Stimulation Of Dorsolateral Prefrontal Cortex Research Articles

A randomised sham-controlled study evaluating rTMS analgesic efficacy for postherpetic neuralgia.

Postherpetic neuralgia (PHN) is a refractory neuropathic pain condition in which new treatment options are being developed. Repetitive transcranial magnetic stimulation (rTMS) may have the potential to reduce pain sensations in patients with postherpetic neuralgia. This study investigated the efficacy on postherpetic neuralgia by stimulating two potential targets, the motor cortex (M1) and the dorsolateral prefrontal cortex (DLPFC). This is a double-blind, randomised, sham-controlled study. Potential participants were recruited from Hangzhou First People's Hospital. Patients were randomly assigned to either the M1, DLPFC or Sham group. Patients received ten daily sessions of 10-Hz rTMS in 2 consecutive weeks. The primary outcome measure was visual analogue scale (VAS) assessed at baseline, first week of treatment (week 1), post-treatment (week 2), 1-week (week 4), 1-month (week 6) and 3-month (week 14) follow-up. Of sixty patients enrolled, 51 received treatment and completed all outcome assessments. M1 stimulation resulted in a larger analgesia during and after treatment compared to the Sham (week 2 - week 14, p < 0.005), as well as to the DLPFC stimulation (week 1 - week 14, p < 0.05). In addition to pain, sleep disturbance was significantly improved and relieved by targeting either the M1 or the DLPFC (M1: week 4 - week 14, p < 0.01; DLPFC: week 4 - week 14, p < 0.01). Moreover, pain sensations following M1 stimulation uniquely predicted improvement in sleep quality. M1 rTMS is superior to DLPFC stimulation in treating PHN with excellent pain response and long-term analgesia. Meanwhile, M1 and DLPFC stimulation were equally effective in improving sleep quality in PHN. https://www.chictr.org.cn/, identifier ChiCTR2100051963.

Transcranial Magnetic Stimulation of the Dorsolateral Prefrontal Cortex Increases Posterior Theta Rhythm and Reduces Latency of Motor Imagery

Experiments show activation of the left dorsolateral prefrontal cortex (DLPFC) in motor imagery (MI) tasks, but its functional role requires further investigation. Here, we address this issue by applying repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC and evaluating its effect on brain activity and the latency of MI response. This is a randomized, sham-controlled EEG study. Participants were randomly assigned to receive sham (15 subjects) or real high-frequency rTMS (15 subjects). We performed EEG sensor-level, source-level, and connectivity analyses to evaluate the rTMS effects. We revealed that excitatory stimulation of the left DLPFC increases theta-band power in the right precuneus (PrecuneusR) via the functional connectivity between them. The precuneus theta-band power negatively correlates with the latency of the MI response, so the rTMS speeds up the responses in 50% of participants. We suppose that posterior theta-band power reflects attention modulation of sensory processing; therefore, high power may indicate attentive processing and cause faster responses.

