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Zahra FT, Carey LM, Haslam B, Zoghi M. Is there a relationship between somatosensory impairment and the perception of pain in stroke survivors? An exploratory study. Int J Rehabil Res 2024:00004356-990000000-00093. [PMID: 38682376 DOI: 10.1097/mrr.0000000000000629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Pain and somatosensory impairments are commonly reported following stroke. This study investigated the relationship between somatosensory impairments (touch detection, touch discrimination and proprioceptive discrimination) and the reported presence and perception of any bodily pain in stroke survivors. Stroke survivors with somatosensory impairment (N = 45) completed the Weinstein Enhanced Sensory Test (WEST), Tactile Discrimination Test, and Wrist Position Sense Test for quantification of somatosensation in both hands and the McGill Pain Questionnaire, visual analog scale and the Neuropathic Pain Symptom Inventory (NPSI) for reporting presence and perception of pain. No relationship was observed between somatosensory impairment (affected contralesional hand) of touch detection, discriminative touch or proprioceptive discrimination with the presence or perception of pain. However, a weak to moderate negative relationship between touch detection in the affected hand (WEST) and perception of pain intensity (NPSI) was found, suggesting that stroke survivors with milder somatosensory impairment of touch detection, rather than severe loss, are likely to experience higher pain intensity [rho = -0.35; 95% confidence interval (CI), -0.60 to -0.03; P = 0.03]. Further, a moderate, negative relationship was found specifically with evoked pain (NPSI) and touch detection in the affected hand (rho = -0.43; 95% CI, -0.72 to -0.02; P = 0.03). In summary, our findings indicate a weak to moderate, albeit still uncertain, association, which prevents making a definitive conclusion. Nevertheless, our findings contribute to our understanding of the complexities surrounding the experience of pain in survivors of stroke and provide direction for future studies.
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Affiliation(s)
- Fatima-Tul Zahra
- Discipline of Occupational therapy, School of Allied Health, Human Services and Sport, La Trobe University
| | - Leeanne M Carey
- Discipline of Occupational therapy, School of Allied Health, Human Services and Sport, La Trobe University
- Neurorehabilitation and Recovery, Florey Institute , The University of Melbourne, Melbourne
| | - Brendon Haslam
- Discipline of Occupational therapy, School of Allied Health, Human Services and Sport, La Trobe University
- Neurorehabilitation and Recovery, Florey Institute , The University of Melbourne, Melbourne
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Victoria
- Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
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Hashemirad F, Zoghi M, Fitzgerald PB, Hashemirad M, Jaberzadeh S. Site Dependency of Anodal Transcranial Direct-Current Stimulation on Reaction Time and Transfer of Learning during a Sequential Visual Isometric Pinch Task. Brain Sci 2024; 14:408. [PMID: 38672057 PMCID: PMC11048073 DOI: 10.3390/brainsci14040408] [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: 03/05/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Considering the advantages of brain stimulation techniques in detecting the role of different areas of the brain in human sensorimotor behaviors, we used anodal transcranial direct-current stimulation (a-tDCS) over three different brain sites of the frontoparietal cortex (FPC) in healthy participants to elucidate the role of these three brain areas of the FPC on reaction time (RT) during a sequential visual isometric pinch task (SVIPT). We also aimed to assess if the stimulation of these cortical sites affects the transfer of learning during SVIPT. A total of 48 right-handed healthy participants were randomly assigned to one of the four a-tDCS groups: (1) left primary motor cortex (M1), (2) left dorsolateral prefrontal cortex (DLPFC), (3) left posterior parietal cortex (PPC), and (4) sham. A-tDCS (0.3 mA, 20 min) was applied concurrently with the SVIPT, in which the participants precisely controlled their forces to reach seven different target forces from 10 to 40% of the maximum voluntary contraction (MVC) presented on a computer screen with the right dominant hand. Four test blocks were randomly performed at the baseline and 15 min after the intervention, including sequence and random blocks with either hand. Our results showed significant elongations in the ratio of RTs between the M1 and sham groups in the sequence blocks of both the right-trained and left-untrained hands. No significant differences were found between the DLPFC and sham groups and the PPC and sham groups in RT measurements within the SVIPT. Our findings suggest that RT improvement within implicit learning of an SVIPT is not mediated by single-session a-tDCS over M1, DLPFC, or PPC. Further research is needed to understand the optimal characteristics of tDCS and stimulation sites to modulate reaction time in a precision control task such as an SVIPT.
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Affiliation(s)
- Fahimeh Hashemirad
- Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran 1985713871, Iran
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3199, Australia;
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Ballart, VIC 3199, Australia;
| | - Paul B. Fitzgerald
- School of Medicine and Psychology, Australian National University, Canberra, NSW 2601, Australia;
| | | | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3199, Australia;
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Bian RH, Qiu KY, Jiang YF, Li XY, Zoghi M, Zhang X, Chen SZ. Modified Chinese disabilities of arm, shoulder and hand tool: Validity and reliability for upper extremity injuries. Injury 2024; 55:111367. [PMID: 38301489 DOI: 10.1016/j.injury.2024.111367] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 01/16/2024] [Accepted: 01/17/2024] [Indexed: 02/03/2024]
Abstract
DESIGN Clinimetric evaluation study. INTRODUCTION The Chinese Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire has necessitated the development of a revised version to the specific needs of individuals with upper extremity injuries with the progress of times and lifestyle changes. PURPOSE OF THE STUDY This research aimed to evaluate the reliability and validity of Modified Chinese Disability of Arm, Shoulder and Hand (MC-DASH) questionnaire in individuals with upper extremity injuries. METHODS One hundred and one individuals with upper extremity injuries (UEI) were recruited. The function of upper extremity was measured using the electronic version of MC-DASH, and compared against the Chinese Disability of Arm, Shoulder and Hand. The MC-DASH was reassessed within three days in all individuals. We investigated the internal consistency, test-retest reliability, content validity, criterion validity, and construct validity of MC-DASH. RESULTS The internal consistency was deemed sufficient, as indicated by a Cronbach's alpha of 0.986 and an intraclass correlation coefficient of 0.957. Moreover, the mean total scores of MC-DASH on the first-test and retest were 37.86 and 38.19, respectively (ICC: 0.957, 95 %CI: 0.937-0.971, p < 0.001). Furthermore, the MC-DASH version exhibited satisfactory content validity evidenced by its strong correlation (R= 0.903, p < 0.001) with the Chinese DASH. Three major influencing factors were identified from 37 items. The cumulative variance contribution rate of the MC-DASH questionnaire was 75.76 %, confirming its construct validity. CONCLUSION The Modified Chinese Disability of Arm, Shoulder and Hand questionnaire has been shown to be a valid, reliable, and practical tool for use in patients with upper extremity injuries.
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Affiliation(s)
- Rui-Hao Bian
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Kai-Yi Qiu
- Department of Hand and Foot Rehabilitation, Guangdong Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Yi-Fan Jiang
- Rehabilitation of people with developmental disabilities, Department of Rehabilitation Science, Hong Kong Polytechnic University, Hong Kong, China
| | - Xue-Yi Li
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China
| | - Maryam Zoghi
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; Institute of Health and Wellbeing, Federation University, Australia
| | - Xue Zhang
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Shao-Zhen Chen
- Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guangzhou, China.
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Malekahmad M, Frazer A, Zoghi M, Jaberzadeh S. Transcranial pulsed current stimulation: A scoping review of the current literature on scope, nature, underlying mechanisms, and gaps. Psychophysiology 2024; 61:e14521. [PMID: 38200645 DOI: 10.1111/psyp.14521] [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: 05/18/2023] [Revised: 09/28/2023] [Accepted: 12/01/2023] [Indexed: 01/12/2024]
Abstract
Transcranial pulsed current stimulation (tPCS) is a noninvasive brain stimulation technique that has aroused considerable attention in recent years. This review aims to provide an overview of the existing literature on tPCS, examine the scope and nature of previous research, investigate its underlying mechanisms, and identify gaps in the literature. Searching online databases resulted in 36 published tPCS studies from inception until May 2023. These studies were categorized into three groups: human studies on healthy individuals, human studies on clinical conditions, and animal studies. The findings suggest that tPCS has the potential to modulate brain excitability by entraining neural oscillations and utilizing stochastic resonance. However, the underlying mechanisms of tPCS are not yet fully understood and require further investigation. Furthermore, the included studies indicate that tPCS may have therapeutic potential for neurological diseases. However, before tPCS can be applied in clinical settings, a better understanding of its mechanisms is crucial. Hence, the tPCS studies were categorized into four types of research: basic, strategic, applied, and experimental research, to identify the nature of the literature and gaps. Analysis of these categories revealed that tPCS, with its diverse parameters, effects, and mechanisms, presents a wide range of research opportunities for future investigations.
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Affiliation(s)
- Mona Malekahmad
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Ashlyn Frazer
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, Federation University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Monash University, Melbourne, Victoria, Australia
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Jaberzadeh S, Zoghi M. Exploring sensory, motor, and pain responses as potential side or therapeutic effects of sub-2 mA, 400 Hz transcranial pulsed current stimulation. PLoS One 2023; 18:e0290137. [PMID: 38091312 PMCID: PMC10718437 DOI: 10.1371/journal.pone.0290137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/27/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Various brain stimulation devices capable of generating high-frequency currents are readily available. However, our comprehension of the potential side or therapeutic effects associated with high-frequency transcranial pulsed current stimulation (tPCS), particularly concerning the new 400 Hz tPCS device, AscenZ-IV Stimulator, developed by AscenZion Neuromodulation Co. Pte. Ltd. in Singapore, remains incomplete. OBJECTIVE This study examines preliminary parameters for the safe and comfortable application of 400 Hz tPCS at intensities below 2 mA. METHODS In a cross-sectional study, 45 healthy participants underwent sub-2 mA 400 Hz tPCS to assess sensory, motor, and pain thresholds on the dominant side. Study 1 (N = 15) targeted the primary motor cortex of the right-hand area, while study 2 (N = 30) focused on the back of the right forearm. RESULTS Study one showed that increasing the current intensity gradually resulted in no responses at sub-0.3 mA levels, but higher intensities (p < 0.001) induced sensory perception and pain responses. Study two replicated these findings and additionally induced motor responses along with the sensory and pain responses. CONCLUSION Despite the theoretical classification of tPCS as a subsensory level of stimulation, and the expectation that individuals receiving this type of current should not typically feel its application on the body, this high-frequency tPCS device generates different levels of stimulation due to the physiological phenomenon known as temporal summation. These novel levels of stimulation could be viewed as either potential "side-effects" of high frequency tPCS or as additional "therapeutic benefits". This dual capacity may position the device as one that generates both neuromodulatory and neurostimulatory currents. Comprehensive comprehension of this is vital for the development of therapeutic protocols that incorporate high-frequency tPCS.
