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Sample records for repetitive transcranial stimulation

  1. 21 CFR 882.5805 - Repetitive transcranial magnetic stimulation system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Repetitive transcranial magnetic stimulation....5805 Repetitive transcranial magnetic stimulation system. (a) Identification. A repetitive transcranial magnetic stimulation system is an external device that delivers transcranial repetitive pulsed...

  2. 21 CFR 882.5805 - Repetitive transcranial magnetic stimulation system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Repetitive transcranial magnetic stimulation....5805 Repetitive transcranial magnetic stimulation system. (a) Identification. A repetitive transcranial magnetic stimulation system is an external device that delivers transcranial repetitive pulsed...

  3. 21 CFR 882.5805 - Repetitive transcranial magnetic stimulation system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Repetitive transcranial magnetic stimulation....5805 Repetitive transcranial magnetic stimulation system. (a) Identification. A repetitive transcranial magnetic stimulation system is an external device that delivers transcranial repetitive pulsed...

  4. Effects of slow repetitive transcranial magnetic stimulation in patients with corticobasal syndrome.

    PubMed

    Civardi, Carlo; Pisano, Fabrizio; Delconte, Carmen; Collini, Alessandra; Monaco, Francesco

    2015-06-01

    Corticobasal syndrome is characterized by asymmetric cortical sensorimotor dysfunction and parkinsonism; an altered cortical excitability has been reported. We explored with transcranial magnetic stimulation the motor cortical excitability in corticobasal syndrome, and the effects of slow repetitive transcranial magnetic stimulation. With transcranial magnetic stimulation, we studied two corticobasal syndrome patients. We determined bilaterally from the first dorsal interosseous muscle: relaxed threshold, and contralateral and ipsilateral silent period. We also evaluated the contralateral silent period after active/sham slow repetitive transcranial magnetic stimulation on the most affected side. At T0 the silent period was bilaterally short. On the most affected side, active slow repetitive transcranial magnetic stimulation induced a short lasting prolongation of the contralateral silent period. In corticobasal syndrome, transcranial magnetic stimulation showed a reduction cortical inhibitory phenomenon potentially reversed transiently by slow repetitive transcranial magnetic stimulation. PMID:25693871

  5. Repetitive Transcranial Magnetic Stimulation Activates Specific Regions in Rat Brain

    NASA Astrophysics Data System (ADS)

    Ji, Ru-Rong; Schlaepfer, Thomas E.; Aizenman, Carlos D.; Epstein, Charles M.; Qiu, Dike; Huang, Justin C.; Rupp, Fabio

    1998-12-01

    Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive technique to induce electric currents in the brain. Although rTMS is being evaluated as a possible alternative to electroconvulsive therapy for the treatment of refractory depression, little is known about the pattern of activation induced in the brain by rTMS. We have compared immediate early gene expression in rat brain after rTMS and electroconvulsive stimulation, a well-established animal model for electroconvulsive therapy. Our result shows that rTMS applied in conditions effective in animal models of depression induces different patterns of immediate-early gene expression than does electroconvulsive stimulation. In particular, rTMS evokes strong neural responses in the paraventricular nucleus of the thalamus (PVT) and in other regions involved in the regulation of circadian rhythms. The response in PVT is independent of the orientation of the stimulation probe relative to the head. Part of this response is likely because of direct activation, as repetitive magnetic stimulation also activates PVT neurons in brain slices.

  6. Repetitive transcranial magnetic stimulation in anorexia nervosa: a pilot study.

    PubMed

    Van den Eynde, F; Guillaume, S; Broadbent, H; Campbell, I C; Schmidt, U

    2013-02-01

    The search for new treatments to improve outcome in people with anorexia nervosa continues. This pilot study investigated whether one session of high frequency repetitive transcranial magnetic stimulation (rTMS) delivered to the left dorsolateral prefrontal cortex reduces eating disorder related symptoms following exposure to visual and real food stimuli. Safety and tolerability were also assessed. Ten right-handed people with anorexia nervosa underwent one session of rTMS. Subjective experiences related to the eating disorder (e.g. urge to restrict, feeling full etc.) were assessed before and after rTMS. Non-parametric repeated measures tests were used. rTMS was safe and well-tolerated, and resulted in reduced levels of feeling full, feeling fat and feeling anxious. Thus, rTMS may reduce core symptoms of anorexia nervosa. Future research should establish the therapeutic potential of rTMS in anorexia nervosa. PMID:21880470

  7. Repetitive Transcranial Magnetic Stimulation Improves Handwriting in Parkinson's Disease

    PubMed Central

    Randhawa, Bubblepreet K.; Farley, Becky G.; Boyd, Lara A.

    2013-01-01

    Background. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive “l”s), and on cortical excitability, in individuals with PD. Methods. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed. Results. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex. Conclusions. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD. PMID:23841021

  8. Repetitive transcranial magnetic stimulation improves handwriting in Parkinson's disease.

    PubMed

    Randhawa, Bubblepreet K; Farley, Becky G; Boyd, Lara A

    2013-01-01

    Background. Parkinson disease (PD) is characterized by hypometric movements resulting from loss of dopaminergic neurons in the substantia nigra. PD leads to decreased activation of the supplementary motor area (SMA); the net result of these changes is a poverty of movement. The present study determined the impact of 5 Hz repetitive transcranial magnetic stimulation (rTMS) over the SMA on a fine motor movement, handwriting (writing cursive "l"s), and on cortical excitability, in individuals with PD. Methods. In a cross-over design, ten individuals with PD were randomized to receive either 5 Hz or control stimulation over the SMA. Immediately following brain stimulation right handed writing was assessed. Results. 5 Hz stimulation increased vertical size of handwriting and diminished axial pressure. In addition, 5 Hz rTMS significantly decreased the threshold for excitability in the primary motor cortex. Conclusions. These data suggest that in the short term 5 Hz rTMS benefits functional fine motor task performance, perhaps by altering cortical excitability across a network of brain regions. Further, these data may provide the foundation for a larger investigation of the effects of noninvasive brain stimulation over the SMA in individuals with PD. PMID:23841021

  9. Neuronavigation-guided Repetitive Transcranial Magnetic Stimulation for Aphasia.

    PubMed

    Kim, Woo-Jin; Hahn, Soo Jung; Kim, Won-Seok; Paik, Nam-Jong

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is widely used for several neurological conditions, as it has gained acknowledgement for its potential therapeutic effects. Brain excitability is non-invasively modulated by rTMS, and rTMS to the language areas has proved its potential effects on treatment of aphasia. In our protocol, we aim to artificially induce virtual aphasia in healthy subjects by inhibiting Brodmann area 44 and 45 using neuronavigational TMS (nTMS), and F3 of the International 10-20 EEG system for conventional TMS (cTMS). To measure the degree of aphasia, changes in reaction time to a picture naming task pre- and post-stimulation are measured and compare the delay in reaction time between nTMS and cTMS. Accuracy of the two TMS stimulation methods is compared by averaging the Talairach coordinates of the target and the actual stimulation. Consistency of stimulation is demonstrated by the error range from the target. The purpose of this study is to demonstrate use of nTMS and to describe the benefits and limitations of the nTMS compared to those of cTMS. PMID:27214154

  10. [Contralateral and ipsilateral repetitive transcranial magnetic stimulation in Parkinson patients].

    PubMed

    de Groot, M; Hermann, W; Steffen, J; Wagner, A; Grahmann, F

    2001-12-01

    In seven women and two men with Parkinson's disease, Hoehn and Yahr stage 1 or 2, the effect of repetitive transcranial magnetic stimulation (rTMS) was evaluated. Primary endpoint outcome measure was the changing of the motor items of the Unified Parkinson's Disease Rating Scale (subscale III of UP-DRS) 24 h after stimulation. Kinesiologic tests and writing samples were secondary outcome measures. After discontinuing all medication, stimulation was performed with 5 Hz at 90% of the motor threshold over the primary motor cortex of the more affected. There were 2250 stimuli applied, divided into 15 trains at intervals of 10 s. The identical treatment of the opposite side served as control treatment. Only treatment of the more affected side resulted in a significant improvement of the clinical symptoms of 46% as assessed by the UPDRS (p < 0.02). This effectiveness differed significantly from the control treatment (21%, p < 0.02). The kinesiological testing did not show any significant speeding of movements (p > 0.05). Some patients showed a normalisation of the previously disturbed handwriting specimen. These data confirm the previous observation that rTMS of primary motor regions leads to at least temporary clinical improvement of symptoms in patients with Parkinson's disease. PMID:11789438

  11. Repetitive transcranial magnetic stimulator with controllable pulse parameters

    NASA Astrophysics Data System (ADS)

    Peterchev, Angel V.; Murphy, David L.; Lisanby, Sarah H.

    2011-06-01

    The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10-310 µs and positive/negative phase amplitude ratio of 1-56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation up to 82% and 57% and decreases coil heating up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications and could lead to clinical applications with potentially enhanced potency.

  12. Repetitive Transcranial Magnetic Stimulator with Controllable Pulse Parameters

    PubMed Central

    Peterchev, Angel V; Murphy, David L; Lisanby, Sarah H

    2013-01-01

    The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10–310 μs and positive/negative phase amplitude ratio of 1–56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation by up to 82% and 57%, and decreases coil heating by up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3,000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications, and could lead to clinical applications with potentially enhanced potency. PMID:21540487

  13. Repetitive transcranial magnetic stimulator with controllable pulse parameters.

    PubMed

    Peterchev, Angel V; Murphy, David L; Lisanby, Sarah H

    2011-06-01

    The characteristics of transcranial magnetic stimulation (TMS) pulses influence the physiological effect of TMS. However, available TMS devices allow very limited adjustment of the pulse parameters. We describe a novel TMS device that uses a circuit topology incorporating two energy storage capacitors and two insulated-gate bipolar transistor (IGBT) modules to generate near-rectangular electric field pulses with adjustable number, polarity, duration, and amplitude of the pulse phases. This controllable pulse parameter TMS (cTMS) device can induce electric field pulses with phase widths of 10-310 µs and positive/negative phase amplitude ratio of 1-56. Compared to conventional monophasic and biphasic TMS, cTMS reduces energy dissipation up to 82% and 57% and decreases coil heating up to 33% and 41%, respectively. We demonstrate repetitive TMS trains of 3000 pulses at frequencies up to 50 Hz with electric field pulse amplitude and width variability less than the measurement resolution (1.7% and 1%, respectively). Offering flexible pulse parameter adjustment and reduced power consumption and coil heating, cTMS enhances existing TMS paradigms, enables novel research applications and could lead to clinical applications with potentially enhanced potency. PMID:21540487

  14. Repetitive Transcranial Magnetic Stimulation to the Primary Motor Cortex Interferes with Motor Learning by Observing

    ERIC Educational Resources Information Center

    Brown, Liana E.; Wilson, Elizabeth T.; Gribble, Paul L.

    2009-01-01

    Neural representations of novel motor skills can be acquired through visual observation. We used repetitive transcranial magnetic stimulation (rTMS) to test the idea that this "motor learning by observing" is based on engagement of neural processes for learning in the primary motor cortex (M1). Human subjects who observed another person learning…

  15. Pressure Pain Thresholds Increase after Preconditioning 1 Hz Repetitive Transcranial Magnetic Stimulation with Transcranial Direct Current Stimulation

    PubMed Central

    Moloney, Tonya M.; Witney, Alice G.

    2014-01-01

    Background The primary motor cortex (M1) is an effective target of non-invasive cortical stimulation (NICS) for pain threshold modulation. It has been suggested that the initial level of cortical excitability of M1 plays a key role in the plastic effects of NICS. Objective Here we investigate whether transcranial direct current stimulation (tDCS) primed 1 Hz repetitive transcranial magnetic stimulation (rTMS) modulates experimental pressure pain thresholds and if this is related to observed alterations in cortical excitability. Method 15 healthy, male participants received 10 min 1 mA anodal, cathodal and sham tDCS to the left M1 before 15 min 1 Hz rTMS in separate sessions over a period of 3 weeks. Motor cortical excitability was recorded at baseline, post-tDCS priming and post-rTMS through recording motor evoked potentials (MEPs) from right FDI muscle. Pressure pain thresholds were determined by quantitative sensory testing (QST) through a computerized algometer, on the palmar thenar of the right hand pre- and post-stimulation. Results Cathodal tDCS-primed 1 Hz-rTMS was found to reverse the expected suppressive effect of 1 Hz rTMS on cortical excitability; leading to an overall increase in activity (p<0.001) with a parallel increase in pressure pain thresholds (p<0.01). In contrast, anodal tDCS-primed 1 Hz-rTMS resulted in a corresponding decrease in cortical excitability (p<0.05), with no significant effect on pressure pain. Conclusion This study demonstrates that priming the M1 before stimulation of 1 Hz-rTMS modulates experimental pressure pain thresholds in a safe and controlled manner, producing a form of analgesia. PMID:24658333

  16. Repetitive Transcranial Magnetic Stimulation to Supplementary Motor Area in Refractory Obsessive-Compulsive Disorder Treatment: a Sham-Controlled Trial

    PubMed Central

    Harika-Germaneau, Ghina; Rachid, Fady; Gaudeau-Bosma, Christian; Tanguy, Marie-Laure; BenAdhira, Rene; Bouaziz, Noomane; Popa, Traian; Wassouf, Issa; Saba, Ghassen; Januel, Dominique; Jaafari, Nematollah

    2016-01-01

    Background: Repetitive transcranial magnetic stimulation has been explored in patients with obsessive-compulsive disorder, but with negative or conflicting results. This randomized double-blind study was designed to assess the efficacy of 1-Hz repetitive transcranial magnetic stimulation over the presupplementary area. Methods: Forty medication-resistant patients were assigned to 4 weeks of either active or sham repetitive transcranial magnetic stimulation targeting the presupplementary area with the help of a neuronavigation system. Results: According to the Yale-Brown obsessive-compulsive scale, the baseline-week 4 evolution showed no significant differences between groups. Responder rates at week 4 were not different between groups (repetitive transcranial magnetic stimulation 10.5% vs sham 20%; P=.63). Conclusion: Low-frequency repetitive transcranial magnetic stimulation applied to the presupplementary area seems ineffective for the treatment of obsessive-compulsive disorder patients, at least in severe and drug-refractory cases such as those included in this study. Further research is required to determine profiles of responder patients and appropriate repetitive transcranial magnetic stimulation parameters for obsessive-compulsive disorder. PMID:27207923

  17. Phantom limb pain: low frequency repetitive transcranial magnetic stimulation in unaffected hemisphere.

    PubMed

    Di Rollo, Andrea; Pallanti, Stefano

    2011-01-01

    Phantom limb pain is very common after limb amputation and is often difficult to treat. The motor cortex stimulation is a valid treatment for deafferentation pain that does not respond to conventional pain treatment, with relief for 50% to 70% of patients. This treatment is invasive as it uses implanted epidural electrodes. Cortical stimulation can be performed noninvasively by repetitive transcranial magnetic stimulation (rTMS). The stimulation of the hemisphere that isn't involved in phantom limb (unaffected hemisphere), remains unexplored. We report a case of phantom limb pain treated with 1 Hz rTMS stimulation over motor cortex in unaffected hemisphere. This stimulation produces a relevant clinical improvement of phantom limb pain; however, further studies are necessary to determine the efficacy of the method and the stimulation parameters. PMID:21629848

  18. Repetitive transcranial magnetic stimulation may induce language switching in bilingual patients.

    PubMed

    Holtzheimer, Paul; Fawaz, Walid; Wilson, Christopher; Avery, David

    2005-09-01

    The dorsolateral prefrontal cortex (DLPFC) may participate in the process of language switching in multilingual individuals. We present two cases of bilingual patients who experienced unexpected language switching after receiving high-frequency, repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC as a treatment for major depression. These preliminary findings support the role of the DLPFC in language switching in polyglots and highlight the potential value of rTMS for non-invasively investigating language function in humans. Further investigation is warranted. PMID:16098377

  19. Cognitive effects of repetitive transcranial magnetic stimulation in patients with neurodegenerative diseases - clinician's perspective.

    PubMed

    Anderkova, Lubomira; Rektorova, Irena

    2014-04-15

    Repetitive transcranial magnetic stimulation (rTMS) represents a promising tool for studying and influencing cognition in people with neurodegenerative diseases. This procedure is noninvasive and painless, and it does not require the use of anesthesia or pharmacological substances. In this systematic critical review we report outcomes from research focused on behavioral cognitive effects induced by rTMS in patients with Alzheimer's disease (AD), Parkinson's disease (PD), and mild cognitive impairment (MCI) preceding AD. There are still major limitations to rTMS use, such as a poor understanding of its after-effects and inter-individual variability in their magnitude, discrepancies in stimulation protocols and study designs, varied selection of the specific stimulated areas and control procedures, and neuropsychological methods for assessment of after-effects; hence, the results of the present research can only be considered preliminary. The future directions are discussed. PMID:24530170

  20. Modulation of N400 in Chronic Non-Fluent Aphasia Using Low Frequency Repetitive Transcranial Magnetic Stimulation (rTMS)

    ERIC Educational Resources Information Center

    Barwood, Caroline H. S.; Murdoch, Bruce E.; Whelan, Brooke-Mai; Lloyd, David; Riek, Stephan; O'Sullivan, John D.; Coulthard, Alan; Wong, Andrew

    2011-01-01

    Low frequency Repetitive Transcranial Magnetic Stimulation (rTMS) has previously been applied to language homologues in non-fluent populations of persons with aphasia yielding significant improvements in behavioral language function up to 43 months post stimulation. The present study aimed to investigate the electrophysiological correlates…

  1. Daily left prefrontal repetitive transcranial magnetic stimulation for medication-resistant burning mouth syndrome.

    PubMed

    Umezaki, Y; Badran, B W; Gonzales, T S; George, M S

    2015-08-01

    Burning mouth syndrome (BMS) is a persistent and chronic burning sensation in the mouth in the absence of any abnormal organic findings. The pathophysiology of BMS is unclear and its treatment is not fully established. Although antidepressant medication is commonly used for treatment, there are some medication-resistant patients, and a new treatment for medication-resistant BMS is needed. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive brain stimulation technology approved by the US Food and Drug Administration (FDA) for the treatment of depression. Recent studies have found beneficial effects of TMS for the treatment of pain. A case of BMS treated successfully with daily left prefrontal rTMS over a 2-week period is reported here. Based on this patient's clinical course and a recent pain study, the mechanism by which TMS may act to decrease the burning pain is discussed. PMID:25979192

  2. Repetitive transcranial magnetic stimulation of the dorsolateral prefrontal cortex enhances working memory.

    PubMed

    Bagherzadeh, Yasaman; Khorrami, Anahita; Zarrindast, Mohammad Reza; Shariat, Seyed Vahid; Pantazis, Dimitrios

    2016-07-01

    Neuroimaging and electrophysiological studies have unequivocally identified the dorsolateral prefrontal cortex (DLPFC) as a crucial structure for top-down control of working memory (WM) processes. By modulating the excitability of neurons in a targeted cortical area, transcranial magnetic stimulation (TMS) offers a unique way to modulate DLPFC function, opening the possibility of WM facilitation. Even though TMS neuromodulation effects over the left DLPFC have successfully improved WM performance in patients with depression and schizophrenia in a multitude of studies, raising the potential of TMS as a safe efficacious treatment for WM deficits, TMS interventions in healthy individuals have produced mixed and inconclusive results. Here, we stimulated the left DLPFC of healthy individuals using a high-frequency repetitive TMS protocol and evaluated behavioral performance in a battery of cognitive tasks. We found that TMS treatment enhanced WM performance in a verbal digit span and a visuospatial 2-back task. PMID:26884132

  3. Update on repetitive transcranial magnetic stimulation in obsessive-compulsive disorder: different targets.

    PubMed

    Blom, Rianne M; Figee, Martijn; Vulink, Nienke; Denys, Damiaan

    2011-08-01

    Obsessive-compulsive disorder (OCD) is a chronic, disabling disorder. Ten percent of patients remain treatment refractory despite several treatments. For these severe, treatment-refractory patients, repetitive transcranial magnetic stimulation (rTMS) has been suggested as a treatment option. Since 1997, in published trials, a total of 110 OCD patients have been treated with rTMS. This review aims to provide an update on rTMS treatment in patients with OCD. First, the mechanism of action is discussed, followed by the efficacy and side effects of rTMS at various brain targets, and finally implications for the future. Due to the lack of studies with comparable stimulation or treatment parameters and with reliable designs, it is difficult to draw clear conclusions. In general, rTMS appears to be effective in open-label studies; however, this has not yet been replicated in randomized, sham-controlled trials. PMID:21547545

  4. Effects of Repetitive Transcranial Magnetic Stimulation in Performing Eye-Hand Integration Tasks: Four Preliminary Studies with Children Showing Low-Functioning Autism

    ERIC Educational Resources Information Center

    Panerai, Simonetta; Tasca, Domenica; Lanuzza, Bartolo; Trubia, Grazia; Ferri, Raffaele; Musso, Sabrina; Alagona, Giovanna; Di Guardo, Giuseppe; Barone, Concetta; Gaglione, Maria P.; Elia, Maurizio

    2014-01-01

    This report, based on four studies with children with low-functioning autism, aimed at evaluating the effects of repetitive transcranial magnetic stimulation delivered on the left and right premotor cortices on eye-hand integration tasks; defining the long-lasting effects of high-frequency repetitive transcranial magnetic stimulation; and…

  5. Repetitive transcranial magnetic stimulation and transcranial direct-current stimulation in neuropathic pain due to radiculopathy: a randomized sham-controlled comparative study.

    PubMed

    Attal, Nadine; Ayache, Samar S; Ciampi De Andrade, Daniel; Mhalla, Alaa; Baudic, Sophie; Jazat, Frédérique; Ahdab, Rechdi; Neves, Danusa O; Sorel, Marc; Lefaucheur, Jean-Pascal; Bouhassira, Didier

    2016-06-01

    No study has directly compared the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS) in neuropathic pain (NP). In this 2-centre randomised double-blind sham-controlled study, we compared the efficacy of 10-Hz rTMS and anodal 2-mA tDCS of the motor cortex and sham stimulation contralateral to the painful area (3 daily sessions) in patients with NP due to lumbosacral radiculopathy. Average pain intensity (primary outcome) was evaluated after each session and 5 days later. Secondary outcomes included neuropathic symptoms and thermal pain thresholds for the upper limbs. We used an innovative design that minimised bias by randomly assigning patients to 1 of 2 groups: active rTMS and tDCS or sham rTMS and tDCS. For each treatment group (active or sham), the order of the sessions was again randomised according to a crossover design. In total, 51 patients were screened and 35 (51% women) were randomized. Active rTMS was superior to tDCS and sham in pain intensity (F = 2.89 and P = 0.023). Transcranial direct-current stimulation was not superior to sham, but its analgesic effects were correlated to that of rTMS (P = 0.046), suggesting common mechanisms of action. Repetitive transcranial magnetic stimulation lowered cold pain thresholds (P = 0.04) and its effect on cold pain was correlated with its analgesic efficacy (P = 0.006). However, rTMS had no impact on individual neuropathic symptoms. Thus, rTMS is more effective than tDCS and sham in patients with NP due to lumbosacral radiculopathy and may modulate the sensory and affective dimensions of pain. PMID:26845524

  6. History, Studies and Specific Uses of Repetitive Transcranial Magnetic Stimulation (rTMS) in Treating Epilepsy

    PubMed Central

    NOOHI, Sima; AMIRSALARI, Susan

    2016-01-01

    Objective In this study, repetitive Transcranial Magnetic Stimulation (rTMS) and its specific use for treating epilepsy were carefully scrutinized. Materials & Methods Target researches such as review articles, case reports, books and theses, which had to do with therapeutic method of rTMS were surveyed. It is worth mentioning that until the final stages, the search for records and documents related to rTMS went on and in the end, the collected data underwent a qualitative analysis. Results As the literature review suggests, TMS principally applies electromagnetic induction to generate an electric current inside the brain without physical contact. The therapeutic uses of rTMS are for a wide range of mental disorders, namely epilepsy, chronic pains, motor disorders and so on. Conclusion Despite safety concerns and possible side effects, many researchers subscribe to rTMS and see a bright future for it. PMID:27057180

  7. Calcium dependent plasticity applied to repetitive transcranial magnetic stimulation with a neural field model.

    PubMed

    Wilson, M T; Fung, P K; Robinson, P A; Shemmell, J; Reynolds, J N J

    2016-08-01

    The calcium dependent plasticity (CaDP) approach to the modeling of synaptic weight change is applied using a neural field approach to realistic repetitive transcranial magnetic stimulation (rTMS) protocols. A spatially-symmetric nonlinear neural field model consisting of populations of excitatory and inhibitory neurons is used. The plasticity between excitatory cell populations is then evaluated using a CaDP approach that incorporates metaplasticity. The direction and size of the plasticity (potentiation or depression) depends on both the amplitude of stimulation and duration of the protocol. The breaks in the inhibitory theta-burst stimulation protocol are crucial to ensuring that the stimulation bursts are potentiating in nature. Tuning the parameters of a spike-timing dependent plasticity (STDP) window with a Monte Carlo approach to maximize agreement between STDP predictions and the CaDP results reproduces a realistically-shaped window with two regions of depression in agreement with the existing literature. Developing understanding of how TMS interacts with cells at a network level may be important for future investigation. PMID:27259518

  8. Electrophysiological correlates of bilateral and unilateral repetitive transcranial magnetic stimulation in patients with bipolar depression.

