corporation, Cambridge, Cambridge, MA, USA
- Neuroelectrics Corporation, Barcelona, Barcelona, Spain
| | - Michaela Ruttorf
- Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Arshiya Sangchooli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Gottfried Schlaug
- Neuroimaging-Neuromodulation and Stroke Recovery Laboratories, Department of Neurology, Baystate-University of Massachusetts Medical School, and Department of Biomedical Engineering, Institute of Applied Life Sciences, University of Massachusetts, Amherst, MA, USA
| | - Bernhard Sehm
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Department of Neurology, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Ghazaleh Soleimani
- Department of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Hosna Tavakoli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- Department of Cognitive Neuroscience, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Benjamin Thompson
- School of Optometry and Vision Science, University of Auckland, Auckland, New Zealand
- School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
- Centre for Eye and Vision Research, Hong Kong, Hong Kong
| | - Dagmar Timmann
- Department of Neurology and Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen University Hospital, University of Duisburg-Essen, Essen, Germany
| | | | - Martin Ulrich
- Department of Psychiatry, University of Ulm, Ulm, Germany
| | - Johannes Vosskuhl
- Experimental Psychology Lab, Cluster of Excellence "Hearing4all", European Medical School, University of Oldenburg, Oldenburg, Germany
| | - Christiane A Weinrich
- Department of Neurology, University Medical Center Goettingen, Goettingen, Germany
- Department of Cognitive Neurology, University Medical Center Goettingen, Goettingen, Germany
| | - Mehran Zare-Bidoky
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
- Shahid-Sadoughi University of Medical Sciences, Yazd, Iran
| | - Xiaochu Zhang
- Department of Psychology, School of Humanities & Social Science, University of Science & Technology of China, Hefei, China
| | - Benedikt Zoefel
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
- Centre de Recherche Cerveau et Cognition (CerCo), CNRS, Toulouse, France
- Université Toulouse III Paul Sabatier, Toulouse, France
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | - Marom Bikson
- Department of Biomedical Engineering, The City College of New York of CUNY, New York, NY, USA
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Roheger M, Riemann S, Grittner U, Flöel A, Meinzer M. Non-pharmacological interventions for improving language and communication in people with primary progressive aphasia: a network meta-analysis. Cochrane Database of Systematic Reviews 2021. [DOI: 10.1002/14651858.cd015067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Mandy Roheger
- Department of Neurology; University Medicine Greifswald; Greifswald Germany
| | - Steffen Riemann
- Department of Neurology; University Medicine Greifswald; Greifswald Germany
| | - Ulrike Grittner
- Berlin Institute of Health at Charité - University Medicine Berlin; Berlin Germany
| | - Agnes Flöel
- Department of Neurology; University Medicine Greifswald; Greifswald Germany
| | - Marcus Meinzer
- Department of Neurology; University Medicine Greifswald; Greifswald Germany
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15
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Taud B, Lindenberg R, Darkow R, Wevers J, Höfflin D, Grittner U, Meinzer M, Flöel A. Limited Add-On Effects of Unilateral and Bilateral Transcranial Direct Current Stimulation on Visuo-Motor Grip Force Tracking Task Training Outcome in Chronic Stroke. A Randomized Controlled Trial. Front Neurol 2021; 12:736075. [PMID: 34858310 PMCID: PMC8631774 DOI: 10.3389/fneur.2021.736075] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/01/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This randomized controlled trial investigated if uni- and bihemispheric transcranial direct current stimulation (tDCS) of the motor cortex can enhance the effects of visuo-motor grip force tracking task training and transfer to clinical assessments of upper extremity motor function. Methods: In a randomized, double-blind, sham-controlled trial, 40 chronic stroke patients underwent 5 days of visuo-motor grip force tracking task training of the paretic hand with either unilateral or bilateral (N = 15/group) or placebo tDCS (N = 10). Immediate and long-term (3 months) effects on training outcome and motor recovery (Upper Extremity Fugl-Meyer, UE-FM, Wolf Motor Function Test, and WMFT) were investigated. Results: Trained task performance significantly improved independently of tDCS in a curvilinear fashion. In the anodal stimulation group UE-FM scores were higher than in the sham group at day 5 (adjusted mean difference: 2.6, 95%CI: 0.6–4.5, p = 0.010) and at 3 months follow up (adjusted mean difference: 2.8, 95%CI: 0.8–4.7, p = 0.006). Neither training alone, nor the combination of training and tDCS improved WMFT performance. Conclusions: Visuo-motor grip force tracking task training can facilitate recovery of upper extremity function. Only minimal add-on effects of anodal but not dual tDCS were observed. Clinical Trial Registration:https://clinicaltrials.gov/ct2/results?recrs=&cond=&term=NCT01969097&cntry=&state=&city=&dist=, identifier: NCT01969097, retrospectively registered on 25/10/2013.
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Affiliation(s)
- Benedikt Taud
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany
| | - Robert Lindenberg
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany.,Department of History, Philosophy and Ethics of Medicine, Heinrich Heine University, Düsseldorf, Germany
| | - Robert Darkow
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany
| | - Jasmin Wevers
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany
| | - Dorothee Höfflin
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany
| | - Ulrike Grittner
- Berlin Institute of Health at Charité, Charité University Medicine, Berlin, Germany.,Institute of Biometry and Clinical Epidemiology, Charité University Medicine, Berlin, Germany
| | - Marcus Meinzer
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Agnes Flöel
- Neurocure Cluster of Excellence, Charité University Medicine, Berlin, Germany.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,German Centre for Neurodegenerative Diseases, Site Greifswald/Rostock, Greifswald, Germany.,Center for Stroke Research, Charité University Medicine, Berlin, Germany
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16
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Roheger M, Hennersdorf X, Riemann S, Flöel A, Meinzer M. A systematic review and network meta-analysis of interventions for subjective cognitive decline. Alzheimers Dement (N Y) 2021; 7:e12180. [PMID: 34268448 PMCID: PMC8274308 DOI: 10.1002/trc2.12180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/01/2020] [Accepted: 04/13/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is considered a risk factor for Alzheimer's disease (AD), highlighting the need for identifying and ranking effective interventions. This was addressed in a systematic review and network meta-analysis (NMA) of pharmacological and non-pharmacological interventions for SCD. METHODS MEDLINE, Web of Science Core Collection, CENTRAL, and PsycINFO were searched for randomized controlled trials (RCTs) investigating effects on memory, global cognition, and quality of life. Random-effect model NMAs were conducted. The Cochrane Risk-of-Bias-2 tool assessed methodological quality. Prospero-Registration: CRD42020180457. RESULTS The systematic review included 56 RCTs. Education programs were most effective for improving memory, second most effective for improving global cognition. Quality of life and adverse events could not be included due to insufficient data. Overall methodological quality of studies was low. CONCLUSION Education programs were most effective for improving memory and cognition, warranting further research into effective elements of this intervention. There is urgent need to address identified methodological shortcomings in SCD intervention research.
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Affiliation(s)
- Mandy Roheger
- Department of NeurologyUniversity Medicine GreifswaldGreifswaldGermany
| | | | - Steffen Riemann
- Department of NeurologyUniversity Medicine GreifswaldGreifswaldGermany
| | - Agnes Flöel
- Department of NeurologyUniversity Medicine GreifswaldGreifswaldGermany
| | - Marcus Meinzer
- Department of NeurologyUniversity Medicine GreifswaldGreifswaldGermany
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17
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Rose ML, Rai T, Copland D, Nickels L, Togher L, Meinzer M, Godecke E, Kim J, Cadilhac DA, Hurley M, Wilcox C, Carragher M. Statistical analysis plan for the COMPARE trial: a 3-arm randomised controlled trial comparing the effectiveness of Constraint-induced Aphasia Therapy Plus and Multi-modality Aphasia Therapy to usual care in chronic post-stroke aphasia (COMPARE). Trials 2021; 22:303. [PMID: 33892764 PMCID: PMC8062936 DOI: 10.1186/s13063-021-05238-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 03/30/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND While high-quality meta-analyses have confirmed the effectiveness of aphasia therapy after stroke, there is limited evidence for the comparative effectiveness of different aphasia interventions. Two commonly used interventions, Constraint-induced Aphasia Therapy Plus (CIAT Plus) and Multi-modality Aphasia Therapy (M-MAT), are hypothesised to rely on diverse underlying neural mechanisms for recovery and may be differentially responsive to aphasia severity. COMPARE is a prospective randomised open-blinded end-point trial designed to determine whether, in people with chronic post-stroke aphasia living in the community, CIAT Plus and M-MAT provide greater therapeutic benefit compared to usual care, are differentially effective according to aphasia severity, and are cost-effective. This paper details the statistical analysis plan for the COMPARE trial developed prior to data analysis. METHODS Participants (n = 216) are randomised to one of three arms, CIAT Plus, M-MAT or usual care, and undertake therapy with a study trained speech pathologist in groups of three participants stratified by aphasia severity. Therapy occurs for 3 h blocks per day for 10 days across 2 weeks. The primary clinical outcome is aphasia severity as measured by the Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ) immediately post intervention. Secondary outcomes include WAB-R-AQ at 12-week follow-up, and functional communication, discourse efficiency, multimodal communication, and health-related quality of life immediately post intervention and at 12-week follow-up. RESULTS Linear mixed models (LMMs) will be used to analyse differences between M-MAT and UC, and CIAT-Plus and UC on each outcome measure immediately and at 12 weeks post-intervention. The LMM for WAB-R-AQ will assess the differences in efficacy between M-MAT and CIAT-Plus. All analyses will control for baseline aphasia severity (fixed effect) and for the clustering effect of treatment groups (random effect). DISCUSSION This trial will provide relative effectiveness data for two common interventions for people with chronic post-stroke aphasia, and highlight possible differential effects based on aphasia severity. Together with the health economic analysis data, the results will enable more informed personalised prescription for aphasia therapy after stroke. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN 12615000618550 . Registered on 15 June 2016.
