Potential of Transcranial Direct Current Stimulation in Alzheimer’s Disease: Optimizing Trials Toward Clinical Use

Pilloni, Giuseppina; Charvet, Leigh; Bikson, Marom; Palekar, Nikhil; Kim, Min-Jeong

doi:10.3988/jcn.2022.18.4.391

Cited by 8 publications

(6 citation statements)

References 105 publications

(154 reference statements)

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“…However, repeated sessions can produce cumulative and long-lasting modulations of neural activity and neuroplasticity [9,10]. tDCS has therefore gained attention as a potential therapeutic tool for use in a range of various neuropsychiatric conditions [11][12][13][14][15][16][17]. Our systematic review and meta-analysis of tDCS in migraine found that repeated tDCS sessions may be a promising non-pharmacological treatment for reducing headache pain intensity and duration [18].…”

Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Remotely Supervised At-home tDCS for Veterans with Persistent Post-Traumatic Headache: A Double-Blind, Sham-Controlled Randomized Pilot Clinical Trial

Charvet

Harrison

Mangold

et al. 2023

Preprint

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Background. There is a scientific gap concerning the unmet need for treating persistent post-traumatic headache (PPTH) secondary to traumatic brain injury (TBI). No FDA approved therapy for PPTH is available. As such, the objective of the present trial was to evaluate the feasibility and preliminary efficacy of a four-week at-home remotely supervised transcranial direct current stimulation (RS-tDCS) intervention in veterans with PPTH secondary to mild TBI. Methods. Veterans with PPTH completed this single site, randomized, double-blind, sham-controlled pilot clinical trial. Following a baseline period (four-weeks), participants completed 20-sessions of RS-tDCS with real-time video monitoring. Participants were followed up for four-weeks post-intervention. Primary outcomes were overall treatment adherence rate (feasibility) and change in moderate/severe headache days (efficacy) during the treatment phase. Secondary outcomes were change in total number of headache days, Headache Impact Test, and other functional outcomes. Results. Twenty-six veterans (46.6±8.7 years) with PPTH completed baseline observations and were randomized to either active (n=13) or sham(n=13) RS-tDCS. Twenty-five veterans passed tolerability tests. Eighty-eight percent of participants fully completed either active (10/12) or sham (12/13) RS-tDCS interventions (p=.59). Moderate/severe headache days were significantly reduced within the active (difference=-2.5; 95% CI= [-4.98,-0.02]) but not sham group (difference=1.0; 95% CI= [-2.52,4.52]), however there was no statistically significant reduction when comparing active vs. shamgroups (B=-3.5; 95% CI= [-7.28,0.28]). There was a statistically significant reduction in total number of headache days within active RS-tDCS (difference=-4.0; 95% CI= [-7.71,-0.29]) but not sham (difference=0.58; 95% CI= [-2.52,3.69]). There was a statistically significant reduction in total number of headache days in active vs. sham RS-tDCS (B=-4.58; 95% CI= [-8.6,-0.56]). Conclusion. Our RS-tDCS paradigm enables safe, highly feasible, effective tDCS treatment. Clinical application of this RS-tDCS protocol will not only serve as an efficacious neuromodulation but also facilitate outreach to rural communities, where veterans have limited access to care related to PPTH. Trial Registry. ClinicalTrials.gov Identifier: NCT04012853

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Section: Introductionmentioning

confidence: 99%

WITHDRAWN: Remotely Supervised At-home tDCS for Veterans with Persistent Post-Traumatic Headache: A Double-Blind, Sham-Controlled Randomized Pilot Clinical Trial

Charvet

Harrison

Mangold

et al. 2023

Preprint

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“…Randomized controlled trials have been conducted in patients with AD and mild cognitive impairment (MCI), and anodal tDCS was usually applied with a current of 2 mA for 20–30 min per session and target region at the DLPFC. Most of the trial findings (up to phase II) showed short-term cognitive improvement in delayed recall memory, executive function, language, and global cognition [ 6 ]. Furthermore, higher dosing or multiple-session protocols may induce greater effects in terms of behavioral change than single-session protocols.…”

