Benefits Of tDCS Research Articles

Effect of transcranial direct-current stimulation on cognitive function in stroke patients: A systematic review and meta-analysis.

Transcranial direct-current stimulation (tDCS) is a noninvasive approach that can alter brain excitability. Several studies have shown the effectiveness of tDCS in improving language and movement function in stroke patients. However, the effect of tDCS on cognitive function after stroke remains uncertain. We searched Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the China National Knowledge Infrastructure, the China Science and Technology Journal Database, and the Wanfang Data Knowledge Service Platform from inception to April 2, 2019. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of the included studies using the Cochrane Collaboration Risk of Bias Tool. All statistical analyses were performed in RevMan 5.3, and the mean difference (MD) or standard mean difference (SMD) were used as the pooled statistics. Fifteen studies involving 820 participants were included. When compared with passive tDCS, anodal tDCS was associated with improved general cognitive performance as examined by the Minimum Mental State Examination or Montreal Cognitive Assessment (SMD = 1.31, 95% CI 0.91-1.71, P < 0.00001), attention performance (SMD = 0.66, 95% CI 0.11-1.20, P = 0.02). There was no significant difference in memory performance (SMD = 0.41, 95% CI -0.67-1.50, P = 0.46). tDCS is likely to be effective for patients with cognitive impairment after stroke. The evidence for different effects based on population characteristics and stimulation methods was limited, but a real effect cannot be ruled out. More high-quality research in this field is required to determine the potential benefits of tDCS in the treatment of cognitive deficits after stroke and to establish the optimal treatment program.

Patient-Controlled Intravenous Morphine Analgesia Combined with Transcranial Direct Current Stimulation for Post-Thoracotomy Pain: A Cost-Effectiveness Study and A Feasibility For Its Future Implementation.

This prospective randomized study aims to evaluate the feasibility and cost-effectiveness of combining transcranial direct current stimulation (tDCS) with patient controlled intravenous morphine analgesia (PCA-IV) as part of multimodal analgesia after thoracotomy. Patients assigned to the active treatment group (a-tDCS, n = 27) received tDCS over the left primary motor cortex for five days, whereas patients assigned to the control group (sham-tDCS, n = 28) received sham tDCS stimulations. All patients received postoperative PCA-IV morphine. For cost-effectiveness analysis we used data about total amount of PCA-IV morphine and maximum visual analog pain scale with cough (VASP-Cmax). Direct costs of hospitalization were assumed as equal for both groups. Cost-effectiveness analysis was performed with the incremental cost-effectiveness ratio (ICER), expressed as the incremental cost (RSD or US$) per incremental gain in mm of VASP-Cmax reduction. Calculated ICER was 510.87 RSD per VASP-Cmax 1 mm reduction. Conversion on USA market (USA data 1.325 US$ for 1 mg of morphine) revealed ICER of 189.08 US$ or 18960.39 RSD/1 VASP-Cmax 1 mm reduction. Cost-effectiveness expressed through ICER showed significant reduction of PCA-IV morphine costs in the tDCS group. Further investigation of tDCS benefits with regards to reduction of postoperative pain treatment costs should also include the long-term benefits of reduced morphine use.

Effect of multi-session prefrontal transcranial direct current stimulation on cognition in schizophrenia: A systematic review and meta-analysis

Patients with schizophrenia experience cognitive deficits that play a central role in predicting functional outcomes. In this study, we sought to evaluate the effect of transcranial direct current stimulation (tDCS) on cognition using meta-analysis. A search was performed from inception to 8 January 2019, to identify randomized controlled trials assessing the ability of tDCS to ameliorate cognitive deficits in patients with schizophrenia and schizoaffective disorder. The effect size, calculated as the standardized mean difference (Hedge’s g), was obtained with a random effect model. We analyzed mean effects on specific cognitive domains that were evaluated in four or more studies. Nine articles were included in the systematic review, which encompassed 270 patients: 133 in the active stimulation group and 137 in the sham stimulation group. Meta-analysis demonstrated a significant mean effect of tDCS on working memory (SMD = 0.49, 95% CI = 0.16 to 0.83), while non-significant results were produced for other domains. These findings were supported by sensitivity analyses indicating that the results would not change in a meaningful way after the exclusion of each single study, and meta-regression analyses verifying the consistent effect irrespective of any moderators. Thus, tDCS may provide a potential option to improve working memory deficits in individuals with schizophrenia. Further trials examining the cognitive benefit of tDCS with medication or other adjunctive treatments are warranted.