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Affiliation(s)
- Miranda L Rose
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Kingsbury Drive, Bundoora, Victoria, 3084, Australia.
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia.
| | - Tapan Rai
- University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David Copland
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- University of Queensland, Brisbane, Queensland, Australia
| | - Lyndsey Nickels
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Department of Cognitive Science, Macquarie University, Sydney, New South Wales, Australia
| | - Leanne Togher
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- The University of Sydney, Sydney, New South Wales, Australia
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Erin Godecke
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia
| | - Joosup Kim
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Australia School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Dominique A Cadilhac
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- Australia School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Monash Health, Clayton, Victoria, Australia
| | - Melanie Hurley
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Kingsbury Drive, Bundoora, Victoria, 3084, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Cassie Wilcox
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Kingsbury Drive, Bundoora, Victoria, 3084, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Marcella Carragher
- School of Allied Health, Human Services and Sport, La Trobe University Melbourne, Kingsbury Drive, Bundoora, Victoria, 3084, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
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18
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de Boer DML, Johnston PJ, Kerr G, Meinzer M, Cleeremans A. Author Correction: A causal role for the right angular gyrus in self-location mediated perspective taking. Sci Rep 2021; 11:3819. [PMID: 33564099 PMCID: PMC7873186 DOI: 10.1038/s41598-021-83014-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- D M L de Boer
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, QLD, 4059, Australia. .,Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisbane, Australia.
| | - P J Johnston
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, QLD, 4059, Australia.,Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisbane, Australia
| | - G Kerr
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Kelvin Grove, QLD, 4059, Australia.,Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology (QUT), Brisbane, Australia
| | - M Meinzer
- Centre for Clinical Research (UQCCR), The University of Queensland, Brisbane, Australia.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - A Cleeremans
- Consciousness, Cognition, and Computation Group (CO3), Centre for Research in Cognition and Neurosciences (CRCN), ULB Neuroscience Institute (UNI), Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt 50, CP191, 1050, Brussels, Belgium
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19
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Martin AK, Su P, Meinzer M. Improving Cross-cultural "Mind-reading" with Electrical Brain Stimulation. Neuroscience 2020; 455:107-112. [PMID: 33346121 DOI: 10.1016/j.neuroscience.2020.12.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 12/05/2020] [Accepted: 12/07/2020] [Indexed: 01/07/2023]
Abstract
A cross-cultural disadvantage exists when inferring the mental state of others, which may be detrimental for individuals acting in an increasingly globalized world. The dorsomedial prefrontal cortex (dmPFC) is a key hub of the social brain involved in ToM. We explored whether facilitation of dmPFC function by focal high-definition tDCS can improve cross-cultural mind-reading. 52 (26 F/M) Singaporeans performed the Caucasian version of the Reading the Mind in the Eyes Test (RMET) and received HD-tDCS to either the dmPFC or a control site (right temporoparietal junction, rTPJ) in sham-controlled, double-blinded, crossover studies. Contact with Caucasians was determined for the Singaporean cohort as a potential mediator of RMET performance and HD-tDCS response. 52 Caucasians completed the RMET during sham-tDCS and served as a comparison group. A cross-cultural disadvantage on the RMET was confirmed in the Singaporean cohort and this disadvantage was more pronounced in those participants who had less contact with Caucasians. Importantly, HD-tDCS to the dmPFC improved RMET performance in those with less contact. No effect was identified for rTPJ HD-tDCS or for the age/sex control task demonstrating task and site specificity of the stimulation effects. Electrical stimulation of the dmPFC selectively improves the rate of cross-cultural ToM inference from facial cues, effectively removing cross-cultural disadvantage that was found in individuals with lower cross-cultural exposure.
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Affiliation(s)
- A K Martin
- The University of Queensland, Centre for Clinical Research (UQCCR), Brisbane, Australia; The University of Kent, Department of Psychology, Canterbury, UK.
| | - P Su
- The University of Queensland, Centre for Clinical Research (UQCCR), Brisbane, Australia
| | - M Meinzer
- The University of Queensland, Centre for Clinical Research (UQCCR), Brisbane, Australia; University Medicine Greifswald, Department of Neurology, Greifswald, Germany
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20
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Martin DM, Mohan A, Alonzo A, Gates N, Gbadeyan O, Meinzer M, Sachdev P, Brodaty H, Loo C. A Pilot Double-Blind Randomized Controlled Trial of Cognitive Training Combined with Transcranial Direct Current Stimulation for Amnestic Mild Cognitive Impairment. J Alzheimers Dis 2020; 71:503-512. [PMID: 31424410 DOI: 10.3233/jad-190306] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND There is currently no effective intervention for improving memory in people at increased risk for dementia. Cognitive training (CT) has been promising, though effects are modest, particularly at follow-up. OBJECTIVE To investigate whether adjunctive non-invasive brain stimulation (transcranial direct current stimulation, tDCS) could enhance the memory benefits of CT in amnestic mild cognitive impairment (aMCI). METHODS Participants with aMCI were randomized to receive CT with either Active tDCS (2 mA for 30 min and 0.016 mA for 30 min) or Sham tDCS (0.016 mA for 60 min) for 15 sessions over a period of 5 weeks in a double-blind, sham-controlled, parallel group clinical trial. The primary outcome measure was the California Verbal Learning Task 2nd Edition. RESULTS 68 participants commenced the intervention. Intention-to-treat (ITT) analysis showed that the CT+Active tDCS group significantly improved at post treatment (p = 0.033), and the CT+Sham tDCS group did not (p = 0.050), but there was no difference between groups. At the 3-month follow-up, both groups showed large-sized memory improvements compared to pre-treatment (CT+Active tDCS: p < 0.01, d = 0.99; CT+Sham tDCS: p < 0.01, d = 0.74), although there was no significant difference between groups. CONCLUSION This study found that CT+Active tDCS did not produce greater memory improvement compared to CT+Sham tDCS. Large-sized memory improvements occurred in both conditions at follow-up. One possible interpretation, based on recent novel findings, is that low intensity tDCS (used as 'sham') may have contributed biological effects. Further work should use a completely inert tDCS sham condition.
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Affiliation(s)
- Donel M Martin
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Adith Mohan
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Angelo Alonzo
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nicola Gates
- School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Oyetunde Gbadeyan
- University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Marcus Meinzer
- University of Queensland Centre for Clinical Research, Brisbane, Australia.,Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Perminder Sachdev
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- School of Psychiatry, University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Colleen Loo
- Black Dog Institute, Sydney, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia.,St George Hospital, South Eastern Sydney Health, Sydney, Australia
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21
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Gbadeyan O, Steinhauser M, Hunold A, Martin AK, Haueisen J, Meinzer M. Modulation of Adaptive Cognitive Control by Prefrontal High-Definition Transcranial Direct Current Stimulation in Older Adults. J Gerontol B Psychol Sci Soc Sci 2020; 74:1174-1183. [PMID: 31045231 DOI: 10.1093/geronb/gbz048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 04/14/2019] [Accepted: 04/24/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Adaptive cognitive control frequently declines in advanced age. Because high-definition transcranial direct current stimulation (HD-tDCS) of the right dorsolateral prefrontal cortex (DLPFC) improved cognitive control in young adults, we investigated if this montage can also improve cognitive control in older individuals. METHOD In a double-blind, sham HD-tDCS controlled, cross-over design, 36 older participants received right DLPFC HD-tDCS during a visual flanker task. Conflict adaptation (CA) effects on response time (RT) and error rates (ER) assessed adaptive cognitive control. Biophysical modeling assessed the magnitude and distribution of induced current in older adults. RESULTS Active HD-tDCS enhanced CA in older adults. However, this positive behavioral effect was limited to CA in ER. Similar to results obtained in healthy young adults, current modeling analysis demonstrated focal current delivery to the DLPFC with sufficient magnitude of the induced current to modulate neural function in older adults. DISCUSSION This study confirms the effectiveness of HD-tDCS to modulate adaptive cognitive control in advanced age.