Section: E Lectric and Magnetic Neuromodulationmentioning

confidence: 99%

Application of transcranial brain stimulation in dementia

Luo

Yang

2023

Tzu Chi Medical Journal

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The number of patients with dementia grows rapidly as the global population ages, which posits tremendous health-care burden to the society. Only cholinesterase inhibitors and a N-methyl-D-aspartate receptor antagonist have been approved for treating patients with Alzheimer’s disease (AD), and their clinical effects remained limited. Medical devices serve as an alternative therapeutic approach to modulating neural activities and enhancing cognitive function. Four major brain stimulation technologies including deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and transcranial ultrasound stimulation (TUS) have been applied to AD in a clinical trial setting. DBS allows electrical stimulation at the specified nucleus but remains resource-demanding, and after all, an invasive surgery; whereas TMS and tDCS are widely available and affordable but less ideal with respect to localization. The unique physical property of TUS, on the other hand, allows both thermal and mechanical energy to be transduced and focused for neuromodulation. In the context of dementia, using focused ultrasound to induce blood-brain barrier opening for delivering drugs and metabolizing amyloid protein has drawn great attention in recent years. Furthermore, low-intensity pulsed ultrasound has demonstrated its neuroprotective effects in both in vitro and in vivo studies, leading to ongoing clinical trials for AD. The potential and limitation of transcranial brain stimulation for treating patients with dementia would be discussed in this review.

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“…Diverse pharmacological and physical therapies have been studied for MCI; unfortunately, to date, no consistent reports of long-term effectiveness have been published ( 5 ). However, increasing evidence suggests that transcranial direct current stimulation (tDCS) may be an effective add-on therapy to improve cognitive function in patients with MCI ( 2 , 6 , 7 ). tDCS is a non-invasive brain stimulation technique that involves placing electrodes on the scalp to apply a weak direct current to the brain cortex with the intent of modulating brain excitability ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Safety and feasibility of optimized transcranial direct current stimulation in patients with mild cognitive impairment due to Alzheimer’s disease: a multicenter study protocol for a randomized controlled trial

Kim,

Kang,

Salazar Fajardo

et al. 2024

Front. Neurol.

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IntroductionTranscranial direct current stimulation (tDCS) may effectively preserve and improve cognitive function in patients with mild cognitive impairment (MCI). Research has shown that Individual brain characteristics can influence the effects of tDCS. Computer three-dimensional brain modeling based on magnetic resonance imaging (MRI) has been suggested as an alternative for determining the most accurate tDCS electrode position based on the patients’ individual brain characteristics to enhance tDCS effects. Therefore, this study aims to determine the feasibility and safety of applying tDCS treatment using optimized and personalized tDCS electrode positions in patients with Alzheimer’s disease (AD)-induced MCI using computer modeling and compare the results with those of a sham group to improve cognitive function.MethodA prospective active-sham group feasibility study was set to recruit 40 participants, who will be randomized into Optimized-tDCS and Sham-tDCS groups. The parameters for tDCS will be 2 mA (disk electrodes R = 1.5 cm) for 30 min during two sets of 15 sessions (2 weeks of resting period in between), using two electrodes in pairs. Using computer modeling, the tDCS electrode positions of each participant will be personalized. Outcome measurements are going to be obtained at three points: baseline, first post-test, and second post-test. The AD assessment scale-cognitive subscale (ADAS-Cog) and the Korean version of Mini-Mental State Examination (K-MMSE), together with other secondary outcomes and safety tests will be used.DiscussionFor the present study, we hypothesize that compared to a sham group, the optimized personalized tDCS application would be effective in improving the cognitive function of patients with AD-induced MCI and the participants would tolerate the tDCS intervention without any significant adverse effects.Clinical trial registration: https://cris.nih.go.kr, identifier [KCT0008918].

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Potential of Transcranial Direct Current Stimulation in Alzheimer’s Disease: Optimizing Trials Toward Clinical Use

Cited by 8 publications

References 105 publications

WITHDRAWN: Remotely Supervised At-home tDCS for Veterans with Persistent Post-Traumatic Headache: A Double-Blind, Sham-Controlled Randomized Pilot Clinical Trial

WITHDRAWN: Remotely Supervised At-home tDCS for Veterans with Persistent Post-Traumatic Headache: A Double-Blind, Sham-Controlled Randomized Pilot Clinical Trial

Application of transcranial brain stimulation in dementia

Safety and feasibility of optimized transcranial direct current stimulation in patients with mild cognitive impairment due to Alzheimer’s disease: a multicenter study protocol for a randomized controlled trial

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