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Affiliation(s)
- Shapour Jaberzadeh
- Department of Physiotherapy, Monash Neuromodulation Research Unit, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, Federation University, Churchill, Victoria, Australia
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Zhang X, Tse T, Chen SZ, Qiu KY, Li X, Zoghi M. Response to the Letter to Editor about the article "Before blaming unilateral upper-limb trauma for cognitive dysfunctions, alternative causes must be ruled out". Hand Surg Rehabil 2023; 42:560. [PMID: 37490951 DOI: 10.1016/j.hansur.2023.07.012] [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] [Received: 07/05/2023] [Accepted: 07/05/2023] [Indexed: 07/27/2023]
Affiliation(s)
- Xue Zhang
- Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Tamara Tse
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Shao-Zhen Chen
- Occupational Therapy, Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guanghou, China
| | - Kai-Yi Qiu
- Occupational Therapy, Department of Hand and Foot Rehabilitation, Guangdong Work Injury Rehabilitation Hospital, Guanghou, China
| | - Xia Li
- Statistician, Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Australia
| | - Maryam Zoghi
- Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Australia
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Zhang X, Tse T, Chen SZ, Qiu KY, Li X, Zoghi M. Effect of traumatic upper-limb injury on cognitive functions: A cross-sectional observational study. Hand Surg Rehabil 2023; 42:413-418. [PMID: 37217077 DOI: 10.1016/j.hansur.2023.05.006] [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] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/24/2023]
Abstract
OBJECTIVES There is growing evidence of cognitive impairment after traumatic peripheral lesions. The purpose of this study was to explore the association between cognitive function and traumatic upper-limb injury. We assessed difference in cognitive function between participants with and without upper-limb injury, and explored the association between cognitive function and certain variables in injured individuals: gender, age, body mass index (BMI), educational level, and occupation. We sought to identify the factors associated with cognitive function in injured subjects: time since injury, injury side, nerve injury, hand function, pain, and finger sensation. MATERIAL AND METHODS A cross-sectional observational study was conducted, with 2 groups: observational group (with traumatic upper-limb injury) and control group (uninjured). The 2 groups were matched for age, gender, BMI, educational level and occupation. Short-term memory and executive functions were assessed using the Rey Auditory and Verbal Learning Test (RAVLT) and Stroop Color and Word Test (SCWT), respectively. RESULTS 104 participants with traumatic upper-limb injury and 104 uninjured control subjects were included. There was a significant inter-group difference only in RAVLT (p < 0.01; Cohen d, of 0.38). Regression analysis demonstrated an association of pain on VAS (beta = -0.16, p < 0.01) and touch-test (beta = 1.09, p < 0.05) with total RAVLT score (short-term memory) in injured subjects (R2 = 0.19, F (2, 82) = 9.54, p < 0.001). CONCLUSION Traumatic upper-limb injury can impact short-term memory, which should be kept in mind during rehabilitation.
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Affiliation(s)
- Xue Zhang
- Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia.
| | - Tamara Tse
- Occupational Therapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia
| | - Shao-Zhen Chen
- Occupational Therapy, Department of Rehabilitation Medicine, Sun Yat-sen University First Affiliated Hospital, Guanghou, China
| | - Kai-Yi Qiu
- Occupational Therapy, Department of Hand and Foot Rehabilitation, Guangdong Work Injury Rehabilitation Hospital, Guanghou, China
| | - Xia Li
- Statistician, Department of Mathematical and Physical Sciences, La Trobe University, Melbourne, Australia
| | - Maryam Zoghi
- Physiotherapy, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Australia; Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Melbourne, Australia
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Zoghi M, Pourmadadi M, Yazdian F, Nigjeh MN, Rashedi H, Sahraeian R. Synthesis and characterization of chitosan/carbon quantum dots/Fe 2O 3 nanocomposite comprising curcumin for targeted drug delivery in breast cancer therapy. Int J Biol Macromol 2023; 249:125788. [PMID: 37437675 DOI: 10.1016/j.ijbiomac.2023.125788] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 01/13/2023] [Revised: 06/21/2023] [Accepted: 07/09/2023] [Indexed: 07/14/2023]
Abstract
Curcumin, a natural compound with promising anti-cancerous features, suffers from a number of shortcomings such as low chemical stability, bioavailability, and solubility, which impedes its application as an alternative for conventional cancer therapy. In this study, curcumin comprising Fe2O3/Chitosan/CQDs was fabricated through double emulsion method (W/O/W) for the first time to exploit its anticancer features while alleviating its limitation, making this nanocomposite promising in targeted drug delivery. Chitosan, a hydrophilic biopolymer, has incorporated to constitute an adhesive pH-sensitive matrix that can trap the hydrophobic drug resulting in controlled drug release in cancerous environment. Carbon quantum dots render luminescence and water solubility properties, which is favorable for tracing drug release and bio imaging along with enhancement of biocompatibility. Fe2O3 can improve chemical stability and bioavailability in addition to anti-cancerous property. XRD and FTIR analysis confirmed the physical interaction between the drug and fabricated nano composite in addition to chemical bonding between the prepared nano composite. Matrix and spherical structure of the formed drug is corroborated by FESEM analysis. DLS analysis' results determine the mean size of the nano composite at about 227.2 nm and zeta potential result is indicative of perfect stability of the fabricated drug. Various kinetic models for drug release were fitted to experimental data in order to investigate the drug release in which Korsmeyer-Peppas' model was the predominant release system in cancerous environment. In vitro studies through flow cytometry and MTT assay exerted noticeable cytotoxicity effect on MCF-7 cell lines. It can be deduced from these results that curcumin encapsulated with CS/CQDs/Fe2O3 nanocomposites is an excellent alternative for targeted drug delivery.
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Affiliation(s)
- Maryam Zoghi
- Department of Biotechnology, School of Chemical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Mehrab Pourmadadi
- Department of Biotechnology, School of Chemical Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Fatemeh Yazdian
- Department of Life Science Engineering, Faculty of New Science and Technologies, University of Tehran, Tehran, Iran.
| | - Mona Navaei Nigjeh
- Pharmaceutical Sciences Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences (TUMS), Tehran, Iran; Department of Pharmaceutical Biomaterials and Medical Biomaterials Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hamid Rashedi
- Department of Biotechnology, School of Chemical Engineering, College of Engineering, University of Tehran, Tehran, Iran.
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Ehsani F, Hafez Yousefi MS, Jafarzadeh A, Zoghi M, Jaberzadeh S. Does Multisession Cathodal Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Prime the Effects of Cognitive Behavioral Therapy on Fear of Pain, Fear of Movement, and Disability in Patients with Nonspecific Low Back Pain? A Randomized Clinical Trial Study. Brain Sci 2023; 13:1381. [PMID: 37891750 PMCID: PMC10605034 DOI: 10.3390/brainsci13101381] [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: 08/22/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
Many studies have shown that low back pain (LBP) is associated with psychosomatic symptoms which may lead to brain changes. This study aimed to investigate the effect of the concurrent application of cognitive behavioral therapy (CBT) and transcranial direct electrical stimulation (tDCS) over the left dorsolateral prefrontal cortex (DLPFC) on fear of pain, fear of movement, and disability in patients with nonspecific LBP. This study was performed on 45 LBP patients (23 women, 22 men; mean age 33.00 ± 1.77 years) in three groups: experimental (2 mA cathodal tDCS (c-tDCS)), sham (c-tDCS turned off after 30 s), and control (only received CBT). In all groups, CBT was conducted for 20 min per session, with two sessions per week for four weeks. Fear of pain, fear of movement, and disability were evaluated using questionnaires at baseline, immediately after, and one month after completion of interventions. Results indicated that all three different types of intervention could significantly reduce fear and disability immediately after intervention (p > 0.05). However, improvement in the experimental group was significantly higher than in the other groups immediately after and at the one-month follow-up after interventions (p < 0.05). DLPFC c-tDCS can prime the immediate effects of CBT and also the lasting effects on the reduction in the fear of pain, fear of movement, and disability in LBP patients.
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Affiliation(s)
- Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Mohaddeseh Sadat Hafez Yousefi
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
- Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran 5166614711, Iran
| | - Abbas Jafarzadeh
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan 3514799442, Iran; (F.E.); (A.J.)
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Victoria, Ballarat, VIC 3350, Australia;
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia;
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Anoushiravani S, Alizadehgoradel J, Iranpour A, Yousefi Bilehsavar O, Pouresmali A, Nitsche MA, Salehinejad MA, Mosayebi-Samani M, Zoghi M. The impact of bilateral anodal transcranial direct current stimulation of the premotor and cerebellar cortices on physiological and performance parameters of gymnastic athletes: a randomized, cross-over, sham-controlled study. Sci Rep 2023; 13:10611. [PMID: 37391555 PMCID: PMC10313825 DOI: 10.1038/s41598-023-37843-1] [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: 02/03/2023] [Accepted: 06/28/2023] [Indexed: 07/02/2023] Open
Abstract
Professional sports performance relies critically on the interaction between the brain and muscles during movement. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique which modulates cortical excitability and can be used to improve motor performance in athletes. The present study aimed to investigate the effect of bilateral anodal tDCS (2 mA, 20 min) over the premotor cortex or cerebellum on motor and physiological functions and peak performance of professional gymnastics athletes. Seventeen professional gymnastics athletes participated in a randomized, sham-controlled, crossover study. In this study, we assessed the efficacy of two anodal tDCS protocols (2 mA, 20 min) with stimulation over the bilateral premotor cortex or cerebellum with the return electrodes placed over the opposite supraorbital areas. Power speed, strength coordination, endurance, static and dynamic strength, static and dynamic flexibility, and rating of perceived exertion were measured before and immediately after tDCS interventions (bilateral anodal tDCS over premotor cortices, anodal tDCS over the cerebellum, and sham tDCS). Additionally, physiological muscle performance parameters, including maximum voluntary isometric contraction (MVIC) of upper body muscles, were assessed during tDCS. Bilateral anodal tDCS over the premotor cortex, compared to anodal tDCS over the cerebellum and sham tDCS conditions, significantly improved power speed, strength coordination, and static and dynamic strength variables of professional gymnastics athletes. Furthermore, bilateral anodal tDCS over the cerebellum, compared to sham tDCS, significantly improved strength coordination. Moreover, bilateral premotor anodal tDCS significantly increased MVIC of all upper body muscles during stimulation, while anodal tDCS over the cerebellum increased MVIC in only some muscles. Bilateral anodal tDCS over the premotor cortex, and to a minor degree over the cerebellum, might be suited to improve some aspects of motor and physiological functions and peak performance levels of professional gymnastics athletes.Clinical Trial Registration ID: IRCT20180724040579N2.
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Affiliation(s)
- Sajjad Anoushiravani
- Department of Sports Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Jaber Alizadehgoradel
- Department of Psychology, Faculty of Humanities, University of Zanjan, Zanjan, Iran.
| | - Asgar Iranpour
- Department of Sports Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Omid Yousefi Bilehsavar
- Department of Sports Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Asghar Pouresmali
- Department of Family Health, Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Michael A Nitsche
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- University Hospital OWL, Protestant Hospital of Bethel Foundation, University Clinic of Psychiatry and Psychotherapy and University Clinic of Child and Adolescent Psychiatry and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Mohsen Mosayebi-Samani
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Victoria, Australia
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Zoghi M, Jaberzadeh S. A step toward restoring hand functions in patients with multiple sclerosis-a study protocol. Front Rehabil Sci 2023; 4:1053577. [PMID: 37387732 PMCID: PMC10303119 DOI: 10.3389/fresc.2023.1053577] [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] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 05/15/2023] [Indexed: 07/01/2023]
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease characterized by inflammation, demyelination of axons, and oligodendrocyte loss in the central nervous system. This leads to neurological dysfunction, including hand impairment, which is prevalent among patients with MS. However, hand impairment is the least targeted area for neurorehabilitation studies. Therefore, this study proposes a novel approach to improve hand functions compared to current strategies. Studies have shown that learning new skills in the motor cortex (M1) can trigger the production of oligodendrocytes and myelin, which is a critical mechanism for neuroplasticity. Transcranial direct current stimulation (tDCS) has been used to enhance motor learning and function in human subjects. However, tDCS induces non-specific effects, and concurrent behavioral training has been found to optimize its benefits. Recent research indicates that applying tDCS during motor learning can have priming effects on the long-term potentiation mechanism and prolong the effects of motor training in health and disease. Therefore, this study aims to assess whether applying repeated tDCS during the learning of a new motor skill in M1 can be more effective in improving hand functions in patients with MS than current neurorehabilitation strategies. If this approach proves successful in improving hand functions in patients with MS, it could be adopted as a new approach to restore hand functions. Additionally, if the application of tDCS demonstrates an accumulative effect in improving hand functions in patients with MS, it could provide an adjunct intervention during rehabilitation for these patients. This study will contribute to the growing body of literature on the use of tDCS in neurorehabilitation and could have a significant impact on the quality of life of patients with MS.