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Affiliation(s)
- Oyetunde Gbadeyan
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Marco Steinhauser
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Germany
| | - Alexander Hunold
- Institute of Biomedical Engineering and Informatics, Technical University Ilmenau, Germany
| | - Andrew K Martin
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia
| | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Technical University Ilmenau, Germany
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland, Brisbane, Australia.,Department of Neurology, University Medicine Greifswald, Germany
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22
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Perceval G, Martin AK, Copland DA, Laine M, Meinzer M. Multisession transcranial direct current stimulation facilitates verbal learning and memory consolidation in young and older adults. Brain Lang 2020; 205:104788. [PMID: 32199339 DOI: 10.1016/j.bandl.2020.104788] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 01/27/2020] [Accepted: 03/05/2020] [Indexed: 06/10/2023]
Abstract
This study investigated effects of multisession transcranial direct-current stimulation on learning and maintenance of novel memory content and scrutinised effects of baseline cognitive status and the role of multi-session tDCS on overnight memory consolidation. In a prospective, randomized, double-blind, parallel-group, sham-tDCS controlled design, 101 healthy young and older adults completed a five-day verbal associative learning paradigm while receiving multisession tDCS to the task-relevant left prefrontal cortex. In older adults, active multisession tDCS enhanced recall performance after each daily training session. Effects were maintained the next morning and during follow-up assessments (one week; three months). In young adults, multisession tDCS significantly increased long-term recall. Unlike previous findings in the motor domain, beneficial effects of multisession tDCS on cognitive learning and memory were notexclusively due to enhanced memory consolidation. Positive stimulation effects were primarily found in participants with lower baseline learning ability, suggesting that multisession tDCS may counteract memory impairment in health and disease.
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Affiliation(s)
- Garon Perceval
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; Department of Psychology, School of Education, Soochow University, Suzhou, China
| | - Andrew K Martin
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; University of Kent, Department of Psychology, Canterbury, UK
| | - David A Copland
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia
| | - Matti Laine
- Åbo Akademi University, Department of Psychology, Turku, Finland
| | - Marcus Meinzer
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia; University Medicine Greifswald, Department of Neurology, Greifswald, Germany.
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Brady MC, Ali M, VandenBerg K, Williams LJ, Williams LR, Abo M, Becker F, Bowen A, Brandenburg C, Breitenstein C, Bruehl S, Copland DA, Cranfill TB, Pietro-Bachmann MD, Enderby P, Fillingham J, Galli FL, Gandolfi M, Glize B, Godecke E, Hawkins N, Hilari K, Hinckley J, Horton S, Howard D, Jaecks P, Jefferies E, Jesus LMT, Kambanaros M, Kang EK, Khedr EM, Kong APH, Kukkonen T, Laganaro M, Ralph MAL, Laska AC, Leemann B, Leff AP, Lima RR, Lorenz A, MacWhinney B, Marshall RS, Mattioli F, Maviş I, Meinzer M, Nilipour R, Noé E, Paik NJ, Palmer R, Papathanasiou I, Patricio BF, Martins IP, Price C, Jakovac TP, Rochon E, Rose ML, Rosso C, Rubi-Fessen I, Ruiter MB, Snell C, Stahl B, Szaflarski JP, Thomas SA, van de Sandt-Koenderman M, van der Meulen I, Visch-Brink E, Worrall L, Wright HH. RELEASE: a protocol for a systematic review based, individual participant data, meta- and network meta-analysis, of complex speech-language therapy interventions for stroke-related aphasia. Aphasiology 2020; 34:137-157. [PMID: 37560459 PMCID: PMC7614912 DOI: 10.1080/02687038.2019.1643003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
BACKGROUND Speech and language therapy (SLT) benefits people with aphasia following stroke. Group level summary statistics from randomised controlled trials hinder exploration of highly complex SLT interventions and a clinically relevant heterogeneous population. Creating a database of individual participant data (IPD) for people with aphasia aims to allow exploration of individual and therapy-related predictors of recovery and prognosis. AIM To explore the contribution that individual participant characteristics (including stroke and aphasia profiles) and SLT intervention components make to language recovery following stroke. METHODS AND PROCEDURES We will identify eligible IPD datasets (including randomised controlled trials, non-randomised comparison studies, observational studies and registries) and invite their contribution to the database. Where possible, we will use meta- and network meta-analysis to explore language performance after stroke and predictors of recovery as it relates to participants who had no SLT, historical SLT or SLT in the primary research study. We will also examine the components of effective SLT interventions. OUTCOMES AND RESULTS Outcomes include changes in measures of functional communication, overall severity of language impairment, auditory comprehension, spoken language (including naming), reading and writing from baseline. Data captured on assessment tools will be collated and transformed to a standardised measure for each of the outcome domains. CONCLUSION Our planned systematic-review-based IPD meta- and network meta-analysis is a large scale, international, multidisciplinary and methodologically complex endeavour. It will enable hypotheses to be generated and tested to optimise and inform development of interventions for people with aphasia after stroke. SYSTEMATIC REVIEW REGISTRATION The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO; registration number: CRD42018110947).
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Affiliation(s)
- Marian C. Brady
- Nursing Midwifery and Allied Health Professions Unit, Glasgow Caledonian University, Glasgow, UK
| | - Myzoon Ali
- Nursing Midwifery and Allied Health Professions Unit, Glasgow Caledonian University, Glasgow, UK
| | - Kathryn VandenBerg
- Nursing Midwifery and Allied Health Professions Unit, Glasgow Caledonian University, Glasgow, UK
| | - Linda J. Williams
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Louise R. Williams
- Nursing Midwifery and Allied Health Professions Unit, Glasgow Caledonian University, Glasgow, UK
| | - Masahiro Abo
- Department of Rehabilitation Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Frank Becker
- University of Oslo, Oslo, and Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
| | - Audrey Bowen
- Division of Neuroscience & Psychology, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Caitlin Brandenburg
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Caterina Breitenstein
- Department of Neurology with Institute of Translational Neurology, University of Muenster, Muenster, Germany
| | - Stefanie Bruehl
- School of Biological Sciences, University of Manchester, Manchester, UK
| | - David A. Copland
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | | | - Marie di Pietro-Bachmann
- Division of Neurorehabilitation, Department of Clinical Neurosciences, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Pamela Enderby
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | - Federica Lucia Galli
- Neurorehabilitation Clinic, Neurological Sciences Department, Marche Polytechnic University, Ancona, Italy
| | - Marialuisa Gandolfi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Bertrand Glize
- EA 4136 Handicap Activity Cognition Health, University of Bordeaux and Department of Physical Medicine and Rehabilitation, CHU de Bordeaux, France
| | - Erin Godecke
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Australia
| | - Neil Hawkins
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Katerina Hilari
- Division of Language and Communication Science, City, University of London, London, UK
| | - Jacqueline Hinckley
- Department of Speech-Language Pathology, Nova Southeastern University, Fort Lauderdale, FL, USA
| | - Simon Horton
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - David Howard
- School of Education Communication and Language Sciences, Newcastle University, Newcastle-Upon-Tyne, UK
| | - Petra Jaecks
- Faculty of Linguistics and Literary Studies, Bielefeld University, Bielefeld, Germany
| | | | - Luis M. T. Jesus
- School of Health Sciences (ESSUA) and Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, Aveiro, Portugal
| | - Maria Kambanaros
- Department of Rehabilitation Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Eun Kyoung Kang
- Department of Rehabilitation Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea
| | - Eman M. Khedr
- Department of Neurology, Assiut University Hospital, Assiut, Egypt
| | - Anthony Pak-Hin Kong
- School of Communication Sciences and Disorders, University of Central Florida, Orlando, FL, USA
| | - Tarja Kukkonen
- ENT/Department of Phoniatry, Tampere University Hospital, Tampere, Finland
| | - Marina Laganaro
- Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | | | - Ann Charlotte Laska
- Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden
| | - Béatrice Leemann
- Neurorééducation, Département des Neurosciences Cliniques, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - Alexander P. Leff
- Department of Brain Repair and Rehabilitation, Institute of Neurology, UCL, London, UK
| | - Roxele R. Lima