Maximizing the Treatment Benefit of tDCS in Neurodegenerative Anomia.

We evaluated whether transcranial direct current stimulation (tDCS) in two different montages could improve picture naming abilities in participants with anomic Alzheimer Disease or Frontotemporal dementia.MethodsUtilizing a double-blind cross-over design, twelve participants were trained on picture naming over a series of 10 sessions with 30 min of anodal (2 mA) tDCS stimulation to either the left inferior parietotemporal region (P3), the left dorsolateral prefrontal cortex (F3), or sham stimulation. We evaluated performance on a trained picture naming list, an equivalent novel untrained list, and additional neuropsychological tasks.ResultsFor trained item picture naming, significantly larger improvement was seen for real stimulation vs. sham stimulation for both the DLPFC and left inferior parieto-temporal stimulation montages at the end of the stimulation sessions. The parieto-temporal montage remained superior to sham 2 weeks poststimulation. Significant improvement vs. sham was also seen for novel “untrained” item picture naming 2 weeks post-stimulation when the parieto-temporal montage was given, whereas no change was observed when the DLPFC montage was given. Finally, comparing groups when they received the parieto-temporal montage, participants with semantic variant Primary Progressive Aphasia (PPA) showed the least improvement for untrained items after their sessions. Scores on the additional neuropsychological tasks were unchanged.ConclusiontDCS stimulation has promise as a treatment for individuals with anomia arising from neurodegenerative disease, but its effectiveness can vary depending on the training given, the montage location used, as well as a participants’ diagnosis.

Anodal Transcranial Direct Current Stimulation over the Vertex Enhances Leg Motor Cortex Excitability Bilaterally.

In many studies, anodal transcranial Direct Current Stimulation (tDCS) is applied near the vertex to simultaneously facilitate leg motor cortex (M1) of both hemispheres and enhance recovery of gait and balance in neurological disorders. However, its effect on the excitability of leg M1 in either hemisphere is not well known. In this double-blind sham-controlled study, corticospinal excitability changes induced in leg M1 of both hemispheres by anodal (2 mA for 20 minutes) or sham tDCS (for 20 min) over the vertex were evaluated. Peak amplitudes of Transcranial Magnetic Stimulation (TMS) induced motor evoked potentials (MEPs) were measured over the contralateral Tibialis Anterior (TA) muscle before and up to 40 min after tDCS in 11 normal participants. Analysis of data from all participants found significant overall increase in the excitability of leg M1 after tDCS. However, in individual subjects there was variability in observed effects. In 4 participants, 20 min of tDCS increased mean MEPs of TAs on both sides; in 4 participants there was increased mean MEP only on one side and in 3 subjects there was no change. It’s not known if the benefits of tDCS in improving gait and balance are dependent on excitability changes induced in one or both leg M1; such information may be useful to predict treatment outcomes.

Improved language production with transcranial direct current stimulation in progressive supranuclear palsy

Progressive supranuclear palsy (PSP) is an atypical parkinsonian disorder that can present with language production deficits in addition to the characteristic progressive parkinsonian motor symptoms. Although typical parkinsonism treatments such as pharmacotherapy are not effective in PSP, non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have shown promise for treating cognitive deficits relating to this disorder. We report the case of KN, who presented with reduced verbal fluency and connected speech production in the context of PSP. KN completed a set of language tasks, followed by an alternate version of the tasks in conjunction with either sham or active tDCS over the left dorsolateral prefrontal cortex (DLPFC) across four sessions. Results showed improved performance with active stimulation compared to sham stimulation for phonemic fluency and action naming, as well as mixed results suggesting possible benefits for connected speech production. There were no benefits of active stimulation for control tasks, indicating that tDCS can produce specific benefits for phonemic fluency, action naming, and connected speech production in PSP. These promising, preliminary findings warrant further investigation into whether these benefits of tDCS can be a useful therapeutic tool for PSP patients to maintain language.