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Affiliation(s)
- Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, Melbourne, VIC, Australia
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care (SPAHC), Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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12
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Salihu AT, Usman JS, Hill KD, Zoghi M, Jaberzadeh S. Mental fatigue does not affect static balance under both single and dual task conditions in young adults. Exp Brain Res 2023:10.1007/s00221-023-06643-4. [PMID: 37219602 DOI: 10.1007/s00221-023-06643-4] [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: 03/10/2023] [Accepted: 05/16/2023] [Indexed: 05/24/2023]
Abstract
The ability to control balance and prevent falls while carrying out daily life activities may require a predominantly controlled (cognitive) or automatic processing depending on the balance challenge, age, or other factors. Consequently, this process may be affected by mental fatigue which has been shown to impair cognitive abilities. Controlling static balance in young adults is a relatively easy task that may proceed automatically with minimal cognitive input making it insusceptible to mental fatigue. To investigate this hypothesis, static single and dual task (while concurrently counting backward by seven) balance was assessed in 60 young adults (25.2 ± 2.4 years) before and after 45 min of Stroop task (mental fatigue condition) and watching documentary (control), presented in a randomized counterbalanced order on separate days. Moreover, because mental fatigue can occur due to task underload or overload, participants carried out two different Stroop tasks (i.e., all congruent, and mainly incongruent trials) on separate days in the mental fatigue condition. Results of the study revealed a significantly higher feeling of mental fatigue after the mental fatigue conditions compared to control (p < 0.001). Similarly, the performance on congruent Stroop trials decreases with time indicating objective mental fatigue (p < 0.01). However, there was no difference in balance or concurrent task performance under both single and dual task assessments between the three conditions (p > 0.05) indicating lack of effect of mental fatigue on static balance in this population. Therefore, future studies investigating this phenomenon in occupational or sport settings in similar population should consider using more challenging balance tasks.
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Affiliation(s)
- Abubakar Tijjani Salihu
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Jibrin Sammani Usman
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University, Kano, Nigeria
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, School of Primary and Allied Health Care, Monash University, Frankston, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Australia, Gippsland, Australia
| | - Shapour Jaberzadeh
- Monash Neuromodulation Research Unit, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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13
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Mozafaripour E, Sadati SKM, Najafi L, Zoghi M. The Effect of Motor Imaginary Combined with Transcranial Direct Current Stimulation (tDCS) on Balance in Middle-Aged Women with High Fall Risk: A Double-Blind Randomized Controlled Trial. Neural Plast 2023; 2023:9680371. [PMID: 37035217 PMCID: PMC10081897 DOI: 10.1155/2023/9680371] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 01/19/2023] [Accepted: 02/07/2023] [Indexed: 04/03/2023] Open
Abstract
Introduction. The risk of falling and its subsequent injuries increases with aging. Impaired balance and gait are important contributing factors to the increased risk of falling. A wide range of methods was examined to improve balance, but these interventions might produce small effects or be inapplicable for this population. The current study aimed at investigating the effect of motor imaginary (MI) training combined with transcranial direct current stimulation (tDCS) over the cerebellum on balance in middle-aged women with high fall risk. Methods. Thirty subjects aged 40-65 years old were divided into two groups including intervention (
) and sham control (
). The participants completed a 4-week program 3 times per week. The intervention group performed MI training combined with tDCS over the cerebellum, and the control group performed MI training combined with sham tDCS over the cerebellum. Static and dynamic balance were measured at baseline and after completing the 4-week program using balance error scoring system (BESS) and Y balance testing, respectively. Result. A one-way analysis of covariance and paired
-tests were used to analyze the data. Significant improvement was observed in both balance tests in the intervention group after the implementation of the 4-week intervention program compared to the control group. The within-group analysis showed that both static and dynamic balance improved significantly from the baseline values only in the intervention group (
) and not in the control group (
). Conclusion. The results of the study indicate that MI training combined with tDCS over the cerebellum can lead to balance improvement in middle-aged women with high fall risk.
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Affiliation(s)
- Esmaeil Mozafaripour
- Department of Health and Sports Medicine, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Seyed Kazem Mousavi Sadati
- Department of Physical Education and Sport Science, East Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Leila Najafi
- Department of Physical Education and Sport Science, East Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University Australia, Victoria, Australia
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14
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Zoghi M, Rubega M, Fung J. Editorial: Women in science: Interventions for rehabilitation. Front Rehabilit Sci 2022; 3:1008741. [PMID: 36188927 PMCID: PMC9452839 DOI: 10.3389/fresc.2022.1008741] [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] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Maryam Zoghi
- Discipline of Physiotherapy, Institute of Health and Wellbeing, Federation University, VIC, Australia
- Correspondence: Maryam Zoghi
| | - Maria Rubega
- Section of Rehabilitation, Department of Neuroscience, University of Padova, Padova, Italy
| | - Joyce Fung
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
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15
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Ekin T, Kis M, Gungoren F, Atici A, Kunak AÜ, Mutlu D, Katkat F, Demir M, Sarac İ, Soydan E, Karaduman M, Bekar L, Boyuk F, Adiyaman MS, Zoghi M. Awareness and knowledge of pneumococcal vaccination in cardiology outpatient clinics and impact of physicians' recommendation on vaccination rates. Eur J Prev Cardiol 2022. [PMCID: PMC9384017 DOI: 10.1093/eurjpc/zwac056.170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Although there is not enough data on pneumococcal vaccination status in patients with cardiovascular disease and or risk factors in our country, it is known that vaccination rates are quite low in the current data.
Purpose
We aimed to evaluate the awareness of pneumococcal vaccination (PCV13, PPSV23) in general cardiology outpatient clinics and impact of physician’s recommendation (with educational brochures) on vaccination rate.
Methods
Awareness of vaccination, before COVID-19 pandemic, was measured in patients admitting to cardiology outpatient clinics from 40 center of our country by a questionnaire contained 19 questions. The demographics (including gender, age, educational level, awareness vaccination level) and comorbidities were obtained. The vaccination rates were calculated within 3-months follow-up from the admitting of patient to cardiology clinics.
Results
The 403 (18.2%) of patients with previous pneumococcal vaccination were excluded from the study. The mean age of study population (n=1808) was 61.9±12.1 years and 55.4% were male. The 58.7% had coronary artery disease, hypertension (74.1%) was the most common risk factor and 32.7% of the patients had never been vaccinated although they had information about vaccination before. The 98.5% were referred to family medicine (n=1412, 78.1%) or vaccination outpatient clinics (n=370, 20.5%) and the vaccination rate was 62.1% during the follow-up period. The differences between vaccinated and not-vaccinated patients are presented in Table 1.
The physician’s recommendation was positively correlated with vaccination intention and behavior in our participants. Multivariate logistic regression analysis showed a significant between vaccination and female sex [OR=1.55 (95% CI=1.25–1.92), p<0.001], higher education level [OR=1.49 (95% CI=1.15-1.92), p=0.002] patients’ knowledge [OR=1.93 (95% CI=1.56-2.40), p<0.001], and their physician’s recommendation [OR=5.12 (95% CI=1.92-13.68), p=0.001].
Conclusion
To our knowledge this is the first report about the awareness pneumococcal vaccination rates and impact of physician’s recommendation in patients with cardiovascular disease by high study population. These findings suggest providing information on the benefits of vaccination by physician’s and educational advice was significantly associated with an increase vaccination rate and have a key role.
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Affiliation(s)
- T Ekin
- Sorgun State Hospital, Cardiology, Yozgat, Turkey
| | - M Kis
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | | | - A Atici
- Medeniyet University, Istanbul, Turkey
| | - AÜ Kunak
- Medstar Hospital, Antalya, Turkey
| | - D Mutlu
- Istanbul University Cerrahpasa Faculty of Medicine, Istanbul, Turkey
| | - F Katkat
- Istanbul Education and Research Hospital, Istanbul, Turkey
| | - M Demir
- Kutahya Health Sciences University, Kutahya, Turkey
| | - İ Sarac
- Regional Training and Research Hospital, Erzurum, Turkey
| | | | | | - L Bekar
- HITIT UNIVERSITY, Corum, Turkey
| | - F Boyuk
- Yedikule Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - MS Adiyaman
- Gazi Yasargil Research Hospital, Diyarbakir, Turkey
| | - M Zoghi
- Ege University, Izmir, Turkey
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16
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Jaberzadeh S, Zoghi M. Transcranial Direct Current Stimulation Enhances Exercise Performance: A Mini Review of the Underlying Mechanisms. Front Neurogenom 2022; 3:841911. [PMID: 38235480 PMCID: PMC10790841 DOI: 10.3389/fnrgo.2022.841911] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/18/2022] [Indexed: 01/19/2024]
Abstract
Exercise performance (EP) is affected by a combination of factors including physical, physiological, and psychological factors. This includes factors such as peripheral, central, and mental fatigue, external peripheral factors such as pain and temperature, and psychological factors such as motivation and self-confidence. During the last century, numerous studies from different fields of research were carried out to improve EP by modifying these factors. During the last two decades, the focus of research has been mainly moved toward the brain as a dynamic ever-changing organ and the ways changes in this organ may lead to improvements in physical performance. Development of centrally-acting performance modifiers such as level of motivation or sleep deprivation and the emergence of novel non-invasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are the key motives behind this move. This article includes three sections. Section Introduction provides an overview of the mechanisms behind the reduction of EP. The main focus of the Effects of tDCS on EP section is to provide a brief description of the effects of tDCS on maximal and submaximal types of exercise and finally, the section Mechanisms Behind the Effects of tDCS on EP provides description of the mechanisms behind the effects of tDCS on EP.
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Affiliation(s)
- Shapour Jaberzadeh
- Non-invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, School of Health, Federation University Australia, Churchill, VIC, Australia
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17
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Jandaghi S, Tahan N, Akbarzadeh Baghban A, Zoghi M. Stroke Patients Showed Improvements in Balance in Response to Visual Restriction Exercise. Phys Ther Res 2022; 24:211-217. [PMID: 35036254 DOI: 10.1298/ptr.e10081] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 10/30/2020] [Accepted: 03/04/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Several strategies have been designed to improve balance after stroke. Although recent studies have suggested that the balance training in stroke should include exercises that are performed in different sensory conflict conditions, little attention has been paid to manipulation of visual input. This study aimed to compare effects of balance training on an unstable surface with balance training under visual deprivation conditions in persons with stroke. METHOD Forty-five stroke patients were randomized into three groups: the visual deprivation- stable based training (VD-SBT); unstable based training (UBT); and control (C) groups. Subjects of the VD-SBT group performed balance training on a stable surface with closed eyes. The UBT group performed balance training on an unstable surface with open eyes. Patients were assessed before and after interventions for Timed Up and Go (TUG), Four Square Step (FSS) and Five Times Sit to Stand (FTSS) tests. RESULT There was a significant difference in pre- post intervention time of TUG, FSS and FTSS tests in all three groups. In a comparison of three groups, the UBT and VD-SBT groups had a significant improvement in time of all tests but significant improvement in time of all tests was observed in the VD-SBT group in comparison with the UBT group. In the field of balance training, the manipulation of visual input was more effective than the manipulation of standing surface to reweighting the sensory information. CONCLUSION We recommended balance rehabilitation programs after stroke performed under conditions to stimulate the use of underused sensory input.