- Department of Speech Language Pathology, Educational Association Bom Jesus – IELUSC, Santa Catarina, Brazil
| | - Antje Lorenz
- Institut für Psychologie, Humboldt University Berlin, Berlin, Germany
| | - Brian MacWhinney
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, USA
| | | | - Flavia Mattioli
- Neuropsychology Unit, ASST Spedali Civili of Brescia, Brescia, Italy
| | - ilknur Maviş
- Department of Speech and Language Therapy, Anadolu University, Eskişehir, Turkey
| | - Marcus Meinzer
- UQ Centre for Clinical Research, The University of Queensland, Hertston, Australia
| | - Reza Nilipour
- Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Nam-Jong Paik
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Rebecca Palmer
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ilias Papathanasiou
- Department of Speech and Language Therapy, Technological Educational Institute of Western Greece, Patras, Greece
| | - Brigida F. Patricio
- Speech Therapy Department of Health School of Polytechnic Institute of Porto, Porto, Portugal
| | - Isabel Pavão Martins
- Laboratório de Estudos de Linguagem, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisbon, Portugal
| | - Cathy Price
- Wellcome Centre for Human Neuroimaging, UCL, London, UK
| | - Tatjana Prizl Jakovac
- Department of Speech and Language Pathology, Faculty of Education and Rehabilitation Sciences, University of Zagreb, Zagreb, Croatia
| | - Elizabeth Rochon
- Department of Speech-Language Pathology and Rehabilitation Sciences Institute, University of Toronto, and Toronto Rehabilitation Institute, Toronto, Canada
| | - Miranda L. Rose
- School of Allied Health, La Trobe University, Melbourne, Australia
| | - Charlotte Rosso
- Institut du Cerveau et del la Moelle épinière, Sorbonne University, APHP, Urgences Cérébro-Vasculaires, Hôpital de la Pitié Salpêtrière, Paris, France
| | - Ilona Rubi-Fessen
- RehaNova Rehabilitation Hospital and Department of Special Education and Rehabilitation, University of Cologne, Cologne, Germany
| | - Marina B. Ruiter
- Sint Maartenskliniek, Rehabilitation Centre and Centre for Language Studies, Radboud University, Nijmegen, The Netherlands
| | - Claerwen Snell
- Warrington Hospital, Warrington and Halton NHS Foundation Trust, Warrington, UK
| | - Benjamin Stahl
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Jerzy P. Szaflarski
- UAB Epilepsy Centre, Department of Neurology, University of Alabama at Birmingham, AL, USA
| | - Shirley A. Thomas
- Division of Rehabilitation & Ageing; School of Medicine, University of Nottingham, Nottingham, UK
| | | | - Ineke van der Meulen
- Rijndam rehabilitation Rotterdam and Erasmus University Medical Center, Rotterdam, Netherlands
| | - Evy Visch-Brink
- Department of Neurology and Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Linda Worrall
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
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Rose ML, Copland D, Nickels L, Togher L, Meinzer M, Rai T, Cadilhac DA, Kim J, Foster A, Carragher M, Hurley M, Godecke E. Constraint-induced or multi-modal personalized aphasia rehabilitation (COMPARE): A randomized controlled trial for stroke-related chronic aphasia. Int J Stroke 2019; 14:972-976. [PMID: 31496440 DOI: 10.1177/1747493019870401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
RATIONALE The comparative efficacy and cost-effectiveness of constraint-induced and multi-modality aphasia therapy in chronic stroke are unknown. AIMS AND HYPOTHESES In the COMPARE trial, we aim to determine whether Multi-Modal Aphasia Treatment (M-MAT) and Constraint-Induced Aphasia Therapy Plus (CIAT-Plus) are superior to usual care (UC) for chronic post-stroke aphasia. Primary hypothesis: CIAT-Plus and M-MAT will reduce aphasia severity (Western Aphasia Battery-Revised Aphasia Quotient (WAB-R-AQ)) compared with UC: CIAT-Plus superior for moderate aphasia; M-MAT superior for mild and severe aphasia. SAMPLE SIZE ESTIMATES A total of 216 participants (72 per arm) will provide 90% power to detect a 5-point difference on the WAB-R-AQ between CIAT-Plus or M-MAT and UC at α = 0.05. METHODS AND DESIGN Prospective, randomized, parallel group, open-label, assessor blinded trial. Participants: Stroke >6 months; aphasia severity categorized using WAB-R-AQ. Computer-generated blocked and stratified randomization by aphasia severity (mild, moderate, and severe), to 3 arms: CIAT-Plus, M-MAT (both 30 h therapy over two weeks); UC (self-reported usual community care). STUDY OUTCOMES WAB-R-AQ immediately post-intervention. Secondary outcomes: WAB-R-AQ at 12-week follow-up; naming scores, discourse measures, Communicative Effectiveness Index, Scenario Test, and Stroke and Aphasia Quality of Life Scale-39 g immediately and at 12 weeks post-intervention; incremental cost-effectiveness ratios compared with UC at 12 weeks. DISCUSSION This trial will determine whether CIAT-Plus and M-MAT are superior and more cost-effective than UC in chronic aphasia. Participant subgroups with the greatest response to CIAT-Plus and M-MAT will be described.
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Affiliation(s)
- Miranda L Rose
- Department of Speech Pathology, Audiology and Orthoptics, School of Allied Health, La Trobe University, Melbourne, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - David Copland
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Australia
| | - Lyndsey Nickels
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- ARC Centre of Excellence in Cognition and its Disorders (CCD), Department of Cognitive Science, Macquarie University, Sydney, Australia
| | - Leanne Togher
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Speech Pathology, Faculty of Health Sciences, The University of Sydney, Sydney, Australia
| | - Marcus Meinzer
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Tapan Rai
- Graduate Research School, University of Technology Sydney, Australia
| | - Dominique A Cadilhac
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Joosup Kim
- School of Clinical Sciences at Monash Health, Monash University, Clayton, Australia
| | - Abby Foster
- Department of Speech Pathology, Audiology and Orthoptics, School of Allied Health, La Trobe University, Melbourne, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- Speech Pathology Department, Monash Health, Clayton, Australia
| | - Marcella Carragher
- Department of Speech Pathology, Audiology and Orthoptics, School of Allied Health, La Trobe University, Melbourne, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Melanie Hurley
- Department of Speech Pathology, Audiology and Orthoptics, School of Allied Health, La Trobe University, Melbourne, Australia
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
| | - Erin Godecke
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, La Trobe University, Melbourne, Australia
- School of Medical and Health Sciences, Edith Cowan University, Western Australia, Australia
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Martin AK, Perceval G, Davies I, Su P, Huang J, Meinzer M. Visual perspective taking in young and older adults. ACTA ACUST UNITED AC 2019; 148:2006-2026. [DOI: 10.1037/xge0000584] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Stahl B, Darkow R, von Podewils V, Meinzer M, Grittner U, Reinhold T, Grewe T, Breitenstein C, Flöel A. Transcranial Direct Current Stimulation to Enhance Training Effectiveness in Chronic Post-Stroke Aphasia: A Randomized Controlled Trial Protocol. Front Neurol 2019; 10:1089. [PMID: 31695667 PMCID: PMC6817733 DOI: 10.3389/fneur.2019.01089] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022] Open
Abstract
Background: Intensive speech-language therapy (SLT) can promote recovery from chronic post-stroke aphasia, a major consequence of stroke. However, effect sizes of intensive SLT are moderate, potentially reflecting a physiological limit of training-induced progress. Transcranial direct current stimulation (tDCS) is an easy-to-use, well-tolerated and low-cost approach that may enhance effectiveness of intensive SLT. In a recent phase-II randomized controlled trial, 26 individuals with chronic post-stroke aphasia received intensive SLT combined with anodal-tDCS of the left primary motor cortex (M1), resulting in improved naming and proxy-rated communication ability, with medium-to-large effect sizes. Aims: The proposed protocol seeks to establish the incremental benefit from anodal-tDCS of M1 in a phase-III randomized controlled trial with adequate power, ecologically valid outcomes, and evidence-based SLT. Methods: The planned study is a prospective randomized placebo-controlled (using sham-tDCS), parallel-group, double-blind, multi-center, phase-III superiority trial. A sample of 130 individuals with aphasia at least 6 months post-stroke will be recruited in more than 18 in- and outpatient rehabilitation centers. Outcomes: The primary outcome focuses on communication ability in chronic post-stroke aphasia, as revealed by changes on the Amsterdam-Nijmegen Everyday Language Test (A-scale; primary endpoint: 6-month follow-up; secondary endpoints: immediately after treatment, and 12-month follow-up). Secondary outcomes include measures assessing linguistic-executive skills, attention, memory, emotional well-being, quality of life, health economic costs, and adverse events (endpoints: 6-month follow-up, immediately after treatment, and 12-month follow-up). Discussion: Positive results will increase the quality of life for persons with aphasia and their families while reducing societal costs. After trial completion, a workshop with relevant stakeholders will ensure transfer into best-practice guidelines and successful integration within clinical routine. Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03930121.