Anodal tDCS improves attentional control in older adults

Transcranial direct current stimulation (tDCS) facilitates cognitive enhancement by directly increasing neuroplasticity, and has shown promising results as an external intervention to attenuate age-related cognitive decline. However, stimulation protocols have failed to account for age-associated changes in brain structure and the present literature omits investigation of attentional control, despite the occurrence of substantial inhibitory processing deficits with age. To provide new insight into the benefits of tDCS, the objective of this study was to develop an age-optimised stimulation protocol in which key parameters (amplitude, duration, and electrode configuration) were selected in accordance with knowledge of stimulation effects, specific to the ageing brain. Participants (mean age 66.5 years) completed three sessions of double-blind, anodal or sham stimulation, in conjunction with a novel task-switching paradigm, which was designed to reflect the complexities of simultaneously monitoring and updating stimulus representations. The results show that those who had anodal tDCS exhibited an improvement in task-switching speed (p

Proceedings #48: Long-term Transcranial Direct Current Stimulation Treatment Paired with Adaptive Cognitive Training Leads to Clinical Benefit

Introduction: Transcranial direct current stimulation (tDCS) is a safe and well-tolerated form of noninvasive brain stimulation that delivers a low amplitude (1 – 4 mA) direct current through scalp electrodes. Cognitive impairment is a common and often disabling symptom of multiple sclerosis (MS) which has been shown to improve with cognitive training paired with tDCS. Here we compared the benefits of tDCS paired with either adaptive cognitive training (aCT) or non-adaptive cognitive training (nCT). To provide the extended treatment sessions needed for cognitive training, we administered tDCS to patients in their homes using our remotely supervised or RS-tDCS protocol.

The positive effects of tDCS on sustained attention performance under sleep deprivation conditions are consistent and repeatable

Cognitive performance decrements resulting from sleep deprivation are well-documented and sources of human error for many occupations such as transportation, medicine, and the military. Sustained attention or vigilance is one of those cognitive skills that rapidly declines as fatigue increases. One potentially promising fatigue countermeasure is transcranial direct current stimulation (tDCS), a form of non-invasive brain stimulation. Previous studies show positive benefits of tDCS for fatigue, the question of how repeatable and reliable such findings are has been somewhat unclear. Utilizing data from two of our own laboratory studies that used the Mackworth Clock Test vigilance task, we examined the across-study repeatability and the reliability of using tDCS as a fatigue countermeasure. Both studies had the same experimental design of 3 groups, each group with an n-size of 10-12 participants. Group 1 received 30 minutes of anodal left dorsolateral prefrontal cortex stimulation (lDLPFC) at 1800 hours, Group 2 received 30 minutes of anodal lDLPFC at 0400 hours, and Group 3 received sham stimulation at 1800 and 0400 hours. The reference electrode was placed on the contralateral upper bicep. The ANOVAs show no statistical difference in performance between the same groups for the two studies. Correlations indicate that the comparisons between these two studies for the same groups are high (1800 stim r=0.91, 0400 stim r=0.94, sham r=0.94). These results, across two studies with similar structure but different participants, provides compelling evidence that the positive effects of tDCS on attentional decrements due to sleep deprivation stress are indeed reliable and repeatable. We have found in both studies that when compared to sham, tDCS can provide up to 6 hours of attentional performance enhancement after a single 30-minute session of tDCS regardless of when the stimulation is administered. Therefore, tDCS can be a powerful fatigue countermeasure for combating performance-related attentional deficits.

Anodal tDCS improves attentional control in older adults.