    PubMed

    Kazemi, Reza; Rostami, Reza; Khomami, Sanaz; Horacek, Jiri; Brunovsky, Martin; Novak, Tomas; Fitzgerald, Paul B

    2016-06-30

    Repetitive transcranial magnetic stimulation (rTMS) has been demonstrated to have efficacy in the treatment of unipolar depression but limited research has explored the efficacy of rTMS in bipolar depression. Therefore, we conducted a comparative clinical trial evaluating clinical responses to prefrontal bilateral and unilateral rTMS in patients suffering from bipolar depression. We hypothesized that, 1) the response to the treatment would be associated with a decrease in the frequency of beta waves, 2) bilateral stimulation of the cortex would bring about more extensive changes in brain activity than unilateral stimulation, and 3) bilateral stimulation is more effective than unilateral. Thirty patients with bipolar depression were divided into two groups. Bilateral Group (n=15) who received rTMS in the left DLPFC (10Hz) and right DLPFC (1-Hz), and unilateral group (n=15) who received the stimulation only in the right DLPFC (1-Hz) during 20 treatment sessions. The proportion of responders in the bilateral stimulation group was significantly higher than that in the unilateral group [80% versus 47%]. The remission rate was 40% in the bilateral group and 40% in the unilateral group (not significant). In the responders to bilateral rTMS treatment, a significant reduction of alpha1-2, beta 1-3, and gamma frequencies were observed in medial and superior frontal and cingulate gyrus . Responders to the unilateral treatment showed decrease of gamma frequency in postcentral gyrus, precuneus, superior and inferior parietal lobule, Cuneus and angular gyrus. In conclusion, we found that bilateral stimulation was more effective than the unilateral stimulation and evidence that beta frequency activity could possibly be used as a marker for response to rTMS. PMID:27138833

  9. Effects of low-frequency repetitive transcranial magnetic stimulation on event-related potential P300

    NASA Astrophysics Data System (ADS)

    Torii, Tetsuya; Sato, Aya; Iwahashi, Masakuni; Iramina, Keiji

    2012-04-01

    The present study analyzed the effects of repetitive transcranial magnetic stimulation (rTMS) on brain activity. P300 latency of event-related potential (ERP) was used to evaluate the effects of low-frequency and short-term rTMS by stimulating the supramarginal gyrus (SMG), which is considered to be the related area of P300 origin. In addition, the prolonged stimulation effects on P300 latency were analyzed after applying rTMS. A figure-eight coil was used to stimulate left-right SMG, and intensity of magnetic stimulation was 80% of motor threshold. A total of 100 magnetic pulses were applied for rTMS. The effects of stimulus frequency at 0.5 or 1 Hz were determined. Following rTMS, an odd-ball task was performed and P300 latency of ERP was measured. The odd-ball task was performed at 5, 10, and 15 min post-rTMS. ERP was measured prior to magnetic stimulation as a control. Electroencephalograph (EEG) was measured at Fz, Cz, and Pz that were indicated by the international 10-20 electrode system. Results demonstrated that different effects on P300 latency occurred between 0.5-1 Hz rTMS. With 1 Hz low-frequency magnetic stimulation to the left SMG, P300 latency decreased. Compared to the control, the latency time difference was approximately 15 ms at Cz. This decrease continued for approximately 10 min post-rTMS. In contrast, 0.5 Hz rTMS resulted in delayed P300 latency. Compared to the control, the latency time difference was approximately 20 ms at Fz, and this delayed effect continued for approximately 15 min post-rTMS. Results demonstrated that P300 latency varied according to rTMS frequency. Furthermore, the duration of the effect was not similar for stimulus frequency of low-frequency rTMS.

  10. [Evaluation of repetitive transcranial magnetic stimulation effectiveness in treatment of psychiatric and neurologic diseases].

    PubMed

    Pastuszak, Żanna; Stępień, Anna; Piusińska-Macoch, Renata; Brodacki, Bogdan; Tomczykiewicz, Kazimierz

    2016-06-01

    Repetitive transcranial magnetic stimulation (rTMS) is a treatment option with proved effectiveness especially in drug resist depression. It is used in functional brain mapping before neurosurgery operations and diagnostic of corticospinal tract transmission. Many studies are performed to evaluate rTMS using in treatment of obsessive - compulsive disorder, schizophrenia, autism, strokes, tinnitus, Alzheimer and Parkinson diseases, cranial traumas. Moreover rTMS was used in treatment of multiple sclerosis, migraine, dystonia. Electromagnetical field generated by rTMS penetrate skin of the scalp and infiltrate brain tissues to a depth of 2 cm, cause neurons depolarization and generating motor, cognitive and affective effects. Depending on the stimulation frequency rTMS can stimuli or inhibit brain cortex. rTMS mechanism of action remains elusive. Probably it is connected with enhancement of neurotransmitters, modulation of signals transductions pathways in Central Nervous System, gene transcription and release of neuroprotective substances. Studies with use of animals revealed that rTMS stimulation can generate brain changes similar to those seen after electric shock therapy without provoking seizures. The aim of presenting study was to analyze actual researches evaluating rTMS use in treatment of psychiatric and neurological diseases. PMID:27403908

  11. Low and High Frequency Repetitive Transcranial Magnetic Stimulation for the Treatment of Spasticity

    ERIC Educational Resources Information Center

    Valle, Angela C.; Dionisio, Karen; Pitskel, Naomi Bass; Pascual-Leone, Alvaro; Orsati, Fernanda; Ferreira, Merari J. L.; Boggio, Paulo S.; Lima, Moises C.; Rigonatti, Sergio P.; Fregni, Felipe

    2007-01-01

    The development of non-invasive techniques of cortical stimulation, such as transcranial magnetic stimulation (TMS), has opened new potential avenues for the treatment of neuropsychiatric diseases. We hypothesized that an increase in the activity in the motor cortex by cortical stimulation would increase its inhibitory influence on spinal…

  12. Effect of repetitive transcranial magnetic stimulation on auditory function following acoustic trauma.

    PubMed

    Yang, Haidi; Xiong, Hao; Ou, Yongkang; Xu, Yaodong; Pang, Jiaqi; Lai, Lan; Zheng, Yiqing

    2016-09-01

    Repetitive transcranial magnetic stimulation (rTMS) is one form of non-invasive brain stimulation and increasingly shows neuroprotection in multiple neurological disorders. However, the potential of rTMS for protective action on auditory function following acoustic trauma has not been investigated. Here, we examined effect of TMS on hearing conservation, neurons survival and brain-derived neurotrophin factor (BDNF) expression in the cochlea and auditory cortex following acoustic trauma in rats. Wistar rats were exposed to intense pure tone noise (10 kHz, 120 dB SPL for 2 h) followed by rTMS treatment or sham treatment (handling control) daily for 14 days. Auditory brainstem response revealed there was no significant difference in hearing threshold shifts between rTMS- and sham-treated rats, although rTMS-treated rats showed less neuron loss in the auditory cortex in comparison with sham rats. Additionally, acoustic trauma increased BDNF expression in the cochlea and auditory cortex, and this elevation could be attenuated by rTMS treatment. Our results suggest present regiment of rTMS does not protect hearing against acoustic trauma, but maybe have implications for tinnitus treatment. PMID:27230393

  13. The emerging role for repetitive transcranial magnetic stimulation in optimizing the treatment of adolescent depression.

    PubMed

    Croarkin, Paul E; Wall, Christopher A; McClintock, Shawn M; Kozel, Frank Andrew; Husain, Mustafa M; Sampson, Shirlene M

    2010-12-01

    Major depressive disorder (MDD) in adolescents is a common illness and significant public health problem. Treatment is challenging because of recurrences and limited modalities. Selective serotonin reuptake inhibitors and cognitive behavioral therapy are considered the standard of care in severe or treatment-resistant MDD in this age group. However, responses to these interventions are often suboptimal. A growing body of research supports the efficacy of repetitive transcranial magnetic stimulation (rTMS) for the treatment of MDD in adults. Induced seizures are a primary safety concern, although this is rare with appropriate precautions. There is, however, limited experience with rTMS as a therapeutic intervention for adolescent psychiatric disturbances. This review will summarize the rTMS efficacy and safety data in adults and describe all published experience with adolescent MDD. Applications in other adolescent psychiatric illnesses such as schizophrenia and attention-deficit/hyperactivity disorder are reviewed. Safety and ethical issues are paramount with investigational treatments in adolescent psychiatric illnesses. However, further research with rTMS in adolescent MDD is imperative to establish standards for optimal stimulation site, treatment parameters, and its role in treatment algorithms. These may diverge from adult data. Early intervention with neuromodulation could also hold the promise of addressing the developmental course of dysfunctional neurocircuitry. PMID:20418774

  14. flexTMS--a novel repetitive transcranial magnetic stimulation device with freely programmable stimulus currents.

    PubMed

    Gattinger, Norbert; Moessnang, Georg; Gleich, Bernhard

    2012-07-01

    Transcranial magnetic stimulation (TMS) is able to noninvasively excite neuronal populations due to brief magnetic field pulses. The efficiency and the characteristics of stimulation pulse shapes influence the physiological effect of TMS. However, commercial devices allow only a minimum of control of different pulse shapes. Basically, just sinusoidal and monophasic pulse shapes with fixed pulse widths are available. Only few research groups work on TMS devices with controllable pulse parameters such as pulse shape or pulse width. We describe a novel TMS device with a full-bridge circuit topology incorporating four insulated-gate bipolar transistor (IGBT) modules and one energy storage capacitor to generate arbitrary waveforms. This flexible TMS (flexTMS ) device can generate magnetic pulses which can be adjusted with respect to pulse width, polarity, and intensity. Furthermore, the equipment allows us to set paired pulses with a variable interstimulus interval (ISI) from 0 to 20 ms with a step size of 10  μs. All user-defined pulses can be applied continually with repetition rates up to 30 pulses per second (pps) or, respectively, up to 100 pps in theta burst mode. Offering this variety of flexibility, flexTMS will allow the enhancement of existing TMS paradigms and novel research applications. PMID:22531742

  15. Effect of Repetitive Transcranial Magnetic Stimulation on Patients With Dysarthria After Subacute Stroke

    PubMed Central

    Kwon, Yong Gyu; Do, Kyung Hee; Park, Sung Jong; Chang, Min Cheol

    2015-01-01

    Objective To evaluate whether repetitive transcranial magnetic stimulation (rTMS) could improve dysarthria in stroke patients at the subacute stage. Methods This study was a prospective, randomized, double-blind controlled trial. Patients who had unilateral middle cerebral artery infarction were enrolled. In patients in the rTMS group, we found hot spots by searching for the evoked motor potential of the orbicularis oris on the non-affected side. We performed rTMS at a low frequency (1 Hz), 1,500 stimulations/day, 5 days a week for 2 weeks on the hotspots. We used the same protocol in the sham stimulation group patients as that in the rTMS group, except that the angle of the coil was perpendicular to the skull rather than tangential to it. The patients in both groups received speech therapy for 30 minutes, 5 days a week from a skilled speech therapist. The speech therapist measured the Urimal Test of Articulation and Phonology, alternative motion rates, sequential motion rates, and maximal phonation time before and after intervention sessions. Results Forty-two patients were enrolled in this study and 20 completed the study. Statistical analysis revealed significant improvements on the dysarthria scales in both groups. The sequential motion rate (SMR)-PǝTǝKǝ showed significantly greater improvement in the rTMS group patients than in the sham stimulation group. Conclusion Patients in the rTMS group showed greater improvement in articulation than did patients in the sham rTMS group. Therefore, rTMS can have a synergistic effect with speech therapy in treating dysarthria after stroke. PMID:26605178

  16. Treatment-Resistant Depression Entering Remission Following a Seizure during the Course of Repetitive Transcranial Magnetic Stimulation.

    PubMed

    Kim, Ju-Wan; Bae, Kyung-Yeol; Kim, Sung-Wan; Kang, Hee-Ju; Shin, Il-Seon; Yoon, Jin-Sang; Kim, Jae-Min

    2016-07-01

    Major depressive disorder is often resistant to antidepressant treatment. Repetitive transcranial magnetic stimulation (rTMS) has been used in treatment-resistant depression (TRD). Known adverse events of rTMS include transient headache, local pain, syncope, seizure induction, and hypomania induction. This report outlines a patient with TRD who unexpectedly improved following a seizure during the course of rTMS, which has never been reported. PMID:27482250

  17. Treatment-Resistant Depression Entering Remission Following a Seizure during the Course of Repetitive Transcranial Magnetic Stimulation

    PubMed Central

    Kim, Ju-Wan; Bae, Kyung-Yeol; Kim, Sung-Wan; Kang, Hee-Ju; Shin, Il-Seon; Yoon, Jin-Sang

    2016-01-01

    Major depressive disorder is often resistant to antidepressant treatment. Repetitive transcranial magnetic stimulation (rTMS) has been used in treatment-resistant depression (TRD). Known adverse events of rTMS include transient headache, local pain, syncope, seizure induction, and hypomania induction. This report outlines a patient with TRD who unexpectedly improved following a seizure during the course of rTMS, which has never been reported. PMID:27482250

  18. Safety of repetitive transcranial magnetic stimulation in patients with epilepsy: A systematic review.

    PubMed

    Pereira, Luisa Santos; Müller, Vanessa Teixeira; da Mota Gomes, Marleide; Rotenberg, Alexander; Fregni, Felipe

    2016-04-01

    Approximately one-third of patients with epilepsy remain with pharmacologically intractable seizures. An emerging therapeutic modality for seizure suppression is repetitive transcranial magnetic stimulation (rTMS). Despite being considered a safe technique, rTMS carries the risk of inducing seizures, among other milder adverse events, and thus, its safety in the population with epilepsy should be continuously assessed. We performed an updated systematic review on the safety and tolerability of rTMS in patients with epilepsy, similar to a previous report published in 2007 (Bae EH, Schrader LM, Machii K, Alonso-Alonso M, Riviello JJ, Pascual-Leone A, Rotenberg A. Safety and tolerability of repetitive transcranial magnetic stimulation in patients with epilepsy: a review of the literature. Epilepsy Behav. 2007; 10 (4): 521-8), and estimated the risk of seizures and other adverse events during or shortly after rTMS application. We searched the literature for reports of rTMS being applied on patients with epilepsy, with no time or language restrictions, and obtained studies published from January 1990 to August 2015. A total of 46 publications were identified, of which 16 were new studies published after the previous safety review of 2007. We noted the total number of subjects with epilepsy undergoing rTMS, medication usage, incidence of adverse events, and rTMS protocol parameters: frequency, intensity, total number of stimuli, train duration, intertrain intervals, coil type, and stimulation site. Our main data analysis included separate calculations for crude per subject risk of seizure and other adverse events, as well as risk per 1000 stimuli. We also performed an exploratory, secondary analysis on the risk of seizure and other adverse events according to the type of coil used (figure-of-8 or circular), stimulation frequency (≤1Hz or >1Hz), pulse intensity in terms of motor threshold (<100% or ≥100%), and number of stimuli per session (<500 or≥500). Presence or

  19. Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism - a pilot study.

    PubMed

    Zhou, Wei-Na; Fu, Hai-Yang; Du, Yi-Fei; Sun, Jian-Hua; Zhang, Jing-Lu; Wang, Chen; Svensson, Peter; Wang, Ke-Lun

    2016-01-01

    The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the 'hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0-10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies. PMID:27025267

  20. Innovative treatment approaches in schizophrenia enhancing neuroplasticity: aerobic exercise, erythropoetin and repetitive transcranial magnetic stimulation.

    PubMed

    Wobrock, T; Hasan, A; Falkai, P

    2012-06-01

    Schizophrenia is a brain disorder associated with subtle, but replicable cerebral volume loss mostly prevalent in frontal and temporal brain regions. Post-mortem studies of the hippocampus point to a reduction of the neuropil constituting mainly of synapses associated with changes of molecules mediating plastic responses of neurons during development and learning. Derived from animal studies interventions to enhance neuroplasticity by inducing adult neurogenesis, synaptogenesis, angiogenesis and long-term potentiation (LTP) were developed and the results translated into clinical studies in schizophrenia. Out of these interventions aerobic exercise has been shown to increase hippocampal volume, elevate N-acetyl-aspartate in the hippocampus as neuronal marker, and improve short-term memory in schizophrenia. The hematopoietic growth factor erythropoetin (EPO) is involved in brain development and associated with the production and differentiation of neuronal precursor cells. A first study demonstrated a positive effect of EPO application on cognition in schizophrenia patients. In randomised controlled studies with small sample size, the efficacy of repetitive transcranial magnetic stimulation (rTMS), a biological intervention focussing on the enhancement of LTP, has been shown for the improvement of positive and negative symptoms in schizophrenia,. The putative underlying neurobiological mechanisms of these interventions including the role of neurotrophic factors are outlined and implications for future research regarding neuroprotection strategies to improve schizophrenia are discussed. PMID:22283764

  1. Repetitive Transcranial Magnetic Stimulation as a Novel Therapy in Animal Models of Traumatic Brain Injury.

    PubMed

    Rajan, Thangavelu Soundara; Cuzzocrea, Salvatore; Bruschetta, Daniele; Quartarone, Angelo

    2016-01-01

    Traumatic brain injury (TBI) in humans causes a broad range of structural damage and functional deficits due to both primary and secondary injury mechanisms. Over the past three decades, animal models have been established to replicate the diverse changes of human TBI, to study the underlying pathophysiology and to develop new therapeutic strategies. However, drugs that were identified as neuroprotective in animal brain injury models were not successful in clinical trials phase II or phase III. Repetitive transcranial magnetic stimulation (rTMS) is a powerful noninvasive approach to excite cortical neurons in humans and animals, widely applied for therapeutic purpose in patients with brain diseases. In addition, recent animal studies showed rTMS as a strong neuroprotective tool. In this chapter, we discuss the rationale and mechanisms related to rTMS as well as therapeutic applications and putative molecular mechanisms. Furthermore, relevant biochemical studies and neuroprotective effect in animal models and possible application of rTMS as a novel treatment for rodent brain injury models are discussed. PMID:27604732

  2. Factors Associated With Upper Extremity Motor Recovery After Repetitive Transcranial Magnetic Stimulation in Stroke Patients

    PubMed Central

    Lee, Jong Hwa; Kim, Sang Beom; Lee, Kyeong Woo; Kim, Min Ah; Lee, Sook Joung

    2015-01-01

    Objective To determine factors associated with motor recovery of the upper extremity after repetitive transcranial magnetic stimulation (rTMS) treatment in stroke patients. Methods Twenty-nine patients with subacute stroke participated in this study. rTMS was applied to the hand motor cortex for 10 minutes at a 110% resting motor threshold and 10 Hz frequency for two weeks. We evaluated the biographical, neurological, clinical, and functional variables, in addition to the motor-evoked potential (MEP) response. The Manual Function Test (MFT) was performed before, immediately after, and two weeks after, the treatment. Patients were divided into a responder and non-responder group according to their respective improvements on the MFT. Data were compared between the two groups. Results Patients with exclusively subcortical stroke, absence of aphasia, the presence of a MEP response, high scores on the Mini-Mental Status Examination, Motricity Index arm score, Functional Independence Measure, and Functional Ambulatory Classification; and a shorter period from stroke onset to rTMS were found to be significantly associated with a response to rTMS. Conclusion The results of this study suggest that rTMS may have a greater effect on upper extremity motor recovery in stroke patients who have a MEP response, suffer an exclusively subcortical stroke, mild paresis, and have good functional status. Applying rTMS early would have additional positive effects in the patients with the identified characteristics. PMID:25932424

  3. Repetitive transcranial magnetic stimulation over frontal eye fields disrupts visually cued auditory attention.

    PubMed

    Smith, Daniel T; Jackson, Stephen R; Rorden, Chris

    2009-04-01

    Voluntary eye movements and covert shifts of visual attention activate the same brain regions. Specifically, the intraparietal sulcus and the frontal eye fields (FEF) appear to be involved both with generating voluntary saccades as well with attending to a peripheral spatial location. Furthermore, these regions appear to be required by both tasks--functional disruption of these regions impairs both tasks. Therefore, it appears that the targeting system that allows us to plan saccades is the same system that allows us to covertly track peripheral visual information. Recent neuroimaging studies suggest that these brain regions are also activated when participants engage in auditory spatial attention tasks. However, it remains unclear whether these regions are required by these tasks. We used repetitive transcranial magnetic stimulation (rTMS) to disrupt the FEF while participants performed an auditory localization task. On each trial, a visual cue directed attention to the probable laterality of the auditory target, and the participant decided whether the subsequent target sound came from an upper or lower speaker. In the absence of TMS, individuals were faster to respond to targets that occurred on the cued side (valid trials) than when the target appears contralaterally to the cued side (invalid side). TMS interfered with this effect, such that the costs associated with ipsilateral invalidly cued targets were substantially reduced. These results suggest that the eye-movement system is needed for normal auditory attention. PMID:20502626

  4. Short-term effects of repetitive transcranial magnetic stimulation on sleep bruxism – a pilot study

    PubMed Central

    Zhou, Wei-Na; Fu, Hai-Yang; Du, Yi-Fei; Sun, Jian-Hua; Zhang, Jing-Lu; Wang, Chen; Svensson, Peter; Wang, Ke-Lun

    2016-01-01

    The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the ‘hot spot' of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0–10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P = 0.04; P = 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P < 0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies. PMID:27025267

  5. 1-Hz Repetitive Transcranial Magnetic Stimulation over the Posterior Parietal Cortex Modulates Spatial Attention

    PubMed Central

    Xu, Guang-qing; Lan, Yue; Zhang, Qun; Liu, Dong-xu; He, Xiao-fei; Lin, Tuo

    2016-01-01

    Lesion and neuroimaging studies have suggested that regions in the posterior parietal cortex (PPC) are involved in visual spatial attention. The aim of this study was to investigate the potential effects on spatial attention resulting from a transient parietal impairment induced by 1-Hz repetitive transcranial magnetic stimulation (rTMS). We examined 50 healthy subjects using the attention network test (ANT) after first applying rTMS to right or left PPC. The right parietal rTMS, but not left PPC rTMS, caused a significant slowing in the mean reaction time (RT) to target presentation following a spatial cue during the ANT test. There were no significant effects of rTMS on mean RT under the no-cue, center-cue, and double-cue conditions, or for each flanker type among the experimental groups. Moreover, after rTMS to the right PPC, test subjects displayed deficits in networks related to alerting and orienting, whereas they exhibited improvement following rTMS to the left PPC. These findings indicate that the right PPC serves an important function in spatial orienting and the alerting activities. We interpreted the enhancement in alerting and spatial orienting function following low-frequency rTMS of left PPC as reflecting a disinhibition of right PPC via an inter-hemispheric inhibition account. PMID:26869911

  6. Combining near-infrared spectroscopy with electroencephalography and repetitive transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Näsi, Tiina; Kotilahti, Kalle; Mäki, Hanna; Nissilä, Ilkka; Meriläinen, Pekka

    2009-07-01

    The objective of the study was to assess the usability of a near-infrared spectroscopy (NIRS) device in multimodal measurements. We combined NIRS with electroencephalography (EEG) to record hemodynamic responses and evoked potentials simultaneously, and with transcranial magnetic stimulation (TMS) to investigate hemodynamic responses to repetitive TMS (rTMS). Hemodynamic responses and visual evoked potentials (VEPs) to 3, 6, and 12 s stimuli consisting of pattern-reversing checkerboards were successfully recorded in the NIRS/EEG measurement, and ipsi- and contralateral hemodynamic responses to 0.5, 1, and 2 Hz rTMS in the NIRS/TMS measurement. In the NIRS/EEG measurements, the amplitudes of the hemodynamic responses increased from 3- to 6-s stimulus, but not from 6- to 12-s stimulus, and the VEPs showed peaks N75, P100, and N135. In the NIRS/TMS measurements, the 2-Hz stimulus produced the strongest hemodynamic responses compared to the 0.5- and 1-Hz stimuli. In two subjects oxyhemoglobin concentration decreased and in one increased as a consequence of the 2-Hz rTMS. To locate the origin of the measured NIRS responses, methods have to be developed to investigate TMS-induced scalp muscle contractions. In the future, multimodal measurements may prove useful in monitoring or treating diseases such as stroke or Alzheimer's disease.

  7. 1-Hz Repetitive Transcranial Magnetic Stimulation over the Posterior Parietal Cortex Modulates Spatial Attention.