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Affiliation(s)
- Benjamin Stahl
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.,Psychologische Hochschule Berlin, Berlin, Germany
| | - Robert Darkow
- Department of Neurology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Institute of Logopedics, FH Johanneum University of Applied Sciences, Graz, Austria
| | - Viola von Podewils
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany
| | - Marcus Meinzer
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Ulrike Grittner
- Institute of Biometry and Clinical Epidemiology, Charité Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Tanja Grewe
- Faculty of Health and Social Sciences, Fresenius University of Applied Sciences, Idstein, Germany
| | - Caterina Breitenstein
- Department of Neurology with Institute of Translational Neurology, University of Münster, Münster, Germany
| | - Agnes Flöel
- Department of Neurology, University Medicine Greifswald, Greifswald, Germany.,German Center for Neurodegenerative Diseases, Rostock/Greifswald, Germany
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Crosson B, Rodriguez AD, Copland D, Fridriksson J, Krishnamurthy LC, Meinzer M, Raymer AM, Krishnamurthy V, Leff AP. Neuroplasticity and aphasia treatments: new approaches for an old problem. J Neurol Neurosurg Psychiatry 2019; 90:1147-1155. [PMID: 31055282 PMCID: PMC8014302 DOI: 10.1136/jnnp-2018-319649] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/05/2019] [Accepted: 04/10/2019] [Indexed: 12/11/2022]
Abstract
Given the profound impact of language impairment after stroke (aphasia), neuroplasticity research is garnering considerable attention as means for eventually improving aphasia treatments and how they are delivered. Functional and structural neuroimaging studies indicate that aphasia treatments can recruit both residual and new neural mechanisms to improve language function and that neuroimaging modalities may hold promise in predicting treatment outcome. In relatively small clinical trials, both non-invasive brain stimulation and behavioural manipulations targeting activation or suppression of specific cortices can improve aphasia treatment outcomes. Recent language interventions that employ principles consistent with inducing neuroplasticity also are showing improved performance for both trained and novel items and contexts. While knowledge is rapidly accumulating, larger trials emphasising how to select optimal paradigms for individualised aphasia treatment are needed. Finally, a model of how to incorporate the growing knowledge into clinical practice could help to focus future research.
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Affiliation(s)
- Bruce Crosson
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA .,Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Amy D Rodriguez
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - David Copland
- School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, Queensland, Australia.,Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, South Carolina, USA
| | - Lisa C Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Physics and Astronomy, Georgia State University, Atlanta, Georgia, USA
| | - Marcus Meinzer
- Department of Neurology, University of Greifswald, Greifswald, Germany
| | - Anastasia M Raymer
- Department of Communication Disorders and Special Education, Old Dominion University, Norfolk, Virginia, USA
| | - Venkatagiri Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Neurology, Emory University, Atlanta, Georgia, USA
| | - Alexander P Leff
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
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Martin AK, Su P, Meinzer M. Common and unique effects of HD-tDCS to the social brain across cultural groups. Neuropsychologia 2019; 133:107170. [PMID: 31425711 DOI: 10.1016/j.neuropsychologia.2019.107170] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 07/22/2019] [Accepted: 08/13/2019] [Indexed: 12/20/2022]
Abstract
Cultural background influences social cognition, however no study has examined brain stimulation differences attributable to cultural background. 104 young adults [52 South-East Asian Singaporeans (SEA); 52 Caucasian Australians (CA)] received anodal high-definition transcranial direct current stimulation (HD-tDCS) to the dorsomedial prefrontal cortex (dmPFC) or the right temporoparietal junction (rTPJ). Participants completed tasks with varying demands on self-other processing including visual perspective taking (VPT)and episodic memory with self and other encoding. At baseline, SEA showed greater self-other integration than CA in the level one (line-of-sight) VPT task as indexed by greater interference from the alternate perspective. Anodal HD-tDCS to the dmPFC resulted in the CA performing closer to the SEA during egocentric perspective judgements. Baseline performance on level two (embodied rotation) VPT task and the self-reference effect (SRE) in episodic memory was comparable between the two groups. In the combined sample, HD-tDCS to the rTPJ decreased the interference from the egocentric perspective during level two VPT and dmPFC HD-tDCS removed the SRE in episodic memory. Stimulation effects were comparable when baseline performance was comparable. When baseline performance differed, stimulation differences were identified. Therefore, social cognitive differences due to cultural background are an important consideration in social brain stimulation studies.
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Affiliation(s)
- A K Martin
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia; Durham University, Department of Psychology, Durham, UK.
| | - P Su
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia
| | - M Meinzer
- The University of Queensland, UQ Centre for Clinical Research, Brisbane, Australia; University of Greifswald, Department of Neurology, Greifswald, Germany
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Trautwein S, Barisch-Fritz B, Scharpf A, Bossers W, Meinzer M, Steib S, Stein T, Bös K, Stahn A, Niessner C, Altmann S, Wittelsberger R, Woll A. Recommendations for assessing motor performance in individuals with dementia: suggestions of an expert panel - a qualitative approach. Eur Rev Aging Phys Act 2019; 16:5. [PMID: 31015865 PMCID: PMC6463628 DOI: 10.1186/s11556-019-0212-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 03/31/2019] [Indexed: 12/02/2022] Open
Abstract
Background Recommendations for assessing motor performance in individuals with dementia (IWD) are rare, and most existing assessment tools previously applied in IWD were initially developed for healthy older adults. However, IWD and their healthy counterparts differ in motor and cognitive capabilities, which needs to be considered when designing studies for this population. This article aims to give recommendations for motor assessments for IWD and to promote standardisation based on a structured discussion of identified assessment tools used in previous trials. Methods Appropriateness and standardisation of previously applied motor assessments for IWD were intensively discussed using a qualitative approach during an expert panel. Furthermore, the use of external cues and walking aids, as well as psychometric properties were considered. Starting with a comprehensive overview of current research practice, the discussion was gradually specified and resulted in the elaboration of specific recommendations. Results The superior discussion emphasised the need for tailoring motor assessments to specific characteristics of IWD and attaching importance to standardised assessment procedures. Specific recommendations include the use of sequential approaches, which incorporate a gradual increase of complexity from simple to more difficult tasks, a selection of motor assessments showing sufficient relative reliability and appropriateness for IWD, as well as allowing external cues and walking aids when restricted to repeated instructions and commonly used devices, respectively. Conclusions These are the first recommendations for assessing motor performance in IWD based on a comprehensive qualitative approach. Due to limited evidence, it was not possible to address all existing questions. It is therefore important to evaluate these recommendations in studies with IWD. Besides tailoring and evaluating available assessments, future research should focus on developing specific tools for IWD. Moreover, further progress in standardisation is necessary to enhance comparability between different trials. This article provides initial approaches for overcoming existing limitations in trials with IWD by giving recommendations and identifying future research questions, and therefore contributes to enhancing evidence regarding efficacy and effectiveness of physical activity interventions.
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Affiliation(s)
- Sandra Trautwein
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Bettina Barisch-Fritz
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Andrea Scharpf
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Willem Bossers
- Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marcus Meinzer
- 3Centre for Clinical Research, University of Queensland, Brisbane, Australia.,4Department of Neurology, Greifswald University Medicine, Greifswald, Germany
| | - Simon Steib
- 5Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - Thorsten Stein
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Klaus Bös
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Alexander Stahn
- 6Unit of Experimental Psychiatry, Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, USA.,Institute of Physiology, Charité - Universitätsmedizin Berlin, a corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Niessner
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Stefan Altmann
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Rita Wittelsberger
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
| | - Alexander Woll
- 1Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Engler-Bunte-Ring 15, 76131 Karlsruhe, Germany
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Gbadeyan O, Steinhauser M, Martin AK, Meinzer M. Abstract #72: High-Definition tDCS to the Dorsolateral Prefrontal Cortex during Cognitive Control in Young and Older Adults. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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31
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Martin AK, Meinzer M, Gbadeyan O. Abstract #69: Self-other processing in young and older adults: a high-definition transcranial direct current study. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gauvin HS, McMahon KL, Meinzer M, de Zubicaray GI. The Shape of Things to Come in Speech Production: A Functional Magnetic Resonance Imaging Study of Visual Form Interference during Lexical Access. J Cogn Neurosci 2019; 31:913-921. [PMID: 30747589 DOI: 10.1162/jocn_a_01382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Studies of context effects in speech production have shown that semantic feature overlap produces interference in naming of categorically related objects. In neuroimaging studies, this semantic interference effect is consistently associated with involvement of left superior and middle temporal gyri. However, at least part of this effect has recently been shown to be attributable to visual form similarity, as categorically related objects typically share visual features. This fMRI study examined interference produced by visual form overlap in the absence of a category relation in a picture-word interference paradigm. Both visually similar and visually dissimilar distractors led to increased BOLD responses in the left inferior frontal gyrus compared with the congruent condition. Naming pictures in context with a distractor word denoting an object visually similar in form slowed RTs compared with unrelated words and was associated with reduced activity in the left posterior middle temporal gyrus. This area is reliably observed in lexical level processing during language production tasks. No significant differential activity was observed in areas typically engaged by early perceptual or conceptual feature level processing or in areas proposed to be engaged by postlexical language processes, suggesting that visual form interference does not arise from uncertainty or confusion during perceptual or conceptual identification or after lexical processing. We conclude that visual form interference has a lexical locus, consistent with the predictions of competitive lexical selection models.