Transcranial direct current stimulation (tDCS) facilitates cognitive enhancement by directly increasing neuroplasticity, and has shown promising results as an external intervention to attenuate age-related cognitive decline. However, stimulation protocols have failed to account for age-associated changes in brain structure and the present literature omits investigation of attentional control, despite the occurrence of substantial inhibitory processing deficits with age. To provide new insight into the benefits of tDCS, the objective of this study was to develop an age-optimised stimulation protocol in which key parameters (amplitude, duration, and electrode configuration) were selected in accordance with knowledge of stimulation effects, specific to the ageing brain. Participants (mean age 66.5 years) completed three sessions of double-blind, anodal or sham stimulation, in conjunction with a novel task switching paradigm, which was designed to reflect the complexities of simultaneously monitoring and updating stimulus representations. The results show that those who had anodal tDCS exhibited an acute, post-stimulation increase in task switching speed (p < .01, d = 1.36). Although the sham group was subject to the same task exposure, only the anodal stimulation group experienced a performance gain, thus emphasising the efficacy of active brain stimulation. For the first time, this study demonstrates the utility of stimulation protocols tailored specifically for use with older adults, targeted towards the modulation of attentional control. This finding has critical implications for cognitive health and encourages the use of age-optimised tDCS as a viable method for enhancing executive function in later life.

Transcranial Direct-Current Stimulation on Motor Function in Pediatric Cerebral Palsy: A Systematic Review.

To determine effects of transcranial direct-current stimulation (tDCS) on motor function for children with cerebral palsy. Six electronic databases were searched using terms related to tDCS, combined with functional deficits/associated clinical measures. Results were filtered, including randomized controlled trials in English and children with cerebral palsy. Data were extracted using standardized procedures, and the PEDro scale was used to assess quality and meta-analyses conducted. From 135 articles, 9 studies with moderate quality met inclusion criteria. Six were included in 7 separate meta-analyses supporting a benefit of tDCS for static balance, only at follow-up. Benefits of tDCS on dynamic balance, step length, and mobility were not established. The findings from meta-analyses suggest that tDCS may provide improvements in static balance at follow-up in children with cerebral palsy and positive effects on gait velocity; however, there was heterogeneity. Further research is needed before this therapy can be endorsed.

Improved conceptual generation and selection with transcranial direct current stimulation in older adults

ABSTRACTIntroduction: Normal aging is associated with deficits in various aspects of spoken language production, including idea generation and selection, and involves activity in frontal brain areas including left inferior frontal cortex (LIFG). These conceptual preparation processes, largely involving executive control, precede formulation and articulation stages and are critical for language production. Noninvasive brain stimulation (e.g., transcranial direct current stimulation, tDCS) has proven beneficial for age-related fluency and naming deficits, but this has not been extended to conceptual preparation mechanisms. Method: We investigated whether tDCS could facilitate idea generation and selection in 24 older adults aged 60–80 years. In the first phase, participants completed an idea generation test and a selection test with no stimulation. In the second phase they completed an alternate version of the tests in conjunction with either active or sham stimulation. Active stimulation applied 1-mA anodal tDCS over LIFG for the test duration (10 min). Results: Responses were faster following active stimulation than following sham. Furthermore, improvements were specific to test conditions involving novel generation (p = .030) and selection (p = .001) and were not observed in control conditions for which these mechanisms were minimally involved. Conclusions: We concluded that tDCS benefits conceptual preparation mechanisms. This preliminary evidence is an important step for addressing age-related decline in propositional language generation, which is integral to conversational speech. This approach could also be extended toward rehabilitation in neurological patients with deficits in these processes.

The influence of activity-dependent stimulation on gait re-training in chronic stroke survivors: A pilot study

