Is Non-invasive Brain Stimulation the Low-Hanging Fruit?

Graaf, Tom A. de; Janssens, Shanice E. W.; Sack, Alexander T.

doi:10.1007/978-3-030-62351-7_8

Cited by 2 publications

(1 citation statement)

References 54 publications

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“…Since its development, TMS has therefore been widely used in cognitive neuroscience research ( Walsh and Cowey, 2000 ; O’Shea and Walsh, 2007 ), not only to map the motor cortex ( Gunduz et al, 2020 ), but also to study domains such as visual perception ( Amassian et al, 1989 ; Kammer, 2007 ; Jacobs et al, 2012a , 2014 ; de Graaf et al, 2014 ; de Graaf and Sack, 2014 ; Janssens et al, 2020b ), attention ( Ashbridge et al, 1997 ; Sack et al, 2002 , 2007 ; Rushworth and Taylor, 2006 ; Ronconi et al, 2014 ; Duecker and Sack, 2015 ), imagery ( Sack et al, 2002 , 2005 ; Cattaneo et al, 2012 ), language ( Pascual-Leone et al, 1991 ; Schuhmann et al, 2012 ; Acheson and Hagoort, 2013 ; Tarapore et al, 2013 ), learning ( de Weerd et al, 2012 ; Platz et al, 2012a , b ), and memory ( Osaka et al, 2007 ; van de Ven et al, 2012 ; van de Ven and Sack, 2013 ; Bonnì et al, 2015 ; Rademaker et al, 2017 ; Ferrari et al, 2018 ). In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders ( Lefaucheur et al, 2014 , 2020 ; de Graaf et al, 2021a , b ). TMS is used during stroke rehabilitation ( Hummel and Cohen, 2006 ; Di Pino et al, 2014 ; Wessel et al, 2015 ), and as treatment for depression ( Loo and Mitchell, 2005 ; Perera et al, 2016 ; Donse et al, 2018 ; Baeken et al, 2019 ; Sonmez et al, 2019 ) and schizophrenia ( Cole et al, 2015 ).…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals

Janssens

Sack

2021

Front. Hum. Neurosci.

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Transcranial magnetic stimulation (TMS) can cause measurable effects on neural activity and behavioral performance in healthy volunteers. In addition, TMS is increasingly used in clinical practice for treating various neuropsychiatric disorders. Unfortunately, TMS-induced effects show large intra- and inter-subject variability, hindering its reliability, and efficacy. One possible source of this variability may be the spontaneous fluctuations of neuronal oscillations. We present recent studies using multimodal TMS including TMS-EMG (electromyography), TMS-tACS (transcranial alternating current stimulation), and concurrent TMS-EEG-fMRI (electroencephalography, functional magnetic resonance imaging), to evaluate how individual oscillatory brain state affects TMS signal propagation within targeted networks. We demonstrate how the spontaneous oscillatory state at the time of TMS influences both immediate and longer-lasting TMS effects. These findings indicate that at least part of the variability in TMS efficacy may be attributable to the current practice of ignoring (spontaneous) oscillatory fluctuations during TMS. Ignoring this state-dependent spread of activity may cause great individual variability which so far is poorly understood and has proven impossible to control. We therefore also compare two technical solutions to directly account for oscillatory state during TMS, namely, to use (a) tACS to externally control these oscillatory states and then apply TMS at the optimal (controlled) brain state, or (b) oscillatory state-triggered TMS (closed-loop TMS). The described multimodal TMS approaches are paramount for establishing more robust TMS effects, and to allow enhanced control over the individual outcome of TMS interventions aimed at modulating information flow in the brain to achieve desirable changes in cognition, mood, and behavior.

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Section: Introductionmentioning

confidence: 99%

Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals

Janssens

Sack

2021

Front. Hum. Neurosci.

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Home-administered transcranial direct current stimulation with asynchronous remote supervision in the treatment of depression: feasibility, tolerability, and clinical effectiveness

Koutsomitros,

Schwarz,

van der Zee

et al. 2023

Front. Psychiatry

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Introduction (Background)Depression is an often chronic condition, characterized by wide-ranging physical, cognitive and psychosocial symptoms that can lead to disability, premature mortality or suicide. It affects 350 million people globally, yet up to 30% do not respond to traditional treatment, creating an urgent need for novel non-pharmacological treatments. This open-label naturalistic study assesses the practical feasibility, tolerability, and clinical effectiveness of home-administered transcranial direct current stimulation (tDCS) with asynchronous remote supervision, in the treatment of depression.MethodOver the course of 3 weeks, 40 patients with depression received psychotherapy and half of this group also received daily bi-frontal tDCS stimulation of the dorsolateral prefrontal cortex. These patients received tDCS for 30 min per session with the anode placed over F3 and the cathode over F4, at an intensity of 2 mA for 21 consecutive days. We measured patients' level of depression symptoms at four time points using the Beck Depression Inventory, before treatment and at 1-week intervals throughout the treatment period. We monitored practical feasibility such as daily protocol compliance and tolerability including side effects, with the PlatoScience cloud-based remote supervision platform.ResultsOf the 20 patients in the tDCS group, 90% were able to comply with the protocol by not missing more than three of their assigned sessions, and none dropped out of the study. No serious adverse events were reported, with only 14 instances of mild to moderate side effects and two instances of scalp pain rated as severe, out of a total of 420 stimulation sessions. Patients in the tDCS group showed a significantly greater reduction in depression symptoms after 3 weeks of treatment, compared to the treatment as usual (TAU) group [t(57.2) = 2.268, p = 0.027]. The tDCS group also showed greater treatment response (50%) and depression remission rates (75%) compared to the TAU group (5 and 30%, respectively).Discussion (Conclusion)These findings provide a possible indication of the clinical effectiveness of home-administered tDCS for the treatment of depression, and its feasibility and tolerability in combination with asynchronous supervision.

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Is Non-invasive Brain Stimulation the Low-Hanging Fruit?

Cited by 2 publications

References 54 publications

Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals

Spontaneous Fluctuations in Oscillatory Brain State Cause Differences in Transcranial Magnetic Stimulation Effects Within and Between Individuals

Home-administered transcranial direct current stimulation with asynchronous remote supervision in the treatment of depression: feasibility, tolerability, and clinical effectiveness

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