    PubMed

    Xu, Guang-Qing; Lan, Yue; Zhang, Qun; Liu, Dong-Xu; He, Xiao-Fei; Lin, Tuo

    2016-01-01

    Lesion and neuroimaging studies have suggested that regions in the posterior parietal cortex (PPC) are involved in visual spatial attention. The aim of this study was to investigate the potential effects on spatial attention resulting from a transient parietal impairment induced by 1-Hz repetitive transcranial magnetic stimulation (rTMS). We examined 50 healthy subjects using the attention network test (ANT) after first applying rTMS to right or left PPC. The right parietal rTMS, but not left PPC rTMS, caused a significant slowing in the mean reaction time (RT) to target presentation following a spatial cue during the ANT test. There were no significant effects of rTMS on mean RT under the no-cue, center-cue, and double-cue conditions, or for each flanker type among the experimental groups. Moreover, after rTMS to the right PPC, test subjects displayed deficits in networks related to alerting and orienting, whereas they exhibited improvement following rTMS to the left PPC. These findings indicate that the right PPC serves an important function in spatial orienting and the alerting activities. We interpreted the enhancement in alerting and spatial orienting function following low-frequency rTMS of left PPC as reflecting a disinhibition of right PPC via an inter-hemispheric inhibition account. PMID:26869911

  8. Effect of repetitive transcranial magnetic stimulation on mood in healthy subjects

    PubMed Central

    Moulier, Virginie; Gaudeau-Bosma, Christian; Isaac, Clémence; Allard, Anne-Camille; Bouaziz, Noomane; Sidhoumi, Djedia; Braha-Zeitoun, Sonia; Benadhira, René; Thomas, Fanny; Januel, Dominique

    2016-01-01

    Background High frequency repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) has shown significant efficiency in the treatment of resistant depression. However in healthy subjects, the effects of rTMS remain unclear. Objective Our aim was to determine the impact of 10 sessions of rTMS applied to the DLPFC on mood and emotion recognition in healthy subjects. Design In a randomised double-blind study, 20 subjects received 10 daily sessions of active (10 Hz frequency) or sham rTMS. The TMS coil was positioned on the left DLPFC through neuronavigation. Several dimensions of mood and emotion processing were assessed at baseline and after rTMS with clinical scales, visual analogue scales (VASs), and the Ekman 60 faces test. Results The 10 rTMS sessions targeting the DLPFC were well tolerated. No significant difference was found between the active group and the control group for clinical scales and the Ekman 60 faces test. Compared to the control group, the active rTMS group presented a significant improvement in their adaptation to daily life, which was assessed through VAS. Conclusion This study did not show any deleterious effect on mood and emotion recognition of 10 sessions of rTMS applied on the DLPFC in healthy subjects. This study also suggested a positive effect of rTMS on quality of life. PMID:26993786

  9. Potentiation of quantitative electroencephalograms following prefrontal repetitive transcranial magnetic stimulation in patients with major depression.

    PubMed

    Noda, Yoshihiro; Nakamura, Motoaki; Saeki, Takashi; Inoue, Misa; Iwanari, Hideo; Kasai, Kiyoto

    2013-01-01

    The long-lasting effects of repetitive transcranial magnetic stimulation (rTMS) on electroencephalogram (EEG) activity are not clear. We aimed to investigate the cumulative rTMS effects on EEG and clinical outcomes in patients with major depression. Twenty-five patients with medication-resistant depression underwent 10 daily rTMS sessions over the left dorsolateral prefrontal cortex. We measured resting EEG and spectrum-power before and after the rTMS course. Clinical efficacy was evaluated with the Hamilton's Depression Rating Scale (HAM-D) and Wisconsin Card Sorting Test (WCST). In an ANOVA model, including all prefrontal electrodes, post hoc analyses revealed significant time effects on the theta (F1,24 = 7.89, P = 0.010; +43%), delta (F1,24 = 6.58, P = 0.017; +26%), and alpha (F1,24 = 4.64, P = 0.042; 31%) bands without site specificity. Clinical correlations were observed between F4 alpha power increases and improvements in HAM-D retardation, F3 alpha power increases and improvements of the absolute changes in perseveration and error number on the WCST, and C3 and C4 theta power increases and improvements of the percent change in perseveration and error number on the WCST following rTMS. Consecutive prefrontal rTMS could induce long-lasting EEG potentiations beyond the aftereffects, resulting in improved cognitive and depressive symptoms. PMID:23827366

  10. Brain SPECT guided repetitive transcranial magnetic stimulation (rTMS) in treatment resistant major depressive disorder.

    PubMed

    Jha, Shailesh; Chadda, Rakesh K; Kumar, Nand; Bal, C S

    2016-06-01

    Repetitive transcranial magnetic stimulation (rTMS) has emerged as a potential treatment in treatment resistant major depressive disorder (MDD). However, there is no consensus about the exact site of stimulation for rTMS. Single-photon emission computed tomography (SPECT) offers a potential technique in deciding the site of stimulation. The present study was conducted to assess the difference in outcome of brain SPECT assisted rTMS versus standard protocol of twenty sessions of high frequency rTMS as add on treatment in 20 patients with treatment resistant MDD, given over a period of 4 weeks. Thirteen subjects (group I) received high frequency rTMS over an area of hypoperfusion in the prefrontal cortex, as identified on SPECT, whereas 7 subjects (group II) were administered rTMS in the left dorsoslateral prefrontal cortex (DLPFC) area. Improvement was monitored using standardized instruments. Patients in the group I showed a significantly better response compared to those in the group II. In group I, 46% of the subjects were responders on MADRS, 38% on BDI and 77% on CGI. The parallel figures of responders in Group II were 0% on MADRS, 14% on BDI and 43% on CGI. There were no remitters in the study. No significant untoward side effects were noticed. The study had limitations of a small sample size and non-controlled design, and all the subjects were also receiving the standard antidepressant therapy. Administration of rTMS over brain SPECT specified area of hypoperfusion may have a better clinical outcome compared to the standard protocol. PMID:27208445

  11. Excitatory repetitive transcranial magnetic stimulation induces improvements in chronic post-stroke aphasia

    PubMed Central

    Szaflarski, Jerzy P.; Vannest, Jennifer; Wu, Steve W.; DiFrancesco, Mark W.; Banks, Christi; Gilbert, Donald L.

    2011-01-01

    Summary Background Aphasia affects 1/3 of stroke patients with improvements noted only in some of them. The goal of this exploratory study was to provide preliminary evidence regarding safety and efficacy of fMRI-guided excitatory repetitive transcranial magnetic stimulation (rTMS) applied to the residual left-hemispheric Broca’s area for chronic aphasia treatment. Material/Methods We enrolled 8 patients with moderate or severe aphasia >1 year after LMCA stroke. Linguistic battery was administered pre-/post-rTMS; a semantic decision/tone decision (SDTD) fMRI task was used to localize left-hemispheric Broca’s area. RTMS protocol consisted of 10 daily treatments of 200 seconds each using an excitatory stimulation protocol called intermittent theta burst stimulation (iTBS). Coil placement was targeted individually to the left Broca’s. Results 6/8 patients showed significant pre-/post-rTMS improvements in semantic fluency (p=0.028); they were able to generate more appropriate words when prompted with a semantic category. Pre-/post-rTMS fMRI maps showed increases in left fronto-temporo-parietal language networks with a significant left-hemispheric shift in the left frontal (p=0.025), left temporo-parietal (p=0.038) regions and global language LI (p=0.018). Patients tended to report subjective improvement on Communicative Activities Log (mini-CAL; p=0.075). None of the subjects reported ill effects of rTMS. Conclusions FMRI-guided, excitatory rTMS applied to the affected Broca’s area improved language skills in patients with chronic post-stroke aphasia; these improvements correlated with increased language lateralization to the left hemisphere. This rTMS protocol appears to be safe and should be further tested in blinded studies assessing its short- and long-term safety/efficacy for post-stroke aphasia rehabilitation. PMID:21358599

  12. The effects of repetitive transcranial magnetic stimulation on proliferation and differentiation of neural stem cells

    PubMed Central

    Abbasnia, Keramatollah; Ghanbari, Amir; Abedian, Mehrnaz; Ghanbari, Ali; Sharififar, Sharareh

    2015-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is a new method for treating many neurological conditions; however, the exact therapeutic mechanisms behind rTMS-induced plasticity are still unknown. Neural stem and progenitor cells (NS/PCs) are active players in brain regeneration and plasticity but their behavior in the context of rTMS therapy needs further elucidation. We aimed to evaluate the effects of rTMS on proliferation and differentiation of NS/PCs in the subventricular zone (SVZ) of adult mouse brain. Adult male mice (n=30) were divided into rTMS (1-Hz and 30-Hz) and sham groups and treated for 7 or 14 consecutive days. Harvested NS/PCs from the SVZ were cultured in the neurosphere assay for 8 days and the number and size of the resulting neurospheres as well as their in vitro differentiation capacity were evaluated. After one week of rTMS treatment at 1-Hz and 30-Hz compared with sham stimulation, the mean neurosphere forming frequency per brain was not different while this measure significantly increased after two weeks (P<0.05). The mean neurosphere diameter in 1-Hz treatment paradigm was significantly larger compared with sham stimulation at both 1 and 2 weeks. In contrast, 30-Hz treatment paradigm resulted in significantly larger neurospheres only after 2 weeks. Importantly, rTMS treatment at both frequencies increased neuronal differentiation of the harvested NS/PCs. Furthermore, one week in vitro rTMS treatment of NS/PCs with both 1-Hz and 30-Hz increased NS/PCs proliferation and neuronal differentiation. It is concluded that both 1-Hz and 30-Hz rTMS treatment increase NS/PCs proliferation and neuronal differentiation. PMID:26140221

  13. Repetitive Transcranial Magnetic Stimulation for Clinical Applications in Neurological and Psychiatric Disorders: An Overview

    PubMed Central

    Machado, Sergio; Arias-Carrión, Oscar; Paes, Flávia; Vieira, Renata Teles; Caixeta, Leonardo; Novaes, Felipe; Marinho, Tamires; Almada, Leonardo Ferreira; Silva, Adriana Cardoso; Nardi, Antonio Egidio

    2013-01-01

    Neurological and psychiatric disorders are characterized by several disabling symptoms for which effective, mechanism-based treatments remain elusive. Consequently, more advanced non-invasive therapeutic methods are required. A method that may modulate brain activity and be viable for use in clinical practice is repetitive transcranial magnetic stimulation (rTMS). It is a non-invasive procedure whereby a pulsed magnetic field stimulates electrical activity in the brain. Here, we focus on the basic foundation of rTMS, the main stimulation parametters, the factors that influence individual responses to rTMS and the experimental advances of rTMS that may become a viable clinical application to treat neurological and psychiatric disorders. The findings showed that rTMS can improve some symptoms associated with these conditions and might be useful for promoting cortical plasticity in patients with neurological and psychiatric disorders. However, these changes are transient and it is premature to propose these applications as realistic therapeutic options, even though the rTMS technique has been evidenced as a potential modulator of sensorimotor integration and neuroplasticity. Functional imaging of the region of interest could highlight the capacity of rTMS to bring about plastic changes of the cortical circuitry and hint at future novel clinical interventions. Thus, we recommend that further studies clearly determine the role of rTMS in the treatment of these conditions. Finally, we must remember that however exciting the neurobiological mechanisms might be, the clinical usefulness of rTMS will be determined by its ability to provide patients with neurological and psychiatric disorders with safe, long-lasting and substantial improvements in quality of life. PMID:25610279

  14. Resting state connectivity in alcohol dependent patients and the effect of repetitive transcranial magnetic stimulation.

    PubMed

    Jansen, Jochem M; van Wingen, Guido; van den Brink, Wim; Goudriaan, Anna E

    2015-12-01

    Alcohol dependence is thought to result from an overactive neural motivation system and a deficient cognitive control system, and rebalancing these systems may mitigate excessive alcohol use. This study examines the differences in functional connectivity of the fronto-parietal cognitive control network (FPn) and the motivational network (striatum and orbitofrontal cortex) between alcohol dependent patients (ADPs) and healthy controls (HCs), and the effect of repetitive transcranial magnetic stimulation (rTMS) on these networks. This randomized controlled trial included 38 ADPs and 37 HCs, matched on age, gender and education. Participants were randomly assigned to sham or right dorsolateral prefrontal cortex (dlPFC) stimulation with rTMS. A 3T resting state functional Magnetic Resonance Imaging (fMRI) scan was acquired before and after active or sham 10Hz rTMS. Group differences of within and between network connectivity and the effect of rTMS on network connectivity was assessed using independent component analysis. Results showed higher connectivity within the left FPn (p=0.012) and the left fronto-striatal motivational network (p=0.03) in ADPs versus HCs, and a further increase in connectivity within the left FPn after active stimulation in ADPs. ADPs also showed higher connectivity between the left and the right FPns (p=0.025), and this higher connectivity was related to fewer alcohol related problems (r=0.30, p=0.06). The results show higher within and between network connectivity in ADPs and a further increase in fronto-parietal connectivity after right dlPFC rTMS in ADPs, suggesting that frontal rTMS may have a beneficial influence on cognitive control and may result in lower relapse rates. PMID:26481907

  15. Effect of high-frequency repetitive transcranial magnetic stimulation on motor cortical excitability and sensory nerve conduction velocity in subacute-stage incomplete spinal cord injury patients

    PubMed Central

    Cha, Hyun Gyu; Ji, Sang-Goo; Kim, Myoung-Kwon

    2016-01-01

    [Purpose] The aim of the present study was to determine whether repetitive transcranial magnetic stimulation can improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. [Subjects and Methods] This study was conducted on 20 subjects with diagnosed paraplegia due to spinal cord injury. These 20 subjects were allocated to an experimental group of 10 subjects that underwent active repetitive transcranial magnetic stimulation or to a control group of 10 subjects that underwent sham repetitive transcranial magnetic stimulation. The SCI patients in the experimental group underwent active repetitive transcranial magnetic stimulation and conventional rehabilitation therapy, whereas the spinal cord injury patients in the control group underwent sham repetitive transcranial magnetic stimulation and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for six-weeks. Latency, amplitude, and sensory nerve conduction velocity were assessed before and after the six week therapy period. [Results] A significant intergroup difference was observed for posttreatment velocity gains, but no significant intergroup difference was observed for amplitude or latency. [Conclusion] repetitive transcranial magnetic stimulation may be improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. PMID:27512251

  16. Effect of high-frequency repetitive transcranial magnetic stimulation on motor cortical excitability and sensory nerve conduction velocity in subacute-stage incomplete spinal cord injury patients.

    PubMed

    Cha, Hyun Gyu; Ji, Sang-Goo; Kim, Myoung-Kwon

    2016-07-01

    [Purpose] The aim of the present study was to determine whether repetitive transcranial magnetic stimulation can improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. [Subjects and Methods] This study was conducted on 20 subjects with diagnosed paraplegia due to spinal cord injury. These 20 subjects were allocated to an experimental group of 10 subjects that underwent active repetitive transcranial magnetic stimulation or to a control group of 10 subjects that underwent sham repetitive transcranial magnetic stimulation. The SCI patients in the experimental group underwent active repetitive transcranial magnetic stimulation and conventional rehabilitation therapy, whereas the spinal cord injury patients in the control group underwent sham repetitive transcranial magnetic stimulation and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for six-weeks. Latency, amplitude, and sensory nerve conduction velocity were assessed before and after the six week therapy period. [Results] A significant intergroup difference was observed for posttreatment velocity gains, but no significant intergroup difference was observed for amplitude or latency. [Conclusion] repetitive transcranial magnetic stimulation may be improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. PMID:27512251

  17. Repetitive transcranial magnetic stimulation induces oscillatory power changes in chronic tinnitus

    PubMed Central

    Schecklmann, Martin; Lehner, Astrid; Gollmitzer, Judith; Schmidt, Eldrid; Schlee, Winfried; Langguth, Berthold

    2015-01-01

    Chronic tinnitus is associated with neuroplastic changes in auditory and non-auditory cortical areas. About 10 years ago, repetitive transcranial magnetic stimulation (rTMS) of auditory and prefrontal cortex was introduced as potential treatment for tinnitus. The resulting changes in tinnitus loudness are interpreted in the context of rTMS induced activity changes (neuroplasticity). Here, we investigate the effect of single rTMS sessions on oscillatory power to probe the capacity of rTMS to interfere with tinnitus-specific cortical plasticity. We measured 20 patients with bilateral chronic tinnitus and 20 healthy controls comparable for age, sex, handedness, and hearing level with a 63-channel electroencephalography (EEG) system. Educational level, intelligence, depressivity and hyperacusis were controlled for by analysis of covariance. Different rTMS protocols were tested: Left and right temporal and left and right prefrontal cortices were each stimulated with 200 pulses at 1 Hz and with an intensity of 60% stimulator output. Stimulation of central parietal cortex with 6-fold reduced intensity (inverted passive-cooled coil) served as sham condition. Before and after each rTMS protocol 5 min of resting state EEG were recorded. The order of rTMS protocols was randomized over two sessions with 1 week interval in between. Analyses on electrode level showed that people with and without tinnitus differed in their response to left temporal and right frontal stimulation. In tinnitus patients left temporal rTMS decreased frontal theta and delta and increased beta2 power, whereas right frontal rTMS decreased right temporal beta3 and gamma power. No changes or increases were observed in the control group. Only non-systematic changes in tinnitus loudness were induced by single sessions of rTMS. This is the first study to show tinnitus-related alterations of neuroplasticity that were specific to stimulation site and oscillatory frequency. The observed effects can be

  18. 5 Hz repetitive transcranial magnetic stimulation over the ipsilesional sensory cortex enhances motor learning after stroke

    PubMed Central

    Brodie, Sonia M.; Meehan, Sean; Borich, Michael R.; Boyd, Lara A.

    2014-01-01

    Sensory feedback is critical for motor learning, and thus to neurorehabilitation after stroke. Whether enhancing sensory feedback by applying excitatory repetitive transcranial magnetic stimulation (rTMS) over the ipsilesional primary sensory cortex (IL-S1) might enhance motor learning in chronic stroke has yet to be investigated. The present study investigated the effects of 5 Hz rTMS over IL-S1 paired with skilled motor practice on motor learning, hemiparetic cutaneous somatosensation, and motor function. Individuals with unilateral chronic stroke were pseudo-randomly divided into either Active or Sham 5 Hz rTMS groups (n = 11/group). Following stimulation, both groups practiced a Serial Tracking Task (STT) with the hemiparetic arm; this was repeated for 5 days. Performance on the STT was quantified by response time, peak velocity, and cumulative distance tracked at baseline, during the 5 days of practice, and at a no-rTMS retention test. Cutaneous somatosensation was measured using two-point discrimination. Standardized sensorimotor tests were performed to assess whether the effects might generalize to impact hemiparetic arm function. The active 5 Hz rTMS + training group demonstrated significantly greater improvements in STT performance {response time [F(1, 286.04) = 13.016, p < 0.0005], peak velocity [F(1, 285.95) = 4.111, p = 0.044], and cumulative distance [F(1, 285.92) = 4.076, p = 0.044]} and cutaneous somatosensation [F(1, 21.15) = 8.793, p = 0.007] across all sessions compared to the sham rTMS + training group. Measures of upper extremity motor function were not significantly different for either group. Our preliminary results suggest that, when paired with motor practice, 5 Hz rTMS over IL-S1 enhances motor learning related change in individuals with chronic stroke, potentially as a consequence of improved cutaneous somatosensation, however no improvement in general upper extremity function was observed. PMID:24711790

  19. The Effect of Daily Prefrontal Repetitive Transcranial Magnetic Stimulation Over Several Weeks on Resting Motor Threshold

    PubMed Central

    Zarkowski, Paul; Navarro, Rita; Pavlicova, Martina; George, Mark S.; Avery, David

    2009-01-01

    Background: The resting motor threshold (rMT) is an important factor in the selection of treatment intensity for patients receiving repetitive transcranial magnetic stimulation (rTMS). In many clinical studies to date, due to concerns about potential drift, the rMT has been routinely re-measured weekly or every fifth session. Objective: Our aim is to investigate whether ongoing treatment with rTMS affects the rMT, the degree of change, and whether frequent remeasurement is needed. Methods: Clinical data were drawn from 50 medication free patients receiving treatment for major depression with rTMS in a large U.S. NIH-sponsored multisite study. Four measurements of rMT were obtained including before and after the double blind phase, followed by weekly measurements during the open phase. Active treatment consisted of 75 four second trains of 10Hz stimulation applied over 37.5 minutes with the coil over the left DLPFC at 120% rMT. Results: For the group as a whole, there was no significant change in the rMT during a minimum of 2 weeks of treatment with prefrontal rTMS (p=0.911, one way ANOVA). The average within-subject coefficient of variation was 6.58%. On average the last rMT was 2.45% less than the baseline rMT (range 32.3% increase, 40.6% decrease). Conclusion: Daily left prefrontal rTMS over several weeks as delivered in this trial does not cause systematic changes in rMT. While most subjects had <10% variance in rMT over time, 5 subjects had changes of ∼20% from baseline, raising dosing and safety issues if undetected. We recommend that clinical trials of rTMS have periodic retesting of rMT, especially if the dose is at or near the edge of the TMS safety tables. PMID:20161065

  20. Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: An Economic Analysis

    PubMed Central

    Tu, Hong Anh; Palimaka, Stefan; Sehatzadeh, Shayan; Blackhouse, Gord; Yap, Belinda; Tsoi, Bernice; Bowen, Jim; O'Reilly, Daria

    2016-01-01

    Background Major depressive disorder (MDD, 10% over a person's lifetime) is common and costly to the health system. Unfortunately, many MDD cases are resistant to treatment with antidepressant drugs and require other treatment to reduce or eliminate depression. Electroconvulsive therapy (ECT) has long been used to treat persons with treatment-resistant depression (TRD). Despite its effectiveness, ECT has side effects that make patients intolerant to the treatment, or they refuse to use it. Repetitive transcranial magnetic stimulation (rTMS), which has fewer side effects than ECT and might be an alternative for TRD patients who are ineligible for or unwilling to undergo ECT, has been developed to treat TRD. Objectives This analysis evaluates the cost-effectiveness of rTMS for patients with TRD compared with ECT or sham rTMS and estimates the potential budgetary impact of various levels of implementation of rTMS in Ontario. Review Methods A cost-utility analysis compared the costs and health outcomes of two treatments for persons with TRD in Ontario: rTMS alone compared with ECT alone and rTMS alone compared with sham rTMS. We calculated the six-month incremental costs and quality-adjusted life-years (QALYs) for these treatments. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model's results. A 1-year budget impact analysis estimated the costs of providing funding for rTMS. The base-case analysis examined the additional costs for funding six centres, where rTMS infrastructure is in place. Sensitivity and scenario analyses explored the impact of increasing diffusion of rTMS to centres with existing ECT infrastructure. All analyses were conducted from the Ontario health care payer perspective. Results ECT was cost effective compared to rTMS when the willingness to pay is greater than $37,640.66 per QALY. In the base-case analysis, which had a six-month time horizon, the cost and effectiveness for rTMS was $5,272 and 0

  1. Repetitive Transcranial Magnetic Stimulation Affects behavior by Biasing Endogenous Cortical Oscillations

    PubMed Central

    Hamidi, Massihullah; Slagter, Heleen A.; Tononi, Giulio; Postle, Bradley R.

    2009-01-01

    A governing assumption about repetitive transcranial magnetic stimulation (rTMS) has been that it interferes with task-related neuronal activity – in effect, by “injecting noise” into the brain – and thereby disrupts behavior. Recent reports of rTMS-produced behavioral enhancement, however, call this assumption into question. We investigated the neurophysiological effects of rTMS delivered during the delay period of a visual working memory task by simultaneously recording brain activity with electroencephalography (EEG). Subjects performed visual working memory for locations or for shapes, and in half the trials a 10-Hz train of rTMS was delivered to the superior parietal lobule (SPL) or a control brain area. The wide range of individual differences in the effects of rTMS on task accuracy, from improvement to impairment, was predicted by individual differences in the effect of rTMS on power in the alpha-band of the EEG (∼10 Hz): a decrease in alpha-band power corresponded to improved performance, whereas an increase in alpha-band power corresponded to the opposite. The EEG effect was localized to cortical sources encompassing the frontal eye fields and the intraparietal sulcus, and was specific to task (location, but not object memory) and to rTMS target (SPL, not control area). Furthermore, for the same task condition, rTMS-induced changes in cross-frequency phase synchrony between alpha- and gamma-band (>40 Hz) oscillations predicted changes in behavior. These results suggest that alpha-band oscillations play an active role cognitive processes and do not simply reflect absence of processing. Furthermore, this study shows that the complex effects of rTMS on behavior can result from biasing endogenous patterns of network-level oscillations. PMID:19587850

  2. Cognitive safety of dorsomedial prefrontal repetitive transcranial magnetic stimulation in major depression.

    PubMed

    Schulze, Laura; Wheeler, Sarah; McAndrews, Mary Pat; Solomon, Chloe J E; Giacobbe, Peter; Downar, Jonathan

    2016-07-01

    The most widely used target for repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD) is the dorsolateral prefrontal cortex (DLPFC). Despite convergent evidence that the dorsomedial prefrontal cortex (DMPFC) may be a promising alternative target for rTMS in TRD, its cognitive safety profile has not previously been assessed. Here, we applied 20 sessions of rTMS to the DMPFC in 21 TRD patients. Before and after treatment, a battery of neuropsychological tasks was administered to evaluate changes in cognition across three general cognitive domains: learning and memory, attention and processing speed, and cognitive flexibility. Subjects also completed the 17-item Hamilton Rating Scale for Depression (HamD17) prior to and following treatment to measure changes in severity of depressive symptoms, and to assess the relationship between mood and cognitive performance over the course of treatment. No serious adverse effects or significant deterioration in cognitive performance were observed. Overall, subjects improved significantly on Stroop Inhibition/Switching and on Trails B, and this improvement was independent of the degree of improvement in depression symptoms. No domains or items significantly predicted clinical outcome, with the exception of baseline performance on Visual Elevator Accuracy. Clinical improvement correlated to improved performance in the overall domain of attention and processing speed, although this effect was not evident following covariate adjustment. DMPFC-rTMS did not produce any detectable cognitive adverse effects during treatment of TRD. Performance did not deteriorate significantly on any measures. Taken together, the present findings support the tolerability and cognitive safety of DMPFC-rTMS in refractory depression. PMID:27157074

  3. Effect of Epidural Electrical Stimulation and Repetitive Transcranial Magnetic Stimulation in Rats With Diffuse Traumatic Brain Injury

    PubMed Central

    Yoon, Yong-Soon; Cho, Kang Hee; Kim, Eun-Sil; Lee, Mi-Sook

    2015-01-01

    Objective To evaluate the effects of epidural electrical stimulation (EES) and repetitive transcranial magnetic stimulation (rTMS) on motor recovery and brain activity in a rat model of diffuse traumatic brain injury (TBI) compared to the control group. Methods Thirty rats weighing 270-285 g with diffuse TBI with 45 kg/cm2 using a weight-drop model were assigned to one of three groups: the EES group (ES) (anodal electrical stimulation at 50 Hz), the rTMS group (MS) (magnetic stimulation at 10 Hz, 3-second stimulation with 6-second intervals, 4,000 total stimulations per day), and the sham-treated control group (sham) (no stimulation). They were pre-trained to perform a single-pellet reaching task (SPRT) and a rotarod test (RRT) for 14 days. Diffuse TBI was then induced and an electrode was implanted over the dominant motor cortex. The changes in SPRT success rate, RRT performance time rate and the expression of c-Fos after two weeks of EES or rTMS were tracked. Results SPRT improved significantly from day 8 to day 12 in the ES group and from day 4 to day 14 in the MS group (p<0.05) compared to the sham group. RRT improved significantly from day 6 to day 11 in ES and from day 4 to day 9 in MS compared to the sham group. The ES and MS groups showed increased expression of c-Fos in the cerebral cortex compared to the sham group. Conclusion ES or MS in a rat model of diffuse TBI can be used to enhance motor recovery and brain activity. PMID:26161348

  4. Preliminary guidelines for safe and effective use of repetitive transcranial magnetic stimulation in moderate to severe traumatic brain injury.