While walking is a major goal in stroke rehabilitation, many chronic stroke survivors have not achieved independent ambulation. Task-specific gait re-training shows promise in post-stroke therapy. Research on transcranial direct current stimulation (tDCS) has shown potential benefits for fine motor skill learning but lacks evidence for gross motor skill learning; specifically gait re-training. It is hypothesized that a combination of these therapies may yield benefits for stroke rehabilitation. Consequently, this study endeavoured to compare the efficacy of gait re-training during real and sham stimulation on gait kinematics in chronic stroke survivors. A randomized double-blinded case study was implemented, whereby 10 chronic stroke survivors (≥ 6 months) were divided into either an attention-matched control group (CON; n = 4), or an 8-week task-specific gait re-training program with concurrent tDCS (1 mA; 20 minutes; n = 2) or with sham stimulation (20 minutes; n = 3). Gait kinematics were measured pre- and post-intervention by using the two-minute walk test and the APDM mobility lab™. Double support (DS) time improved in real (Median = 0.46, IQR = 0.59), compared to sham stimulation (Median = 0.73, IQR = 1.93) and the CON attention-matched group (Median = -1.12, IQR = 1.36). Additionally, DS variability decreased in real (Median = −0.08, IQR = 0.18) and sham (Median = 0.05, IQ = 0.04) stimulation groups; compared to the CON group (Median = 0.25, IQR = 0.46). This study presents preliminary evidence for the benefits of tDCS combined with task-specific gait re-training on gait quality, specifically synchronization, in chronic stroke survivors. Additionally, task-specific gait re-training alone may also benefit gait steadiness.

Boosting Memory by tDCS to Frontal or Parietal Brain Regions? A Study of the Enactment Effect Shows No Effects for Immediate and Delayed Recognition

Boosting memory with transcranial direct current stimulation (tDCS) seems to be an elegant way to optimize learning. Here we tested whether tDCS to the left dorsolateral prefrontal cortex or to the left posterior parietal cortex would boost recognition memory in general and/or particularly for action phrases enacted at study. During study, 48 young adults either read or enacted simple action phrases. Memory for the action phrases was assessed after a retention interval of 45 min and again after 7-days to investigate the long-term consequences of brain stimulation. The results showed a robust enactment effect in both test sessions. Moreover, the decrease in performance was more pronounced for reading than for enacting the phrases at study. However, tDCS did not reveal any effect on subsequent recognition memory performance. We conclude that memory benefits of tDCS are not easily replicated. In contrast, enactment at study reliably boosts subsequent memory.

The Impact of Transcranial Direct Current Stimulation (tDCS) on Bipolar Depression, Mania, and Euthymia: a Systematic Review of Preliminary Data.

The neurobiological basis of bipolar disorders (BD) has received increased attention and several brain regions and brain circuits have been correlated with clinical symptoms. These brain regions and circuits may represent targets for neuromodulation techniques such as transcranial Direct Current Stimulation (tDCS). We systematically reviewed the literature to explore the risks and benefits of tDCS in BD and examined all mood states. Following the PRISMA guidelines, a systematic literature search using several databases was performed from April 2002 to June 2017. From the 135 eligible studies, we retained 19 relevant articles for the systematic review, including 170 patients with BD treated by tDCS. Data from 10 studies suggest that tDCS improves depressive symptoms in BD. One case report of add-on-tDCS reported a significant positive response on manic symptoms. In 4 studies, tDCS impacted specific neurocognitive functions in euthymic patients. There is also preliminary evidence that tDCS improves neurological soft signs and sleep quality in euthymia. Side effects were predominantly transient and low-intensity, although 6 cases of hypomanic/manic affective switches have been reported. The majority of studies have been open trials with few patients. More sufficiently powered randomized controlled trials are needed to clarify the effectiveness of tDCS. Preliminary data suggests that tDCS holds promise as a treatment for BD, especially during depressive episodes. Perhaps most promising are emerging data suggesting tDCS may impact neurocognition and sleep quality in euthymia and be useful for relapse prevention.

Anodal tDCS Enhances Verbal Episodic Memory in Initially Low Performers.