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Affiliation(s)
- Shima Jandaghi
- Faculty of Sport Injury and Corrective Exercises, Karaj Branch, Islamic Azad University, Iran
| | - Nahid Tahan
- Department of Physiotherapy, Loghman Hakim Hospital, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Iran
| | - Alireza Akbarzadeh Baghban
- Proteomics Research Center, Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Iran
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Australia
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18
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Dissanayaka T, Zoghi M, Farrell M, Egan G, Jaberzadeh S. The effects of monophasic anodal transcranial pulsed current stimulation on corticospinal excitability and motor performance in healthy young adults: A randomized double-blind sham-controlled study. Brain Connect 2021; 12:260-274. [PMID: 34963309 DOI: 10.1089/brain.2020.0949] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Transcranial pulsed current stimulation (tPCS) could be used to deliver electrical pulses at different frequencies to entrain the cortical neurons of the brain. Frequency dependence of these pulses in the induction of changes in corticospinal excitability (CSE) has not been reported. OBJECTIVE We aimed to assess the effect of anodal tPCS (a-tPCS) at theta (4 Hz), and gamma (75 Hz) frequencies on CSE as assessed by the peak-to-peak amplitude of transcranial magnetic stimulation (TMS) induced motor evoked potentials (MEPs) and motor performance. METHOD In a randomized double-blinded sham-controlled cross over design study, seventeen healthy participants attended three experimental sessions and received either a-tPCS at 4 Hz, 75 Hz, or sham a-tPCS with 1.5 mA for 15 min. The amplitude of TMS induced resting MEPs and time for completion of the grooved pegboard test were recorded at baseline, immediately after, and 30-min after a-tPCS. RESULTS Both a-tPCS at 75 Hz and 4 Hz showed significantly increased CSE compared to sham. The a-tPCS at 75 Hz induced significantly higher CSE changes compared to 4 Hz. There was a significant increase in intracortical facilitation and a significant reduction in short-interval intra-cortical inhibition with both 4 and 75 Hz stimulation. However, the inhibition and facilitation did not correlate with CSE. Motor performance was unaffected by the interventions. CONCLUSION The high CSE changes in M1 in a-tPCS at 75 Hz provides an initial understanding of the frequency-specific effect of a-tPCS. More research is needed to establish this concept and to assess its behavioural relevance.
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Affiliation(s)
- Thusharika Dissanayaka
- Monash University, 2541, 6/63, Frankston-flinders road, Frankston, Frankston, Victoria, Australia, 3199;
| | - Maryam Zoghi
- La Trobe University, 2080, Melbourne, Victoria, Australia;
| | - Michael Farrell
- Monash University, 2541, Medical Imaging and Radiation Sciences, Wellington Road, Clayton, Victoria, Australia, 3800.,Monash University;
| | - Gary Egan
- Monash University, Monash Biomedical Imaging; School of Psychological Sciences, Melbourne, Victoria, Australia.,ARC Centre of Excellence for Integrative Brain Function, Melbourne, Australia;
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19
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Behrangrad S, Zoghi M, Kidgell D, Jaberzadeh S. The Effect of a Single Session of Non-Invasive Brain Stimulation on Balance in Healthy Individuals: A Systematic Review and Best Evidence Synthesis. Brain Connect 2021; 11:695-716. [PMID: 33798002 DOI: 10.1089/brain.2020.0872] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To evaluate the effects of a single session of non-invasive brain stimulation (NIBS) on postural balance. Introduction: The NIBS has been used widely in improving balance. However, the effect of a single session of NIBS on balance in healthy individuals has not been systemically reviewed. Methods: A systematic literature review and best evidence synthesis were conducted, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, to determine the effects of different NIBS techniques on balance function in healthy individuals. The methodological quality of included articles was assessed by the risk of bias, and the Downs and Black tool. Data were analyzed by using the best evidence synthesis. Thirty-five articles were included that used the following NIBS techniques: anodal transcranial direct current stimulation (a-tDCS), cathodal transcranial direct current stimulation (c-tDCS), continuous theta burst stimulation (cTBS), and repetitive transcranial magnetic stimulation (rTMS) on primary motor cortex (M1), supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPFC), and cerebellum on balance. Results: Strong evidence showed that a-tDCS of M1, SMA improve balance in healthy participants, and the a-tDCS of DLPFC induces improvement only in dual task balance indices. Also, the findings indicate that cerebellar a-tDCS might significantly improve balance, if at least 10 min cerebellar a-tDCS with an intensity of ≥1 mA, over or maximum 1.5 cm below the inion, is used. Strong evidence showed that c-tDCS, cTBS, and rTMS are not effective on the balance. Conclusion: According to the results, the a-tDCS may be a useful technique to improve balance in healthy adults.
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Affiliation(s)
- Shabnam Behrangrad
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Australia
| | - Dawson Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
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20
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Nikooharf Salehi E, Jaydari Fard S, Jaberzadeh S, Zoghi M. Transcranial Direct Current Stimulation Reduces the Negative Impact of Mental Fatigue on Swimming Performance. J Mot Behav 2021; 54:327-336. [PMID: 34433377 DOI: 10.1080/00222895.2021.1962238] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The issue of using transcranial direct current stimulation (tDCS) to improve sport performance has recently been a topic of interest for researchers. The purpose of this study was to examine the effect of tDCS over left dorsolateral prefrontal cortex (DLPFC) on mental fatigue and physical performance in professional swimmers. Fifteen professional swimmers were randomly assigned in a single-blinded, randomized, counterbalanced order to sham, anodal and cathodal stimulation conditions. Mental fatigue was induced by using a 60-min modified Stroop color-word task. Subjective ratings of mental fatigue were measured before and after the stroop task. The results showed that only anodal tDCS of the left DLPFC reduces adverse effects of mental fatigue in 50-meter swimming performance, whereas cathodal stimulation had no significant effect.
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Affiliation(s)
- Elahe Nikooharf Salehi
- Department of Motor Behavior and Sport Psychology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Saeed Jaydari Fard
- Institute for Social Science Research, Faculty of Humanities and Social Sciences, The University of Queensland, Brisbane, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Australia
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21
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Zoghi M, Jaberzadeh S. Letter to the editor: Reducing seizure frequency in patients with refractory epilepsy with cathodal transcranial direct current stimulation. Brain Stimul 2021; 14:1091-1092. [PMID: 34333166 DOI: 10.1016/j.brs.2021.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 07/21/2021] [Accepted: 07/22/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Maryam Zoghi
- Department of Physiotherapy, Podiatry, and Prosthetics and Orthotics, School of Allied Health, Human Services and Sport, La Trobe University, Australia.
| | - Shapour Jaberzadeh
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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22
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Young J, Zoghi M, Khan F, Galea MP. The Effect of Transcranial Direct Current Stimulation on Chronic Neuropathic Pain in Patients with Multiple Sclerosis: Randomized Controlled Trial. Pain Med 2021; 21:3451-3457. [PMID: 32594139 DOI: 10.1093/pm/pnaa128] [Citation(s) in RCA: 19] [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] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Chronic neuropathic pain is a common symptom in multiple sclerosis (MS). This randomized controlled single-blinded study investigated whether a new protocol involving five days of transcranial direct current stimulation (tDCS) with an interval period would be effective to reduce pain using the visual analog scale (VAS). Other secondary outcomes included the Neuropathic Pain Scale (NPS), Depression Anxiety Stress Score (DASS), Short Form McGill Pain Questionnaire (SFMPQ), and Multiple Sclerosis Quality of Life 54 (MSQOL54). DESIGN A total of 30 participants were recruited for the study, with 15 participants randomized to a sham group or and 15 randomized to an active group. After a five-day course of a-tDCS, VAS and NPS scores were measured daily and then weekly after treatment up to four weeks after treatment. Secondary outcomes were measured pretreatment and then weekly up to four weeks. RESULTS After a five-day course of a-tDCS, VAS scores were significantly reduced compared with sham tDCS and remained significantly low up to week 2 post-treatment. There were no statistically significant mean changes in MSQOL54, SFMPQ, NPS, or DASS for the sham or treatment group before treatment or at four-week follow-up. CONCLUSIONS This study shows that repeated stimulation with a-tDCS for five days can reduce pain intensity for a prolonged period in patients with MS who have chronic neuropathic pain.
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Affiliation(s)
- Jamie Young
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine and Radiology, Integrated Critical Care, University of Melbourne, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Fary Khan
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
| | - Mary P Galea
- RehabilitationDepartment, Royal Melbourne Hospital, Royal Park Campus, Melbourne, Australia.,Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Australia
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23
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Dinc Asarcikli L, Kis M, Guvenc T, Tosun V, Acar B, Avci Demir F, Naser A, Zoghi M, Keles F, Usalp S, Aslanturk OF, Uygun T, Karamanlioglu M, Er F, Eliz Uzel K. Usefulness of novel martin/hopkins and sampson equations over friedewald equation in cardiology outpatient: CVSCORE-TR substudy. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
CVSCORE-TR study group
Background
Friedewald equation (LDL-Cf) is known to produce inaccurate estimations of low-density lipoprotein cholesterol (LDL-C) when triglycerides are high (>400 mg/dl) or LDL-C is low (<70 mg/dl). Martin/Hopkins (LDL-Cmh) and Sampson (LDL-Cs) equations were developed to overcome these limitations, but few data are available whether these equations offer incremental usefulness over LDL-Cf.
Purpose
In this pragmatic study, we aimed to evaluate the agreement between LDL-C calculated using LDL-Cmh, LDL-Cs and LDL-Cf equations and to understand whether using LDL-Cmh or LDL-Cs instead of LDL-Cf leads to significant changes on the clinical decision-making
Methods
4196 cardiology outpatient cases that were included in a multicenter registry database were analyzed. Each case was assigned into a cardiovascular risk class using web-based SCORE (Systematic COronary Risk Evaluation) algorithm calibrated for high-risk European countries, and relevant European guidelines were used to assess LDL-C targets. LDL-Cf, LDL-Cs and LDL-Cmh were calculated as previously described.
Results
Compared to LDL-Cmh and LDL-Cs, LDL-Cf was able to correctly identify 96.9%-98.08% of cases as within or out of LDL-C target, respectively, while 1.95%-2.8% of cases were falsely identified as within LDL-C target. Kappa coefficients for agreement between LDL-Cf vs. LDL-Cmh and LDL-Cf vs. LDL-Cs were 0.868 and 0.918 (p < 0.001 for both). For patients not on anticholesterolemic drugs, decision to initiate treatment would be different in 1.2%-1.8% of cases if LDL-Cs or LDL-Cmh were used, respectively. For those already on anticholesterolemic drugs, decisions regarding to treatment intensification would be different in 1.5%-2.4% of cases if LDL-Cs or LDL-Cmh were used.
Conclusions
Friedewald equation had an excellent degree of agreement with the novel Martin/Hopkins and Sampson formulas in most cardiology outpatients, especially those within the lower end of the cardiovascular risk spectrum. In selected patients, especially those with high or very high risk in whom LDL-Cf < 70 mg/dl or those with a TG > 400 mg/dl, agreement was far worse and thus novel equations might have an incremental usefulness for clinical decision making.
Table 1 Reference Comparison Correct estimation Underestimation Overestimation Kappa (p value) All patients that were not on cholesterol-lowering treatment LDL-Cmh LDL-Cf 2785 (98.1%) 51 (1.8%) 3 (0.1%) 0.962 (<0.001) LDL-Cs LDL-Cf 2804 (98.8%) 35 (1.2%) 0 (0.0%) 0.975 (<0.001) Agreement for the indication of cholesterol-lowering treatment for patients not already on cholesterol-lowering drugs. Leftmost column shows the reference method, and the second row shows equation which is compared to the reference method.