Isolating sensory artifacts in the suprathreshold TMS-EEG signal over DLPFC

Combined transcranial magnetic stimulation and electroencephalography (TMS-EEG) is an effective way to evaluate neurophysiological processes at the level of the cortex. To further characterize the TMS-evoked potential (TEP) generated with TMS-EEG, beyond the motor cortex, we aimed to distinguish between cortical reactivity to TMS versus non-specific somatosensory and auditory co-activations using both single-pulse and paired-pulse protocols at suprathreshold stimulation intensities over the left dorsolateral prefrontal cortex (DLPFC). Fifteen right-handed healthy participants received six blocks of stimulation including single and paired TMS delivered as active-masked (i.e., TMS-EEG with auditory masking and foam spacing), active-unmasked (TMS-EEG without auditory masking and foam spacing) and sham (sham TMS coil). We evaluated cortical excitability following single-pulse TMS, and cortical inhibition following a paired-pulse paradigm (long-interval cortical inhibition (LICI)). Repeated measure ANOVAs revealed significant differences in mean cortical evoked activity (CEA) of active-masked, active-unmasked, and sham conditions for both the single-pulse (F(1.76, 24.63) = 21.88, p < 0.001, η2 = 0.61) and LICI (F(1.68, 23.49) = 10.09, p < 0.001, η2 = 0.42) protocols. Furthermore, global mean field amplitude (GMFA) differed significantly across the three conditions for both single-pulse (F(1.85, 25.89) = 24.68, p < 0.001, η2 = 0.64) and LICI (F(1.8, 25.16) = 14.29, p < 0.001, η2 = 0.5). Finally, only active LICI protocols but not sham stimulation ([active-masked (0.78 ± 0.16, P < 0.0001)], [active-unmasked (0.83 ± 0.25, P < 0.01)]) resulted in significant signal inhibition. While previous findings of a significant somatosensory and auditory contribution to the evoked EEG signal are replicated by our study, an artifact attenuated cortical reactivity can reliably be measured in the TMS-EEG signal with suprathreshold stimulation of DLPFC. Artifact attenuation can be accomplished using standard procedures, and even when masked, the level of cortical reactivity is still far above what is produced by sham stimulation. Our study illustrates that TMS-EEG of DLPFC remains a valid investigational tool.

Stimulation of the dorsolateral prefrontal cortex modulates brain cue reactivity to reward (un)availability

Brain imaging studies have shown that stimulation of the left dorsolateral prefrontal cortex (dlPFC), which plays a pivotal role in high-order cognitive control processes, modulates brain reactivity to reward-related cues. Nevertheless, the impact of contextual factors such as reward availability (the reward that is depicted in the cue exposure task) on such modulation effect remains unclear. Here we tested whether a single session of high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) over the left dlPFC differently impacts brain reactivity to cues signalling either availability or unavailability of a sports betting opportunity. Employing a within-subject design (verum versus sham HF-rTMS) among thirty-two frequent sports bettors, we first observed that, as compared to the sham condition, verum HF-rTMS modulated brain reactivity to game cues prior to being made (un)available for betting, through simultaneous increases (posterior insula and caudate nucleus) and decreases (occipital pole) in brain activation. Second, verum HF-rTMS led to increased ventral striatal activity towards cues available for betting but did not modulate brain response to cues unavailable for betting. Taken together, these findings demonstrate that transient stimulation of the left dlPFC led to a general modulation in brain activity in responses to cues, and that this effect is only partly dependent on cues signalling for reward (un)availability.

Anodal tDCS over the left DLPFC but not M1 increases muscle activity and improves psychophysiological responses, cognitive function, and endurance performance in normobaric hypoxia: a randomized controlled trial

BackgroundTranscranial direct current stimulation (tDCS) has been shown to have positive effects on exercise performance and cognitive function in the normal ambient condition. Hypoxia is deemed a stressful situation with detrimental effects on physiological, psychological, cognitive, and perceptual responses of the body. Nevertheless, no study has evaluated the efficacy of tDCS for counteracting the negative effects of hypoxic conditions on exercise performance and cognition so far. Hence, in the present study, we investigated the effects of anodal tDCS on endurance performance, cognitive function, and perceptual responses in hypoxia.Participants and methodsFourteen endurance-trained males participated in five experimental sessions. After familiarization and measuring peak power output in hypoxia, in the first and second sessions, through the 3rd to 5th sessions, participants performed a cycling endurance task until exhaustion after 30 min hypoxic exposure at resting position followed by 20 min of anodal stimulation of the motor cortex (M1), left dorsolateral prefrontal cortex (DLPFC), or sham-tDCS. Color-word Stroop test and choice reaction time were measured at baseline and after exhaustion. Time to exhaustion, heart rate, saturated O2, EMG amplitude of the vastus lateralis, vastus medialis, and rectus femoris muscles, RPE, affective response, and felt arousal were also measured during the task under hypoxia.ResultsThe results showed a longer time to exhaustion (+ 30.96%, p=0.036), lower RPE (− 10.23%, p = 0.045) and higher EMG amplitude of the vastus medialis muscle (+ 37.24%, p=0.003), affective response (+ 260%, p=0.035) and felt arousal (+ 28.9%, p=0.029) in the DLPFC tDCS compared to sham. The choice reaction time was shorter in DLPFC tDCS compared to sham (− 17.55%, p=0.029), and no differences were seen in the color-word Stroop test among the conditions under hypoxia. M1 tDCS resulted in no significant effect for any outcome measure.ConclusionsWe concluded that, as a novel finding, anodal stimulation of the left DLPFC might provide an ergogenic aid for endurance performance and cognitive function under the hypoxic condition probably via increasing neural drive to the working muscles, lowering RPE, and increasing perceptual responses.