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Affiliation(s)
| | - Katie L McMahon
- Queensland University of Technology.,Royal Brisbane & Women's Hospital
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Alizad V, Meinzer M, Frossard L, Polman R, Smith S, Kerr G. Effects of transcranial direct current stimulation on gait in people with Parkinson's disease: study protocol for a randomized, controlled clinical trial. Trials 2018; 19:661. [PMID: 30486849 PMCID: PMC6263538 DOI: 10.1186/s13063-018-2982-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 10/13/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gait difficulties are common and frequently devastating to people with Parkinson's disease (PD). These difficulties are often followed by an increased risk of falls, leading to injury, hospitalization and mortality. The dysfunction in the basal ganglia-thalamocortical motor circuits and reduced activity in the premotor and primary motor cortices has raised interest in transcranial direct current stimulation (tDCS) as an adjunct intervention in PD. tDCS might provide a potentially safe and non-invasive treatment by modulating cortical excitability and behavioural outcomes. The aim of this study is to compare the effects of different monopolar and bipolar montages of tDCS administered to the motor cortex and cerebellum on gait speed in PD. METHODS This study will be conducted in a randomized, double-blind cross-over design. Eighteen participants diagnosed with Parkinson's disease will receive anodal and sham tDCS (1 mA, 20 min, 10 × 4 cm2) over the premotor and primary motor cortices with the cathode over the cerebellum during treadmill walking. Three montages will be applied over three sessions and compared: anodal tDCS with a small active cathode (4 × 4 cm2); anodal tDCS with a large, functionally inert cathode (10 × 10 cm2); and sham tDCS. The primary outcome measure is gait speed, and secondary outcome measures include gait parameters (temporospatial, segmental, kinematic), the Timed Up and Go test and lower limb muscle activity patterns as measured by electromyography. DISCUSSION This study will investigate the short-term effects of anodal tDCS over the premotor and primary motor cortices on gait abilities using monopolar and bipolar montages in people with PD. The outcomes will inform future studies aimed at inducing longer-lasting changes in neural excitability and performance using multisession tDCS designs in PD. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12618000063213 . Registered on 17 January 2018. Retrospectively registered.
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Affiliation(s)
- Vida Alizad
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia. .,Iranian Research Centre on Ageing, The University of Social Welfare and rehabilitation Sciences, Tehran, Iran.
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Laurent Frossard
- Institute of Health and Biomedical Innovation Queensland University of Technology, Brisbane, QLD, Australia
| | - Remco Polman
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Simon Smith
- Institute for Social Science Research (ISSR), The University of Queensland, Brisbane, QLD, Australia
| | - Graham Kerr
- Movement Neuroscience Program, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
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Martin AK, Huang J, Hunold A, Meinzer M. Dissociable Roles Within the Social Brain for Self–Other Processing: A HD-tDCS Study. Cereb Cortex 2018; 29:3642-3654. [DOI: 10.1093/cercor/bhy238] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 08/03/2018] [Accepted: 09/01/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Theories of right temporoparietal junction (rTPJ) function in social cognition include self–other distinction, self-inhibition, or embodied rotation, whereas the dorsomedial prefrontal cortex (dmPFC) is associated with integrating social information. However, no study has provided causal evidence for dissociable roles of the rTPJ and dmPFC in social cognition. A total of 52 healthy young adults were stratified to receive either dmPFC or rTPJ anodal high-definition transcranial direct current stimulation (HD-tDCS) in a sham-controlled, double-blinded, repeated measures design. Self–other processing was assessed across implicit and explicit level 1 (line-of-sight) and level 2 (mental rotation) visual perspective taking (VPT) tasks, and self–other effects on memory. DmPFC stimulation selectively increased the influence of the allocentric perspective during egocentric perspective taking, indexed by an increase in congruency effect across explicit VPT tasks. Moreover, dmPFC stimulation removed the self-reference effect in episodic memory by increasing the recognition of other and decreasing the recognition of self-encoded words. Stimulation of the rTPJ resulted in improved inhibition of the egocentric-perspective during level 2 VPT only, indexed by a reduction of the congruency effect when taking the allocentric perspective. This research supports theories suggesting that the rTPJ facilitates embodied mental rotation of the self into an alternate perspective, whereas the dmPFC integrates social information relevant to self-directed processes.
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Affiliation(s)
- A K Martin
- The University of Queensland, Centre for Clinical Research, Brisbane, Queensland, Australia
| | - J Huang
- The University of Queensland, Centre for Clinical Research, Brisbane, Queensland, Australia
| | - A Hunold
- Technische Universität Ilmenau, Institute of Biomedical Engineering and Informatics, Ilmenau, Germany
| | - M Meinzer
- The University of Queensland, Centre for Clinical Research, Brisbane, Queensland, Australia
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35
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Antonenko D, Nierhaus T, Meinzer M, Prehn K, Thielscher A, Ittermann B, Flöel A. Age-dependent effects of brain stimulation on network centrality. Neuroimage 2018; 176:71-82. [DOI: 10.1016/j.neuroimage.2018.04.038] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 04/13/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022] Open
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36
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Martin AK, Dzafic I, Ramdave S, Meinzer M. Causal evidence for task-specific involvement of the dorsomedial prefrontal cortex in human social cognition. Soc Cogn Affect Neurosci 2018; 12:1209-1218. [PMID: 28444345 PMCID: PMC5597860 DOI: 10.1093/scan/nsx063] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 04/17/2017] [Indexed: 01/17/2023] Open
Abstract
The dorsomedial prefrontal cortex (dmPFC) is a key hub of the 'social brain', but little is known about specific processes supported by this region. Using focal high-definition transcranial direct current stimulation (HD-tDCS) and a social cognitive battery with differing demands on self-other processing, we demonstrate specific involvement of the dmPFC in tasks placing high demands on self-other processing. Specifically, excitatory (anodal) HD-tDCS enhanced the integration of external information into the self for explicit higher-order socio-cognitive tasks across cognitive domains; i.e. visual perspective taking (VPT) and episodic memory. These effects were task specific, as no stimulation effects were found for attributing mental states from the eyes or implicit VPT. Inhibitory (cathodal) HD-tDCS had weaker effects in the opposite direction towards reduced integration of external information into the self. We thus demonstrate for the first time a specific and causal role of the dmPFC in integrating higher-order information from others/external source into that of the self across cognitive domains.
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Affiliation(s)
- Andrew K Martin
- Centre for Clinical Research, University of Queensland, Brisbane, QLD 4029, Australia
| | - Ilvana Dzafic
- Queensland Brain Institute, University of Queensland, Brisbane, QLD 4067, Australia
| | - Swathi Ramdave
- Centre for Clinical Research, University of Queensland, Brisbane, QLD 4029, Australia
| | - Marcus Meinzer
- Centre for Clinical Research, University of Queensland, Brisbane, QLD 4029, Australia
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37
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Lukasik KM, Lehtonen M, Salmi J, Meinzer M, Joutsa J, Laine M. No Effects of Stimulating the Left Ventrolateral Prefrontal Cortex with tDCS on Verbal Working Memory Updating. Front Neurosci 2018; 11:738. [PMID: 29379410 PMCID: PMC5770813 DOI: 10.3389/fnins.2017.00738] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Accepted: 12/18/2017] [Indexed: 01/01/2023] Open
Abstract
The effects of transcranial direct current stimulation (tDCS) on dorsolateral prefrontal cortex functions, such as working memory (WM), have been examined in a number of studies. However, much less is known about the behavioral effects of tDCS over other important WM-related brain regions, such as the ventrolateral prefrontal cortex (VLPFC). In a counterbalanced within-subjects design with 33 young healthy participants, we examined whether online and offline single-session tDCS over VLPFC affects WM updating performance as measured by a digit 3-back task. We compared three conditions: anodal, cathodal and sham. We observed no significant tDCS effects on participants' accuracy or reaction times during or after the stimulation. Neither did we find any differences between anodal and cathodal stimulation. Largely similar results were obtained when comparing subgroups of high- and low-performing participants. Possible reasons for the lack of effects, including individual differences in responsiveness to tDCS, features of montage, task and sample characteristics, and the role of VLPFC in WM, are discussed.