Abstract Figure
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Affiliation(s)
- L Dinc Asarcikli
- Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey
| | - M Kis
- Silopi State Hospital, Sirnak, Turkey
| | - T Guvenc
- Kirklareli University, Faculty of Medicine, Department of Cardiology, Kirklareli, Turkey
| | - V Tosun
- Sanliurfa Research and Educational Hospital, Department of Cardiology, Sanliurfa, Turkey
| | - B Acar
- Kocaeli University Hospital, Department of Cardiology, Kocaeli, Turkey
| | | | - A Naser
- Medical Park Hospital of Istanbul, Cardiology, Istanbul, Turkey
| | - M Zoghi
- Ege University, Cardiology, Izmir, Turkey
| | - F Keles
- Elazig Education and Research Hospital, Cardiology, Elazig, Turkey
| | - S Usalp
- Turhal State Hospital, Cardiology, Tokat, Turkey
| | | | - T Uygun
- Sanliurfa Research and Educational Hospital, Department of Cardiology, Sanliurfa, Turkey
| | | | - F Er
- Yuksek Ihtisas Hospital of Bursa, Cardiology, Bursa, Turkey
| | - K Eliz Uzel
- Adiyaman University Training and Research Hospital, Cardiology, Adiyaman, Turkey
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24
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Pellegrini M, Zoghi M, Jaberzadeh S. Genetic Polymorphisms Do Not Predict Interindividual Variability to Cathodal Transcranial Direct Current Stimulation of the Primary Motor Cortex. Brain Connect 2020; 11:56-72. [PMID: 33198509 DOI: 10.1089/brain.2020.0762] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: High variability between individuals (i.e., interindividual variability) in response to transcranial direct current stimulation (tDCS) has become a commonly reported issue in the tDCS literature in recent years. Inherent genetic differences between individuals have been proposed as a contributing factor to observed response variability. This study investigated whether tDCS interindividual variability was genetically mediated. Methods: A large sample size of 61 healthy males received cathodal tDCS (c-tDCS) and sham-tDCS of the primary motor cortex at 1 mA and 10 min via 6 × 4 cm active and 7 × 5 cm return electrodes. Corticospinal excitability (CSE) was assessed via 25 single-pulse transcranial magnetic stimulation motor-evoked potentials (MEPs). Intracortical inhibition was assessed via twenty-five 3 msec interstimulus interval (ISI) paired-pulse MEPs, known as short-interval intracortical inhibition (SICI). Intracortical facilitation (ICF) was assessed via twenty-five 10 msec ISI paired-pulse MEPs. Gene variants encoding for excitatory and inhibitory neuroreceptors were determined via saliva samples. Predetermined thresholds and statistical cluster analyses were used to subgroup individuals. Results: Two distinct subgroups were identified, "responders" reducing CSE following c-tDCS and "nonresponders" showing no reduction or even increase in CSE. Differences in CSE between responders and nonresponders following c-tDCS were not explained by changes in SICI or ICF. Conclusions: No significant relationships were reported between gene variants and interindividual variability to c-tDCS, suggesting that the chosen gene variants did not influence the activity of the neuroreceptors involved in eliciting changes in CSE in responders following c-tDCS. In this largest c-tDCS study of its kind, novel insights were reported into the contribution genetic factors may play in observed interindividual variability to c-tDCS. Impact statement This study adds insight into the issue of interindividual variability to c-tDCS. It highlights not all individuals respond to c-tDCS similarly when exposed to the same stimulus parameters. This disparity in response to c-tDCS between individuals does not appear to be genetically mediated. For c-tDCS to progress to large-scale clinical application, reliability, predictability and reproducibility are essential. Systematically investigating factors contributing to interindividual variability take steps towards this progress the c-tDCS field towards the potential development of screening tools to determine clinical suitability to c-tDCS to ensure its application in those who may benefit the most.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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25
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Dissanayaka T, Zoghi M, Farrell M, Egan G, Jaberzadeh S. The effects of a single-session cathodal transcranial pulsed current stimulation on corticospinal excitability: A randomized sham-controlled double-blinded study. Eur J Neurosci 2020; 52:4908-4922. [PMID: 33128480 DOI: 10.1111/ejn.14916] [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: 10/06/2019] [Revised: 06/16/2020] [Accepted: 07/11/2020] [Indexed: 12/17/2022]
Abstract
Transcranial pulsed current stimulation (tPCS) of the human motor cortex has received much attention in recent years. Although the effect of anodal tPCS with different frequencies has been investigated, the effect of cathodal tPCS (c-tPCS) has not been explored yet. Therefore, the aim of the present study was to investigate the effect of c-tPCS at 4 and 75 Hz frequencies on corticospinal excitability (CSE) and motor performance. In a randomized sham-controlled crossover design, fifteen healthy participants attended three experimental sessions and received either c-tPCS at 75 Hz, 4 Hz or sham with 1.5 mA for 15 min. Transcranial magnetic stimulation and grooved pegboard test were performed before, immediately after and 30 min after the completion of stimulation at rest. The findings indicate that c-tPCS at both 4 and 75 Hz significantly increased CSE compared to sham. Both c-tPCS at 75 and 4 Hz showed a significant increase in intracortical facilitation compared to sham, whereas the effect on short-interval intracortical inhibition was not significant. The c-tPCS at 4 Hz but not 75 Hz induced modulation of intracortical facilitation correlated with the CSE. Motor performance did not show any significant changes. These results suggest that, compared with sham stimulation, c-tPCS at both 4 and 75 Hz induces an increase in CSE.
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Affiliation(s)
- Thusharika Dissanayaka
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied health, La Trobe University, Bundoora, Melbourne, Vic., Australia
| | - Michael Farrell
- Monash Biomedical Imaging, Monash University, Melbourne, Vic., Australia.,Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Vic., Australia
| | - Gary Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Vic., Australia
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Vic., Australia
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26
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Halakoo S, Ehsani F, Masoudian N, Zoghi M, Jaberzadeh S. Does anodal trans-cranial direct current stimulation of the damaged primary motor cortex affects wrist flexor muscle spasticity and also activity of the wrist flexor and extensor muscles in patients with stroke?: a Randomized Clinical Trial. Neurol Sci 2020; 42:2763-2773. [PMID: 33150514 DOI: 10.1007/s10072-020-04858-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 05/23/2020] [Accepted: 10/24/2020] [Indexed: 11/27/2022]
Abstract
Spasticity is a common symptom in stroke survivors. This study is double-blinded, sham-controlled randomized, clinical trial with three parallel arms. The aim of the study was to investigate the effects of anodal trans-cranial direct current stimulation (a-tDCS) over the damaged primary motor cortex (M1) on spasticity of the wrist flexor and also the activity of wrist flexor and extensor muscles in sub-acute stroke patients. This study was performed on 32 stroke patients. The patients are assigned to three groups (intervention, sham, and control). All participants in the first two groups received 20-min concurrent M1 a-tDCS or sham tDCS and functional electrical stimulation (FES) for 10 sessions (5 sessions per week), while participants in control group were given only 20-min FES for 10 sessions. Modified Ashworth scale of wrist flexors and also electromyography (EMG) activity of flexor carpi radialis (FCR) and extensor carpi radialis (ECR) were recorded before, immediately, and 1 month after the interventions. A significant reduction was shown in the MAS and EMG activity of FCR muscle at passive rest position of the wrist, immediately and 1 month after the intervention in M1 a-tDCS compared to sham and control groups (p < 0.001). Also, the EMG activity of FCR and ECR muscles during active wrist flexion and extension increased immediately and 1 month after intervention in M1 a-tDCS compared to the other groups, respectively (p < 0.001). M1 a-tDCS can significantly decrease the spasticity of wrist flexor muscle and also increase the wrist flexor and extensor muscles activity in stroke patients during active flexion and extension.
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Affiliation(s)
- Sara Halakoo
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Nooshin Masoudian
- Neurology Ward, Department of Internal Medicine, School of Medicine, Kosar Hospital, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria, 3086, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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27
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Nikazar S, Barani M, Rahdar A, Zoghi M, Kyzas GZ. Photo‐ and Magnetothermally Responsive Nanomaterials for Therapy, Controlled Drug Delivery and Imaging Applications. ChemistrySelect 2020. [DOI: 10.1002/slct.202002978] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Sohrab Nikazar
- Chemical Engineering Faculty Engineering College, University of Tehran Tehran P.O. Box:14155-6455 Iran
| | - Mahmood Barani
- Department of Chemistry Shahid Bahonar University of Kerman Kerman Iran
| | - Abbas Rahdar
- Department of Physics, Faculty of science University of Zabol 538-98615 Zabol Iran
| | - Maryam Zoghi
- Chemical Engineering Faculty Engineering College, University of Tehran Tehran P.O. Box:14155-6455 Iran
| | - George Z. Kyzas
- Department of Chemistry International Hellenic University Kavala 65404 Greece
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28
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Zoghi M, Hafezi P, Amatya B, Khan F, Galea MP. Intracortical Circuits in the Contralesional Primary Motor Cortex in Patients With Chronic Stroke After Botulinum Toxin Type A Injection: Case Studies. Front Hum Neurosci 2020; 14:342. [PMID: 33100987 PMCID: PMC7497670 DOI: 10.3389/fnhum.2020.00342] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/03/2020] [Indexed: 11/22/2022] Open
Abstract
Spasticity and motor recovery are both related to neural plasticity after stroke. A balance of activity in the primary motor cortex (M1) in both hemispheres is essential for functional recovery. In this study, we assessed the intracortical inhibitory and facilitatory circuits in the contralesional M1 area in four patients with severe upper limb spasticity after chronic stroke and treated with botulinum toxin-A (BoNT-A) injection and 12 weeks of upper limb rehabilitation. There was little to no change in the level of spasticity post-injection, and only one participant experienced a small improvement in arm function. All reported improvements in quality of life. However, the levels of intracortical inhibition and facilitation in the contralesional hemisphere were different at baseline for all four participants, and there was no clear pattern in the response to the intervention. Further investigation is needed to understand how BoNT-A injections affect inhibitory and facilitatory circuits in the contralesional hemisphere, the severity of spasticity, and functional improvement.