Analgesic efficacy of theta-burst stimulation for postoperative pain

ObjectiveRepetitive transcranial magnetic stimulation (rTMS) may be a relevant method to assist postoperative pain. However, studies to date have only used conventional 10 Hz rTMS and targeted the DLPFC for postoperative pain. A more recent form of rTMS, termed intermittent Theta Burst Stimulation (iTBS), enables to increase cortical excitability in a short period of time. This preliminary double-blind, randomised, sham controlled study was designed to evaluate the efficacy of iTBS in postoperative care across two distinct stimulation targets. MethodsA group of 45 patients post laparoscopic surgery were randomised to receive a single session of iTBS over either the dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), or Sham stimulation (1:1:1 ratio). Outcome measurements were number of pump attempts, total anaesthetic volume used, and self-rated pain experience, assessed at 1 hour, 6 hours, 24 hours, and 48 hours post stimulation. All randomised patients were analysed (n = 15 in each group). ResultsCompared to Sham stimulation, DLPFC-iTBS reduced pump attempts at 6 (DLPFC = 0.73 ± 0.88, Sham = 2.36 ± 1.65, P = 0.031), 24 (DLPFC = 1.40 ± 1.24, Sham = 5.03 ± 3.87, P = 0.008), and 48 (DLPFC = 1.47 ± 1.41, Sham = 5.87 ± 4.34, P = 0.014) hours post-surgery, whereby M1 stimulation had no effect. No group effect was observed on total anaesthetics, which was mainly provided through the continuous administration of opioids at a set speed for each group. There was also no group or interaction effect on pain ratings. Pump attempts were positively associated with pain ratings in the DLPFC (r = 0.59, P = 0.02) and M1 (r = 0.56, P = 0.03) stimulation. ConclusionsOur findings show that iTBS to the DLPFC reduces pump attempts for additional anaesthetics following a laparoscopic surgery. However, reduced pump attempts by DLPFC stimulation did not translate into a significantly smaller volume of total anaesthetic, due to the continuous administration of opioids at a set speed for each group. SignificanceOur findings therefore provide preliminary evidence for iTBS targeting the DLPFC to be used to improve postoperative pain management.

Transcranial direct current stimulation (tDCS) in depression induces structural plasticity

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique involving administration of well-tolerated electrical current to the brain through scalp electrodes. TDCS may improve symptoms in neuropsychiatric disorders, but mixed results from recent clinical trials underscore the need to demonstrate that tDCS can modulate clinically relevant brain systems over time in patients. Here, we analyzed longitudinal structural MRI data from a randomized, double-blind, parallel-design clinical trial in depression (NCT03556124, N = 59) to investigate whether serial tDCS individually targeted to the left dorso-lateral prefrontal cortex (DLPFC) can induce neurostructural changes. Significant (FWEc p < 0.05) treatment-related gray matter changes were observed with active high-definition (HD) tDCS relative to sham tDCS within the left DLPFC stimulation target. No changes were observed with active conventional tDCS. A follow-up analysis within individual treatment groups revealed significant gray matter increases with active HD-tDCS in brain regions functionally connected with the stimulation target, including the bilateral DLPFC, bilateral posterior cingulate cortex, subgenual anterior cingulate cortex, and the right hippocampus, thalamus and left caudate brain regions. Integrity of blinding was verified, no significant differences in stimulation-related discomfort were observed between treatment groups, and tDCS treatments were not augmented by any other adjunct treatments. Overall, these results demonstrate that serial HD-tDCS leads to neurostructural changes at a predetermined brain target in depression and suggest that such plasticity effects may propagate over brain networks.