    PubMed

    Nielson, Dylan M; McKnight, Curtis A; Patel, Riddhi N; Kalnin, Andrew J; Mysiw, Walter J

    2015-04-01

    Transcranial magnetic stimulation has generated extensive interest within the traumatic brain injury (TBI) rehabilitation community, but little work has been done with repetitive protocols, which can produce prolonged changes in behavior. This is partly because of concerns about the safety of repetitive transcranial magnetic stimulation (rTMS) in subjects with TBI, particularly the risk of seizures. These risks can be minimized by careful selection of the rTMS protocol and exclusion criteria. In this article, we identify guidelines for safe use of rTMS in subjects with TBI based on a review of the literature and illustrate their application with a case study. Our subject is a 48-year-old man who sustained a severe TBI 5 years prior to beginning rTMS for the treatment of post-TBI depression. After a 4-week baseline period, we administered daily sessions of low-frequency stimulation to the right dorsolateral prefrontal cortex for 6 weeks. After stimulation, we performed monthly assessments for 3 months. The Hamilton Depression Rating Scale (HAMD) was our primary outcome measure. The stimulation was well tolerated and the patient reported no side effects. After 6 weeks of stimulation, the patient's depression was slightly improved, and these improvements continued through follow-up. At the end of follow-up, the patient's HAMD score was 49% of the average baseline score. PMID:25281871

  5. A Randomised Controlled Trial of Neuronavigated Repetitive Transcranial Magnetic Stimulation (rTMS) in Anorexia Nervosa

    PubMed Central

    McClelland, Jessica; Kekic, Maria; Bozhilova, Natali; Nestler, Steffen; Dew, Tracy; Van den Eynde, Frederique; David, Anthony S.; Rubia, Katya; Campbell, Iain C.; Schmidt, Ulrike

    2016-01-01

    Background Anorexia nervosa (AN) is associated with morbid fear of fatness, extreme food restriction and altered self-regulation. Neuroimaging data implicate fronto-striatal circuitry, including the dorsolateral prefrontal cortex (DLPFC). Methods In this double-blind parallel group study, we investigated the effects of one session of sham-controlled high-frequency repetitive transcranial magnetic stimulation (rTMS) to the left DLPFC (l-DLPFC) in 60 individuals with AN. A food exposure task was administered before and after the procedure to elicit AN-related symptoms. Outcomes The primary outcome measure was ‘core AN symptoms’, a variable which combined several subjective AN-related experiences. The effects of rTMS on other measures of psychopathology (e.g. mood), temporal discounting (TD; intertemporal choice behaviour) and on salivary cortisol concentrations were also investigated. Safety, tolerability and acceptability were assessed. Results Fourty-nine participants completed the study. Whilst there were no interaction effects of rTMS on core AN symptoms, there was a trend for group differences (p = 0.056): after controlling for pre-rTMS scores, individuals who received real rTMS had reduced symptoms post-rTMS and at 24-hour follow-up, relative to those who received sham stimulation. Other psychopathology was not altered differentially following real/sham rTMS. In relation to TD, there was an interaction trend (p = 0.060): real versus sham rTMS resulted in reduced rates of TD (more reflective choice behaviour). Salivary cortisol concentrations were unchanged by stimulation. rTMS was safe, well–tolerated and was considered an acceptable intervention. Conclusions This study provides modest evidence that rTMS to the l-DLPFC transiently reduces core symptoms of AN and encourages prudent decision making. Importantly, individuals with AN considered rTMS to be a viable treatment option. These findings require replication in multiple-session studies to evaluate

  6. Repetitive transcranial magnetic stimulation over the supplementary motor area modifies breathing pattern in response to inspiratory loading in normal humans

    PubMed Central

    Nierat, Marie-Cécile; Hudson, Anna L.; Chaskalovic, Joël; Similowski, Thomas; Laviolette, Louis

    2015-01-01

    In awake humans, breathing depends on automatic brainstem pattern generators. It is also heavily influenced by cortical networks. For example, functional magnetic resonance imaging and electroencephalographic data show that the supplementary motor area becomes active when breathing is made difficult by inspiratory mechanical loads like resistances or threshold valves, which is associated with perceived respiratory discomfort. We hypothesized that manipulating the excitability of the supplementary motor area with repetitive transcranial magnetic stimulation would modify the breathing pattern response to an experimental inspiratory load and possibly respiratory discomfort. Seven subjects (three men, age 25 ± 4) were studied. Breathing pattern and respiratory discomfort during inspiratory loading were described before and after conditioning the supplementary motor area with repetitive stimulation, using an excitatory paradigm (5 Hz stimulation), an inhibitory paradigm, or sham stimulation. No significant change in breathing pattern during loading was observed after sham conditioning. Excitatory conditioning shortened inspiratory time (p = 0.001), decreased tidal volume (p = 0.016), and decreased ventilation (p = 0.003), as corroborated by an increased end-tidal expired carbon dioxide (p = 0.013). Inhibitory conditioning did not affect ventilation, but lengthened expiratory time (p = 0.031). Respiratory discomfort was mild under baseline conditions, and unchanged after conditioning of the supplementary motor area. This is the first study to show that repetitive transcranial magnetic stimulation conditioning of the cerebral cortex can alter breathing pattern. A 5 Hz conditioning protocol, known to enhance corticophrenic excitability, can reduce the amount of hyperventilation induced by inspiratory threshold loading. Further studies are needed to determine whether and under what circumstances rTMS can have an effect on dyspnoea. PMID:26483701

  7. Preliminary Evidence of the Effects of High-frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Swallowing Functions in Post-Stroke Individuals with Chronic Dysphagia

    ERIC Educational Resources Information Center

    Cheng, Ivy K. Y.; Chan, Karen M. K.; Wong, C. S.; Cheung, Raymond T. F.

    2015-01-01

    Background: There is growing evidence of potential benefits of repetitive transcranial magnetic stimulation (rTMS) in the rehabilitation of dysphagia. However, the site and frequency of stimulation for optimal effects are not clear. Aims: The aim of this pilot study is to investigate the short-term effects of high-frequency 5 Hz rTMS applied to…

  8. Repetitive transcranial magnetic stimulation over the orbitofrontal cortex for obsessive-compulsive disorder: a double-blind, crossover study

    PubMed Central

    Nauczyciel, C; Le Jeune, F; Naudet, F; Douabin, S; Esquevin, A; Vérin, M; Dondaine, T; Robert, G; Drapier, D; Millet, B

    2014-01-01

    This pilot study was designed to assess the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) over the right orbitofrontal cortex (OFC) by means of a double-cone coil in patients suffering from obsessive-compulsive disorder. We hypothesized that low-frequency stimulation of the OFC would lead to a reduction in clinical symptoms, as measured on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). A randomized, double-blind, crossover design was implemented with two 1-week treatment periods (active stimulation versus sham stimulation) separated by a 1-month washout period. Concomitantly, a subgroup of patients underwent a positron emission tomography (PET) scan after each stimulation sequence. Statistical analyses compared the Y-BOCS scores at the end of each period. At day 7, we observed a significant decrease from baseline in the Y-BOCS scores, after both active (P<0.01) and sham stimulation (P=0.02). This decrease tended to be larger after active stimulation than after sham stimulation: −6 (−29, 0) points versus −2 (−20, 4) points (P=0.07). Active versus sham PET scan contrasts showed that stimulation was related to a bilateral decrease in the metabolism of the OFC. The OFC should definitely be regarded as a key neuroanatomical target for rTMS, as it is easier to reach than either the striatum or the subthalamic nucleus, structures favored in neurosurgical approaches. PMID:25203167

  9. Noninvasive Brain Stimulation With High-Frequency and Low-Intensity Repetitive Transcranial Magnetic Stimulation Treatment for Posttraumatic Stress Disorder

    PubMed Central

    Boggio, Paulo Sergio; Rocha, Martha; Oliveira, Maira Okada; Fecteau, Shirley; Cohen, Roni B.; Campanhã, Camila; Ferreira-Santos, Eduardo; Meleiro, Alexandrina; Corchs, Felipe; Zaghi, Soroush; Pascual-Leone, Alvaro; Fregni, Felipe

    2011-01-01

    Objective We aimed to investigate the efficacy of 20 Hz repetitive transcranial magnetic stimulation (rTMS) of either right or left dorsolateral prefrontal cortex (DLPFC) as compared to sham rTMS for the relief of posttraumatic stress disorder (PTSD)–associated symptoms. Method In this double-blind, placebo-controlled phase II trial conducted between October 2005 and July 2008, 30 patients with DSM-IV–diagnosed PTSD were randomly assigned to receive 1 of the following treatments: active 20 Hz rTMS of the right DLPFC, active 20 Hz rTMS of the left DLPFC, or sham rTMS. Treatments were administered in 10 daily sessions over 2 weeks. A blinded rater assessed severity of core PTSD symptoms, depression, and anxiety before, during, and after completion of the treatment protocol. In addition, a battery of neuropsychological tests was measured before and after treatment. Results Results show that both active conditions—20 Hz rTMS of left and right DLPFC—induced a significant decrease in PTSD symptoms as indexed by the PTSD Checklist and Treatment Outcome PTSD Scale; however, right rTMS induced a larger effect as compared to left rTMS. In addition, there was a significant improvement of mood after left rTMS and a significant reduction of anxiety following right rTMS. Improvements in PTSD symptoms were long lasting; effects were still significant at the 3-month follow-up. Finally, neuropsychological evaluation showed that active 20 Hz rTMS is not associated with cognitive worsening and is safe for use in patients with PTSD. Conclusions These results support the notion that modulation of prefrontal cortex can alleviate the core symptoms of PTSD and suggest that high-frequency rTMS of right DLPFC might be the optimal treatment strategy. PMID:20051219

  10. Repetitive Transcranial Magnetic Stimulation (rTMS) to Treat Social Anxiety Disorder: Case Reports and a Review of the Literature

    PubMed Central

    Paes, Flávia; Baczynski, Tathiana; Novaes, Felipe; Marinho, Tamires; Arias-Carrión, Oscar; Budde, Henning; Sack, Alexander T.; Huston, Joseph P.; Almada, Leonardo Ferreira; Carta, Mauro; Silva, Adriana Cardoso; Nardi, Antonio E.; Machado, Sergio

    2013-01-01

    Objectives: Social anxiety disorder (SAD) is a common and debilitating anxiety disorders. However, few studies had been dedicated to the neurobiology underlying SAD until the last decade. Rates of non-responders to standard methods of treatment remain unsatisfactorily high of approximately 25%, including SAD. Advances in our understanding of SAD could lead to new treatment strategies. A potential non invasive therapeutic option is repetitive transcranial magnetic stimulation (rTMS). Thus, we reported two cases of SAD treated with rTMS Methods: The bibliographical search used Pubmed/Medline, ISI Web of Knowledge and Scielo databases. The terms chosen for the search were: anxiety disorders, neuroimaging, repetitive transcranial magnetic stimulation. Results: In most of the studies conducted on anxiety disorders, except SAD, the right prefrontal cortex (PFC), more specifically dorsolateral PFC was stimulated, with marked results when applying high-rTMS compared with studies stimulating the opposite side. However, according to the “valence hypothesis”, anxiety disorders might be characterized by an interhemispheric imbalance associated with increased right-hemispheric activity. With regard to the two cases treated with rTMS, we found a decrease in BDI, BAI and LSAS scores from baseline to follow-up. Conclusion: We hypothesize that the application of low-rTMS over the right medial PFC (mPFC; the main structure involved in SAD circuitry) combined with high-rTMS over the left mPFC, for at least 4 weeks on consecutive weekdays, may induce a balance in brain activity, opening an attractive therapeutic option for the treatment of SAD. PMID:24278088

  11. Low-Frequency Repetitive Transcranial Magnetic Stimulation and Intensive Occupational Therapy for Poststroke Patients with Upper Limb Hemiparesis: Preliminary Study of a 15-Day Protocol

    ERIC Educational Resources Information Center

    Kakuda, Wataru; Abo, Masahiro; Kobayashi, Kazushige; Momosaki, Ryo; Yokoi, Aki; Fukuda, Akiko; Ishikawa, Atsushi; Ito, Hiroshi; Tominaga, Ayumi

    2010-01-01

    The purpose of the study was to determine the safety and feasibility of a 15-day protocol of low-frequency repetitive transcranial magnetic stimulation (rTMS) combined with intensive occupational therapy (OT) on motor function and spasticity in hemiparetic upper limbs in poststroke patients. Fifteen poststroke patients (age at study entry 55 [plus…

  12. An Open-Label Feasibility Trial of Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Major Depressive Episodes.

    PubMed

    Fujiwara, Masaki; Inagaki, Masatoshi; Higuchi, Yuji; Uchitomi, Yosuke; Terada, Seishi; Kodama, Masafumi; Kishi, Yoshiki; Yamada, Norihito

    2016-08-01

    Repetitive transcranial magnetic stimulation (rTMS) has been reported to be a new treatment option for treatment-resistant depression. In Japan, there has been limited research into its feasibility, efficacy, and tolerability. We have launched a trial of rTMS for treating medication-resistant major depressive disorder and bipolar depression. We are investigating low-frequency rTMS to the right dorsolateral prefrontal cortex and traditional high-frequency rTMS to the left dorsolateral prefrontal cortex, in 20 patients. The primary outcome of the study is the treatment completion rate. This study will provide new data on the usefulness of rTMS for treatment-resistant depression in Japan. PMID:27549679

  13. Ventrolateral prefrontal cortex repetitive transcranial magnetic stimulation in the treatment of depersonalization disorder: A consecutive case series.

    PubMed

    Jay, Emma-Louise; Nestler, Steffen; Sierra, Mauricio; McClelland, Jessica; Kekic, Maria; David, Anthony S

    2016-06-30

    Case reports and an open trial have reported promising responses to repetitive transcranial magnetic stimulation (rTMS) to prefrontal and temporo-parietal sites in patients with depersonalization disorder (DPD). We recently showed that a single session of rTMS to the ventrolateral prefrontal cortex (VLPFC) was associated with a reduction in symptoms and increase in physiological arousal. Seven patients with medication-resistant DSM-IV DPD received up to 20 sessions of right-sided rTMS to the VLPFC for 10 weeks. Stimulation was guided using neuronavigation software based on participants' individual structural MRIs, and delivered at 110% of resting motor threshold. A session consisted of 1Hz repetitive TMS for 15min. The primary outcome measure was reduction in depersonalization symptoms on the Cambridge Depersonalization Scale (CDS). Secondary outcomes included scores on the Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI). 20 sessions of rTMS treatment to right VLPFC significantly reduced scores on the CDS by on average 44% (range 2-83.5%). Two patients could be classified as "full responders", four as "partial" and one a non-responder. Response usually occurred within the first 6 sessions. There were no significant adverse events. A randomized controlled clinical trial of VLPFC rTMS for DPD is warranted. PMID:27104926

  14. Blood flow and oxygenation changes due to low-frequency repetitive transcranial magnetic stimulation of the cerebral cortex

    NASA Astrophysics Data System (ADS)

    Mesquita, Rickson C.; Faseyitan, Olufunsho K.; Turkeltaub, Peter E.; Buckley, Erin M.; Thomas, Amy; Kim, Meeri N.; Durduran, Turgut; Greenberg, Joel H.; Detre, John A.; Yodh, Arjun G.; Hamilton, Roy H.

    2013-06-01

    Transcranial magnetic stimulation (TMS) modulates processing in the human brain and is therefore of interest as a treatment modality for neurologic conditions. During TMS administration, an electric current passing through a coil on the scalp creates a rapidly varying magnetic field that induces currents in the cerebral cortex. The effects of low-frequency (1 Hz), repetitive TMS (rTMS) on motor cortex cerebral blood flow (CBF) and tissue oxygenation in seven healthy adults, during/after 20 min stimulation, is reported. Noninvasive optical methods are employed: diffuse correlation spectroscopy (DCS) for blood flow and diffuse optical spectroscopy (DOS) for hemoglobin concentrations. A significant increase in median CBF (33%) on the side ipsilateral to stimulation was observed during rTMS and persisted after discontinuation. The measured hemodynamic parameter variations enabled computation of relative changes in cerebral metabolic rate of oxygen consumption during rTMS, which increased significantly (28%) in the stimulated hemisphere. By contrast, hemodynamic changes from baseline were not observed contralateral to rTMS administration (all parameters, p>0.29). In total, these findings provide new information about hemodynamic/metabolic responses to low-frequency rTMS and, importantly, demonstrate the feasibility of DCS/DOS for noninvasive monitoring of TMS-induced physiologic effects.

  15. Bidirectional effects on interhemispheric resting-state functional connectivity induced by excitatory and inhibitory repetitive transcranial magnetic stimulation.

    PubMed

    Watanabe, Takamitsu; Hanajima, Ritsuko; Shirota, Yuichiro; Ohminami, Shinya; Tsutsumi, Ryosuke; Terao, Yasuo; Ugawa, Yoshikazu; Hirose, Satoshi; Miyashita, Yasushi; Konishi, Seiki; Kunimatsu, Akira; Ohtomo, Kuni

    2014-05-01

    Several recent studies using functional magnetic resonance imaging (fMRI) have shown that repetitive transcranial magnetic stimulation (rTMS) affects not only brain activity in stimulated regions but also resting-state functional connectivity (RSFC) between the stimulated region and other remote regions. However, these studies have only demonstrated an effect of either excitatory or inhibitory rTMS on RSFC, and have not clearly shown the bidirectional effects of both types of rTMS. Here, we addressed this issue by performing excitatory and inhibitory quadripulse TMS (QPS), which is considered to exert relatively large and long-lasting effects on cortical excitability. We found that excitatory rTMS (QPS with interstimulus intervals of 5 ms) decreased interhemispheric RSFC between bilateral primary motor cortices, whereas inhibitory rTMS (QPS with interstimulus intervals of 50 ms) increased interhemispheric RSFC. The magnitude of these effects on RSFC was significantly correlated with that of rTMS-induced effects on motor evoked potential from the corresponding muscle. The bidirectional effects of QPS were also observed in the stimulation over prefrontal and parietal association areas. These findings provide evidence for the robust bidirectional effects of excitatory and inhibitory rTMSs on RSFC, and raise a possibility that QPS can be a powerful tool to modulate RSFC. PMID:23897535

  16. H-coil repetitive transcranial magnetic stimulation for treatment of temporal lobe epilepsy: A case report

    PubMed Central

    Gersner, R.; Oberman, L.; Sanchez, M.J.; Chiriboga, N.; Kaye, H.L.; Pascual-Leone, A.; Libenson, M.; Roth, Y.; Zangen, A.; Rotenberg, A.

    2016-01-01

    Low frequency repetitive TMS (rTMS) of a cortical seizure focus is emerging as an antiepileptic treatment. While conventional rTMS stimulators activate only superficial cortical areas, reaching deep epileptic foci, for example in temporal lobe epilepsy (TLE), is possible using specially designed H-coils. We report the results of rTMS in a young adult with pharmacoresistant bilateral TLE who underwent three courses (of 10, 15, and 30 daily sessions) of unilateral rTMS over the hemisphere from which seizures originated most often. Seizure frequency was assessed before and after each block of rTMS sessions, as was the tolerability of the procedure. Seizure frequency declined significantly, by 50 to 70% following each rTMS course. All sessions were well-tolerated. PMID:27114902

  17. H-coil repetitive transcranial magnetic stimulation for treatment of temporal lobe epilepsy: A case report.

    PubMed

    Gersner, R; Oberman, L; Sanchez, M J; Chiriboga, N; Kaye, H L; Pascual-Leone, A; Libenson, M; Roth, Y; Zangen, A; Rotenberg, A

    2016-01-01

    Low frequency repetitive TMS (rTMS) of a cortical seizure focus is emerging as an antiepileptic treatment. While conventional rTMS stimulators activate only superficial cortical areas, reaching deep epileptic foci, for example in temporal lobe epilepsy (TLE), is possible using specially designed H-coils. We report the results of rTMS in a young adult with pharmacoresistant bilateral TLE who underwent three courses (of 10, 15, and 30 daily sessions) of unilateral rTMS over the hemisphere from which seizures originated most often. Seizure frequency was assessed before and after each block of rTMS sessions, as was the tolerability of the procedure. Seizure frequency declined significantly, by 50 to 70% following each rTMS course. All sessions were well-tolerated. PMID:27114902

  18. Improvement of white matter and functional connectivity abnormalities by repetitive transcranial magnetic stimulation in crossed aphasia in dextral

    PubMed Central

    Lu, Haitao; Wu, Haiyan; Cheng, Hewei; Wei, Dongjie; Wang, Xiaoyan; Fan, Yong; Zhang, Hao; Zhang, Tong

    2014-01-01

    As a special aphasia, the occurrence of crossed aphasia in dextral (CAD) is unusual. This study aims to improve the language ability by applying 1 Hz repetitive transcranial magnetic stimulation (rTMS). We studied multiple modality imaging of structural connectivity (diffusion tensor imaging), functional connectivity (resting fMRI), PET, and neurolinguistic analysis on a patient with CAD. Furthermore, we applied rTMS of 1 Hz for 40 times and observed the language function improvement. The results indicated that a significantly reduced structural and function connectivity was found in DTI and fMRI data compared with the control. The PET imaging showed hypo-metabolism in right hemisphere and left cerebellum. In conclusion, one of the mechanisms of CAD is that right hemisphere is the language dominance. Stimulating left Wernicke area could improve auditory comprehension, stimulating left Broca’s area could enhance expression, and the results outlasted 6 months by 1 Hz rTMS balancing the excitability inter-hemisphere in CAD. PMID:25419415

  19. Repetitive Transcranial Magnetic Stimulation for the Treatment of Major Depressive Disorder

    PubMed Central

    2004-01-01

    Executive Summary Objective This review was conducted to assess the effectiveness of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depressive disorder (MDD). The Technology rTMS is a noninvasive way to stimulate nerve cells in areas of the brain. During rTMS, an electrical current passes through a wire coil placed over the scalp. The current induces a magnetic field that produces an electrical field in the brain that then causes nerve cells to depolarize, resulting in the stimulation or disruption of brain activity. Researchers have investigated rTMS as an option to treat MDD, as an add-on to drug therapy, and, in particular, as an alternative to electroconvulsive therapy (ECT) for patients with treatment-resistant depression. The advantages of rTMS over ECT for patients with severe refractory depression are that general anesthesia is not needed, it is an outpatient procedure, it requires less energy, the simulation is specific and targeted, and convulsion is not required. The advantages of rTMS as an add-on treatment to drug therapy may include hastening of the clinical response when used with antidepressant drugs. Review Strategy The Medical Advisory Secretariat used its standard search strategy to locate international health technology assessments and English-language journal articles published from January 1996 to March 2004. Summary of Findings Some early meta-analyses suggested rTMS might be effective for the treatment of MDD (for treatment-resistant MDD and as an add-on treatment to drug therapy for patients not specifically defined as treatment resistant). There were, however, several crucial methodological limitations in the included studies that were not critically assessed. These are discussed below. Recent meta-analyses (including 2 international health technology assessments) have done evidence-based critical analyses of studies that have assessed rTMS for MDD. The 2 most recent health technology assessments (from the

  20. Efficacy of repetitive transcranial magnetic stimulation with quetiapine in treating bipolar II depression: a randomized, double-blinded, control study

    PubMed Central

    Hu, Shao-hua; Lai, Jian-bo; Xu, Dong-rong; Qi, Hong-li; Peterson, Bradley S.; Bao, Ai-min; Hu, Chan-chan; Huang, Man-li; Chen, Jing-kai; Wei, Ning; Hu, Jian-bo; Li, Shu-lan; Zhou, Wei-hua; Xu, Wei-juan; Xu, Yi

    2016-01-01

    The clinical and cognitive responses to repetitive transcranial magnetic stimulation (rTMS) in bipolar II depressed patients remain unclear. In this study, thirty-eight bipolar II depressed patients were randomly assigned into three groups: (i) left high-frequency (n = 12), (ii) right low-frequency (n = 13), (iii) sham stimulation (n = 13), and underwent four-week rTMS with quetiapine concomitantly. Clinical efficacy was evaluated at baseline and weekly intervals using the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive functioning was assessed before and after the study with the Wisconsin Card Sorting Test (WCST), Stroop Word-Color Interference Test (Stroop), and Trail Making Test (TMT). Thirty-five patients were included in the final analysis. Overall, the mean scores of both the HDRS-17 and the MADRS significantly decreased over the 4-week trial, which did not differ among the three groups. Exploratory analyses revealed no differences in factor scores of HDRS-17s, or in response or remission rates. Scores of WCST, Stroop, or TMT did not differ across the three groups. These findings indicated active rTMS combined with quetiapine was not superior to quetiapine monotherapy in improving depressive symptoms or cognitive performance in patients with bipolar II depression. PMID:27460201

  1. Efficacy of repetitive transcranial magnetic stimulation with quetiapine in treating bipolar II depression: a randomized, double-blinded, control study.