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Affiliation(s)
- Maryam Zoghi
- Department of Physiotherapy, Podiatry, Prosthetics and Orthotics, La Trobe University, Melbourne, VIC, Australia
| | | | - Bhasker Amatya
- The Royal Melbourne Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
| | - Fary Khan
- The Royal Melbourne Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
| | - Mary Pauline Galea
- The Royal Melbourne Hospital, Melbourne, VIC, Australia.,University of Melbourne, Melbourne, VIC, Australia
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29
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Pellegrini M, Zoghi M, Jaberzadeh S. Can genetic polymorphisms predict response variability to anodal transcranial direct current stimulation of the primary motor cortex? Eur J Neurosci 2020; 53:1569-1591. [PMID: 33048398 DOI: 10.1111/ejn.15002] [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: 03/21/2020] [Revised: 09/17/2020] [Accepted: 10/02/2020] [Indexed: 11/28/2022]
Abstract
Genetic mediation of cortical plasticity and the role genetic variants play in previously observed response variability to transcranial direct current stimulation (tDCS) have become important issues in the tDCS literature in recent years. This study investigated whether inter-individual variability to tDCS was in-part genetically mediated. In 61 healthy males, anodal-tDCS (a-tDCS) and sham-tDCS were administered to the primary motor cortex at 1 mA for 10-min via 6 × 4 cm active and 7 × 5 cm return electrodes. Twenty-five single-pulse transcranial magnetic stimulation (TMS) motor evoked potentials (MEP) were recorded to represent corticospinal excitability (CSE). Twenty-five paired-pulse MEPs were recorded with 3 ms inter-stimulus interval (ISI) to assess intracortical inhibition (ICI) via short-interval intracranial inhibition (SICI) and 10 ms ISI for intracortical facilitation (ICF). Saliva samples were tested for specific genetic polymorphisms in genes encoding for excitatory and inhibitory neuroreceptors. Individuals were sub-grouped based on a pre-determined threshold and via statistical cluster analysis. Two distinct subgroups were identified, increases in CSE following a-tDCS (i.e. Responders) and no increase or even reductions in CSE (i.e. Non-responders). No changes in ICI or ICF were reported. No relationships were reported between genetic polymorphisms in excitatory receptor genes and a-tDCS responders. An association was reported between a-tDCS responders and GABRA3 gene polymorphisms encoding for GABA-A receptors suggesting potential relationships between GABA-A receptor variations and capacity to undergo tDCS-induced cortical plasticity. In the largest tDCS study of its kind, this study presents an important step forward in determining the contribution genetic factors play in previously observed inter-individual variability to tDCS.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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30
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Pellegrini M, Zoghi M, Jaberzadeh S. A Checklist to Reduce Response Variability in Studies Using Transcranial Magnetic Stimulation for Assessment of Corticospinal Excitability: A Systematic Review of the Literature. Brain Connect 2020; 10:53-71. [PMID: 32093486 DOI: 10.1089/brain.2019.0715] [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] [Indexed: 12/22/2022] Open
Abstract
Response variability between individuals (interindividual variability) and within individuals (intraindividual variability) is an important issue in the transcranial magnetic stimulation (TMS) literature. This has raised questions of the validity of TMS to assess changes in corticospinal excitability (CSE) in a predictable and reliable manner. Several participant-specific factors contribute to this observed response variability with a current lack of consensus on the degree each factor contributes. This highlights a need for consistency and structure in reporting study designs and methodologies. Currently, there is no summarized review of the participant-specific factors that can be controlled and may contribute to response variability. This systematic review aimed to develop a checklist of methodological measures taken by previously published research to increase the homogeneity of participant selection criteria, preparation of participants before experimental testing, participant scheduling, and the instructions given to participants throughout experimental testing to minimize their effect on response variability. Seven databases were searched in full. Studies were included if CSE was measured via TMS and included methodological measures to increase the homogeneity of the participants. Eighty-four studies were included. Twenty-three included measures to increase participant selection homogeneity, 21 included measures to increase participant preparation homogeneity, while 61 included measures to increase participant scheduling and instructions during experimental testing homogeneity. These methodological measures were summarized into a user-friendly checklist with considerations, suggestions, and rationale/justification for their inclusion. This may provide the framework for further insights into ways to reduce response variability in TMS research.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, Discipline of Physiotherapy, School of Allied Health, La Trobe University, Melbourne, Victoria, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Victoria, Australia
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31
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Hassanzahraee M, Nitsche MA, Zoghi M, Jaberzadeh S. Determination of anodal tDCS intensity threshold for reversal of corticospinal excitability: an investigation for induction of counter-regulatory mechanisms. Sci Rep 2020; 10:16108. [PMID: 32999375 PMCID: PMC7527486 DOI: 10.1038/s41598-020-72909-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [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: 06/03/2020] [Accepted: 09/09/2020] [Indexed: 12/05/2022] Open
Abstract
Transcranial direct current stimulation is applied to modulate activity, and excitability of the brain. Basically, LTP-like plasticity is induced when anodal tDCS (a-tDCS) is applied over the primary motor cortex. However, it has been shown that specific parameters of a-tDCS can induce a plasticity reversal. We aimed to systematically assess the intensity threshold for reversal of the direction of plasticity induced by a-tDCS, monitored by corticospinal excitability (CSE), and explored mechanisms regulating this reversal. Fifteen healthy participants received a-tDCS in pseudo-random order for 26 min with four intensities of 0.3, 0.7, 1, and 1.5 mA. To measure CSE changes, single-pulse TMS was applied over the left M1, and motor evoked potentials of a contralateral hand muscle were recorded prior to a-tDCS, immediately and 30-min post-intervention. Paired-pulse TMS was used to evaluate intracortical excitation and inhibition. CSE increased significantly following a-tDCS with an intensity of 0.7 mA; however, the expected effect decreased and even reversed at intensities of 1 and 1.5 mA. ICF was significantly increased while SICI and LICI decreased at 0.7 mA. On the other hand, a significant decrease of ICF, but SICI and LICI enhancement was observed at intensities of 1, and 1.5 mA. The present findings show an intensity threshold of ≥ 1 mA for 26 min a-tDCS to reverse LTP- into LTD-like plasticity. It is suggested that increasing stimulation intensity, with constant stimulation duration, activates counter-regulatory mechanisms to prevent excessive brain excitation. Therefore, stimulation intensity and plasticity induced by a-tDCS might non-linearly correlate in scenarios with prolonged stimulation duration.
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Affiliation(s)
- Maryam Hassanzahraee
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Michael A Nitsche
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany.,Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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32
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Dissanayaka T, Zoghi M, Hill AT, Farrell M, Egan G, Jaberzadeh S. The Effect of Transcranial Pulsed Current Stimulation at 4 and 75 Hz on Electroencephalography Theta and High Gamma Band Power: A Pilot Study. Brain Connect 2020; 10:520-531. [PMID: 32962422 DOI: 10.1089/brain.2020.0756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/13/2022] Open
Abstract
Introduction: Transcranial pulsed current stimulation (tPCS) is an emerging noninvasive brain stimulation technique that has shown significant effects on cortical excitability. To date, electrophysiological measures of the efficiency of monophasic tPCS have not been reported. Objective: We aimed to explore the effects of monophasic anodal and cathodal-tPCS (a-tPCS/c-tPCS) at theta (4 Hz) and gamma (75 Hz) frequencies on theta and high gamma electroencephalography (EEG) oscillatory power. Methods: In a single-blind, randomized, sham-controlled crossover design, 15 healthy participants were randomly assigned into 5 experimental sessions in which they received a-PCS/c-tPCS at 4 and 75 Hz or sham stimulation over the left primary motor cortex (M1) for 15 min at an intensity of 1.5 mA. Changes in theta and high gamma oscillatory power were recorded at baseline, immediately after, and 30 min after stimulation using EEG at rest with eyes open. Results: a-tPCS at 4 Hz showed a significant increase in theta power compared with sham, whereas c-tPCS at 4 Hz had no significant effect on theta power. a-tPCS at 75 Hz produced no changes in high gamma power compared with sham. Importantly, c-tPCS at 75 Hz led to a significant reduction in high gamma power compared with baseline, as well as compared with c-tPCS at 4 Hz and sham stimulation. Conclusion: The results demonstrate the modulation of oscillatory brain activity by monophasic tPCS, and highlight the need for future studies on a larger scale to confirm these initial findings. Impact statement Transcranial pulsed current stimulation (tPCS) is a novel brain stimulation technique. Recently, tPCS has been introduced to directly modulate brain oscillations by applying pulsatile current over the target brain area. Using both anodal and cathodal monophasic tPCS at theta and gamma frequencies, we demonstrate the ability of the stimulation to modulate brain activity. The present findings are the first direct electroencephalography evidence of an interaction between tPCS and ongoing oscillatory activity in the human motor cortex. Our work recommends tPCS as a tool for investigating human brain oscillations and open more studies in this area.
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Affiliation(s)
- Thusharika Dissanayaka
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Aron T Hill
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Canada
| | - Michael Farrell
- Monash Biomedical Imaging, Monash University, Melbourne, Australia.,Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia
| | - Gary Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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33
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Pellegrini M, Zoghi M, Jaberzadeh S. The effects of transcranial direct current stimulation on corticospinal and cortico-cortical excitability and response variability: Conventional versus high-definition montages. Neurosci Res 2020; 166:12-25. [PMID: 32610058 DOI: 10.1016/j.neures.2020.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 03/02/2020] [Revised: 06/08/2020] [Accepted: 06/11/2020] [Indexed: 01/19/2023]
Abstract
Response variability following transcranial direct current stimulation (tDCS) highlights need for exploring different tDCS electrode montages. Corticospinal excitability (CSE), cortico-cortical excitability and intra-individual variability was compared following conventional and high-definition (HD) anodal (a-tDCS) and cathodal (c-tDCS) tDCS. Fifteen healthy males attended four sessions at-least one-week apart: conventional a-tDCS, conventional c-tDCS, HD-a-tDCS, HD-c-tDCS. TDCS was administered (1 mA, 10-minutes) over primary motor cortex (M1), via 6 × 4 cm active and 7 × 5 cm return electrodes (conventional tDCS) and 4 × 1 ring-electrodes 3.5 cm apart over M1 (HD-tDCS). For CSE, twenty-five single-pulse transcranial magnetic stimulation (TMS) peak-to-peak motor evoked potentials (MEP) were recorded at baseline, 0-minutes and 30-minutes post-tDCS. Twenty-five paired-pulse MEPs with 3-millisecond (ms) inter-pulse interval (IPI) and twenty-five at 10 ms assessed short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). MEP standardised z-values standard deviations represented intra-individual variability. No significant changes in CSE from baseline were reported for all four interventions. No significant differences were reported in CSE between conventional and HD a-tDCS, but significant differences between conventional and HD c-tDCS 0-minutes post-tDCS. Conventional tDCS significantly reduced intra-individual variability compared to HD-tDCS for a-tDCS (0-minutes) and c-tDCS (30-minutes). No changes were reported for SICI/ICF. These novel findings of increased intra-individual variability following HD-tDCS, at the current stimulus parameters, highlight need for further nuanced research and refinement to optimise the HD-tDCS dosage-response relationship.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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Hassanzahraee M, Zoghi M, Jaberzadeh S. Longer Transcranial Magnetic Stimulation Intertrial Interval Increases Size, Reduces Variability, and Improves the Reliability of Motor Evoked Potentials. Brain Connect 2020; 9:770-776. [PMID: 31744309 DOI: 10.1089/brain.2019.0714] [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] [Indexed: 12/26/2022] Open
Abstract
High rates of variability in the amplitude of transcranial magnetic stimulation (TMS)-induced motor evoked potentials (MEPs), a popular method for assessing corticospinal excitability (CSE), make it essential to examine inherent reliability of the MEP amplitude. We aimed to investigate the effects of different intertrial intervals (ITIs) of single-pulse TMS on the amplitude, variability, and test-retest reliability of MEPs. Twenty-five TMS single pulses were recorded at four different ITIs of 5, 10, 15, and 20 sec from 15 healthy participants who attended two experimental sessions. Repeated measures analysis of variance (rmANOVA) and standardized z-value standard deviations (SDs) were used to investigate the effects of ITIs on MEP amplitudes and variability. Test-retest reliability of MEP amplitudes was also assessed using rmANOVA and intraclass correlation (ICC). rmANOVA revealed significantly larger MEP amplitudes following ITIs of 10, 15, and 20 sec compared with ITI 5, with no significant increases between ITIs of 15 and 20 sec. Standardized z-value SDs revealed variability rate reduction following longer ITIs with significant reductions occurring following ITIs of 10, 15, and 20 sec compared with ITI 5 with no significant difference between ITIs of 15 and 20 sec. rmANOVA showed no significant Time main effect on the MEP changes confirming within- and between-session agreement. ICCs reported significant within- and between-session reliability in all selected ITIs. The findings of the current study indicate that longer ITIs up to 15 sec can significantly induce larger MEPs with lower variability and higher reliability. The increase in ITIs not only reduces the chance of TMS-induced changes in CSE but also helps us to use this assessment tool in studies with smaller sample sizes.