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Affiliation(s)
| | - Minna Lehtonen
- Department of Psychology, Abo Akademi University, Turku, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Juha Salmi
- Department of Psychology, Abo Akademi University, Turku, Finland.,Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Psychology, University of Turku, Turku, Finland
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland, Brisbane, QLD, Australia
| | - Juho Joutsa
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States.,Berenson-Allen Center for Noninvasive Brain Stimulation, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, United States.,Department of Neurology, University of Turku, Turku, Finland
| | - Matti Laine
- Department of Psychology, Abo Akademi University, Turku, Finland.,Turku Brain and Mind Center, University of Turku, Turku, Finland
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38
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Perceval G, Martin AK, Copland DA, Laine M, Meinzer M. High-definition tDCS of the temporo-parietal cortex enhances access to newly learned words. Sci Rep 2017; 7:17023. [PMID: 29208991 PMCID: PMC5717109 DOI: 10.1038/s41598-017-17279-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/23/2017] [Indexed: 11/16/2022] Open
Abstract
Learning associations between words and their referents is crucial for language learning in the developing and adult brain and for language re-learning after neurological injury. Non-invasive transcranial direct current stimulation (tDCS) to the posterior temporo-parietal cortex has been suggested to enhance this process. However, previous studies employed standard tDCS set-ups that induce diffuse current flow in the brain, preventing the attribution of stimulation effects to the target region. This study employed high-definition tDCS (HD-tDCS) that allowed the current flow to be constrained to the temporo-parietal cortex, to clarify its role in novel word learning. In a sham-controlled, double-blind, between-subjects design, 50 healthy adults learned associations between legal non-words and unfamiliar object pictures. Participants were stratified by baseline learning ability on a short version of the learning paradigm and pairwise randomized to active (20 mins; N = 25) or sham (40 seconds; N = 25) HD-tDCS. Accuracy was comparable during the baseline and experimental phases in both HD-tDCS conditions. However, active HD-tDCS resulted in faster retrieval of correct word-picture pairs. Our findings corroborate the critical role of the temporo-parietal cortex in novel word learning, which has implications for current theories of language acquisition.
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Affiliation(s)
- Garon Perceval
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia
| | - Andrew K Martin
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia
| | - David A Copland
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia.,The University of Queensland, School of Rehabilitation Sciences, Brisbane, Australia
| | - Matti Laine
- Åbo Akademi University, Department of Psychology, Turku, Finland
| | - Marcus Meinzer
- The University of Queensland, Centre for Clinical Research, Brisbane, Australia.
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39
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Martin AK, Meinzer M, Lindenberg R, Sieg MM, Nachtigall L, Flöel A. Effects of Transcranial Direct Current Stimulation on Neural Networks in Young and Older Adults. J Cogn Neurosci 2017; 29:1817-1828. [PMID: 28707568 DOI: 10.1162/jocn_a_01166] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Transcranial direct current stimulation (tDCS) may be a viable tool to improve motor and cognitive function in advanced age. However, although a number of studies have demonstrated improved cognitive performance in older adults, other studies have failed to show restorative effects. The neural effects of beneficial stimulation response in both age groups is lacking. In the current study, tDCS was administered during simultaneous fMRI in 42 healthy young and older participants. Semantic word generation and motor speech baseline tasks were used to investigate behavioral and neural effects of uni- and bihemispheric motor cortex tDCS in a three-way, crossover, sham tDCS controlled design. Independent components analysis assessed differences in task-related activity between the two age groups and tDCS effects at the network level. We also explored whether laterality of language network organization was effected by tDCS. Behaviorally, both active tDCS conditions significantly improved semantic word retrieval performance in young and older adults and were comparable between groups and stimulation conditions. Network-level tDCS effects were identified in the ventral and dorsal anterior cingulate networks in the combined sample during semantic fluency and motor speech tasks. In addition, a shift toward enhanced left laterality was identified in the older adults for both active stimulation conditions. Thus, tDCS results in common network-level modulations and behavioral improvements for both age groups, with an additional effect of increasing left laterality in older adults.
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Affiliation(s)
| | | | | | - Mira M Sieg
- Charité University Medicine, Berlin, Germany
| | | | - Agnes Flöel
- Charité University Medicine, Berlin, Germany.,University of Greifswald
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40
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Martin A, Dzafic I, Ramdave S, Meinzer M. High definition transcranial direct current stimulation over the dorsomedial prefrontal cortex increases the salience of others. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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41
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Flöel A, Darkow R, Meinzer M. Brain stimulation in aphasia rehabilitation: Current state and future projects. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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42
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Martin A, Meinzer M. P170 Impact of high definition transcranial direct current stimulation over the dorsomedial prefrontal cortex on social cognition. Clin Neurophysiol 2017. [DOI: 10.1016/j.clinph.2016.10.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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43
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Gbadeyan O, Steinhauser M, Martin A, McMahon K, Ulm L, Meinzer M. The effect of high definition tDCS on cognitive control: A behavioral and fMRI study. Brain Stimul 2017. [DOI: 10.1016/j.brs.2017.01.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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44
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Darkow R, Martin A, Würtz A, Flöel A, Meinzer M. Transcranial direct current stimulation effects on neural processing in post-stroke aphasia. Hum Brain Mapp 2016; 38:1518-1531. [PMID: 27859982 DOI: 10.1002/hbm.23469] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/14/2016] [Accepted: 11/06/2016] [Indexed: 12/18/2022] Open
Abstract
Non-invasive transcranial direct current stimulation (tDCS) can enhance recovery after stroke. However, fundamental knowledge about how tDCS impacts neural processing in the lesioned human brain is currently lacking. In the present study, it was investigated how tDCS modulates brain function in patients with post-stroke language impairment (aphasia). In a cross-over, randomized trial, patients named pictures of common objects during functional magnetic resonance imaging (fMRI). Concurrently, excitatory (anodal-) or sham-tDCS (1 mA, 20 min, or 30 s, respectively) was administered to the left primary motor cortex, a montage with demonstrated potential to improve aphasic language. By choosing stimuli that could reliable be named by the patients, the authors aimed to derive a pure measure of stimulation effects that was independent of treatment or performance effects and to assess how tDCS interacts with the patients' residual language network. Univariate fMRI data analysis revealed reduced activity in domain-general regions mediating high-level cognitive control during anodal-tDCS. Independent component functional network analysis demonstrated selectively increased language network activity and an inter-correlated shift from higher to lower frequency bands, indicative of increased within-network communication. Compared with healthy controls, anodal-tDCS resulted in overall "normalization" of brain function in the patients. These results demonstrate for the first time how tDCS modulates neural processing in stroke patients. Such information is crucial to assure that behavioral treatments targeting specific neural circuits overlap with regions that are modulated by tDCS, thereby maximizing stimulation effects during therapy. Hum Brain Mapp 38:1518-1531, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Robert Darkow
- Department of Neurology, NeuroCure Clinical Research Center, and Center of Stroke Research Berlin, Berlin, Charité University Medicine, Berlin, 10117, Germany
| | - Andrew Martin
- The University of Queensland, Centre for Clinical Research, Brisbane Queensland, 4029, Australia
| | - Anna Würtz
- Department of Neurology, NeuroCure Clinical Research Center, and Center of Stroke Research Berlin, Berlin, Charité University Medicine, Berlin, 10117, Germany
| | - Agnes Flöel
- Department of Neurology, NeuroCure Clinical Research Center, and Center of Stroke Research Berlin, Berlin, Charité University Medicine, Berlin, 10117, Germany
| | - Marcus Meinzer
- Department of Neurology, NeuroCure Clinical Research Center, and Center of Stroke Research Berlin, Berlin, Charité University Medicine, Berlin, 10117, Germany.,The University of Queensland, Centre for Clinical Research, Brisbane Queensland, 4029, Australia
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45
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Meinzer M, Yetim Ö, McMahon K, de Zubicaray G. Brain mechanisms of semantic interference in spoken word production: An anodal transcranial Direct Current Stimulation (atDCS) study. Brain Lang 2016; 157-158:72-80. [PMID: 27180210 DOI: 10.1016/j.bandl.2016.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 06/05/2023]
Abstract
When naming pictures, categorically-related compared to unrelated contexts typically slow production. We investigated proposed roles for the left inferior frontal gyrus (LIFG) and posterior middle and superior temporal gyri (pMTG/STG) in mediating this semantic interference effect. In a three-way, cross-over, sham-controlled study, we applied online anodal transcranial Direct Current Stimulation (atDCS) to LIFG or pMTG/STG while 24 participants performed parallel versions of the blocked cyclic naming paradigm. Significant effects of semantic context and cycle, and interactions of context and cycle, were observed on naming latencies in all three stimulation sessions. Additionally, atDCS over left pMTG/STG facilitated naming in related blocks from the second cycle onward, significantly reducing but not eliminating the interference effect. Applying atDCS over left LIFG likewise reduced the magnitude of interference compared to sham stimulation, although the facilitation was limited to the first few cycles of naming. We interpret these results as indicating semantic interference in picture naming reflects contributions of two complementary mechanisms: a relatively short-lived, top-down mechanism to bias selection and a more persistent lexical-level activation mechanism.
