Efficacy of repetitive transcranial magnetic stimulation/transcranial direct current stimulation in cognitive neurorehabilitation

Miniussi, Carlo; Cappa, Stefano F.; Cohen, Leonardo G.; Flöel, Agnes; Fregni, Felipe; Nitsche, Michael A.; Oliveri, Massimiliano; Pascual‐Leone, Álvaro; Paulus, Walter; Priori, Alberto; Walsh, Vincent

doi:10.1016/j.brs.2008.07.002

Cited by 231 publications

(149 citation statements)

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“…These results were expected to provide important guidelines for the design of rehabilitation protocols in clinical neuroscience [20] by determining which of the two excitatory techniques is more effective and the optimal timing of each technique. Hf-tRNS was expected to be effective only if applied during task execution, whereas a-tDCS was expected to induce a stronger facilitation when applied before task execution.…”

Section: Introductionmentioning

confidence: 99%

The Role of Timing in the Induction of Neuromodulation in Perceptual Learning by Transcranial Electric Stimulation

2013

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a b s t r a c tBackground: Transcranial electric stimulation (tES) protocols are able to induce neuromodulation, offering important insights to focus and constrain theories of the relationship between brain and behavior. Previous studies have shown that different types of tES (i.e., direct current stimulation e tDCS, and random noise stimulation e tRNS) induce different facilitatory behavioral effects. However to date is not clear which is the optimal timing to apply tES in relation to the induction of robust facilitatory effects. Objective/hypothesis: The goal of this work was to investigate how different types of tES (tDCS and tRNS) can modulate behavioral performance in the healthy adult brain in relation to their timing of application. We applied tES protocols before (offline) or during (online) the execution of a visual perceptual learning (PL) task. PL is a form of implicit memory that is characterized by an improvement in sensory discrimination after repeated exposure to a particular type of stimulus and is considered a manifestation of neural plasticity. Our aim was to understand if the timing of tES is critical for the induction of differential neuromodulatory effects in the primary visual cortex (V1). Methods: We applied high-frequency tRNS, anodal tDCS and sham tDCS on V1 before or during the execution of an orientation discrimination task. The experimental design was between subjects and performance was measured in terms of d' values. Results: The ideal timing of application varied depending on the stimulation type. tRNS facilitated task performance only when it was applied during task execution, whereas anodal tDCS induced a larger facilitation if it was applied before task execution. Conclusion: The main result of this study is the finding that the timing of identical tES protocols yields opposite effects on performance. These results provide important guidelines for designing neuromodulation induction protocols and highlight the different optimal timing of the two excitatory techniques.

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Section: Introductionmentioning

confidence: 99%

The Role of Timing in the Induction of Neuromodulation in Perceptual Learning by Transcranial Electric Stimulation

2013

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“…Several studies have endorsed the use of transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, to modulate cortical excitability and induce neuroplasticity that is associated with cognitive and behavioral changes (Arul-Anandam and Loo, 2009;Boggio et al, 2007;Miniussi et al, 2008;Wagner et al, 2007;Wassermann and Grafman, 2005). As directly shown in animal studies, anodal tDCS increases cortical excitability, inducing a depolarization of the resting membrane potential and increasing neuronal firing rates.…”

Section: Introductionmentioning

confidence: 99%

Excitability modulation of the motor system induced by transcranial direct current stimulation: A multimodal approach

2013

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Anodal and cathodal transcranial direct current stimulations (tDCS) are both established techniques to induce cortical excitability changes. Typically, in the human motor system, such cortical modulations are inferred through changes in the amplitude of the motor evoked potentials (MEPs). However, it is now possible to directly evaluate tDCS-induced changes at the cortical level by recording the transcranial magnetic stimulation evoked potentials (TEPs) using electroencephalography (EEG). The present study investigated the modulation induced by the tDCS on the motor system. The study evaluates changes in the MEPs, in the amplitude and distribution of the TEPs, in resting state oscillatory brain activity and in behavioral performance in a simple manual response task. Both the short-and long-term tDCS effects were investigated by evaluating their time course at~0 and 30 min after tDCS. Anodal tDCS over the left primary motor cortex (M1) induced an enhancement of corticospinal excitability, whereas cathodal stimulation produced a reduction. These changes in excitability were indexed by changes in MEP amplitude. More interestingly, tDCS modulated the cortical reactivity, which is the neuronal activity evoked by TMS, in a polarity-dependent and site-specific manner. Cortical reactivity increased after anodal stimulation over the left M1, whereas it decreased with cathodal stimulation. These effects were partially present also at long term evaluation. No polarity-specific effect was found either on behavioral measures or on oscillatory brain activity. The latter showed a general increase in the power density of low frequency oscillations (theta and alpha) at both stimulation polarities. Our results suggest that tDCS is able to modulate motor cortical reactivity in a polarity-specific manner, inducing a complex pattern of direct and indirect cortical activations or inhibitions of the motor system-related network, which might be related to changes in synaptic efficacy of the motor cortex.