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Affiliation(s)
- Maryam Hassanzahraee
- Noninvasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Noninvasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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Mortezanejad M, Ehsani F, Masoudian N, Zoghi M, Jaberzadeh S. Comparing the effects of multi-session anodal trans-cranial direct current stimulation of primary motor and dorsolateral prefrontal cortices on fatigue and quality of life in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial. Clin Rehabil 2020; 34:1103-1111. [PMID: 32397748 DOI: 10.1177/0269215520921506] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To compare the effects of anodal trans-cranial direct current stimulation (a-tDCS) over primary motor and dorsolateral prefrontal cortices on Fatigue Severity Scale and its lasting effect on fatigue reduction and improvement in quality of life in patients with multiple sclerosis. DESIGN A randomized, double-blinded, sham-controlled parallel clinical trial study. SETTING Neurological physiotherapy clinics. SUBJECTS Thirty-nine participants were randomly assigned to three groups: dorsolateral prefrontal cortex a-tDCS, primary motor a-tDCS (experimental groups) and sham a-tDCS. Finally, 36 participants completed the whole study (n = 12 in each group). INTERVENTIONS Participants in the experimental groups received six-session a-tDCS (1.5 mA, 20 minutes) during two weeks (three sessions per week). The sham group received six sessions of 20-minute sham stimulation. MAIN MEASURES The Fatigue Severity Scale and quality of life were assessed before, immediately and four weeks after the intervention. RESULTS Findings indicated a significant reduction in the Fatigue Severity Scale and a significant increase in the quality of life in both experimental groups, immediately after the intervention (P < 0.001), while Fatigue Severity Scale and quality of life changes were not significant in the sham a-tDCS group (P > 0.05). In addition, improvement of the variables remained four weeks after the intervention in dorsolateral prefrontal cortex a-tDCS (mean differences (95% confidence interval): 0.03 (-0.63 to 0.68) as compared to primary motor (-0.62 (-0.11 to -1.14) and sham a-tDCS groups (-0.47 (-1.37 to 0.43)). CONCLUSION Both primary motor and dorsolateral prefrontal cortex a-tDCS as compared to sham intervention can immediately improve fatigue and quality of life. However, the effects last up to four weeks only by the dorsolateral prefrontal cortex a-tDCS.
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Affiliation(s)
- Marzieh Mortezanejad
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Centre, Semnan University of Medical Sciences, Semnan, Iran
| | - Nooshin Masoudian
- Neurology Ward, Department of Internal Medicine, Kosar Hospital, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Melbourne, VIC, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
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Masoudian N, Ehsani F, Nazari M, Zoghi M, Jaberzadeh S. Does M1 anodal transcranial direct current stimulation affects online and offline motor learning in patients with multiple sclerosis? Neurol Sci 2020; 41:2539-2546. [DOI: 10.1007/s10072-020-04359-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 03/16/2020] [Indexed: 02/07/2023]
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Hassanzahraee M, Nitsche MA, Zoghi M, Jaberzadeh S. Determination of anodal tDCS duration threshold for reversal of corticospinal excitability: An investigation for induction of counter-regulatory mechanisms. Brain Stimul 2020; 13:832-839. [PMID: 32289714 DOI: 10.1016/j.brs.2020.02.027] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [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: 11/13/2019] [Revised: 02/18/2020] [Accepted: 02/21/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Transcranial direct current stimulation (tDCS) is used to induce neuroplasticity in the human brain. Within certain limits of stimulation duration, anodal tDCS (a-tDCS) over the primary motor cortex induces long term potentiation- (LTP) like plasticity. A reversal of the direction of plasticity has however been described with prolonged a-tDCS protocols. OBJECTIVE We aimed to systematically investigate the intervention duration threshold for reversal of a-tDCS-induced effects on corticospinal excitability (CSE) and to determine the probable mechanisms involved in these changes. METHODS Fifteen healthy participants received a-tDCS of 1 mA for five different durations in pseudo-random session order. Transcranial magnetic stimulation (TMS) was delivered over the left M1, and motor evoked potentials (MEPs) of a contralateral hand muscle were recorded before, immediately and 30 min following intervention to measure CSE changes. Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long interval facilitation (LIF) were assessed via paired-pulse TMS protocols. RESULTS A-tDCS significantly increased CSE as expected at stimulation durations of 22 and 24 min. However, this effect of a-tDCS on CSE decreased and even reversed when stimulation duration increased to 26, 28, and 30 min. Respective alterations of ICF, LIF, and SICI indicate the involvement of glutamatergic, and GABAergic systems in these effects. CONCLUSIONS These results confirm a duration threshold for reversal of the excitability-enhancing effect of a-tDCS with stimulation durations ≥ 26 min. Counter-regulatory mechanisms are discussed as a mechanistic foundation for these effects, which might prevent excessive brain activation.
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Affiliation(s)
- Maryam Hassanzahraee
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia.
| | - Michael A Nitsche
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany; Dept. Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Non-invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, Australia
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Halakoo S, Ehsani F, Hosnian M, Zoghi M, Jaberzadeh S. The comparative effects of unilateral and bilateral transcranial direct current stimulation on motor learning and motor performance: A systematic review of literature and meta-analysis. J Clin Neurosci 2020; 72:8-14. [PMID: 31973922 DOI: 10.1016/j.jocn.2019.12.022] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 09/01/2019] [Accepted: 12/01/2019] [Indexed: 11/17/2022]
Abstract
Application of unilateral tDCS (Uni-tDCS) vs. bilateral tDCS (Bi-tDCS) is another important factor that can affect the physiological results of tDCS intervention on motor learning and motor performance. According to the evidence, some studies indicated that motor performance or motor learning are facilitated in healthy individuals by application of the Bi-tDCS more than the Uni-tDCS. On the other hand, some studies showed that there was no significant differences between Uni-tDCS and Bi-tDCS; and both techniques were more effective than sham stimulation. In contrast, the other studies have shown more significant effectiveness of Uni-tDCS than Bi-tDCS on motor performance and motor learning. The aim of this study was to systematically review the studies which investigated the effectiveness of Uni-tDCS and Bi-tDCS intervention on the motor learning and motor performance. The search was performed from databases in the Google Scholar, PubMed, Elsevier, Medline, Ovid and Science Direct with the keywords of motor behavior, motor performance, motor learning, Bi-tDCS or bilateral tDCS, dual tDCS, Uni-tDCS or unilateral tDCS, anodal tDCS and cathodal tDCS from 2000 to 2019. The results indicated that the study population was a key factor in determining study's findings. Data meta-analysis showed that Uni-tDCS was more effective than Bi-tDCS in patients with stroke, while, Bi-tDCS was more effective than Uni-tDCS to improve motor learning and motor performance in healthy individuals.
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Affiliation(s)
- Sara Halakoo
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Fatemeh Ehsani
- Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran.
| | - Motahareh Hosnian
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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Coner A, Saracoglu E, Akdeniz A, Ozkan H, Tuluce K, Gul M, Coskun FY, Kurt D, Karagoz A, Karaarslan O, Gok G, Ozdogan O, Ozpelit E, Ozer SF, Zoghi M. P3622Demographic and clinical characteristics of atrial fibrillation patients suffering from an ACS without prior revascularization history. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The incidence of atrial fibrillation in acute coronary syndromes (ACS) ranges from 3% to 25%. The purpose of the current study was to investigate the demographic and baseline clinical characteristics, cardiovascular risk factors and comorbid conditions between patients (pts) with concomitant atrial fibrillation (AF) to those without AF in patients suffering from ACS without previous coronary artery bypass graft (CABG) and/or percutaneous coronary intervention.
Methods
The MINOCA-TR study has a cross-sectional, multicenter, observational design and was conducted with 32 interventional cardiology centers in our country. Heart rhythm at emergency admission, demographical, clinical and angiographic data was recorded for each patient. Patients with stable coronary artery disease, unstable angina pectoris and with type 4/5 myocardial infarction were excluded from study population.
Results
A total of 1626 patients (male: 70.7%, mean age: 61.4±12.5 years) were classified according to the presence of AF. The rate of AF was 3.1% in study population. This group was older (73.4 vs. 61.0 years, p<0.001) and AF was more common among females (43.1% vs. 28.7%, p=0.027). The frequency of AF was slightly higher (7.8%) in MINOCA group (p=ns).
STEMI presentation was more common in patients without AF (31.3% vs. 46.9%, p=0.028). LVEF was significantly lower in ACS patients with AF (44.1% vs. 49.4%, p=0.039). The frequency of AF was significantly higher (3.7%) in MINOCA group.
AF vs. non-AF ACS pts w/o prior revasc Parameter ACS with AF ACS without AF p value Age (years) 73.4 (±9.4) 61.0 (±12.4) <0.001 Female (%) 43.1 28.7 0.027 cTnT levels (pg/dL) median (IQR) 15.2 (96) 15.3 (428) 0.421 STEMI (%) 31.3 46.9 0.028 LVEF (%) 44.1 (±12.2) 49.4 (±10.4) 0.039 MINOCA (%) 7.8 6.6 0.743 STEMI: ST-segment elevation MI; NSTEMI: Non-ST-segment elevation myocardial infarction; LVEF: left ventricular ejection fraction; MINOCA: Myocardial Infarction with Non-Obstructive Coronary Arteries.
Conclusions
The frequency of AF was relatively lower in patients suffering from an ACS without prior revascularization history. They were older than patients without AF and were common in females. Non-ST-segment elevation myocardial infarction was significantly higher in the AF. The presence of MINOCA was similar between 2 groups.
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Affiliation(s)
- A Coner
- Baskent University Hospital Alanya Application and Research Center, Cardiology, Antalya, Turkey
| | - E Saracoglu
- Doctor Ersin Arslan Research and Training Hospital, Cardiology, Gaziantep, Turkey
| | - A Akdeniz
- Bursa Yuksek Ihtisas Research and Training Hospital, Cardiology, Bursa, Turkey
| | - H Ozkan
- Medical Park Hospital, Cardiology, Bursa, Turkey
| | - K Tuluce
- Cigli Research and Training Hospital, Cardiology, Izmir, Turkey
| | - M Gul
- Aksaray University, Cardiology, Aksaray, Turkey
| | - F Y Coskun
- Gaziantep University, Cardiology, Gaziantep, Turkey
| | - D Kurt
- Giresun University, Cardiology, Giresun, Turkey
| | - A Karagoz
- Giresun University, Cardiology, Giresun, Turkey
| | - O Karaarslan
- Hitit University Erol Olcok Research and Training Center, Cardiology, Corum, Turkey
| | - G Gok
- Mardin State Hospital, Cardiology, Mardin, Turkey
| | - O Ozdogan
- Tepecik Training and Research Hospital, Cardiology, Izmir, Turkey
| | - E Ozpelit
- Dokuz Eylul University, Cardiology, Izmir, Turkey
| | - S F Ozer
- Necmettin Erbakan University, Cardiology, Konya, Turkey
| | - M Zoghi
- Ege University, Cardiology, Izmir, Turkey
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Jafarzadeh A, Ehsani F, Yosephi MH, Zoghi M, Jaberzadeh S. Concurrent postural training and M1 anodal transcranial direct current stimulation improve postural impairment in patients with chronic low back pain. J Clin Neurosci 2019; 68:224-234. [DOI: 10.1016/j.jocn.2019.07.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 07/05/2019] [Indexed: 11/24/2022]
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Behrangrad S, Zoghi M, Kidgell D, Jaberzadeh S. Does cerebellar non-invasive brain stimulation affect corticospinal excitability in healthy individuals? A systematic review of literature and meta-analysis. Neurosci Lett 2019; 706:128-139. [PMID: 31102706 DOI: 10.1016/j.neulet.2019.05.025] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 03/12/2019] [Accepted: 05/14/2019] [Indexed: 10/26/2022]
Abstract
Numerous studies have indicated that non-invasive brain stimulation (NIBS) of the cerebellum could modulate corticospinal excitability (CSE) in young healthy individuals. However, there is no systematic review and meta-analysis that clarifies the effects of cerebellar NIBS on CSE. The aim of this study was to provide a meta-analytic summary of the effects of cerebellar NIBS on CSE. Seven search engines were used to identify any trial evaluating CSE before and after one session of cerebellar NIBS in healthy individuals up to June 2018. Twenty-six studies investigating the corticospinal responses following cerebellar NIBS were included. Meta-analysis was used to pool the findings from included studies. Effects were expressed as mean differences (MD) and the standard deviation (SD). Risk of bias was assessed with the Cochrane tool. Meta-analysis found that paired associative stimulation (PAS) with 2 ms interval, a combination of PAS with 21.5 ms interval and anodal transcranial direct current stimulation, and repetitive transcranial magnetic stimulation with a frequency of < 5 Hz increase CSE (P PAS2 < 0.00001, P PAS21.5 +a-tDCS = 0.02, P rTMS = 0.04). However, continuous theta burst stimulation, a combination of PAS with 25 ms interval and anodal transcranial direct current stimulation, and PAS with a 6 ms interval decreased CSE (P PAS6 < 0.00001, P cTBS < 0.00001, P PAS25 +a-tDCS = 0.003). The results of this review show that cerebellar NIBS techniques are a promising tool for increasing CSE.