The Neurobase of ambiguity loss aversion about decision making.

In our daily decision-making, there are two confusing problems: risk and ambiguity. Many psychological studies and neuroscience studies have shown that the prefrontal cortex (PFC) is an important neural mechanism for modulating the human brain in risk and ambiguity decision-making, especially the dorsolateral prefrontal cortex (DLPFC). We used transcranial direct current stimulation (tDCS) to reveal the causal relationship between the DLPFC and ambiguity decision-making. We design two experimental tasks involving ambiguity to gain and ambiguity to loss. The results of our study show that there is a significant effect on left DLPFC stimulation about ambiguity to loss, there is an insignificant effect on left DLPFC stimulation about ambiguity to gain, and there is an insignificant effect on right DLPFC stimulation about ambiguity to gain and ambiguity to loss. This result indicates that people are more sensitive to ambiguity loss than ambiguity gain. Further analysis found that the degree of participants' attitudes toward ambiguity loss who received anodal simulation was lower than that who received sham stimulation across the left DLPFC, which means that the subjects had a strong ambiguity loss aversion after the participants received the anodal simulation of the left DLPFC.

Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces craving and increases salience network connectivity in people who smoke cigarettes

Transcranial magnetic stimulation of dorsolateral prefrontal cortex reduces craving and increases salience network connectivity in people who smoke cigarettes

Enhancement of Visuospatial Working Memory by Transcranial Direct Current Stimulation on Prefrontal and Parietal Cortices.

Previous studies have reported dorsolateral prefrontal cortex (DLPFC) and posterior parietal cortex (PPC) activation during the performance of spatial working memory (SWM), therefore this study aims to compare the effect of transcranial direct current stimulation (tDCS) between these two areas. Fifty-four healthy right-handed students (27 women, 27 men; age=24.3±0.2 years) were randomly assigned to an anodal group (n=27) and a sham group (n=27), each of these groups was divided into F4 (representing right DLPFC) or P4 (representing right PPC) subgroups, respectively. A computerized Corsi block tapping (CBT) task was used to measure SWM. The tDCS intervention consisted of five daily sessions with a direct current of 1.5 mA for 15 minutes on the F4 or P4 area of the brain at 24-hour intervals. Significant enhancement of the SWM span as well as a faster response was observed after anodal tDCS in both the anterior and posterior direction. Moreover, stimulation of the left DLPFC induced a faster reaction time compared to the right PPC. Stimulation DLPFC and PPC, as an element of the frontoparietal network, showed SWM enhancement, with the DLPFC being more affected. Our finding provides new evidence to compare the effect of stimulation on the two main activated cortical areas during visual SWM.

Comparative efficacy of different noninvasive brain stimulation therapies for recovery of global cognitive function, attention, memory, and executive function after stroke: a network meta-analysis of randomized controlled trials.

Which noninvasive brain stimulation (NIBS) treatment - transcranial direct current stimulation (tDCS) or transcranial magnetic stimulation (TMS) - is more beneficial for stroke patients' cognitive rehabilitation is still up for debate. Our goal is to provide an overview of the research on the effectiveness and safety of various NIBS protocols. Systematic review and network meta-analysis (NMA) of randomized controlled trials (RCTs). This NMA compared any active NIBS versus sham stimulation in adult stroke survivors to enhance cognitive function, with a focus on global cognitive function (GCF), attention, memory, and executive function (EF) using the databases MEDLINE, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov. The NMA statistical approach was built on a frequency framework. The effect size was estimated by the standardized mean difference (SMD) and a 95% confidence interval (CI). We compiled a relative ranking of the competing interventions based on their surface under the cumulative ranking curve (SUCRA). NMA showed that high-frequency repeated TMS (HF-rTMS) improved GCF compared with sham stimulation (SMD = 1.95; 95% CI: 0.47-3.43), while dual-tDCS improved memory performance versus sham stimulation significantly (SMD = 6.38; 95% CI: 3.51-9.25). However, various NIBS stimulation protocols revealed no significant impact on enhancing attention, executive function, or activities of daily living. There was no significant difference between the active stimulation protocols for TMS and tDCS and sham stimulation in terms of safety. Subgroup analysis demonstrated an effect favoring activation site of the left dorsolateral prefrontal cortex (DLPFC) (SUCRA = 89.1) for enhancing GCF and bilateral DLPFC (SUCRA = 99.9) stimulation for enhancing memory performance. The HF-rTMS over the left DLPFC appears to be the most promising NIBS therapeutic option for improving global cognitive performance after stroke, according to a comparison of numerous NIBS protocols. Furthermore, for patients with post-stroke memory impairment, dual-tDCS over bilateral DLPFC may be more advantageous than other NIBS protocols. Both tDCS and TMS are reasonably safe. PROSPERO ID: CRD42022304865.