    PubMed

    Hu, Shao-Hua; Lai, Jian-Bo; Xu, Dong-Rong; Qi, Hong-Li; Peterson, Bradley S; Bao, Ai-Min; Hu, Chan-Chan; Huang, Man-Li; Chen, Jing-Kai; Wei, Ning; Hu, Jian-Bo; Li, Shu-Lan; Zhou, Wei-Hua; Xu, Wei-Juan; Xu, Yi

    2016-01-01

    The clinical and cognitive responses to repetitive transcranial magnetic stimulation (rTMS) in bipolar II depressed patients remain unclear. In this study, thirty-eight bipolar II depressed patients were randomly assigned into three groups: (i) left high-frequency (n = 12), (ii) right low-frequency (n = 13), (iii) sham stimulation (n = 13), and underwent four-week rTMS with quetiapine concomitantly. Clinical efficacy was evaluated at baseline and weekly intervals using the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive functioning was assessed before and after the study with the Wisconsin Card Sorting Test (WCST), Stroop Word-Color Interference Test (Stroop), and Trail Making Test (TMT). Thirty-five patients were included in the final analysis. Overall, the mean scores of both the HDRS-17 and the MADRS significantly decreased over the 4-week trial, which did not differ among the three groups. Exploratory analyses revealed no differences in factor scores of HDRS-17s, or in response or remission rates. Scores of WCST, Stroop, or TMT did not differ across the three groups. These findings indicated active rTMS combined with quetiapine was not superior to quetiapine monotherapy in improving depressive symptoms or cognitive performance in patients with bipolar II depression. PMID:27460201

  2. Test-retest assessment of cortical activation induced by repetitive transcranial magnetic stimulation with brain atlas-guided optical topography

    NASA Astrophysics Data System (ADS)

    Tian, Fenghua; Kozel, F. Andrew; Yennu, Amarnath; Croarkin, Paul E.; McClintock, Shawn M.; Mapes, Kimberly S.; Husain, Mustafa M.; Liu, Hanli

    2012-11-01

    Repetitive transcranial magnetic stimulation (rTMS) is a technology that stimulates neurons with rapidly changing magnetic pulses with demonstrated therapeutic applications for various neuropsychiatric disorders. Functional near-infrared spectroscopy (fNIRS) is a suitable tool to assess rTMS-evoked brain responses without interference from the magnetic or electric fields generated by the TMS coil. We have previously reported a channel-wise study of combined rTMS/fNIRS on the motor and prefrontal cortices, showing a robust decrease of oxygenated hemoglobin concentration (Δ[HbO2]) at the sites of 1-Hz rTMS and the contralateral brain regions. However, the reliability of this putative clinical tool is unknown. In this study, we develop a rapid optical topography approach to spatially characterize the rTMS-evoked hemodynamic responses on a standard brain atlas. A hemispherical approximation of the brain is employed to convert the three-dimensional topography on the complex brain surface to a two-dimensional topography in the spherical coordinate system. The test-retest reliability of the combined rTMS/fNIRS is assessed using repeated measurements performed two to three days apart. The results demonstrate that the Δ[HbO2] amplitudes have moderate-to-high reliability at the group level; and the spatial patterns of the topographic images have high reproducibility in size and a moderate degree of overlap at the individual level.

  3. Bilateral Repetitive Transcranial Magnetic Stimulation for Auditory Hallucinations in Patients with Schizophrenia: A Randomized Controlled, Cross-over Study

    PubMed Central

    Kim, Eun-Ji; Yeo, Seonguk; Hwang, Inho; Park, Jong-Il; Cui, Yin; Jin, Hong-Mei; Kim, Hyung Tae; Hwang, Tae-Young

    2014-01-01

    Objective A randomized double-blind cross-over trial was conducted in patients with persistent auditory hallucinations (AHs) to investigate whether bilateral repetitive transcranial magnetic stimulation (rTMS) at the temporoparietal area or Broca's area is more effective at high- or low-frequencies compared to a sham condition. Methods Twenty three patients with persistent AHs who remained stable on the same medication for 2 months were enrolled. They were randomized to one of four conditions: low-frequency (1 Hz)-rTMS to the temporoparietal area (L-TP), high-frequency (20 Hz)-rTMS to the temporoparietal area (H-TP), high-frequency (20 Hz)-rTMS to Broca's area (H-B), or sham. Results All the four rTMS conditions resulted in significant decrease in the scores under the auditory hallucination rating scale and hallucination change scale over time. However, there were no significant treatment effects or interaction between time and treatment, suggesting no superior effects of the new paradigms over the sham condition. Conclusion Our findings suggest that bilateral rTMS at the temporoparietal area or Broca's area with high- or low-frequency does not produce superior effects in reducing AHs compared to sham stimulation. PMID:25598827

  4. Unilateral and bilateral MRI-targeted repetitive transcranial magnetic stimulation for treatment-resistant depression: a randomized controlled study

    PubMed Central

    Blumberger, Daniel M.; Maller, Jerome J.; Thomson, Lauren; Mulsant, Benoit H.; Rajji, Tarek K.; Maher, Missy; Brown, Patrick E.; Downar, Jonathan; Vila-Rodriguez, Fidel; Fitzgerald, Paul B.; Daskalakis, Zafiris J.

    2016-01-01

    Background Several factors may mitigate the efficacy of repetitive transcranial magnetic stimulation (rTMS) over sham rTMS in patients with treatment-resistant depression (TRD). These factors include unilateral stimulation (i.e., treatment of only the left dorsolateral prefrontal cortex [DLPFC]), suboptimal methods of targeting the DLPFC and insufficient stimulation intensity (based on coil-to-cortex distance). Methods We recruited patients with TRD between the ages of 18 and 85 years from a university hospital, and participants were randomized to receive sequential bilateral rTMS (600 pulses at 1 Hz followed by 1500 pulses at 10 Hz), unilateral high-frequency left (HFL)-rTMS (2100 pulses at 10 Hz) or sham rTMS for 3 or 6 weeks depending on treatment response. Stimulation was targeted with MRI localization over the junction of the middle and anterior thirds of the middle frontal gyrus, using 120% of the coil-to-cortex adjusted motor threshold. Our primary outcome of interest was the remission rate. Results A total of 121 patients participated in this study. The remission rate was significantly higher in the bilateral group than the sham group. The remission rate in the HFL-rTMS group was intermediate and did not differ statistically from the rate in the 2 other groups. There were no significant differences in reduction of depression scores among the 3 groups. Limitations The number of pulses used per session in the unilateral group was somewhat lower in our trial than in more recent trials, and the sham condition did not involve active stimulation. Conclusion Our findings suggest that sequential bilateral rTMS is superior to sham rTMS; however, adjusting for coil-to-cortex distance did not yield enhanced efficacy rates. PMID:27269205

  5. Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Event-Related Potential (ERP) Indices of Attention in Autism

    PubMed Central

    Casanova, Manuel F.; Baruth, Joshua M.; El-Baz, Ayman; Tasman, Allan; Sears, Lonnie; Sokhadze, Estate

    2014-01-01

    Individuals with autism spectrum disorder (ASD) have previously been shown to have significantly augmented and prolonged event-related potentials (ERP) to irrelevant visual stimuli compared to controls at both early and later stages (e.g., N200, P300) of visual processing and evidence of an overall lack of stimulus discrimination. Abnormally large and indiscriminative cortical responses to sensory stimuli may reflect cortical inhibitory deficits and a disruption in the excitation/inhibition ratio. Low-frequency (≤1HZ) repetitive transcranial magnetic stimulation (rTMS) has been shown to increase inhibition of stimulated cortex by the activation of inhibitory circuits. It was our prediction that after 12 sessions of low-frequency rTMS applied bilaterally to the dorsolateral prefrontal cortices in individuals with ASD there would be a significant improvement in ERP indices of selective attention evoked at later (i.e., 200–600 ms) stages of attentional processing as well as an improvement in motor response error rate. We assessed 25 participants with ASD in a task of selective attention using illusory figures before and after 12 sessions of rTMS in a controlled design where a waiting-list group of 20 children with ASD performed the same task twice. We found a significant improvement in both N200 and P300 components as a result of rTMS as well as a significant reduction in response errors. We also found significant reductions in both repetitive behavior and irritability according to clinical behavioral questionnaires as a result of rTMS. We propose that rTMS has the potential to become an important therapeutic tool in ASD research and treatment. PMID:24683490

  6. Chronic repetitive transcranial magnetic stimulation is antidepressant but not anxiolytic in rat models of anxiety and depression.

    PubMed

    Hargreaves, Garth A; McGregor, Iain S; Sachdev, Perminder S

    2005-11-15

    Transcranial magnetic stimulation (TMS) has been proposed as a treatment for depression and anxiety disorders. While the antidepressant effect has been modelled in animals, there have been few attempts to examine a possible anxiolytic effect of repetitive TMS (rTMS) in animal models. We administered 18 days of rTMS to male Sprague-Dawley rats. On days 10 through 18, rats were tested in several anxiety models (social interaction, emergence, elevated plus-maze, and predator odor avoidance) and in the forced swim test. No group differences were apparent on any of the anxiety models, while TMS produced an antidepressant effect in the forced swim test. Interestingly, on day 1 of the forced swim test, the home cage control group displayed increased swimming behaviour compared with sham-treated animals, suggesting an observable level of stress may have accompanied sham treatment. The results from the forced swim test suggested that TMS had modest antidepressant properties, but it did not show anxiolytic properties in the models examined. The study also suggested that stress associated with handling should be taken into account in the interpretation of TMS studies in animals. PMID:16223528

  7. Impact of Repetitive Transcranial Magnetic Stimulation on Post-Stroke Dysmnesia and the Role of BDNF Val66Met SNP

    PubMed Central

    Lu, Haitao; Zhang, Tong; Wen, Mei; Sun, Li

    2015-01-01

    Background Little is known about the effects of low-frequency repetitive transcranial magnetic stimulation (rTMS) on dysmnesia and the impact of brain nucleotide neurotrophic factor (BDNF) Val66Met single-nucleotide polymorphism (SNP). This study investigated the impact of low-frequency rTMS on post-stroke dysmnesia and the impact of BDNF Val66Met SNP. Material/Methods Forty patients with post-stroke dysmnesia were prospectively randomized into the rTMS and sham groups. BDNF Val66Met SNP was determined using restriction fragment length polymorphism. Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy of Cognitive Assessment (LOTCA), and Rivermead Behavior Memory Test (RBMT) scores, as well as plasma BDNF concentrations, were measured at baseline and at 3 days and 2 months post-treatment. Results MoCA, LOTCA, and RBMT scores were higher after rTMS. Three days after treatment, BDNF decreased in the rTMS group but it increased in the sham group (P<0.05). Two months after treatment, RMBT scores in the rTMS group were higher than in the sham group, but not MoCA and LOTCA scores. Conclusions Low-frequency rTMS may improve after-stoke memory through various pathways, which may involve polymorphisms and several neural genes, but not through an increase in BDNF levels. PMID:25770310

  8. Benefit of Multiple Sessions of Perilesional Repetitive Transcranial Magnetic Stimulation for an Effective Rehabilitation of Visuo-Spatial Function

    PubMed Central

    Afifi, Linda; Rushmore, R. Jarrett; Valero-Cabré, Antoni

    2012-01-01

    Non-invasive neurostimulation techniques have been used alone or in conjunction with rehabilitation therapy to treat the neurological sequelae of brain damage with rather variable therapeutic outcomes. One potential factor limiting a consistent success for such techniques may be the few sessions carried out in patients, despite reports that their accrual may play a key role in alleviating neurological deficits long-term. In this study, we tested the effects of seventy consecutive sessions of perilesional high frequency (10 Hz) repetitive transcranial magnetic stimulation (rTMS) in the treatment of chronic neglect deficits in a well-established feline model of visuo-spatial neglect. Under identical rTMS parameters and visuo-spatial testing regimes, half of the subjects improved in visuo-spatial orienting performance. The other half experienced either none or extremely moderate ameliorations in the neglected hemispace and displayed transient patterns of maladaptive visuo-spatial behavior. Detailed analyses suggest that lesion location and extent did not account for the behavioral differences observed between these two groups of animals. We conclude that multi-session perilesional rTMS regimes have the potential to induce functional ameliorations following focal chronic brain injury, and that behavioral performance prior to the onset of the rTMS treatment is the factor that best predicts positive outcomes for non-invasive neurostimulation treatments in visuo-spatial neglect. PMID:23167832

  9. Effect of high-frequency repetitive transcranial magnetic stimulation on major depressive disorder in patients with Parkinson's disease.

    PubMed

    Shin, Hae-Won; Youn, Young C; Chung, Sun J; Sohn, Young H

    2016-07-01

    Major depressive disorder (MDD) occurs in a small proportion of patients with Parkinson's disease (PD) and reduces their quality of life. We performed a randomized sham-controlled study to evaluate the effect of high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC) on MDD in patients with PD. Ten patients participated to a real-rTMS group and eight patients to a sham-rTMS group. Evaluations were performed at baseline, 2 and 6 weeks after rTMS treatment. All participants underwent examinations of depression rating scales, including the Hamilton Rating Scale, the Montgomery-Asberg Depression Rating Scale (MADRS), and the Beck Depression Inventory (BDI) and the motor part of the Unified Parkinson Disease Rating Scale (UPDRS-III). The real-rTMS group had improved scores on HRS and the MADRS after 10 sessions, and these beneficial effects persisted for 6 weeks after the initial session. The BDI score did not change immediately after the sessions. The sham-rTMS group had no significant changes in any of the depression rating scales. The UPDRS-III did not change in either group. HF-rTMS of the left DLPFC is an effective treatment for MDD in patients with PD. PMID:27178002

  10. Repetitive transcranial magnetic stimulation improves both hearing function and tinnitus perception in sudden sensorineural hearing loss patients

    PubMed Central

    Zhang, Dai; Ma, Yuewen

    2015-01-01

    The occurrence of sudden sensorineural hearing loss (SSHL) affects not only cochlear activity but also neural activity in the central auditory system. Repetitive transcranial magnetic stimulation (rTMS) above the auditory cortex has been reported to improve auditory processing and to reduce the perception of tinnitus, which results from network dysfunction involving both auditory and non-auditory brain regions. SSHL patients who were refractory to standard corticosteroid therapy (SCT) and hyperbaric oxygen (HBO) therapy received 20 sessions of 1 Hz rTMS to the temporoparietal junction ipsilateral to the symptomatic ear (rTMS group). RTMS therapy administered in addition to SCT and HBO therapy resulted in significantly greater recovery of hearing function and improvement of tinnitus perception compared SCT and HBO therapy without rTMS therapy. Additionally, the single photon emission computed tomography (SPECT) measurements obtained in a subgroup of patients suggested that the rTMS therapy could have alleviated the decrease in regional cerebral brain flow (rCBF) in SSHL patients. RTMS appears to be an effective, practical, and safe treatment strategy for SSHL. PMID:26463446

  11. Repetitive transcranial magnetic stimulation improves both hearing function and tinnitus perception in sudden sensorineural hearing loss patients.

    PubMed

    Zhang, Dai; Ma, Yuewen

    2015-01-01

    The occurrence of sudden sensorineural hearing loss (SSHL) affects not only cochlear activity but also neural activity in the central auditory system. Repetitive transcranial magnetic stimulation (rTMS) above the auditory cortex has been reported to improve auditory processing and to reduce the perception of tinnitus, which results from network dysfunction involving both auditory and non-auditory brain regions. SSHL patients who were refractory to standard corticosteroid therapy (SCT) and hyperbaric oxygen (HBO) therapy received 20 sessions of 1 Hz rTMS to the temporoparietal junction ipsilateral to the symptomatic ear (rTMS group). RTMS therapy administered in addition to SCT and HBO therapy resulted in significantly greater recovery of hearing function and improvement of tinnitus perception compared SCT and HBO therapy without rTMS therapy. Additionally, the single photon emission computed tomography (SPECT) measurements obtained in a subgroup of patients suggested that the rTMS therapy could have alleviated the decrease in regional cerebral brain flow (rCBF) in SSHL patients. RTMS appears to be an effective, practical, and safe treatment strategy for SSHL. PMID:26463446

  12. Effects of unilateral repetitive transcranial magnetic stimulation of the motor cortex on chronic widespread pain in fibromyalgia.

    PubMed

    Passard, A; Attal, N; Benadhira, R; Brasseur, L; Saba, G; Sichere, P; Perrot, S; Januel, D; Bouhassira, D

    2007-10-01

    Non-invasive unilateral repetitive transcranial magnetic stimulation (rTMS) of the motor cortex induces analgesic effects in focal chronic pain syndromes, probably by modifying central pain modulatory systems. Neuroimaging studies have shown bilateral activation of a large number of structures, including some of those involved in pain processing, suggesting that such stimulation may induce generalized analgesic effects. The goal of this study was to assess the effects of unilateral rTMS of the motor cortex on chronic widespread pain in patients with fibromyalgia. Thirty patients with fibromyalgia syndrome (age: 52.6 +/- 7.9) were randomly assigned, in a double-blind fashion, to two groups, one receiving active rTMS (n = 15) and the other sham stimulation (n = 15), applied to the left primary motor cortex in 10 daily sessions. The primary outcome measure was self-reported average pain intensity over the last 24 h, measured at baseline, daily during the stimulation period and then 15, 30 and 60 days after the first stimulation. Other outcome measures included: sensory and affective pain scores for the McGill pain Questionnaire, quality of life (assessed with the pain interference items of the Brief Pain Inventory and the Fibromyalgia Impact Questionnaire), mood and anxiety (assessed with the Hamilton Depression Rating Scale, the Beck Depression Inventory and the Hospital Anxiety and Depression Scale). We also assessed the effects of rTMS on the pressure pain threshold at tender points ipsi- and contralateral to stimulation. Follow-up data were obtained for all the patients on days 15 and 30 and for 26 patients (13 in each treatment group) on day 60. Active rTMS significantly reduced pain and improved several aspects of quality of life (including fatigue, morning tiredness, general activity, walking and sleep) for up to 2 weeks after treatment had ended. The analgesic effects were observed from the fifth stimulation onwards and were not related to changes in mood or

  13. Changes in motor cortex excitability associated with temporal repetitive transcranial magnetic stimulation in tinnitus: hints for cross-modal plasticity?

    PubMed Central

    2014-01-01

    Background Motor cortex excitability was found to be changed after repetitive transcranial magnetic stimulation (rTMS) of the temporal cortex highlighting the occurrence of cross-modal plasticity in non-invasive brain stimulation. Here, we investigated the effects of temporal low-frequency rTMS on motor cortex plasticity in a large sample of tinnitus patients. In 116 patients with chronic tinnitus different parameters of cortical excitability were assessed before and after ten rTMS treatment sessions. Patients received one of three different protocols all including 1 Hz rTMS over the left temporal cortex. Treatment response was defined as improvement by at least five points in the tinnitus questionnaire (TQ). Variables of interest were resting motor threshold (RMT), short-interval intra-cortical inhibition (SICI), intracortical facilitation (ICF), and cortical silent period (CSP). Results After rTMS treatment RMT was decreased by about 1% of stimulator output near-significantly in the whole group of patients. SICI was associated with significant changes with respect to treatment response. The group of treatment responders showed a decrease of SICI over the course of treatment, the group of non-responders the reverse pattern. Conclusions Minor RMT changes during rTMS treatment do not necessarily suggest the need for systematic re-examination of the RMT for safety and efficacy issues. Treatment response to rTMS was shown to be related to changes in SICI that might reflect modulation of GABAergic mechanisms directly or indirectly related to rTMS treatment effects. PMID:24898574

  14. A Pilot Study of EEG Source Analysis Based Repetitive Transcranial Magnetic Stimulation for the Treatment of Tinnitus

    PubMed Central

    Wang, Hui; Li, Bei; Feng, Yanmei; Cui, Biao; Wu, Hongmin; Shi, Haibo; Yin, Shankai

    2015-01-01

    Objective Repetitive Transcranial Magnetic Stimulation (rTMS) is a novel therapeutic tool to induce a suppression of tinnitus. However, the optimal target sites are unknown. We aimed to determine whether low-frequency rTMS induced lasting suppression of tinnitus by decreasing neural activity in the cortex, navigated by high-density electroencephalogram (EEG) source analysis, and the utility of EEG for targeting treatment. Methods In this controlled three-armed trial, seven normal hearing patients with tonal tinnitus received a 10-day course of 1-Hz rTMS to the cortex, navigated by high-density EEG source analysis, to the left temporoparietal cortex region, and to the left temporoparietal with sham stimulation. The Tinnitus handicap inventory (THI) and a visual analog scale (VAS) were used to assess tinnitus severity and loudness. Measurements were taken before, and immediately, 2 weeks, and 4 weeks after the end of the interventions. Results Low-frequency rTMS decreased tinnitus significantly after active, but not sham, treatment. Responders in the EEG source analysis-based rTMS group, 71.4% (5/7) patients, experienced a significant reduction in tinnitus loudness, as evidenced by VAS scores. The target site of neuronal generators most consistently associated with a positive response was the frontal lobe in the right hemisphere, sourced using high-density EEG equipment, in the tinnitus patients. After left temporoparietal rTMS stimulation, 42.8% (3/7) patients experienced a decrease in tinnitus loudness. Conclusions Active EEG source analysis based rTMS resulted in significant suppression in tinnitus loudness, showing the superiority of neuronavigation-guided coil positioning in dealing with tinnitus. Non-auditory areas should be considered in the pathophysiology of tinnitus. This knowledge in turn can contribute to investigate the pathophysiology of tinnitus. PMID:26430749

  15. Randomized sham controlled double-blind trial of repetitive transcranial magnetic stimulation for adults with severe Tourette syndrome

    PubMed Central

    Landeros-Weisenberger, Angeli; Mantovani, Antonio; Motlagh, Maria; de Alvarenga, Pedro Gomes; Katsovich, Liliya; Leckman, James F.; Lisanby, Sarah H.