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Affiliation(s)
- Shabnam Behrangrad
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, P.O. Box 527, Australia.
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
| | - Dawson Kidgell
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, P.O. Box 527, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, P.O. Box 527, Australia
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Yosephi MH, Ehsani F, Daghiani M, Zoghi M, Jaberzadeh S. The effects of trans-cranial direct current stimulation intervention on fear: A systematic review of literature. J Clin Neurosci 2019; 62:7-13. [DOI: 10.1016/j.jocn.2019.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Accepted: 01/04/2019] [Indexed: 11/27/2022]
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Pellegrini M, Zoghi M, Jaberzadeh S. The effect of transcranial magnetic stimulation test intensity on the amplitude, variability and reliability of motor evoked potentials. Brain Res 2018; 1700:190-198. [DOI: 10.1016/j.brainres.2018.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/14/2018] [Accepted: 09/04/2018] [Indexed: 10/28/2022]
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Yosephi MH, Ehsani F, Zoghi M, Jaberzadeh S. Multi-session anodal tDCS enhances the effects of postural training on balance and postural stability in older adults with high fall risk: Primary motor cortex versus cerebellar stimulation. Brain Stimul 2018; 11:1239-1250. [DOI: 10.1016/j.brs.2018.07.044] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Revised: 06/25/2018] [Accepted: 07/12/2018] [Indexed: 10/28/2022] Open
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Biabani M, Farrell M, Zoghi M, Egan G, Jaberzadeh S. Crossover design in transcranial direct current stimulation studies on motor learning: potential pitfalls and difficulties in interpretation of findings. Rev Neurosci 2018; 29:463-473. [PMID: 29232195 DOI: 10.1515/revneuro-2017-0056] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 07/20/2017] [Accepted: 10/06/2017] [Indexed: 11/15/2022]
Abstract
Crossover designs are used by a high proportion of studies investigating the effects of transcranial direct current stimulation (tDCS) on motor learning. These designs necessitate attention to aspects of data collection and analysis to take account of design-related confounds including order, carryover, and period effects. In this systematic review, we appraised the method sections of crossover-designed tDCS studies of motor learning and discussed the strategies adopted to address these factors. A systematic search of 10 databases was performed and 19 research papers, including 21 experimental studies, were identified. Potential risks of bias were addressed in all of the studies, however, not in a rigorous and structured manner. In the data collection phase, unclear methods of randomization, various lengths of washout period, and inconsistency in the counteracting period effect can be observed. In the analytical procedures, the stratification by sequence group was often ignored, and data were treated as if it belongs to a simple repeated-measures design. An inappropriate use of crossover design can seriously affect the findings and therefore the conclusions drawn from tDCS studies on motor learning. The results indicate a pressing need for the development of detailed guidelines for this type of studies to benefit from the advantages of a crossover design.
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Affiliation(s)
- Mana Biabani
- Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Melbourne, Victoria 3199, Australia.,Monash Biomedical Imaging, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria 3800, Australia
| | - Michael Farrell
- Monash Biomedical Imaging, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria 3800, Australia
| | - Maryam Zoghi
- Discipline of Physiotherapy, Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Melbourne, Victoria 3086, Australia
| | - Gary Egan
- Monash Biomedical Imaging, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Melbourne, Victoria 3800, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Melbourne, Victoria 3199, Australia
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Pellegrini M, Zoghi M, Jaberzadeh S. Cluster analysis and subgrouping to investigate inter-individual variability to non-invasive brain stimulation: a systematic review. Rev Neurosci 2018; 29:675-697. [PMID: 29329109 DOI: 10.1515/revneuro-2017-0083] [Citation(s) in RCA: 20] [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: 09/27/2017] [Accepted: 11/25/2017] [Indexed: 01/17/2023]
Abstract
Cluster analysis and other subgrouping techniques have risen in popularity in recent years in non-invasive brain stimulation research in the attempt to investigate the issue of inter-individual variability - the issue of why some individuals respond, as traditionally expected, to non-invasive brain stimulation protocols and others do not. Cluster analysis and subgrouping techniques have been used to categorise individuals, based on their response patterns, as responder or non-responders. There is, however, a lack of consensus and consistency on the most appropriate technique to use. This systematic review aimed to provide a systematic summary of the cluster analysis and subgrouping techniques used to date and suggest recommendations moving forward. Twenty studies were included that utilised subgrouping techniques, while seven of these additionally utilised cluster analysis techniques. The results of this systematic review appear to indicate that statistical cluster analysis techniques are effective in identifying subgroups of individuals based on response patterns to non-invasive brain stimulation. This systematic review also reports a lack of consensus amongst researchers on the most effective subgrouping technique and the criteria used to determine whether an individual is categorised as a responder or a non-responder. This systematic review provides a step-by-step guide to carrying out statistical cluster analyses and subgrouping techniques to provide a framework for analysis when developing further insights into the contributing factors of inter-individual variability in response to non-invasive brain stimulation.
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Affiliation(s)
- Michael Pellegrini
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Peninsula Campus, PO Box 527, Frankston, VIC 3199, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, VIC 3086, Australia
| | - Shapour Jaberzadeh
- Non-Invasive Brain Stimulation and Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, Peninsula Campus, PO Box 527, Frankston, VIC 3199, Australia
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48
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Dissanayaka TD, Zoghi M, Farrell M, Egan GF, Jaberzadeh S. Sham transcranial electrical stimulation and its effects on corticospinal excitability: a systematic review and meta-analysis. Rev Neurosci 2018; 29:223-232. [PMID: 28889119 DOI: 10.1515/revneuro-2017-0026] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 04/10/2017] [Accepted: 07/09/2017] [Indexed: 11/15/2022]
Abstract
Sham stimulation is used in randomized controlled trials (RCTs) to assess the efficacy of active stimulation and placebo effects. It should mimic the characteristics of active stimulation to achieve blinding integrity. The present study was a systematic review and meta-analysis of the published literature to identify the effects of sham transcranial electrical stimulation (tES) - including anodal and cathodal transcranial direct current stimulation (a-tDCS, c-tDCS), transcranial alternating current stimulation (tACS), transcranial random noise stimulation (tRNS) and transcranial pulsed current stimulation (tPCS) - on corticospinal excitability (CSE), compared to baseline in healthy individuals. Electronic databases - PubMed, CINAHL, Scopus, Science Direct and MEDLINE (Ovid) - were searched for RCTs of tES from 1990 to March 2017. Thirty RCTs were identified. Using a random-effects model, meta-analysis of a-tDCS, c-tDCS, tACS, tRNS and tPCS studies showed statistically non-significant pre-post effects of sham interventions on CSE. This review found evidence for statically non-significant effects of sham tES on CSE.
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Affiliation(s)
- Thusharika D Dissanayaka
- Faculty of Medicine, Department of Physiotherapy, School of Primary Healthcare, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, La Trobe University, Bundoora, Victoria 3086, Australia
| | - Michael Farrell
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - Gary F Egan
- Monash Biomedical Imaging, Monash University, Melbourne 3168, Australia
| | - Shapour Jaberzadeh
- Faculty of Medicine, Department of Physiotherapy, School of Primary Healthcare, Nursing and Health Sciences, Monash University, Melbourne 3199, Australia
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49
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Pellegrini M, Zoghi M, Jaberzadeh S. Biological and anatomical factors influencing interindividual variability to noninvasive brain stimulation of the primary motor cortex: a systematic review and meta-analysis. Rev Neurosci 2018; 29:199-222. [PMID: 29055940 DOI: 10.1515/revneuro-2017-0048] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 07/15/2017] [Indexed: 11/15/2022]
Abstract
Noninvasive brain stimulation (NIBS) modifies corticospinal excitability (CSE) historically in a predictable manner dependent on stimulation parameters. Researchers, however, discuss high degrees of variability between individuals, either responding as expected or not responding as expected. The explanation for this interindividual variability remains unknown with suggested interplay between stimulation parameters and variations in biological, anatomical, and physiological factors. This systematic review and meta-analysis aimed to investigate the effect of variation in inherent factors within an individual (biological and anatomical factors) on CSE in response to NIBS of the primary motor cortex. Twenty-two studies were included investigating genetic variation (n=7), age variation (n=4), gender variation (n=7), and anatomical variation (n=5). The results indicate that variation in brain-derived neurotrophic factor genotypes may have an effect on CSE after NIBS. Variation between younger and older adults also affects CSE after NIBS. Variation between age-matched males and females does not affect CSE after NIBS, but variation across the menstrual cycle does. Variation between skull thickness and brain tissue morphology influences the electric field magnitude that ultimately reaches the primary motor cortex. These findings indicate that biological and anatomical variations may in part account for interindividual variability in CSE in response to NIBS of the primary motor cortex, categorizing individuals as responding as expected (responders) or not responding as expected (nonresponders).
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Affiliation(s)
- Michael Pellegrini
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, P.O. Box 527, Melbourne 3199, Victoria, Australia
| | - Maryam Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied Health, Discipline of Physiotherapy, La Trobe University, Melbourne, Australia
| | - Shapour Jaberzadeh
- Department of Physiotherapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Science, Monash University, P.O. Box 527, Melbourne 3199, Victoria, Australia
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50
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Dissanayaka TD, Farrell M, Zoghi M, Egan GF, Jaberzadeh S. Test–retest reliability of subjective supra-threshold scaling of multiple pressure-pain sensations among healthy individuals: a study using hydraulic pressure algometry. Somatosens Mot Res 2018; 35:153-161. [DOI: 10.1080/08990220.2018.1505608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- T. D. Dissanayaka
- Non-Invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
| | - M. Farrell
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
- Biomedicine Discovery Institute and Department of Medical Imaging and Radiation Sciences, Monash University, Clayton, Australia
| | - M. Zoghi
- Department of Rehabilitation, Nutrition and Sport, School of Allied health, La Trobe University, Melbourne, Australia
| | - G. F. Egan
- Monash Biomedical Imaging, Monash University, Melbourne, Australia
| | - S. Jaberzadeh
- Non-Invasive Brain Stimulation & Neuroplasticity Laboratory, Department of Physiotherapy, School of Primary Healthcare, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
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