The left dorsolateral prefrontal cortex (DLPFC) is involved in encoding and retrieval of episodic memories, and thus, is frequently targeted in non-invasive brain stimulation paradigms, aiming for its functional modulation. Anodal transcranial direct current stimulation (tDCS), that boosts neuronal excitability in stimulated cortical areas, has been found to increase cognitive skills differentially, depending on the initial performance. We hypothesize that the benefit of tDCS on verbal episodic memory can be extrapolated from the participants’ baseline performance. In the present randomized, double-blind, parallel group study, healthy young adults (n = 43) received either real anodal or sham tDCS over their left DLPFC during the encoding phase of a verbal episodic memory task. Forty words were presented visually thrice with immediate vocal retrieval after each block and an additional delayed recall. We conducted a moderation analysis to test the modulating effect of initial episodic memory retrieval, adjusted for primacy and recency effects, on delayed recall under real or sham stimulation. Despite the absence of a significantly beneficial tDCS effect at the group level, we found that the number of remembered midlist words in the first retrieval significantly moderated the stimulation effect in such a way that initially low performers experienced the highest gain from real stimulation. These results suggest that anodal tDCS to the left DLPFC improves memory functions only so far. While only marginal stimulation-induced gains occur in cognitively unimpaired populations, greater stimulation benefits might be expected in individuals with clinically relevant deficiencies in the verbal episodic memory domain.

Balanced bifrontal transcranial direct current stimulation enhances working memory in adults with high-functioning autism: a sham-controlled crossover study

BackgroundWorking memory (WM) often is impaired in autism spectrum disorder (ASD). Such impairment may underlie core deficits in cognition and social functioning. Transcranial direct current stimulation (tDCS) has been shown to enhance WM in both healthy adults and clinical populations, but its efficacy in ASD is unknown. We predicted that bifrontal tDCS would improve WM performances of adults with high-functioning autism during active stimulation compared to sham stimulation and that such enhancement would generalize to an untrained task.MethodsTwelve adults with high-functioning ASD engaged in a battery of WM tasks that included backward spatial span, backward digit span, spatial n-back and letter n-back. While engaged, 40 min of 1.5 mA bifrontal stimulation was applied over the left and the right dorsolateral prefrontal cortices (DLPFC). Using a single-blind crossover design, each participant received left anodal/right cathodal stimulation, right anodal/left cathodal stimulation, or sham stimulation, in randomized counterbalanced order on three separate days. Following tDCS, participants again engaged in letter and spatial n-back tasks before taking the Brief Test of Attention (BTA). We used repeated-measures ANOVA to compare overall performance on the WM battery as measured by a composite of z-scores for all five measures. Post hoc ANOVAs, t tests, Friedman’s tests, and Wilcoxon signed-rank tests were used to measure the online and offline effects of tDCS and to assess performances on individual measures.ResultsCompared to sham stimulation, both left DLPFC anodal stimulation (t11 = 5.4, p = 0.0002) and right DLPFC anodal stimulation (t11 = 3.57, p = 0.004) improved overall WM performance. Left anodal stimulation (t11 = 3.9, p = 0.003) and right anodal stimulation (t11 = 2.7, p = 0.019) enhanced performances during stimulation. Enhancement transferred to an untrained task 50 min after right anodal stimulation (z11 = 2.263, p = 0.024). The tasks that showed the largest effects of active stimulation were spatial span backward (z11 = 2.39, p = 0.017) and BTA (z11 = 2.263, p = 0.024).ConclusionsIn adults with high-functioning ASD, active bifrontal tDCS given during WM tasks appears to improve performance. TDCS benefits also transferred to an untrained task completed shortly after stimulation. These results suggest that tDCS can improve WM task performance and could reduce some core deficits of autism.Trial registrationNCT01602263

Boosting Cognition: Effects of Multiple-Session Transcranial Direct Current Stimulation on Working Memory.