    2014-01-01

    Background A small proportion of individuals with Tourette syndrome (TS) have a lifelong course of illness that fails to respond to conventional treatments. Open label studies have suggested that low frequency (1-Hz) repetitive transcranial magnetic stimulation (rTMS) targeting the supplementary motor area (SMA) may be effective in reducing tic severity. Objective/Hypothesis To examine the efficacy of rTMS over the SMA for TS in a randomized double-blind sham-controlled trial (RCT). Methods We conducted a two-site RCT-rTMS with 20 adults with severe TS for 3 weeks. Treatment consisted of 15 sessions (1-Hz; 30 min; 1,800 pulses per day) of active or sham rTMS at 110% of the motor threshold over the SMA. A subsequent 3 week course of active rTMS treatment was offered. Results Of the 20 patients (16 males; mean age of 33.7 ± 12.2 years), 9 received active and 11 received sham rTMS. After 3 weeks, patients receiving active rTMS showed on average a 17.3% reduction in the YGTSS total tic score compared to a 13.2% reduction in those receiving sham rTMS, resulting in no statistically significant reduction in tic severity (p=0.27). An additional 3 week open label active treatment for those patients (n = 7) initially randomized to active rTMS resulted in a significant overall 29.7% reduction in tic severity compared to baseline (p=0.04). Conclusion This RCT did not demonstrate efficacy of 3-week SMA-targeted low frequency rTMS in the treatment of severe adult TS. Further studies using longer or alternative stimulation protocols are warranted. PMID:25912296

  16. Increased cerebellar activation after repetitive transcranial magnetic stimulation over the primary motor cortex in patients with multiple system atrophy

    PubMed Central

    Li, Linling; Wu, Tianxia; Hou, Bo; Wu, Shuang; Feng, Feng; Cui, Liying

    2016-01-01

    Background Previous review reported that the high-frequency repetitive transcranial magnetic stimulation (rTMS) over the primary motor area (M1) of Parkinson’s disease (PD) patients could alleviate their symptoms. This study aimed to investigate the effect of rTMS over the left M1 of patients with multiple system atrophy (MSA). Methods Fifteen MSA patients were randomly assigned to receive a 10-session real (EP: group of experimental patients; n=7) or sham (CP: group of control patients; n=8) rTMS stimulation over two weeks. The overall experimental procedure consisted of two functional magnetic resonance imaging (fMRI) sessions, before and after a 10-session rTMS treatment. A complex self-paced sequential tapping task was performed during fMRI scanning. In addition, 18 age and gender matched healthy controls (HC) were enrolled. Subjects from the HC group did not receive any rTMS treatment and they underwent fMRI examination only once. The primary end point was the motor score change of the Unified Multiple System Atrophy Rating Scale (UMSARS-II) measured before and after the 5th and 10th session. Task-related activation was also compared among groups. Results After active rTMS treatment, only patients of EP group significant improvement in UMSARS-II score. Compared to HC, MSA patients showed significant activation over similar brain areas except for the cerebellum. Increased activation was obtained in the bilateral cerebellum after rTMS treatment in the EP group. On the contrary, no increased activation was identified in the CP group. Conclusions Our results highlight rTMS over M1 induced motor improvement in MSA patients that may be associated with increased activation in the cerebellum. PMID:27127756

  17. Increases in frontostriatal connectivity are associated with response to dorsomedial repetitive transcranial magnetic stimulation in refractory binge/purge behaviors

    PubMed Central

    Dunlop, Katharine; Woodside, Blake; Lam, Eileen; Olmsted, Marion; Colton, Patricia; Giacobbe, Peter; Downar, Jonathan

    2015-01-01

    Background Conventional treatments for eating disorders are associated with poor response rates and frequent relapse. Novel treatments are needed, in combination with markers to characterize and predict treatment response. Here, resting-state functional magnetic resonance imaging (rs-fMRI) was used to identify predictors and correlates of response to repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (dmPFC) at 10 Hz for eating disorders with refractory binge/purge symptomatology. Methods 28 subjects with anorexia nervosa, binge−purge subtype or bulimia nervosa underwent 20–30 sessions of 10 Hz dmPFC rTMS. rs-fMRI data were collected before and after rTMS. Subjects were stratified into responder and nonresponder groups using a criterion of ≥50% reduction in weekly binge/purge frequency. Neural predictors and correlates of response were identified using seed-based functional connectivity (FC), using the dmPFC and adjacent dorsal anterior cingulate cortex (dACC) as regions of interest. Results 16 of 28 subjects met response criteria. Treatment responders had lower baseline FC from dmPFC to lateral orbitofrontal cortex and right posterior insula, and from dACC to right posterior insula and hippocampus. Responders had low baseline FC from the dACC to the ventral striatum and anterior insula; this connectivity increased over treatment. However, in nonresponders, frontostriatal FC was high at baseline, and dmPFC-rTMS suppressed FC in association with symptomatic worsening. Conclusions Enhanced frontostriatal connectivity was associated with responders to dmPFC-rTMS for binge/purge behavior. rTMS caused paradoxical suppression of frontostriatal connectivity in nonresponders. rs-fMRI could prove critical for optimizing stimulation parameters in a future sham-controlled trial of rTMS in disordered eating. PMID:26199873

  18. Low Intensity Repetitive Transcranial Magnetic Stimulation Does Not Induce Cell Survival or Regeneration in a Mouse Optic Nerve Crush Model

    PubMed Central

    Tang, Alexander D.; Makowiecki, Kalina; Bartlett, Carole; Rodger, Jennifer

    2015-01-01

    Low intensity repetitive Transcranial Magnetic Stimulation (LI-rTMS), a non-invasive form of brain stimulation, has been shown to induce structural and functional brain plasticity, including short distance axonal sprouting. However, the potential for LI-rTMS to promote axonal regeneration following neurotrauma has not been investigated. This study examined the effect of LI-rTMS on retinal ganglion cell (RGC) survival, axon regeneration and levels of BDNF in an optic nerve crush neurotrauma model. Adult C57Bl/6J mice received a unilateral intraorbital optic nerve crush. Mice received 10 minutes of sham (handling control without stimulation) (n=6) or LI-rTMS (n = 8) daily stimulation for 14 days to the operated eye. Immunohistochemistry was used to assess RGC survival (β-3 Tubulin) and axon regeneration across the injury (GAP43). Additionally, BDNF expression was quantified in a separate cohort by ELISA in the retina and optic nerve of injured (optic nerve crush) (sham n = 5, LI-rTMS n = 5) and non-injured mice (sham n = 5, LI-rTMS n = 5) that received daily stimulation as above for 7 days. Following 14 days of LI-rTMS there was no significant difference in mean RGC survival between sham and treated animals (p>0.05). Also, neither sham nor LI-rTMS animals showed GAP43 positive labelling in the optic nerve, indicating that regeneration did not occur. At 1 week, there was no significant difference in BDNF levels in the retina or optic nerves between sham and LI-rTMS in injured or non-injured mice (p>0.05). Although LI-rTMS has been shown to induce structural and molecular plasticity in the visual system and cerebellum, our results suggest LI-rTMS does not induce neuroprotection or regeneration following a complete optic nerve crush. These results help define the therapeutic capacity and limitations of LI-rTMS in the treatment of neurotrauma. PMID:25993112

  19. Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

    PubMed Central

    2016-01-01

    Background To date, several randomized controlled trials (RCTs) have shown the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the treatment of major depression. Objective This analysis examined the antidepressant efficacy of rTMS in patients with treatment-resistant unipolar depression. Methods A literature search was performed for RCTs published from January 1, 1994, to November 20, 2014. The search was updated on March 1, 2015. Two independent reviewers evaluated the abstracts for inclusion, reviewed full texts of eligible studies, and abstracted data. Meta-analyses were conducted to obtain summary estimates. The primary outcome was changes in depression scores measured by the Hamilton Rating Scale for Depression (HRSD), and we considered, a priori, the mean difference of 3.5 points to be a clinically important treatment effect. Remission and response to the treatment were secondary outcomes, and we calculated number needed to treat on the basis of these outcomes. We examined the possibility of publication bias by constructing funnel plots and by Begg's and Egger's tests. A meta-regression was undertaken to examine the effect of specific rTMS technical parameters on the treatment effects. Results Twenty-three RCTs compared rTMS with sham, and six RCTs compared rTMS with electroconvulsive therapy (ECT). Trials of rTMS versus sham showed a statistically significant improvement in depression scores with rTMS (weighted mean difference [WMD] 2.31, 95% CI 1.19–3.43; P < .001). This improvement was smaller than the pre-specified clinically important treatment effect. There was a 10% absolute difference between rTMS and sham in the rates of remission or response. This translates to a number needed to treat of 10. Risk ratios for remission and response were 2.20 (95% CI 1.44–3.38, P = .001 and 1.72 [95% CI], 1.13–2.62, P = .01), respectively, favouring rTMS. No publication bias was detected. Trials of rTMS versus ECT showed a statistically and

  20. Factors Associated With Upper Extremity Functional Recovery Following Low-Frequency Repetitive Transcranial Magnetic Stimulation in Stroke Patients

    PubMed Central

    2016-01-01

    Objective To investigate the factors related to upper extremity functional improvement following inhibitory repetitive transcranial magnetic stimulation (rTMS) in stroke patients. Methods Forty-one stroke patients received low-frequency rTMS over the contralesional hemisphere according to a standard protocol, in addition to conventional physical and occupational therapy. The rTMS-treated patients were divided into two groups according to their responsiveness to rTMS measured by the self-care score of the Korean version of Modified Barthel Index (K-MBI): responded group (n=19) and non-responded group (n=22). Forty-one age-matched stroke patients who had not received rTMS served as controls. Neurological, cognitive and functional assessments were performed before rTMS and 4 weeks after rTMS treatment. Results Among the rTMS-treated patients, the responded group was significantly younger than the non-responded group (51.6±10.5 years and 65.5±13.7 years, respectively; p=0.001). Four weeks after rTMS, the National Institutes of Health Stroke Scale, the Brunnstrom recovery stage and upper extremity muscle power scores were significantly more improved in the responded group than in the control group. Besides the self-care score, the mobility score of the K-MBI was also more improved in the responded group than in the non-responded group or controls. Conclusion Age is the most obvious factor determining upper extremity functional responsiveness to low-frequency rTMS in stroke patients. PMID:27446773

  1. The Role of Right Inferior Parietal Cortex in Auditory Spatial Attention: A Repetitive Transcranial Magnetic Stimulation Study.

    PubMed

    Karhson, Debra S; Mock, Jeffrey R; Golob, Edward J

    2015-01-01

    Behavioral studies support the concept of an auditory spatial attention gradient by demonstrating that attentional benefits progressively diminish as distance increases from an attended location. Damage to the right inferior parietal cortex can induce a rightward attention bias, which implicates this region in the construction of attention gradients. This study used event-related potentials (ERPs) to define attention-related gradients before and after repetitive transcranial magnetic stimulation (rTMS) to the right inferior parietal cortex. Subjects (n = 16) listened to noise bursts at five azimuth locations (left to right: -90°, -45°, 0° midline, +45°, +90°) and responded to stimuli at one target location (-90°, +90°, separate blocks). ERPs as a function of non-target location were examined before (baseline) and after 0.9 Hz rTMS. Results showed that ERP attention gradients were observed in three time windows (frontal 230-340, parietal 400-460, frontal 550-750 ms). Significant transient rTMS effects were seen in the first and third windows. The first window had a voltage decrease at the farthest location when attending to either the left or right side. The third window had on overall increase in positivity, but only when attending to the left side. These findings suggest that rTMS induced a small contraction in spatial attention gradients within the first time window. The asymmetric effect of attended location on gradients in the third time window may relate to neglect of the left hemispace after right parietal injury. Together, these results highlight the role of the right inferior parietal cortex in modulating frontal lobe attention network activity. PMID:26636333

  2. Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex Modulates Repetition Suppression to Unfamiliar Faces: An ERP Study

    PubMed Central

    Lafontaine, Marc Philippe; Théoret, Hugo; Gosselin, Frédéric; Lippé, Sarah

    2013-01-01

    Repeated visual processing of an unfamiliar face suppresses neural activity in face-specific areas of the occipito-temporal cortex. This "repetition suppression" (RS) is a primitive mechanism involved in learning of unfamiliar faces, which can be detected through amplitude reduction of the N170 event-related potential (ERP). The dorsolateral prefrontal cortex (DLPFC) exerts top-down influence on early visual processing. However, its contribution to N170 RS and learning of unfamiliar faces remains unclear. Transcranial direct current stimulation (tDCS) transiently increases or decreases cortical excitability, as a function of polarity. We hypothesized that DLPFC excitability modulation by tDCS would cause polarity-dependent modulations of N170 RS during encoding of unfamiliar faces. tDCS-induced N170 RS enhancement would improve long-term recognition reaction time (RT) and/or accuracy rates, whereas N170 RS impairment would compromise recognition ability. Participants underwent three tDCS conditions in random order at ∼72 hour intervals: right anodal/left cathodal, right cathodal/left anodal and sham. Immediately following tDCS conditions, an EEG was recorded during encoding of unfamiliar faces for assessment of P100 and N170 visual ERPs. The P3a component was analyzed to detect prefrontal function modulation. Recognition tasks were administered ∼72 hours following encoding. Results indicate the right anodal/left cathodal condition facilitated N170 RS and induced larger P3a amplitudes, leading to faster recognition RT. Conversely, the right cathodal/left anodal condition caused N170 amplitude and RTs to increase, and a delay in P3a latency. These data demonstrate that DLPFC excitability modulation can influence early visual encoding of unfamiliar faces, highlighting the importance of DLPFC in basic learning mechanisms. PMID:24324721

  3. Cognitive and anatomical underpinnings of the conceptual knowledge for common objects and familiar people: a repetitive transcranial magnetic stimulation study.

    PubMed

    Campanella, Fabio; Fabbro, Franco; Urgesi, Cosimo

    2013-01-01

    Several studies have addressed the issue of how knowledge of common objects is organized in the brain, whereas the cognitive and anatomical underpinnings of familiar people knowledge have been less explored. Here we applied repetitive transcranial magnetic stimulation (rTMS) over the left and right temporal poles before asking healthy individuals to perform a speeded word-to-picture matching task using familiar people and common objects as stimuli. We manipulated two widely used semantic variables, namely the semantic distance and the familiarity of stimuli, to assess whether the semantic organization of familiar people knowledge is similar to that of common objects. For both objects and faces we reliably found semantic distance and familiarity effects, with less accurate and slower responses for stimulus pairs that were more closely related and less familiar. However, the effects of semantic variables differed across categories, with semantic distance effects larger for objects and familiarity effects larger for faces, suggesting that objects and faces might share a partially comparable organization of their semantic representations. The application of rTMS to the left temporal pole modulated, for both categories, semantic distance, but not familiarity effects, revealing that accessing object and face concepts might rely on overlapping processes within left anterior temporal regions. Crucially, rTMS of the left temporal pole affected only the recognition of pairs of stimuli that could be discriminated at specific levels of categorization (e.g., two kitchen tools or two famous persons), with no effect for discriminations at either superordinate or individual levels. Conversely, rTMS of the right temporal pole induced an overall slowing of reaction times that positively correlated with the visual similarity of the stimuli, suggesting a more perceptual rather than semantic role of the right anterior temporal regions. Results are discussed in the light of current

  4. Primed low-frequency repetitive transcranial magnetic stimulation and constraint-induced movement therapy in pediatric hemiparesis: a randomized trial

    PubMed Central

    GILLICK, BERNADETTE T; KRACH, LINDA E; FEYMA, TIM; RICH, TONYA L; MOBERG, KELLI; THOMAS, WILLIAM; CASSIDY, JESSICA M; MENK, JEREMIAH; CAREY, JAMES R

    2013-01-01

    Aim The aim of this study was to determine the feasibility and efficacy of five treatments of 6Hz primed, low-frequency, repetitive transcranial magnetic stimulation (rTMS) combined with constraint-induced movement therapy (CIMT) to promote recovery of the paretic hand in children with congenital hemiparesis. Method Nineteen children with congenital hemiparesis aged between 8 and 17 years (10 males, nine females; mean age 10y 10mo, SD 2y 10mo; Manual Ability Classification Scale levels I-III) underwent five sessions of either real rTMS (n=10) or sham rTMS (n=9) alternated daily with CIMT. CIMT consisted of 13 days of continuous long-arm casting with five skin-check sessions. Each child received a total of 10 hours of one-to-one therapy. The primary outcome measure was the Assisting Hand Assessment (AHA) and the secondary outcome variables were the Canadian Occupational Performance Measure (COPM) and stereognosis. A Wilcoxon signed-rank sum test was used to analyze differences between pre- and post-test scores within the groups. Analysis of covariance was used to compute mean differences between groups adjusting for baseline. Fisher’s exact test was used to compare individual change in AHA raw scores with the smallest detectable difference (SDD) of 4 points. Results All participants receiving treatment finished the study. Improvement in AHA differed significantly between groups (p=0.007). No significant differences in the secondary outcome measures were found. Eight out of 10 participants in the rTMS/CIMT group showed improvement greater than the SDD, but only two out of nine in the sham rTMS/CIMT group showed such improvement (p=0.023). No serious adverse events occurred. Interpretation Primed, low-frequency rTMS combined with CIMT appears to be safe, feasible, and efficacious in pediatric hemiparesis. Larger clinical trials are now indicated. PMID:23962321

  5. Cognitive and Anatomical Underpinnings of the Conceptual Knowledge for Common Objects and Familiar People: A Repetitive Transcranial Magnetic Stimulation Study

    PubMed Central

    Campanella, Fabio; Fabbro, Franco; Urgesi, Cosimo

    2013-01-01

    Several studies have addressed the issue of how knowledge of common objects is organized in the brain, whereas the cognitive and anatomical underpinnings of familiar people knowledge have been less explored. Here we applied repetitive transcranial magnetic stimulation (rTMS) over the left and right temporal poles before asking healthy individuals to perform a speeded word-to-picture matching task using familiar people and common objects as stimuli. We manipulated two widely used semantic variables, namely the semantic distance and the familiarity of stimuli, to assess whether the semantic organization of familiar people knowledge is similar to that of common objects. For both objects and faces we reliably found semantic distance and familiarity effects, with less accurate and slower responses for stimulus pairs that were more closely related and less familiar. However, the effects of semantic variables differed across categories, with semantic distance effects larger for objects and familiarity effects larger for faces, suggesting that objects and faces might share a partially comparable organization of their semantic representations. The application of rTMS to the left temporal pole modulated, for both categories, semantic distance, but not familiarity effects, revealing that accessing object and face concepts might rely on overlapping processes within left anterior temporal regions. Crucially, rTMS of the left temporal pole affected only the recognition of pairs of stimuli that could be discriminated at specific levels of categorization (e.g., two kitchen tools or two famous persons), with no effect for discriminations at either superordinate or individual levels. Conversely, rTMS of the right temporal pole induced an overall slowing of reaction times that positively correlated with the visual similarity of the stimuli, suggesting a more perceptual rather than semantic role of the right anterior temporal regions. Results are discussed in the light of current

  6. Therapeutic impact of repetitive transcranial magnetic stimulation (rTMS) on tinnitus: a systematic review and meta-analysis.

    PubMed

    Soleimani, Robabeh; Jalali, Mir Mohammad; Hasandokht, Tolou

    2016-07-01

    In this study, we conducted a systematic literature review and meta-analysis on the effect of repetitive transcranial magnetic stimulation (rTMS) compared with sham in chronic tinnitus patients. We searched databases, from their onset up to August 2014, for randomized controlled trials (RCT) in English that assessed the effectiveness of rTMS for chronic tinnitus. RCTs were selected according to inclusion/exclusion criteria before data were extracted. For the meta-analysis weighted mean differences (and standard deviations) of Tinnitus Questionnaire (TQ) and Tinnitus Handicap Inventory (THI) scores were determined. Therapeutic success was defined as difference of at least 7 points in the THI score between baseline and the follow-up assessment after treatment. The odds ratio (OR) for this variable was assessed. Results from 15 RCTs were analyzed. The mean difference for TQ score at 1 week after intervention was 3.42. For THI, the data of mean difference score in two groups, 1 and 6 month after intervention, was 6.71 and 12.89, respectively. The all comparisons indicated a significant medium to large effect size in follow-up which is in favor of the rTMS. The pooled OR of therapeutic success of the studies which used THI at 1 month after intervention was 15.75. These data underscore the clinical effect of rTMS in the treatment of tinnitus. However, there is high variability of studies design and reported outcomes. Replication of data in multicenter trials with a large number of patients and long-term follow-up is needed before further conclusions can be drawn. PMID:25968009

  7. Delayed effect of repetitive transcranial magnetic stimulation (rTMS) on negative symptoms of schizophrenia: Findings from a randomized controlled trial.

    PubMed

    Li, Zhe; Yin, Ming; Lyu, Xiao-Li; Zhang, Lan-Lan; Du, Xiang-Dong; Hung, Galen Chin-Lun

    2016-06-30

    Evidence is inconsistent regarding the effect of repetitive transcranial magnetic stimulation (rTMS) on negative symptoms of schizophrenia. In this study, 47 patients were randomized to receive either active rTMS over left dorsolateral prefrontal cortex (n=25) or sham stimulation (n=22). Negative symptoms were assessed with the Scale for the Assessment of Negative Symptoms (SANS) at baseline, 4 weeks and 8 weeks. At 4 weeks, there was no difference in SANS scores between 2 groups. By 8 weeks, patients with active rTMS had significantly reduced SANS score than controls. Our findings suggest a delayed effect of rTMS on negative symptoms. PMID:27138827

  8. Repetitive transcranial magnetic stimulation (rTMS) influences spatial cognition and modulates hippocampal structural synaptic plasticity in aging mice.

    PubMed

    Ma, Jun; Zhang, Zhanchi; Kang, Lin; Geng, Dandan; Wang, Yanyong; Wang, Mingwei; Cui, Huixian

    2014-10-01

    Normal aging is characteristic with the gradual decline in cognitive function associated with the progressive reduction of structural and functional plasticity in the hippocampus. Repetitive transcranial magnetic stimulation (rTMS) has developed into a novel neurological and psychiatric tool that can be used to investigate the neurobiology of cognitive function. Recent studies have demonstrated that low-frequency rTMS (≤1Hz) affects synaptic plasticity in rats with vascular dementia (VaD), and it ameliorates the spatial cognitive ability in mice with Aβ1-42-mediated memory deficits, but there are little concerns about the effects of rTMS on normal aging related cognition and synaptic plasticity changes. Thus, the current study investigated the effects of rTMS on spatial memory behavior, neuron and synapse morphology in the hippocampus, and synaptic protein markers and brain-derived neurotrophic factor (BDNF)/tropomyosin-related kinase B (TrkB) in normal aging mice, to illustrate the mechanisms of rTMS in regulating cognitive capacity. Relative to adult animals, aging caused hippocampal-dependent cognitive impairment, simultaneously inhibited the activation of the BDNF-TrkB signaling pathway, reduced the transcription and expression of synaptic protein markers: synaptophysin (SYN), growth associated protein 43 (GAP43) and post-synaptic density protein 95 (PSD95), as well as decreased synapse density and PSD (post-synaptic density) thickness. Interestingly, rTMS with low intensity (110% average resting motor threshold intensity, 1Hz, LIMS) triggered the activation of BDNF and TrkB, upregulated the level of synaptic protein markers, and increased synapse density and thickened PSD, and further reversed the spatial cognition dysfunction in aging mice. Conversely, high-intensity magnetic stimulation (150% average resting motor threshold intensity, 1Hz, HIMS) appeared to be detrimental, inducing thinning of PSDs, disordered synaptic structure, and a large number of

  9. Deception rate in a "lying game": different effects of excitatory repetitive transcranial magnetic stimulation of right and left dorsolateral prefrontal cortex not found with inhibitory stimulation.

    PubMed

    Karton, Inga; Palu, Annegrete; Jõks, Kerli; Bachmann, Talis

    2014-11-01

    Knowing the brain processes involved in lying is the key point in today's deception detection studies. We have previously found that stimulating the dorsolateral prefrontal cortex (DLPFC) with repetitive transcranial magnetic stimulation (rTMS) affects the rate of spontaneous lying in simple behavioural tasks. The main idea of this study was to examine the role of rTMS applied to the DLPFC in the behavioural conditions where subjects were better motivated to lie compared to our earlier studies and where all possible conditions (inhibition of left and right DLPFC with 1-Hz and sham; excitation of left and right DLPFC with 10-Hz and sham) were administered to the same subjects. It was expected that excitation of the left DLPFC with rTMS decreases and excitation of the right DLPFC increases the rate of lying and that inhibitory stimulation reverses the effects. As was expected, excitation of the left DLPFC decreased lying compared to excitation of the right DLPFC, but contrary to the expectation, inhibition had no different effects. These findings suggest that propensity to lie can be manipulated by non-invasive excitatory brain stimulation by TMS targeted at DLPFC and the direction of the effect depends on the cortical target locus. PMID:25233864

  10. Economic evaluation of resistant major depressive disorder treatment in Iranian population: a comparison between repetitive Transcranial Magnetic Stimulation with electroconvulsive

    PubMed Central

    Ghiasvand, Hesam; Moradi- Joo, Mohammad; Abolhassani, Nazanin; Ravaghi, Hamid; Raygani, Seyed Mansoor; Mohabbat-Bahar, Sahar

    2016-01-01

    Background: It is estimated that major depression disorders constitute 8.2% of years lived with disability (YLDs) globally. The repetitive Transcranial Magnetic Stimulation (rTMS) and Electroconvulsive Therapy (ECT) are two relative common interventions to treat major depressive disorders, especially for treatment resistant depression. In this study the cost- effectiveness and cost-utility of rTMS were compared with ECT in Iranian population suffering from major depressive disorder using a decision tree model. Methods: A decision tree model conducted to compare the cost-effectiveness ratio of rTMS with ECT in a health system prospective and 7 months’ time horizon. The outcome variables were: response rate, remission rate and quality-adjusted life-years (QALYs) of the rTMS and ECT as primary and secondary outcomes extracted from systematic reviews and randomized control trials. The costs were also calculated through a field study in one clinic and one hospital; the direct costs have only been considered. Results: The total cost for rTMS and ECTstrategieswere11015000Rials (373US$) and 11742700 Rials (397.7US$), respectively. Also the rTMS/ECT ratio of costs per improved patients was 1194410Rials (40.5 US$); the ratio for costs per QALYs utility was 21017139 Rials (711.72 US$). The incremental cost- effectiveness ratio of rTMS versus ECT was 1194410 Rials (40.44 US$) after treatment and maintenance courses. Conclusion: Given the current prevalence of depressive disorders in Iranian population, the ECT is more cost-effective than TMS. The sensitivity analysis showed that if the prevalence of major depressive disorders declines to below 5% or the costs of rTMS decrease (rTMS provided by public sector), then the rTMS becomes more cost-effective compared with ECT. However, efficacy of rTMS depends on the frequency of pulsed magnetic field, the location of rTMS on the head, the number of therapeutic sessions and the length of each session. PMID:27390700

  11. [Transcranial magnetic stimulation used in psychiatry].