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Affiliation(s)
- Marcus Meinzer
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Özlem Yetim
- Centre for Clinical Research, University of Queensland, Brisbane, Australia
| | - Katie McMahon
- Centre for Advanced Imaging, University of Queensland, Brisbane, Australia
| | - Greig de Zubicaray
- Faculty of Health and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
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46
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Perceval G, Flöel A, Meinzer M. Can transcranial direct current stimulation counteract age-associated functional impairment? Neurosci Biobehav Rev 2016; 65:157-72. [DOI: 10.1016/j.neubiorev.2016.03.028] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 02/05/2016] [Accepted: 03/14/2016] [Indexed: 12/21/2022]
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47
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Gbadeyan O, Steinhauser M, McMahon K, Meinzer M. Safety, Tolerability, Blinding Efficacy and Behavioural Effects of a Novel MRI-Compatible, High-Definition tDCS Set-Up. Brain Stimul 2016; 9:545-52. [PMID: 27108392 DOI: 10.1016/j.brs.2016.03.018] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 03/01/2016] [Accepted: 03/24/2016] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND High-definition transcranial direct current stimulation (HD-tDCS) may allow more specific neural modulation than conventional-tDCS. OBJECTIVE We compared safety, tolerability, blinding efficacy and cognitive effects of a novel HD-tDCS set-up to that of conventional-tDCS and established compatibility with simultaneous functional magnetic resonance imaging (fMRI). METHODS Two groups of healthy participants completed a visual flanker task either with conventional (N = 30) or HD-tDCS (N = 30) administered to the right dorsolateral prefrontal cortex (1 mA) in a double-blind, sham-tDCS-controlled, cross-over design. HD-tDCS was administered with a one-channel DC-stimulator using a small conductive rubber "centre" electrode and a circular return electrode, mimicking the frequently used 4 × 1 HD-tDCS set-up. Tolerability, adverse effects, impact on performance and blinding efficacy were compared within and between the two montages. In a separate experiment, potential heating and impact on image quality of the novel HD-tDCS set-up were assessed during simultaneous fMRI. RESULTS Both montages elicited only mild adverse effects and those were less pronounced for the novel HD-tDCS set-up. Participant and investigator blinding was achieved with both montages. Only HD-tDCS resulted in significant modulation of the conflict adaptation effect during the flanker task; however, no differences were found for the direct comparison of the two montages. No significant heating occurred during fMRI and only minor effects on image quality were observed during HD-tDCS. CONCLUSIONS This study confirmed safety, tolerability and blinding efficacy of a novel, re-usable and MRI-compatible HD-tDCS set-up. It also highlights its potential to exert beneficial effects on behavioural performance. Use of this novel set-up during simultaneous fMRI in future studies will help clarify the neural mechanisms by which this HD-tDCS impacts on behavioural and neural function.
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Affiliation(s)
- Oyetunde Gbadeyan
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
| | - Marco Steinhauser
- Department of Psychology, Catholic University of Eichstätt-Ingolstadt, Eichstätt, Bavaria, Germany
| | - Katie McMahon
- Centre for Advanced Imaging, The University of Queensland, Brisbane, Queensland, Australia
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
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48
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Ulm L, McMahon K, Copland D, de Zubicaray GI, Meinzer M. Neural Mechanisms Underlying Perilesional Transcranial Direct Current Stimulation in Aphasia: A Feasibility Study. Front Hum Neurosci 2015; 9:550. [PMID: 26500522 PMCID: PMC4595771 DOI: 10.3389/fnhum.2015.00550] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 09/21/2015] [Indexed: 01/29/2023] Open
Abstract
Little is known about the neural mechanisms by which transcranial direct current stimulation (tDCS) impacts on language processing in post-stroke aphasia. This was addressed in a proof-of-principle study that explored the effects of tDCS application in aphasia during simultaneous functional magnetic resonance imaging (fMRI). We employed a single subject, cross-over, sham-tDCS controlled design, and the stimulation was administered to an individualized perilesional stimulation site that was identified by a baseline fMRI scan and a picture naming task. Peak activity during the baseline scan was located in the spared left inferior frontal gyrus and this area was stimulated during a subsequent cross-over phase. tDCS was successfully administered to the target region and anodal- vs. sham-tDCS resulted in selectively increased activity at the stimulation site. Our results thus demonstrate that it is feasible to precisely target an individualized stimulation site in aphasia patients during simultaneous fMRI, which allows assessing the neural mechanisms underlying tDCS application. The functional imaging results of this case report highlight one possible mechanism that may have contributed to beneficial behavioral stimulation effects in previous clinical tDCS trials in aphasia. In the future, this approach will allow identifying distinct patterns of stimulation effects on neural processing in larger cohorts of patients. This may ultimately yield information about the variability of tDCS effects on brain functions in aphasia.
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Affiliation(s)
- Lena Ulm
- Centre for Clinical Research, The University of Queensland , Brisbane, QLD , Australia
| | - Katie McMahon
- Centre for Advanced Imaging, The University of Queensland , Brisbane, QLD , Australia
| | - David Copland
- Centre for Clinical Research, The University of Queensland , Brisbane, QLD , Australia ; School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, QLD , Australia
| | - Greig I de Zubicaray
- Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology , Brisbane, QLD , Australia
| | - Marcus Meinzer
- Centre for Clinical Research, The University of Queensland , Brisbane, QLD , Australia ; School of Health and Rehabilitation Sciences, The University of Queensland , Brisbane, QLD , Australia
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Riggall K, Forlini C, Carter A, Hall W, Weier M, Partridge B, Meinzer M. Researchers' perspectives on scientific and ethical issues with transcranial direct current stimulation: An international survey. Sci Rep 2015; 5:10618. [PMID: 26068889 PMCID: PMC4464285 DOI: 10.1038/srep10618] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 04/21/2015] [Indexed: 12/20/2022] Open
Abstract
In the last decade, an increasing number of studies have suggested that transcranial direct current stimulation (tDCS) may enhance brain function in healthy individuals, and ameliorate cognitive and other symptoms in patients suffering from various medical conditions. This, along with its presumed safety, simplicity, and affordability, has generated great enthusiasm amongst researchers, clinicians, patient populations, and the public (including a growing “do-it-yourself” community). However, discussion about the effectiveness and ethics of tDCS thus far has been confined to small groups of tDCS researchers and bioethicists. We conducted an international online survey targeting the opinions of researchers using tDCS who were asked to rate the technique’s efficacy in different contexts. We also surveyed opinions about ethical concerns, self-enhancement and public availability. 265 complete responses were received and analyzed statistically and thematically. Our results emphasize the potential uses of tDCS in clinical and research contexts, but also highlight a number of emerging methodological and safety concerns, ethical challenges and the need for improved communication between researchers and bioethicists with regard to regulation of the device. Neither the media reputation of tDCS as a “miracle device” nor concerns expressed in recent neuroethical publications were entirely borne out in expert opinion.
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Affiliation(s)
- Kate Riggall
- The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia
| | - Cynthia Forlini
- The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia
| | - Adrian Carter
- 1] The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia [2] Monash University, School of Psychological Sciences, Melbourne 3168, Australia
| | - Wayne Hall
- 1] The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia [2] The University of Queensland, Centre for Youth Substance Abuse, Brisbane 4029, Australia
| | - Megan Weier
- The University of Queensland, Centre for Youth Substance Abuse, Brisbane 4029, Australia
| | - Brad Partridge
- The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia
| | - Marcus Meinzer
- The University of Queensland, Centre for Clinical Research, Brisbane 4029, Australia
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Riggall K, Forlini C, Carter A, Weier M, Hall W, Meinzer M. Researchers' perspectives on scientific and ethical issues with transcranial direct current stimulation: An international survey. Brain Stimul 2015. [DOI: 10.1016/j.brs.2015.01.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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