The brain stimulation of DLPFC regulates choice preference in intertemporal choice self-other differences

Intertemporal choice requires to make decision by evaluating the value of two options consisting of different times and benefits. The dorsolateral prefrontal cortex (DLPFC) is a key brain region for modulating intertemporal choice. The aim of this study is to investigate the effect of non-invasive brain stimulation over DLPFC on intertemporal choice behavior for self and others. We used transcranial direct current stimulation (tDCS) and continuous theta burst stimulation (cTBS) to stimulate bilateral DLPFC in two experiments respectively. After stimulation, subjects made a choice between a Smaller-Sooner (SS) reward and a Larger-Later (LL) reward in intertemporal choice task. The results showed that cTBS stimulation on the left DLPFC reduced the choice preference for SS reward when individuals made choices for themselves. The cTBS stimulation caused preference difference between choosing for self and parents. But tDCS stimulation had no effect on regulating choice preference. In addition, subjects preferred SS reward for self than strangers. Time-types and monetary difference of rewards affected the choice preference. The presence of immediate time increased the choice preference of SS reward. As the monetary difference increased, the choice proportion of SS reward decreased. Our study demonstrates that brain stimulation on the left DLPFC can regulate choice preference behavior in intertemporal choice.

Offline rTMS inhibition of the right dorsolateral prefrontal cortex impairs reappraisal efficacy.

In this study we verified the causal role of the bilateral dorsolateral prefrontal cortex (DLPFC) in emotional regulation using a strategy of reappraisal, which involves intentionally changing the meaning of an affective event to reduce its emotional impact. Healthy participants (n = 26; mean age = 25.4) underwent three sessions of inhibitory continuous theta burst stimulation (cTBS) applied on three different days over the left or right DLPFC, or the vertex. After applying the stimulation protocol participants were presented with neutral and negative pictorial stimuli that had to be either passively watched or reappraised. The efficacy of emotional control was quantified using the Late Positive Potential (LPP), the neural marker of motivated attention and elaborated stimulus processing. The results showed that reappraisal was compromised after inhibitory stimulation of the right DLPFC compared to the vertex. This impairment of affective modulation was reflected in both early (350-750ms) and late (750-1500ms) time windows. As no session differences during the passive watching conditions were found, the decrease in reappraisal efficacy due to non-specific changes in basic perceptual processing was considered unlikely. Instead, we suggest that inhibition of the right DLPFC primarily affects the top-down mechanism of attentional deployment. This results in disturbances of attentional processes that are necessary to thoroughly elaborate the content of affective stimuli to enable their new, less negative interpretation.

The effects of prefrontal vs. parietal cortex transcranial direct current stimulation on craving, inhibition, and measures of self-esteem.