Transcranial direct current stimulation (tDCS) is a promising tool for neurocognitive enhancement. Several studies have shown that just a single session of tDCS over the left dorsolateral pFC (lDLPFC) can improve the core cognitive function of working memory (WM) in healthy adults. Yet, recent studies combining multiple sessions of anodal tDCS over lDLPFC with verbal WM training did not observe additional benefits of tDCS in subsequent stimulation sessions nor transfer of benefits to novel WM tasks posttraining. Using an enhanced stimulation protocol as well as a design that included a baseline measure each day, the current study aimed to further investigate the effects of multiple sessions of tDCS on WM. Specifically, we investigated the effects of three subsequent days of stimulation with anodal (20 min, 1 mA) versus sham tDCS (1 min, 1 mA) over lDLPFC (with a right supraorbital reference) paired with a challenging verbal WM task. WM performance was measured with a verbal WM updating task (the letter n-back) in the stimulation sessions and several WM transfer tasks (different letter set n-back, spatial n-back, operation span) before and 2 days after stimulation. Anodal tDCS over lDLPFC enhanced WM performance in the first stimulation session, an effect that remained visible 24 hr later. However, no further gains of anodal tDCS were observed in the second and third stimulation sessions, nor did benefits transfer to other WM tasks at the group level. Yet, interestingly, post hoc individual difference analyses revealed that in the anodal stimulation group the extent of change in WM performance on the first day of stimulation predicted pre to post changes on both the verbal and the spatial transfer task. Notably, this relationship was not observed in the sham group. Performance of two individuals worsened during anodal stimulation and on the transfer tasks. Together, these findings suggest that repeated anodal tDCS over lDLPFC combined with a challenging WM task may be an effective method to enhance domain-independent WM functioning in some individuals, but not others, or can even impair WM. They thus call for a thorough investigation into individual differences in tDCS respondence as well as further research into the design of multisession tDCS protocols that may be optimal for boosting cognition across a wide range of individuals.

Transcranial Direct Current Stimulation Modulates Cortical Neuronal Activity in Alzheimer's Disease.

Quantitative electroencephalography (qEEG) showed that Alzheimer's disease (AD) is characterized by increased theta power, decreased alpha and beta power, and decreased coherence in the alpha and theta band in posterior regions. These abnormalities are thought to be associated with functional disconnections among cortical areas, death of cortical neurons, axonal pathology, and cholinergic deficits. Since transcranial Direct Current Stimulation (tDCS) over the temporo-parietal area is thought to have beneficial effects in patients with AD, in this study we aimed to investigate whether tDCS benefits are related to tDCS-induced changes in cortical activity, as represented by qEEG. A weak anodal current (1.5 mA, 15 min) was delivered bilaterally over the temporal-parietal lobe to seven subjects with probable AD (Mini-Mental State Examination, MMSE score >20). EEG (21 electrodes, 10–20 international system) was recorded for 5 min with eyes closed before (baseline, t0) and 30 min after anodal and cathodal tDCS ended (t1). At the same time points, patients performed a Word Recognition Task (WRT) to assess working memory functions. The spectral power and the inter- and intra-hemispheric EEG coherence in different frequency bands (e.g., low frequencies, including delta and theta; high frequencies, including alpha and beta) were calculated for each subject at t0 and t1. tDCS-induced changes in EEG neurophysiological markers were correlated with the performance of patients at the WRT. At baseline, qEEG features in AD patients confirmed that the decreased high frequency power was correlated with lower MMSE. After anodal tDCS, we observed an increase in the high-frequency power in the temporo-parietal area and an increase in the temporo-parieto-occipital coherence that correlated with the improvement at the WRT. In addition, cathodal tDCS produced a non-specific effect of decreased theta power all over the scalp that was not correlated with the clinical observation at the WRT. Our findings disclosed that tDCS induces significant modulations in the cortical EEG activity in AD patients. The abnormal pattern of EEG activity observed in AD during memory processing is partially reversed by applying anodal tDCS, suggesting that anodal tDCS benefits in AD patients during working memory tasks are supported by the modulation of cortical activity.

Self-Rated Attentiveness Interacts with Transcranial Direct Current Stimulation and Noise Stimulation in Reaction Time in a Go/No-Go Task.

Previous research has found that stimulating inattentive people with auditory white noise induces enhancement in cognitive performance. This enhancement is believed to occur due to a statistical phenomenon called stochastic resonance, where noise increases the probability of a signal passing the firing threshold in the neural cells. Here we investigate whether people with low attentiveness benefit to a larger extent than attentive people from stimulation by auditory white noise and transcranial direct current stimulation (tDCS). The results show, for both auditory noise and tDCS stimulation, that the changes in performance relative to nonstimulation correlate with the degree of attentiveness in a Go/No-Go task, but not in a N-back task. These results suggest that the benefit of tDCS may interact with inattentiveness.