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“…Although the mechanism of tDCS remains an area of active research, there is evidence to suggest that in the cortex tDCS modulates synaptic strength and likely stimulates pyramidal neurons and interneurons (Nitsche et al, 2005;Stagg and Nitsche, 2011). As a therapy, tDCS has shown some success in treating major depression (Fregni et al, 2006a,b;Brunoni et al, 2011), memory deficits in Parkinson's disease (Boggio et al, 2006), memory deficits in Alzheimer's disease (Boggio et al, 2009(Boggio et al, , 2012, aphasia (Baker et al, 2010;Kang et al, 2011;You et al, 2011), and as a recovery aid for stroke patients (Fregni et al, 2005b;Miniussi et al, 2008;Jo et al, 2009;Kang et al, 2009;Bolognini et al, 2011;Bueno et al, 2011). Despite these findings, less research has been done investigating the effects of tDCS on WM.…”

Section: Introductionmentioning

confidence: 99%

Parietal Contributions to Visual Working Memory Depend on Task Difficulty

Jones¹,

Crane²,

Feenstra³

et al. 2012

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The nature of parietal contributions to working memory (WM) remain poorly understood but of considerable interest. We previously reported that posterior parietal damage selectively impaired WM probed by recognition (Berryhill and Olson, 2008a). Recent studies provided support using a neuromodulatory technique, transcranial direct current stimulation (tDCS) applied to the right parietal cortex (P4). These studies confirmed parietal involvement in WM because parietal tDCS altered WM performance: anodal current tDCS improved performance in a change detection task, and cathodal current tDCS impaired performance on a sequential presentation task. Here, we tested whether these complementary results were due to different degrees of parietal involvement as a function of WM task demands, WM task difficulty, and/or participants' WM capacity. In Experiment 1, we applied cathodal and anodal tDCS to the right parietal cortex and tested participants on both previously used WM tasks. We observed an interaction between tDCS (anodal, cathodal), WM task difficulty, and participants' WM capacity. When the WM task was difficult, parietal stimulation (anodal or cathodal) improved WM performance selectively in participants with high WM capacity. In the low WM capacity group, parietal stimulation (anodal or cathodal) impaired WM performance. These nearly equal and opposite effects were only observed when the WM task was challenging, as in the change detection task. Experiment 2 probed the interplay of WM task difficulty and WM capacity in a parametric manner by varying set size in the WM change detection task. Here, the effect of parietal stimulation (anodal or cathodal) on the high WM capacity group followed a linear function as WM task difficulty increased with set size. The low WM capacity participants were largely unaffected by tDCS. These findings provide evidence that parietal involvement in WM performance depends on both WM capacity and WM task demands. We discuss these findings in terms of alternative WM strategies employed by low and high WM capacity individuals. We speculate that low WM capacity individuals do not recruit the posterior parietal lobe for WM tasks as efficiently as high WM capacity individuals. Consequently, tDCS provides greater benefit to individuals with high WM capacity.

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Efficacy of repetitive transcranial magnetic stimulation/transcranial direct current stimulation in cognitive neurorehabilitation

Cited by 231 publications

References 117 publications

The Role of Timing in the Induction of Neuromodulation in Perceptual Learning by Transcranial Electric Stimulation

The Role of Timing in the Induction of Neuromodulation in Perceptual Learning by Transcranial Electric Stimulation

Excitability modulation of the motor system induced by transcranial direct current stimulation: A multimodal approach

Parietal Contributions to Visual Working Memory Depend on Task Difficulty

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