While prefrontal cortex dysfunction has been implicated in high food cravings, other cortical regions, like the parietal cortex, are potentially also involved in regulating craving. This study explored the effects of stimulating the inferior parietal lobule (IPL) and dorsolateral prefrontal cortex (DLPFC) on food craving state and trait. Transcranial direct current stimulation (tDCS) was administered at 1.5 mA for 5 consecutive days. Participants received 20 min of IPL, DLPFC, or sham stimulation (SHAM) each day which consisted of two rounds of 10-min stimulation, divided by a 10-min mindfulness task break. In addition, we studied inhibition and subjective psychological aspects like body image and self-esteem state and trait. To decompose immediate and cumulative effects, we measured the following on days 1 and 5: inhibition through the Go/No-go task; and food craving, self-esteem, and body appreciation through a battery of questionnaires. We found that false alarm errors decreased in the participants receiving active stimulation in the DLPFC (DLPFC-group). In contrast, false alarm errors increased in participants receiving active stimulation in the IPL (IPL-group). At the same time, no change was found in the participants receiving SHAM (SHAM-group). There was a trending reduction in craving trait in all groups. Momentary craving was decreased in the DLPFC-group and increased in IPL-group, yet a statistical difference was not reached. According to time and baseline, self-esteem and body perception improved in the IPL-group. Furthermore, self-esteem trait significantly improved over time in the DLPFC-group and IPL-group. These preliminary results indicate that tDCS modulates inhibition in frontoparietal areas with opposite effects, enhancing it in DLPFC and impairing it in IPL. Moreover, craving is moderately linked to inhibition, self-esteem, and body appreciation which seem not to be affected by neuromodulation but may rely instead on broader regions as more complex constructs. Finally, the fractionated protocol can effectively influence inhibition with milder effects on other constructs.

PO080 / #705 NOVEL MULTI-TARGET REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION PROTOCOL FOR THE TREATMENT OF COMORBID DEPRESSION AND CHRONIC PAIN: E-POSTER VIEWING

Major Depressive Disorder (MDD) and chronic pain are frequently co-occurring, and the onset of either condition can either precede or follow the onset of the other. Notably, clinical outcome for pharmacological and rTMS treatment for depression is significantly worse in the presence of chronic pain symptoms. To improve clinical care for depression it is thus critical to address the comorbidity of depression and chronic pain in a unified approach rather than treating them as separate conditions. We examined whether an open label multi-target rTMS protocol including stimulation of the left dorsolateral prefrontal cortex (DLPFC) and primary motor cortex (M1), the most effective rTMS target for pain, would improve depressive and chronic pain symptoms more than a single target DLPFC stimulation.

Delayed improvements in visual memory task performance among chronic schizophrenia patients after high-frequency repetitive transcranial magnetic stimulation.

BACKGROUNDCognitive impairments are core characteristics of schizophrenia, but are largely resistant to current treatments. Several recent studies have shown that high-frequency repetitive transcranial magnetic stimulation (rTMS) of the left dor-solateral prefrontal cortex (DLPFC) can reduce negative symptoms and improve certain cognitive deficits in schizophrenia patients. However, results are inconsistent across studies.AIMTo examine if high-frequency rTMS of the DLPFC can improve visual memory deficits in patients with schizophrenia.METHODSForty-seven chronic schizophrenia patients with severe negative symptoms on stable treatment regimens were randomly assigned to receive active rTMS to the DLPFC (n = 25) or sham stimulation (n = 22) on weekdays for four consecutive weeks. Patients performed the pattern recognition memory (PRM) task from the Cambridge Neuropsychological Test Automated Battery at baseline, at the end of rTMS treatment (week 4), and 4 wk after rTMS treatment (week 8). Clinical symptoms were also measured at these same time points using the Scale for the Assessment of Negative Symptoms (SANS) and the Positive and Negative Syndrome Scale (PANSS).RESULTSThere were no significant differences in PRM performance metrics, SANS total score, SANS subscores, PANSS total score, and PANSS subscores between active and sham rTMS groups at the end of the 4-wk treatment period, but PRM performance metrics (percent correct and number correct) and changes in these metrics from baseline were significantly greater in the active rTMS group at week 8 compared to the sham group (all P < 0.05). Active rTMS treatment also significantly reduced SANS score at week 8 compared to sham treatment. Moreover, the improvement in visual memory was correlated with the reduction in negative symptoms at week 8. In contrast, there were no between-group differences in PANSS total score and subscale scores at either week 4 or week 8 (all P > 0.05).CONCLUSIONHigh-frequency transcranial magnetic stimulation improves visual memory and reduces negative symptoms in schizophrenia, but these effects are delayed, potentially due to the requirement for extensive neuroplastic changes within DLPFC networks.