    PubMed

    Bouché, Christophe; Marigaux, Sandrine; Pattedoie, Nicolas

    2015-11-01

    Repetitive transcranial magnetic stimulation is a non-invasive treatment technique, using electromagnetism properties. It has been used for around twenty years in neurology (treatment of neuropathic pain, certain abnormal movements, Parkinson's disease), and in psychiatry (obsessive compulsive disorder, hallucinations, mood disorders, etc.). The presence and support of a nurse during the sessions is essential. PMID:26548388

  12. Bilateral responses of prefrontal and motor cortices to repetitive transcranial magnetic stimulation as measured by functional near infrared spectroscopy

    NASA Astrophysics Data System (ADS)

    Tian, Fenghua; Kozel, Frank Andrew; Dhamne, Sameer; McClintock, Shawn M.; Croarkin, Paul; Mapes, Kimberly; Husain, Mustafa M.; Liu, Hanli

    2009-02-01

    Simultaneously acquiring cortical functional Near Infrared Spectroscopy (fNIRS) during repeated Transcranial Magnetic Stimulation (rTMS) offers the possibility of directly investigating the effects of rTMS on brain regions without quantifiable behavioral changes. In this study, the left motor cortex and subsequently the left prefrontal cortex were stimulated at 1 Hz while fNIRS data was simultaneously acquired. Changes in hemodynamic signals were measured on both ipsilateral and contralateral sides. In each cortex, a significantly larger decrease in the concentration of oxygenated hemoglobin and a smaller increase in the concentration of deoxygenated hemoglobin during the stimulation periods were observed in both the motor and prefrontal cortices. The ipsilateral and contralateral changes showed high temporal consistency. Same experiment was repeated for each subject 2 or 3 days later. The hemodynamic responses associated with the stimulation showed good reproducibility in two sessions. To our knowledge, this is the first report of simultaneous fNIRS measurement of ipsilateral and contralateral changes of either the motor or prefrontal cortex during rTMS stimulation.

  13. Repetitive transcranial magnetic stimulation (rTMS) in schizophrenia with treatment-refractory auditory hallucinations and major self-mutilation.

    PubMed

    Schulz, Torsten; Berger, Christoph; Krecklow, Beate; Kurth, Jens; Schwarzenboeck, Sarah; Foley, Paul; Thome, Johannes; Krause, Bernd Joachim; Hoeppner, Jacqueline

    2015-08-01

    Major self-mutilation is one of the most hazardous complications encountered in psychiatric patients, and is generally associated with auditory verbal hallucinations as part of a psychotic syndrome. This case report exemplarily discusses the treatment of such hallucinations with repeated (20 sessions) low-frequency (1 Hz) transcranial magnetic stimulation targeting areas of elevated metabolic activity in the temporo-parietal cortex ('neuronavigated rTMS'), drawing upon experience concerning treatment of a patient with chronic auditory verbal hallucinations that had proved intractable to antipsychotic medication combined with cognitive behavioural therapy, and who had severed a forearm because of the content of these hallucinations. This example of major self-mutilation underscores the urgent requirement for effective management of chronic auditory verbal hallucinations in patients suffering from psychiatric disease, and neuronavigated rTMS represents an approach that deserves further exploration in this regard. PMID:24398780

  14. Repetitive Transcranial Direct Current Stimulation Induced Excitability Changes of Primary Visual Cortex and Visual Learning Effects—A Pilot Study

    PubMed Central

    Sczesny-Kaiser, Matthias; Beckhaus, Katharina; Dinse, Hubert R.; Schwenkreis, Peter; Tegenthoff, Martin; Höffken, Oliver

    2016-01-01

    Studies on noninvasive motor cortex stimulation and motor learning demonstrated cortical excitability as a marker for a learning effect. Transcranial direct current stimulation (tDCS) is a non-invasive tool to modulate cortical excitability. It is as yet unknown how tDCS-induced excitability changes and perceptual learning in visual cortex correlate. Our study aimed to examine the influence of tDCS on visual perceptual learning in healthy humans. Additionally, we measured excitability in primary visual cortex (V1). We hypothesized that anodal tDCS would improve and cathodal tDCS would have minor or no effects on visual learning. Anodal, cathodal or sham tDCS were applied over V1 in a randomized, double-blinded design over four consecutive days (n = 30). During 20 min of tDCS, subjects had to learn a visual orientation-discrimination task (ODT). Excitability parameters were measured by analyzing paired-stimulation behavior of visual-evoked potentials (ps-VEP) and by measuring phosphene thresholds (PTs) before and after the stimulation period of 4 days. Compared with sham-tDCS, anodal tDCS led to an improvement of visual discrimination learning (p < 0.003). We found reduced PTs and increased ps-VEP ratios indicating increased cortical excitability after anodal tDCS (PT: p = 0.002, ps-VEP: p = 0.003). Correlation analysis within the anodal tDCS group revealed no significant correlation between PTs and learning effect. For cathodal tDCS, no significant effects on learning or on excitability could be seen. Our results showed that anodal tDCS over V1 resulted in improved visual perceptual learning and increased cortical excitability. tDCS is a promising tool to alter V1 excitability and, hence, perceptual visual learning. PMID:27375452

  15. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report

    PubMed Central

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young

    2015-01-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  16. Successful Treatment of Phantom Limb Pain by 1 Hz Repetitive Transcranial Magnetic Stimulation Over Affected Supplementary Motor Complex: A Case Report.

    PubMed

    Lee, Jong-Hoo; Byun, Jeong-Hyun; Choe, Yu-Ri; Lim, Seung-Kyu; Lee, Ka-Young; Choi, In-Sung

    2015-08-01

    A 37-year-old man with a right transfemoral amputation suffered from severe phantom limb pain (PLP). After targeting the affected supplementary motor complex (SMC) or primary motor cortex (PMC) using a neuro-navigation system with 800 stimuli of 1 Hz repetitive transcranial magnetic stimulation (rTMS) at 85% of resting motor threshold, the 1 Hz rTMS over SMC dramatically reduced his visual analog scale (VAS) of PLP from 7 to 0. However, the 1 Hz rTMS over PMC failed to reduce pain. To our knowledge, this is the first case report of a successfully treated severe PLP with a low frequency rTMS over SMC in affected hemisphere. PMID:26361601

  17. In Vitro Assessment Reveals Parameters-Dependent Modulation on Excitability and Functional Connectivity of Cerebellar Slice by Repetitive Transcranial Magnetic Stimulation

    PubMed Central

    Tang, Rongyu; Zhang, Guanghao; Weng, Xiechuan; Han, Yao; Lang, Yiran; Zhao, Yuwei; Zhao, Xiaobo; Wang, Kun; Lin, Qiuxia; Wang, Changyong

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is an increasingly common technique used to selectively modify neural excitability and plasticity. There is still controversy concerning the cortical response to rTMS of different frequencies. In this study, a novel in vitro paradigm utilizing the Multi-Electrodes Array (MEA) system and acute cerebellar slicing is described. In a controllable environment that comprises perfusion, incubation, recording and stimulation modules, the spontaneous single-unit spiking activity in response to rTMS of different frequencies and powers was directly measured and analyzed. Investigation using this in vitro paradigm revealed frequency-dependent modulation upon the excitability and functional connectivity of cerebellar slices. The 1-Hz rTMS sessions induced short-term inhibition or lagged inhibition, whereas 20-Hz sessions induced excitation. The level of modulation is influenced by the value of power. However the long-term response fluctuated without persistent direction. The choice of evaluation method may also interfere with the interpretation of modulation direction. Furthermore, both short-term and long-term functional connectivity was strengthened by 1-Hz rTMS and weakened by 20-Hz rTMS. PMID:27000527

  18. Meta-analysis of the effects of repetitive transcranial magnetic stimulation (rTMS) on negative and positive symptoms in schizophrenia

    PubMed Central

    Freitas, Catarina; Fregni, Felipe; Pascual-Leone, Alvaro

    2009-01-01

    Background A growing body of evidence suggests that repetitive transcranial magnetic stimulation (rTMS) can alleviate negative and positive symptoms of refractory schizophrenia. However, trials to date have been small and results are mixed. Methods We performed meta-analyses of all prospective studies of the therapeutic application of rTMS in refractory schizophrenia assessing the effects of high-frequency rTMS to the left dorsolateral prefrontal cortex (DLPFC) to treat negative symptoms, and low-frequency rTMS to the left temporo-parietal cortex (TPC) to treat auditory hallucinations (AH) and overall positive symptoms. Results When analyzing controlled (active arms) and uncontrolled studies together, the effect sizes showed significant and moderate effects of rTMS on negative and positive symptoms (based on PANSS-N or SANS, and PANSS-P or SAPS, respectively). However, the analysis for the sham-controlled studies revealed a small non-significant effect size for negative (0.27, p=0.417) and for positive symptoms (0.17, p=0.129). When specifically analyzing AH (based on AHRS, HCS or SAH), the effect size for the sham-controlled studies was large and significant (1.04; p=0.002). Conclusions These meta-analyses support the need for further controlled, larger trials to assess the clinical efficacy of rTMS on negative and positive symptoms of schizophrenia, while suggesting the need for exploration for alternative stimulation protocols. PMID:19138833

  19. The role of the left inferior frontal gyrus in episodic encoding of faces: An interference study by repetitive transcranial magnetic stimulation.

    PubMed

    Feurra, Matteo; Fuggetta, Giorgio; Rossi, Simone; Walsh, Vincent

    2010-06-01

    Despite extensive research on face recognition, only a few studies have examined the integration of perceptual features with semantic, biographical, and episodic information. In order to address this issue, we used repetitive transcranial magnetic stimulation (rTMS) to target the left inferior frontal gyrus (IFG) and the left occipital face area (OFA) during a face recognition task. rTMS was delivered during the encoding of "context" faces (i.e., linked to an occupation, e.g., "lawyer") and "no-context" faces (i.e., linked to a nonword pattern, e.g., "xxxx"). Subjects were then asked to perform a recognition memory task. Accuracy at retrieval showed a mild decrease after left OFA stimulation, whereas rTMS over the left IFG drastically compromised memory performance selectively for no-context faces. On the other hand, absence of rTMS interference on context faces might be due either to the fact that pairing an occupation to a face makes the memory trace stronger, therefore less susceptible to rTMS interference, or to a different functional specificity of the left IFG subregions. PMID:24168278

  20. Neural correlates associated with symptom provocation in pediatric obsessive compulsive disorder after a single session of sham-controlled repetitive transcranial magnetic stimulation.

    PubMed

    Pedapati, Ernest; DiFrancesco, Mark; Wu, Steve; Giovanetti, Cathy; Nash, Tiffany; Mantovani, Antonio; Ammerman, Robert; Harris, Elana

    2015-09-30

    Treatments for pediatric obsessive-compulsive disorder (OCD) could be enhanced if the physiological changes engendered by treatment were known. This study examined neural correlates of a provocation task in youth with OCD, before and after sham-controlled repetitive transcranial magnetic stimulation (rTMS). We hypothesized that rTMS to the right dorsolateral prefrontal cortex would inhibit activity in cortico-striato-thalamic (CST) circuits associated with OCD to a greater extent than sham rTMS. After baseline (Time 1) functional magnetic resonance imaging (fMRI) during a provocation task, subjects received one session of either fMRI-guided sham (SG; n=8) or active (AG; n=10) 1-Hz rTMS over the rDLPFC for 30min. During rTMS, subjects were presented with personalized images that evoked OCD-related anxiety. Following stimulation, fMRI and the provocation task were repeated (Time 2). Contrary to our prediction for the provocation task, the AG was associated with no changes in BOLD response from Times 1 to 2. In contrast, the SG had a significant increase at Time 2 in BOLD response in the right inferior frontal gyrus and right putamen, which persisted after adjusting for age, gender, and time to scanner as covariates. This study provides an initial framework for TMS interrogation of the CST circuit in pediatric OCD. PMID:26228567

  1. Low-frequency, Repetitive Transcranial Magnetic Stimulation for the Treatment of Patients with Posttraumatic Stress Disorder: a Double-blind, Sham-controlled Study

    PubMed Central

    Nam, Dong-Hyun; Pae, Chi-Un

    2013-01-01

    Objective Several studies have suggested that repetitive transcranial magnetic stimulation (rTMS) of the right prefrontal cortex may be useful in the treatment of posttraumatic stress disorder (PTSD). The aim of this study was to compare the effect of rTMS on the right prefrontal cortex with that of sham stimulation among patients with PTSD. Methods In total, 18 patients with PTSD were randomly assigned to the 1-Hz low-frequency rTMS group or the sham group for 3 weeks. Primary efficacy measures were the Clinician-Administered PTSD Scale (CAPS) and its subscales, assessed at baseline and at 2, 4, and 8 weeks. Results All CAPS scores improved significantly over the study period. We found significant differences in the re-experiencing scores (F=7.47, p=0.004) and total scores (F=6.45, p=0.008) on the CAPS. The CAPS avoidance scores showed a trend toward significance (F=2.74, p=0.055), but no significant differences in the CAPS hyperarousal scores were observed. Conclusion The present study showed low-frequency rTMS to be an effective and tolerable option for the treatment of PTSD. Trials using variable indices of rTMS to the right prefrontal cortex and explorations of the differences in the effects on specific symptom clusters may be promising avenues of research regarding the use of rTMS for PTSD. PMID:24023554

  2. Effect of the stimulus frequency and pulse number of repetitive transcranial magnetic stimulation on the inter-reversal time of perceptual reversal on the right superior parietal lobule

    NASA Astrophysics Data System (ADS)

    Nojima, Kazuhisa; Ge, Sheng; Katayama, Yoshinori; Ueno, Shoogo; Iramina, Keiji

    2010-05-01

    The aim of this study is to investigate the effect of the stimulus frequency and pulses number of repetitive transcranial magnetic stimulation (rTMS) on the inter-reversal time (IRT) of perceptual reversal on the right superior parietal lobule (SPL). The spinning wheel illusion was used as the ambiguous figures stimulation in this study. To investigate the rTMS effect over the right SPL during perceptual reversal, 0.25 Hz 60 pulse, 1 Hz 60 pulse, 0.5 Hz 120 pulse, 1 Hz 120 pulse, and 1 Hz 240 pulse biphasic rTMS at 90% of resting motor threshold was applied over the right SPL and the right posterior temporal lobe (PTL), respectively. As a control, a no TMS was also conducted. It was found that rTMS on 0.25 Hz 60 pulse and 1 Hz 60 pulse applied over the right SPL caused shorter IRT. In contrast, it was found that rTMS on 1 Hz 240-pulse applied over the right SPL caused longer IRT. On the other hand, there is no significant difference between IRTs when the rTMS on 0.5 Hz 120 pulse and 1 Hz 120 pulse were applied over the right SPL. Therefore, the applying of rTMS over the right SPL suggests that the IRT of perceptual reversal is effected by the rTMS conditions such as the stimulus frequency and the number of pulses.

  3. Intensity-dependent effects of repetitive anodal transcranial direct current stimulation on learning and memory in a rat model of Alzheimer's disease.

    PubMed

    Yu, Xuehong; Li, Yiyan; Wen, Huizhong; Zhang, Yinghui; Tian, Xuelong

    2015-09-01

    Single-session anodal transcranial direct current stimulation (tDCS) can improve the learning-memory function of patients with Alzheimer's disease (AD). After-effects of tDCS can be more significant if the stimulation is repeated regularly in a period. Here the behavioral and the histologic effects of the repetitive anodal tDCS on a rat model of AD were investigated. Sprague-Dawley rats were divided into 6 groups, the sham group, the β-amyloid (Aβ) group, the Aβ+20μA tDCS group, the Aβ+60μA tDCS group, the Aβ+100μA tDCS group and the Aβ+200μA tDCS group. Bilateral hippocampus of the rats in the Aβ group and the Aβ+tDCS groups were lesioned by Aβ1-40 to produce AD models. One day after drug injection, repetitive anodal tDCS (10 sessions in two weeks, 20min per session) was applied to the frontal cortex of the rats in the tDCS groups, while sham stimulation was applied to the Aβ group and the sham group. The spatial learning and memory capability of the rats were tested by Morris water maze. Bielschowsky's silver staining, Nissl's staining, choline acetyltransferase (ChAT) and glial-fibrillary-acidic protein (GFAP) immunohistochemistry of the hippocampus were conducted for histologic analysis. Results show in the Morris water maze task, rats in the Aβ+100μA and the Aβ+200μA tDCS groups had shorter escape latency and larger number of crossings on the platform. Significant histologic differences were observed in the Aβ+100μA and the Aβ+200μA tDCS groups compared to the Aβ group. The behavioral and the histological experiments indicate that the proposed repetitive anodal tDCS treatment can protect spatial learning and memory dysfunction of Aβ1-40-lesioned AD rats. PMID:26070657

  4. Repetitive Transcranial Magnetic Stimulation Changes Cerebral Oxygenation on the Left Dorsolateral Prefrontal Cortex in Bulimia Nervosa: A Near-Infrared Spectroscopy Pilot Study.

    PubMed

    Sutoh, Chihiro; Koga, Yasuko; Kimura, Hiroshi; Kanahara, Nobuhisa; Numata, Noriko; Hirano, Yoshiyuki; Matsuzawa, Daisuke; Iyo, Masaomi; Nakazato, Michiko; Shimizu, Eiji

    2016-01-01

    Previous studies showed that food craving in eating disorders can be weakened with high-frequency repetitive transcranial magnetic stimulation (rTMS) on the left dorsolateral prefrontal cortex (DLPFC). The aims of this study were to assess cerebral oxygenation change induced with rTMS and to assess the short-term impact of rTMS on food craving and other bulimic symptoms in patients with bulimia nervosa (BN). Eight women diagnosed with BN according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria participated in this study. We measured haemoglobin concentration changes in the DLPFC with near-infrared spectroscopy during cognitive tasks measuring self-regulatory control in response to food photo stimuli, both at baseline and after a single session of rTMS. Subjective ratings for food cravings demonstrated significant reduction. A significant decrease in cerebral oxygenation of the left DLPFC was also observed after a single session of rTMS. Measurement with NIRS after rTMS intervention may be applicable for discussing the mechanisms underlying rTMS modulation in patients with BN. PMID:26481583

  5. Unanticipated Rapid Remission of Refractory Bulimia Nervosa, during High-Dose Repetitive Transcranial Magnetic Stimulation of the Dorsomedial Prefrontal Cortex: A Case Report

    PubMed Central

    Downar, Jonathan; Sankar, Ashwin; Giacobbe, Peter; Woodside, Blake; Colton, Patricia

    2012-01-01

    A woman with severe, refractory bulimia nervosa (BN) underwent treatment for comorbid depression using repetitive transcranial magnetic stimulation (rTMS) of the dorsomedial prefrontal cortex (DMPFC) using a novel technique. Unexpectedly, she showed a rapid, dramatic remission from BN. For 5 months pre-treatment, she had reported two 5-h binge-purge episodes per day. After rTMS session 2 the episodes stopped entirely for 1 week; after session 10 there were no further recurrences. Depression scores improved more gradually to remission at session 10. Full remission from depression and binge-eating/purging episodes was sustained more than 2 months after treatment completion. In neuroimaging studies, the DMPFC is important in impulse control, and is underactive in BN. DMPFC–rTMS may have enhanced the patient’s ability to deploy previously acquired strategies to avoid binge-eating and purging via a reduction in her impulsivity. A larger sham-controlled trial of DMPFC–rTMS for binge-eating and purging behavior may be warranted. PMID:22529822

  6. Improvement in Paretic Arm Reach-to-Grasp following Low Frequency Repetitive Transcranial Magnetic Stimulation Depends on Object Size: A Pilot Study

    PubMed Central

    Tretriluxana, Jarugool; Kantak, Shailesh; Tretriluxana, Suradej; Wu, Allan D.; Fisher, Beth E.

    2015-01-01

    Introduction. Low frequency repetitive transcranial magnetic stimulation (LF-rTMS) delivered to the nonlesioned hemisphere has been shown to improve limited function of the paretic upper extremity (UE) following stroke. The outcome measures have largely included clinical assessments with little investigation on changes in kinematics and coordination. To date, there is no study investigating how the effects of LF-rTMS are modulated by the sizes of an object to be grasped. Objective. To investigate the effect of LF-rTMS on kinematics and coordination of the paretic hand reach-to-grasp (RTG) for two object sizes in chronic stroke. Methods. Nine participants received two TMS conditions: real rTMS and sham rTMS conditions. Before and after the rTMS conditions, cortico-motor excitability (CE) of the nonlesioned hemisphere, RTG kinematics, and coordination was evaluated. Object sizes were 1.2 and 7.2 cm in diameter. Results. Compared to sham rTMS, real rTMS significantly reduced CE of the non-lesioned M1. While rTMS had no effect on RTG action for the larger object, real rTMS significantly improved movement time, aperture opening, and RTG coordination for the smaller object. Conclusions. LF-rTMS improves RTG action for only the smaller object in chronic stroke. The findings suggest a dissociation between effects of rTMS on M1 and task difficulty for this complex skill. PMID:26664827

  7. Long-term Effectiveness of Modified Electroconvulsive Therapy Compared With Repetitive Transcranial Magnetic Stimulation for the Treatment of Recurrent Major Depressive Disorder.

    PubMed

    Jin, Xi-Long; Xu, Wei-Qin; Le, Ya-Juan; Dai, Xiong-Kai

    2016-06-01

    This retrospective study recruited 150 patients with recurrent major depressive disorder (MDD) who received modified electroconvulsive therapy (MECT) and 150 cases treated with repetitive transcranial magnetic stimulation (rTMS), which aimed to compare the short- and long-term effectiveness, as well as economic outcomes, of MECT and rTMS with a large sample size in patients with recurrent MDD. The results showed that the response rate of patients in the rTMS group was lower than that in the MECT group (46.0% vs 58.7%, p < 0.05). Patients in the rTMS group had elevated rate of dizziness, but reduced rates of poor memory and headache, as well as lower costs compared with the MECT group (p < 0.05). Importantly, we found that the relapse-free survival of patients was similar between the rTMS and MECT groups in the long term. In conclusion, rTMS is an alternative method for MECT in the treatment of patients with recurrent MDD. PMID:26915018

  8. Adjunctive Low-frequency Repetitive Transcranial Magnetic Stimulation over the Right Dorsolateral Prefrontal Cortex in Patients with Treatment-resistant Obsessive-compulsive Disorder: A Randomized Controlled Trial

    PubMed Central

    Seo, Ho-Jun; Jung, Young-Eun; Lim, Hyun Kook; Um, Yoo-Hyun; Lee, Chang Uk; Chae, Jeong-Ho

    2016-01-01

    Objective The present study aimed to evaluate the efficacy of low frequency (LF) repetitive transcranial magnetic stimulation (rTMS) over the right dorsolateral prefrontal cortex (DLPFC) for the treatment of obsessive-compulsive disorder (OCD). Methods Twenty-seven patients with treatment resistant OCD were randomly assigned to 3 week either active (n=14) or sham (n=13) rTMS. The active rTMS parameters consisted of 1 Hz, 20-minute trains (1,200 pulses/day) at 100% of the resting motor threshold (MT). OCD symptoms, mood, and anxiety were assessed at baseline and every week throughout the treatment period. Results A repeated-measures analysis of variance (ANOVA) was used to evaluate changes on the Yale-Brown Obsessive Compulsive Scale (YBOCS). Our results revealed a significant reduction in YBOCS scores in the active group compared with the sham group after 3 weeks. Similarly, a repeated-measures ANOVA revealed significant effect of time and time×group interaction on scores on the Hamilton Depression Rating Scale and the Clinical Global Impression-Severity scale. There were no reports of any serious adverse effects following the active and sham rTMS treatments. Conclusion LF rTMS over the right DLPFC appeared to be superior to sham rTMS for relieving OCD symptoms and depression in patients with treatment-resistant OCD. Further trials with larger sample sizes should be conducted to confirm the present findings. PMID:27121426

  9. Effects of repetitive transcranial magnetic stimulation over supplementary motor area in patients with schizophrenia with obsessive-compulsive-symptoms: A pilot study.