The impact of prefrontal transcranial direct current stimulation (tDCS) on theory of mind, emotion regulation and emotional-behavioral functions in children with autism disorder: A randomized, sham-controlled, and parallel-group study.

Advances in our knowledge about the neuropsychological mechanisms underlying core deficits in autism spectrum disorder (ASD) have produced several novel treatment modalities. One of these approaches is modulation of activity of the brain regions involved in ASD symptoms. This study examined the effects of transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) on autism symptom severity, theory of mind, emotion regulation strategies, and emotional-behavioral functions in children with ASD. Thirty-two children (Mage =10.16, SD=1.93, range 7-12 years) diagnosed with ASD were randomly assigned to active (N=17) or sham stimulation (N=15) groups in a randomized, sham-controlled, parallel-group design. Participants underwent 10 sessions of active (1.5mA, 15 min, bilateral left anodal/right cathodal DLPFC, 2 sessions per week) or sham tDCS. Autism symptom severity, theory of mind, emotion regulation strategies, and emotional-behavioral functioning of the patients were assessed at baseline, immediately after the intervention, and 1 month after the intervention. A significant improvement of autism symptom severity (i.e., communication), theory of mind (i.e., ToM 3), and emotion regulation strategies was observed for the active as compared to the sham stimulation group at the end of the intervention, and these effects were maintained at the one-month follow-up. The results suggest that repeated tDCS with anodal stimulation of left and cathodal stimulation of right DLPFC improves autism symptom severity as well as social cognition and emotion regulation in ASD. LAY SUMMARY: Previous research has suggested that targeting core mechanisms underlying cognitive-emotional and behavioral deficits of autistic children might improve symptoms of ASD. Deficient social and behavioral functioning, impaired theory of mind, and emotional regulation deficits have been identified as core treatment targets for this group. Specific subregions of the prefrontal cortex are involved in these deficits, including hypoactivity of the dorsolateral prefrontal cortex (DLPFC). Upregulation of this area with non-invasive brain stimulation, namely anodal transcranial direct current stimulation (tDCS), results in improved social and behavioral functioning in children with ASD. Very few studies have however examined the effects of this intervention on theory of mind, emotional regulation, and emotional-behavioral problems. We examined the effects of anodal tDCS over the left DLPFC (F3), combined with cathodal tDCS over the right DLPFC (F4) on autism symptom severity as well as theory of mind, emotional regulation, and emotional-behavioral problems of children with ASD. This intervention improved autism symptom severity, specific domains of theory of mind, and emotion regulation. These findings have clinical implications for the treatment of ASD and suggest that targeting core mechanisms underlying socio-cognitive-emotional deficits of autistic children using tDCS might improve symptoms of ASD.

Changes in the TMS-evoked potential N100 in the dorsolateral prefrontal cortex as a function of depression severity in adolescents

Studies using transcranial magnetic stimulation with simultaneous electroencephalography (TMS-EEG) revealed an imbalance between cortical excitation and inhibition (E/I) in the dorsolateral prefrontal cortex (DLPFC) in depression. As adolescence is a developmental period with an increase in depression prevalence and profound neural changes, it is crucial to study the relationship between depression and cortical excitability in adolescence. We aimed to investigate the cortical excitability of the DLPFC in adolescents with depression and a dependency of the TMS-evoked potential N100 on the depression severity. 36 clinical patients (12–18 years of age; 21 females) with a major depressive episode were assessed twice in a longitudinal design: shortly after admission (T0) and after six weeks of intervention (T1). GABA-B-mediated cortical inhibition in the left and right DLPFC, as assessed by the N100, was recorded with EEG. Significantly higher depression scores were reported at T0 compared to T1 (p < 0.001). N100 amplitudes were significantly increased (i.e., more negative) at T0 compared to T1 (p = 0.03). No significant hemispheric difference was found in the N100 component. The correlation between the difference in depression severity and the difference in N100 amplitudes (T0–T1) obtained during stimulation of the left DLPFC did not remain significant after correction for testing in both hemispheres. Higher N100 amplitudes during a state of greater depression severity are suggestive of an E/I imbalance in the DLPFC in adolescents with an acute depressive episode. The N100 reduction potentially reflects a normalization of DLPFC over inhibition in association with decreased depressive symptomatology, indicating severity dependency.

Functional Connectivity Increases in Response to High-Definition Transcranial Direct Current Stimulation in Patients with Chronic Disorder of Consciousness.

Highlights Functional connectivity induced by HD-tDCS in DLPFC has different trends in CRS-R score improvers and non-improvers.An increase in theta PLV in the left frontal–parietooccipital region was significantly associated with CRS-R changes.DOC patients with increased PLV of the alpha band in the intra-bifrontal region have a better prognosis than those without. High-definition transcranial direct current stimulation (HD-tDCS) has been shown to play an important role in improving consciousness in patients with disorders of consciousness (DOCs), but its neuroelectrophysiological evidence is still lacking. To better explain the electrophysiological mechanisms of the effects of HD-tDCS on patients with DOCs, 22 DOC patients underwent 10 anodal HD-tDCS sessions of the left dorsolateral prefrontal cortex (DLPFC). This study used the Coma Recovery Scale-Revised (CRS-R) to assess the level of consciousness in DOC patients. According to whether the CRS-R score increased before and after stimulation, DOC patients were divided into a responsive group and a non-responsive group. By comparing the differences in resting-state EEG functional connectivity between different frequency bands and brain regions, as well as the relationship between functional connectivity values and clinical scores, the electrophysiological mechanism of the clinical effects of HD-tDCS was further explored. The change of the phase locking value (PLV) on the theta frequency band in the left frontal–parietooccipital region was positively correlated with the change in the CRS-R scores. As the number of interventions increased, we observed that in the responsive group, the change in PLV showed an upward trend, and the increase in the PLV appeared in the left frontal–parietooccipital region at 4–8 Hz and in the intra-bifrontal region at 8–13 Hz. In the non-responsive group, although the CRS-R scores did not change after stimulation, the PLV showed a downward trend, and the decrease in the PLV appeared in the intra-bifrontal region at 8–13 Hz. In addition, at the three-month follow-up, patients with increased PLV in the intra-bifrontal region at 8–13 Hz after repeated HD-tDCS stimulation had better outcomes than those without. Repeated anodal stimulation of the left DLPFC with HD-tDCS resulted in improved consciousness in some patients with DOCs. The increase in functional connectivity in the brain regions may be associated with the improvement of related awareness after HD-tDCS and may be a predictor of better long-term outcomes.

Impact of methodological variability on EEG responses evoked by transcranial magnetic stimulation: A meta-analysis

ObjectiveThis meta-analysis aimed to synthesize the existing literature on how different parameters of transcranial magnetic stimulation (TMS) and electroencephalogram (EEG) modulate the amplitudes of TMS-evoked potentials (TEPs). MethodsA comprehensive search was run in PubMed and completed by Google Scholar to find articles studying healthy participants who underwent single pulse TMS-EEG sessions over their left primary motor cortex (M1) or dorsolateral prefrontal cortex (DLPFC). The amplitudes of the most commonly investigated TEP peaks for DLPFC stimulation (positives: 25, 60, 185 ms, negatives: 40, 100 ms) and M1 stimulation (positives: 30, 55,180 ms and negatives: 15, 45, 100, 280 ms) were extracted from studies. ResultsCohen’s d effect sizes were obtained in five independent categories that were stratified based on the stimulation, recording, and analyzing parameters. The overall effect sizes and equivalent means and standard deviations were computed within every category. ConclusionsThis meta-analysis spotlights the need to rigorously and systematically control for the critical parameters in recording and analyzing TMS-EEG data to make the outcomes of further studies more comparable to the current body of literature. SignificanceThe study demonstrates the possibility of reliably measuring TEPs by offering approximate ranges for every TEP peak in the most commonly targeted areas of DLPFC and M1.