    PubMed

    Mendes-Filho, Vauto Alves; de Jesus, Danilo Rocha; Belmonte-de-Abreu, Paulo; Cachoeira, Carolina Tosetto; Rodrigues Lobato, Maria Inês

    2016-08-30

    In patients with schizophrenia, obsessive-compulsive symptoms (OCS) are associated with lower rates of quality of life and polypharmacy. No previous controlled studies have tested the efficacy of repetitive transcranial magnetic stimulation (rTMS) on the treatment of OCS in this population. The present study examined the therapeutic effects of rTMS applied to the supplementary motor area (1Hz, 20min, 20 sessions) on OCS and general symptoms in patients with schizophrenia or schizoaffective disorder, and whether this intervention can produce changes in plasma levels of brain derived neurotrophic factor (BDNF). A double-blind randomized controlled trial was conducted. Active and sham rTMS were delivered to 12 patients (6 on each group). Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and Brief Psychiatric Rating Scale (BPRS) scores, as well as BDNF levels, were assessed before, after, and 4 weeks after treatment. rTMS did not significantly change the outcomes after treatment and on the follow-up (Y-BOCS: Wald's X(2)=3.172; p=0.205; BPRS: X(2)=1.629; p=0.443; BDNF: X(2)=2.930; p=0.231). There seemed to be a trend towards improvement of BPRS scores 4 weeks after rTMS treatment comparing with sham (Cohen's d=0.875, with 32.9% statistical power). No side effects were reported. Future studies with larger sample sizes are needed. PMID:27254652

  10. Safety of primed repetitive transcranial magnetic stimulation and modified constraint-induced movement therapy in a randomized controlled trial in pediatric hemiparesis

    PubMed Central

    Gillick, Bernadette; Krach, Linda E; Feyma, Tim; Rich, Tonya L; Moberg, Kelli; Menk, Jeremiah; Cassidy, Jessica; Kimberley, Teresa; Carey, James R

    2014-01-01

    Objective To investigate the safety of combining 6-Hz primed low-frequency repetitive transcranial magnetic stimulation (rTMS) intervention in the contralesional hemisphere with a modified constraint-induced movement therapy (mCIMT) program in children with congenital hemiparesis. Design Phase 1 randomized, double-blinded, placebo-controlled pretest/posttest trial. Setting University academic facility and a pediatric specialty hospital. Participants Nineteen subjects aged 8 to 17 years with congenital hemiparesis due to ischemic stroke or periventricular leukomalacia. No subject withdrew due to adverse events. All subjects included completed the study. Interventions Subjects were randomized to one of two groups: either rTMSreal with mCIMT (n = 10) or rTMSsham with mCIMT (n = 9). Main Outcome Measures Adverse events, physician assessment, ipsilateral hand function, stereognosis, cognitive function, subject report of symptoms assessment and subject questionnaire. Results No major adverse events occurred. Minor adverse events were found in both groups. The most common were headaches (real: 50%, sham: 89%, p=0.14) and cast irritation (real: 30%, sham: 44%, p = 0.65). No differences between groups in secondary cognitive and unaffected hand motor measures were found. Conclusions Primed rTMS can be used safely with mCIMT in congenital hemiparesis. We provide new information on the use of rTMS in combination with mCIMT in children. These findings could be useful in research and future clinical applications in advancing function in congenital hemiparesis. PMID:25283350

  11. Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression in Adult and Youth Populations: A Systematic Literature Review and Meta-Analysis

    PubMed Central

    Leggett, Laura E.; Soril, Lesley J. J.; Coward, Stephanie; Lorenzetti, Diane L.; MacKean, Gail; Clement, Fiona M.

    2015-01-01

    Background: Between 30% and 60% of individuals with major depressive disorder will have treatment-resistant depression (TRD): depression that does not subside with pharmaceutical treatment. Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment for TRD. Objective: To establish the efficacy and optimal protocol for rTMS among adults and youth with TRD. Data Sources: Two systematic reviews were conducted: one to determine the efficacy of rTMS for adults with TRD and another to determine the effectiveness of rTMS for youth with TRD. For adults, MEDLINE, Cochrane Central Register of Controlled Trials, PubMed, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, and Health Technology Assessment Database were searched from inception until January 10, 2014 with no language restrictions. Terms aimed at capturing the target diagnosis, such as depression and depressive disorder, were combined with terms describing the technology, such as transcranial magnetic stimulation and rTMS. Results were limited to studies involving human participants and designed as a randomized controlled trial. For youth, the search was altered to include youth only (aged 13–25 years) and all study designs. When possible, meta-analysis of response and remission rates was conducted. Study Selection: Seventy-three articles were included in this review: 70 on adult and 3 on youth populations. Results: Meta-analysis comparing rTMS and sham in adults found statistically significant results favoring rTMS for response (RR: 2.35 [95% CI, 1.70–3.25]) and remission (RR: 2.24 [95% CI, 1.53–3.27]). No statistically significant differences were found when comparing high- and low-frequency, unilateral and bilateral, low- and high-intensity rTMS or rTMS and electroconvulsive therapy (ECT). While meta-analysis of results from the youth literature was not possible, the limited evidence base suggests that rTMS may be effective for treating TRD in youth. Conclusions: The evidence

  12. Synergistic effects of noradrenergic modulation with atomoxetine and 10 Hz repetitive transcranial magnetic stimulation on motor learning in healthy humans

    PubMed Central

    2014-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) is able to induce changes in neuronal activity that outlast stimulation. The underlying mechanisms are not completely understood. They might be analogous to long-term potentiation or depression, as the duration of the effects seems to implicate changes in synaptic plasticity. Norepinephrine (NE) has been shown to play a crucial role in neuronal plasticity in the healthy and injured human brain. Atomoxetine (ATX) and other NE reuptake inhibitors have been shown to increase excitability in different systems and to influence learning processes. Thus, the combination of two facilitative interventions may lead to further increase in excitability and motor learning. But in some cases homeostatic metaplasticity might protect the brain from harmful hyperexcitability. In this study, the combination of 60 mg ATX and 10 Hz rTMS over the primary motor cortex was used to examine changes in cortical excitability and motor learning and to investigate their influence on synaptic plasticity mechanisms. Results The results of this double-blind placebo-controlled study showed that ATX facilitated corticospinal and intracortical excitability in motor cortex. 10 Hertz rTMS applied during a motor task was able to further increase intracortical excitability only in combination with ATX. In addition, only the combination of 10 Hz rTMS and ATX was capable of enhancing the total number of correct responses and reaction time significantly, indicating an interaction effect between rTMS and ATX without signs of homeostatic metaplasticity. Conclusion These results suggest that pharmacologically enhanced NE transmission and 10 Hz rTMS exert a synergistic effect on motor cortex excitability and motor learning in healthy humans. PMID:24690416

  13. Efficacy of Adjunctive High Frequency Repetitive Transcranial Magnetic Stimulation of Right Prefrontal Cortex in Adolescent Mania: A Randomized Sham-Controlled Study

    PubMed Central

    Pathak, Vijay; Sinha, Vinod Kumar; Praharaj, Samir Kumar

    2015-01-01

    Objective To examine the efficacy of adjunctive right prefrontal high-frequency repetitive transcranial magnetic stimulation (rTMS) treatment in adolescent mania patients as compared to sham stimulation. Methods Twenty six right handed patients aged 12–17 years diagnosed with bipolar mania were randomized to receive daily sessions of active or sham rTMS (20 Hz, 110% of motor threshold, 20 trains, 10 s intertrain interval) over the right dorsolateral prefrontal cortex for 10 days. Mania was rated using Young Mania Rating Scale (YMRS) and Clinical Global Impression (CGI) at baseline, and after 5th and 10th rTMS. Results For YMRS scores, repeated measures analysis of variance (ANOVA) showed a significant main effect (F=44.49, degree of freedom [df]=1.2/29.29, p<0.001, Greenhouse-Geisser corrected, effect size η2=0.65), but the interaction effect was not significant (F=0.03, df=1.2/29.29, p=0.912, Greenhouse-Geisser corrected). For CGI-Severity, repeated measures ANOVA showed a significant main effect (F=24.49, df=1.42/34.21, p<0.001, Greenhouse-Geisser corrected, effect size η2=0.51), but the interaction effect was not significant (F=0.06, df=1.2/29.29, p=0.881, Greenhouse-Geisser corrected). Conclusion High-frequency right prefrontal rTMS was found to be ineffective as add-on to standard pharmacotherapy in adolescent mania. PMID:26598581

  14. Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Modulates Evoked-Gamma Frequency Oscillations in Autism Spectrum Disorder (ASD)

    PubMed Central

    Baruth, Joshua M.; Casanova, Manuel F.; El-Baz, Ayman; Horrell, Tim; Mathai, Grace; Sears, Lonnie; Sokhadze, Estate

    2010-01-01

    Introduction It has been reported that individuals with Autism Spectrum Disorder (ASD) have abnormal reactions to the sensory environment and visuo-perceptual abnormalities. Electrophysiological research has provided evidence that gamma band activity (30-80 Hz) is a physiological indicator of the co-activation of cortical cells engaged in processing visual stimuli and integrating different features of a stimulus. A number of studies have found augmented and indiscriminative gamma band power at early stages of visual processing in ASD; this may be related to decreased inhibitory processing and an increase in the ratio of cortical excitation to inhibition. Low frequency or ‘slow’ (≤1HZ) repetitive transcranial magnetic stimulation (rTMS) has been shown to increase inhibition of stimulated cortex by the activation of inhibitory circuits. Methods We wanted to test the hypothesis of gamma band abnormalities at early stages of visual processing in ASD by investigating relative evoked (i.e. ~ 100 ms) gamma power in 25 subjects with ASD and 20 age-matched controls using Kanizsa illusory figures. Additionally, we wanted to assess the effects of 12 sessions of bilateral ‘slow’ rTMS to the dorsolateral prefrontal cortex (DLPFC) on evoked gamma activity using a randomized controlled design. Results In individuals with ASD evoked gamma activity was not discriminative of stimulus type, whereas in controls early gamma power differences between target and non-target stimuli were highly significant. Following rTMS individuals with ASD showed significant improvement in discriminatory gamma activity between relevant and irrelevant visual stimuli. We also found significant improvement in the responses on behavioral questionnaires (i.e., irritability, repetitive behavior) as a result of rTMS. Conclusion We proposed that ‘slow’ rTMS may have increased cortical inhibitory tone which improved discriminatory gamma activity at early stages of visual processing. rTMS has the

  15. Effects of high-frequency repetitive transcranial magnetic stimulation (rTMS) on spontaneously hypertensive rats, an animal model of attention-deficit/hyperactivity disorder.

    PubMed

    Kim, Jungyun; Park, Heamen; Yu, Seong-Lan; Jee, Sungju; Cheon, Keun-Ah; Song, Dong Ho; Kim, Seung Jun; Im, Woo-Young; Kang, Jaeku

    2016-10-01

    The current treatment of choice for attention deficit hyperactivity disorder (ADHD) is pharmacotherapy. A search for new treatment options is underway, however, as the wide application of drugs to the general population of patients with ADHD is limited by side effects and the variance of pharmacokinetic effects of the drugs in each patient. In the present study, we applied repetitive transcranial magnetic stimulation (rTMS), a non-invasive treatment used in a number of other psychiatric disorders, to spontaneously hypertensive rats (SHRs), an animal model of ADHD, in order to assess the efficacy of the treatment in modifying behavioural symptoms as well as levels of dopamine, noradrenaline, serotonin, and brain-derived neurotrophic factor (BDNF). A total of fifteen sessions of high-frequency rTMS treatment were administered. Behavioural symptoms were observed using open field, Y-maze, and elevated plus-maze tests. Upon completion of the experiments, rats were sacrificed, and the neurochemical changes in brain tissue were analysed using high performance liquid chromatography and Western blotting. The SHRs treated with rTMS tended to exhibit less locomotor activity in the open field test over the course of treatment, but there was no improvement in inattention as measured by the Y-maze test. Furthermore, BDNF concentration increased and noradrenaline concentration decreased in the prefrontal cortex of SHRs treated with rTMS. The results of the present preclinical study indicate that rTMS may constitute a new modality of treatment for patients with ADHD, through further evaluation of specific treatment parameters as well as safety and efficacy in humans are required. PMID:27469434

  16. Repetitive Transcranial Magnetic Stimulation Promotes Neural Stem Cell Proliferation via the Regulation of MiR-25 in a Rat Model of Focal Cerebral Ischemia

    PubMed Central

    Zhang, Jinghui; Zhao, Xiuxiu; Lou, Jicheng; Chen, Hong; Huang, Xiaolin

    2014-01-01

    Repetitive transcranial magnetic stimulation (rTMS) has increasingly been studied over the past decade to determine whether it has a therapeutic benefit on focal cerebral ischemia. However, the underlying mechanism of rTMS in this process remains unclear. In the current study, we investigated the effects of rTMS on the proliferation of adult neural stem cells (NSCs) and explored microRNAs (miRNAs) that were affected by rTMS. Our data showed that 10 Hz rTMS significantly increased the proliferation of adult NSCs after focal cerebral ischemia in the subventricular zone (SVZ), and the expression of miR-25 was obviously up-regulated in the ischemic cortex after rTMS. p57, an identified miR-25 target gene that regulates factors linked to NSC proliferation, was also evaluated, and it exhibited down-regulation. To further verify the role of miR-25, rats were injected with a single dose of antagomir-25 and were subjected to focal cerebral ischemia followed by rTMS treatment. The results confirmed that miR-25 could be repressed specifically and could drive the up-regulation of its target gene (p57), which resulted in the inhibition of adult NSC proliferation in the SVZ after rTMS. Thus, our studies strongly indicated that 10 Hz rTMS can promote the proliferation of adult NSCs in the SVZ after focal cerebral ischemia by regulating the miR-25/p57 pathway. PMID:25302788

  17. Role of Brain-Derived Neurotrophic Factor in Beneficial Effects of Repetitive Transcranial Magnetic Stimulation for Upper Limb Hemiparesis after Stroke

    PubMed Central

    Kakuda, Wataru; Miyano, Satoshi; Momosaki, Ryo; Abo, Masahiro

    2016-01-01

    Background Repetitive transcranial magnetic stimulation (rTMS) can improve upper limb hemiparesis after stroke but the mechanism underlying its efficacy remains elusive. rTMS seems to alter brain-derived neurotrophic factor (BDNF) and such effect is influenced by BDNF gene polymorphism. Objectives To investigate the molecular effects of rTMS on serum levels of BDNF, its precursor proBDNF and matrix metalloproteinase-9 (MMP-9) in poststroke patients with upper limb hemiparesis. Methods Poststroke patients with upper limb hemiparesis were studied. Sixty-two patients underwent rehabilitation plus rTMS combination therapy and 33 patients underwent rehabilitation monotherapy without rTMS for 14 days at our hospital. One Hz rTMS was applied over the motor representation of the first dorsal interosseous muscle on the non-lesional hemisphere. Fugl-Meyer Assessment and Wolf Motor Function (WMFT) were used to evaluate motor function on the affected upper limb before and after intervention. Blood samples were collected for analysis of BDNF polymorphism and measurement of BDNF, proBDNF and MMP-9 levels. Results Two-week combination therapy increased BDNF and MMP-9 serum levels, but not serum proBDNF. Serum BDNF and MMP-9 levels did not correlate with motor function improvement, though baseline serum proBDNF levels correlated negatively and significantly with improvement in WMFT (ρ = -0.422, p = 0.002). The outcome of rTMS therapy was not altered by BDNF gene polymorphism. Conclusions The combination therapy of rehabilitation plus low-frequency rTMS seems to improve motor function in the affected limb, by activating BDNF processing. BDNF and its precursor proBDNF could be potentially suitable biomarkers for poststroke motor recovery. PMID:27007747

  18. The Effects of Different Repetitive Transcranial Magnetic Stimulation (rTMS) Protocols on Cortical Gene Expression in a Rat Model of Cerebral Ischemic-Reperfusion Injury

    PubMed Central

    Ljubisavljevic, Milos R.; Javid, Asma; Oommen, Joji; Parekh, Khatija; Nagelkerke, Nico; Shehab, Safa; Adrian, Thomas E.

    2015-01-01

    Although repetitive Transcranial Magnetic Stimulation (rTMS) in treatment of stroke in humans has been explored over the past decade the data remain controversial in terms of optimal stimulation parameters and the mechanisms of rTMS long-term effects. This study aimed to explore the potential of different rTMS protocols to induce changes in gene expression in rat cortices after acute ischemic-reperfusion brain injury. The stroke was induced by middle cerebral artery occlusion (MCAO) with subsequent reperfusion. Changes in the expression of 96 genes were examined using low-density expression arrays after MCAO alone and after MCAO combined with 1Hz, 5Hz, continuous (cTBS) and intermittent (iTBS) theta-burst rTMS. rTMS over the lesioned hemisphere was given for two weeks (with a 2-day pause) in a single daily session and a total of 2400 pulses. MCAO alone induced significant upregulation in the expression of 44 genes and downregulation in 10. Two weeks of iTBS induced significant increase in the expression of 52 genes. There were no downregulated genes. 1Hz and 5Hz had no significant effects on gene expression, while cTBS effects were negligible. Upregulated genes included those involved in angiogenesis, inflammation, injury response and cellular repair, structural remodeling, neuroprotection, neurotransmission and neuronal plasticity. The results show that long-term rTMS in acute ischemic-reperfusion brain injury induces complex changes in gene expression that span multiple pathways, which generally promote the recovery. They also demonstrate that induced changes primarily depend on the rTMS frequency (1Hz and 5Hz vs. iTBS) and pattern (cTBS vs. iTBS). The results further underlines the premise that one of the benefits of rTMS application in stroke may be to prime the brain, enhancing its potential to cope with the injury and to rewire. This could further augment its potential to favorably respond to rehabilitation, and to restore some of the loss functions. PMID

  19. Cathodal Transcranial Direct Current Stimulation of the Right Wernicke's Area Improves Comprehension in Subacute Stroke Patients

    ERIC Educational Resources Information Center

    You, Dae Sang; Kim, Dae-Yul; Chun, Min Ho; Jung, Seung Eun; Park, Sung Jong

    2011-01-01

    Previous studies have shown the appearance of right-sided language-related brain activity in right-handed patients after a stroke. Non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have been shown to modulate excitability in the brain. Moreover, rTMS and…

  20. Efficacy and safety of the Chinese herbal medicine shuganjieyu with and without adjunctive repetitive transcranial magnetic stimulation (rTMS) for geriatric depression: a randomized controlled trial

    PubMed Central

    XIE, Minmin; JIANG, Wenhai; YANG, Haibo

    2015-01-01

    Background Pharmacological treatment of geriatric depression is often ineffective because patients cannot tolerate adequate doses of antidepressant medications. Aim Examine the efficacy and safety of shuganjieyu – the first Chinese herbal medicine approved for the treatment of depression by China’s drug regulatory agency -- with and without adjunctive treatment with repetitive transcranial magnetic stimulation (rTMS) in the treatment of geriatric depression. Methods Sixty-five inpatients 60 or older who met ICD-10 criteria for depression were randomly assigned to an experimental group (shuganjieyu + rTMS) (n=36) or a control group (shuganjieyu + sham rTMS)(n=29). All participants received 4 capsules of shuganjieyu daily for 6 weeks. rTMS (or sham rTMS) was administered 20 minutes daily, five days a week for 4 weeks. Blinded raters used the Hamilton Rating Scale for Depression (HAMD-17) and the Treatment Emergent Symptom Scale to assess clinical efficacy and safety at baseline and 1, 2, 4, and 6 weeks after starting treatment. Over the six-week trial, there was only one dropout from the experimental group and two dropouts from the control group. Results None of the patients had serious side effects, but 40% in the experimental group and 50% in the control group experienced minor side effects that all resolved spontaneously. Both groups showed substantial stepwise improvement in depressive symptoms over the 6 weeks. Repeated measures ANOVA found no differences between the two groups. After 6 weeks, 97% of the experimental group had experienced a 25% or greater drop in the level of depression, but only 20% had experience a 50% or greater drop in the level of depression; the corresponding values in the control group were 96% and 19%. There were some minor, non-significant differences in the onset of the treatment effect between the different types of depressive symptoms, but by the second week of treatment all five HAMD-17 subscale scores had improved significantly

  1. Low-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) Affects Event-Related Potential Measures of Novelty Processing in Autism

    PubMed Central

    Baruth, Joshua; Tasman, Allan; Mansoor, Mehreen; Ramaswamy, Rajesh; Sears, Lonnie; Mathai, Grace; El-Baz, Ayman; Casanova, Manuel F.

    2009-01-01

    In our previous study on individuals with autism spectrum disorder (ASD) (Sokhadze et al., Appl Psychophysiol Biofeedback 34:37–51, 2009a) we reported abnormalities in the attention-orienting frontal event-related potentials (ERP) and the sustained-attention centro-parietal ERPs in a visual oddball experiment. These results suggest that individuals with autism over-process information needed for the successful differentiation of target and novel stimuli. In the present study we examine the effects of low-frequency, repetitive Transcranial Magnetic Stimulation (rTMS) on novelty processing as well as behavior and social functioning in 13 individuals with ASD. Our hypothesis was that low-frequency rTMS application to dorsolateral prefrontal cortex (DLFPC) would result in an alteration of the cortical excitatory/inhibitory balance through the activation of inhibitory GABAergic double bouquet interneurons. We expected to find post-TMS differences in amplitude and latency of early and late ERP components. The results of our current study validate the use of low-frequency rTMS as a modulatory tool that altered the disrupted ratio of cortical excitation to inhibition in autism. After rTMS the parieto-occipital P50 amplitude decreased to novel distracters but not to targets; also the amplitude and latency to targets increased for the frontal P50 while decreasing to non-target stimuli. Low-frequency rTMS minimized early cortical responses to irrelevant stimuli and increased responses to relevant stimuli. Improved selectivity in early cortical responses lead to better stimulus differentiation at later-stage responses as was made evident by our P3b and P3a component findings. These results indicate a significant change in early, middle-latency and late ERP components at the frontal, centro-parietal, and parieto-occipital regions of interest in response to target and distracter stimuli as a result of rTMS treatment. Overall, our preliminary results show that rTMS may prove to

  2. Treatment of Alzheimer's Disease with Repetitive Transcranial Magnetic Stimulation Combined with Cognitive Training: A Prospective, Randomized, Double-Blind, Placebo-Controlled Study

    PubMed Central

    Lee, Juyoun; Choi, Byong Hee; Oh, Eungseok; Sohn, Eun Hee

    2016-01-01

    Background and Purpose Repetitive transcranial magnetic stimulation (rTMS) has been examined as a potential treatment for many neurological disorders. High-frequency rTMS in particular improves cognitive functions such as verbal fluency and memory. This study explored the effect of rTMS combined with cognitive training (rTMS-COG) on patients with Alzheimer's disease (AD). Methods A prospective, randomized, double-blind, placebo-controlled study was performed with 27 AD patients (18 and 8 in the treatment and sham groups, respectively, and 1 drop-out). The participants were categorized into mild [Mini-Mental State Examination (MMSE) score=21-26] and moderate (MMSE score=18-20) AD groups. The rTMS protocols were configured for six cortical areas (both dorsolateral prefrontal and parietal somatosensory associated cortices and Broca's and Wernicke's areas; 10 Hz, 90-110% intensity, and 5 days/week for 6 weeks). Neuropsychological assessments were performed using the AD Assessment Scale-cognitive subscale (ADAS-cog), Clinical Global Impression of Change (CGIC), and MMSE before, immediately after, and 6 weeks after the end of rTMS-COG treatment. Results Data from 26 AD patients were analyzed in this study. There was no significant interactive effect of time between the groups. The ADAS-cog score in the treatment group was significantly improved compared to the sham group (4.28 and 5.39 in the treatment group vs. 1.75 and 2.88 in the sham group at immediately and 6 weeks after treatment, respectively). The MMSE and CGIC scores were also improved in the treatment group. Based on subgroup analysis, the effect of rTMS-COG was superior for the mild group compared to the total patients, especially in the domains of memory and language. Conclusions The present results suggest that rTMS-COG represents a useful adjuvant therapy with cholinesterase inhibitors, particularly during the mild stage of AD. The effect of rTMS-COG was remarkable in the memory and language domains, which

  3. Low-frequency repetitive transcranial magnetic simulation prevents chronic epileptic seizure

    PubMed Central

    Wang, Yinxu; Wang, Xiaoming; Ke, Sha; Tan, Juan; Hu, Litian; Zhang, Yaodan; Cui, Wenjuan

    2013-01-01

    Although low-frequency repetitive transcranial magnetic simulation can potentially treat epilepsy, its underlying mechanism remains unclear. This study investigated the influence of low-frequency re-petitive transcranial magnetic simulation on changes in several nonlinear dynamic electroence-phalographic parameters in rats with chronic epilepsy and explored the mechanism underlying petitive transcranial magnetic simulation-induced antiepileptic effects. An epilepsy model was es-tablished using lithium-pilocarpine intraperitoneal injection into adult Sprague-Dawley rats, which were then treated with repetitive transcranial magnetic simulation for 7 consecutive days. Nonlinear electroencephalographic parameters were obtained from the rats at 7, 14, and 28 days post-stimulation. Results showed significantly lower mean correlation-dimension and Kolmogo-rov-entropy values for stimulated rats than for non-stimulated rats. At 28 days, the complexity and point-wise correlation dimensional values were lower in stimulated rats. Low-frequency repetitive transcranial magnetic simulation has suppressive effects on electrical activity in epileptic rats, thus explaining its effectiveness in treating epilepsy. PMID:25206567

  4. Low-frequency repetitive transcranial magnetic simulation prevents chronic epileptic seizure.

    PubMed

    Wang, Yinxu; Wang, Xiaoming; Ke, Sha; Tan, Juan; Hu, Litian; Zhang, Yaodan; Cui, Wenjuan

    2013-09-25

    Although low-frequency repetitive transcranial magnetic simulation can potentially treat epilepsy, its underlying mechanism remains unclear. This study investigated the influence of low-frequency re-petitive transcranial magnetic simulation on changes in several nonlinear dynamic electroence-phalographic parameters in rats with chronic epilepsy and explored the mechanism underlying petitive transcranial magnetic simulation-induced antiepileptic effects. An epilepsy model was es-tablished using lithium-pilocarpine intraperitoneal injection into adult Sprague-Dawley rats, which were then treated with repetitive transcranial magnetic simulation for 7 consecutive days. Nonlinear electroencephalographic parameters were obtained from the rats at 7, 14, and 28 days post-stimulation. Results showed significantly lower mean correlation-dimension and Kolmogo-rov-entropy values for stimulated rats than for non-stimulated rats. At 28 days, the complexity and point-wise correlation dimensional values were lower in stimulated rats. Low-frequency repetitive transcranial magnetic simulation has suppressive effects on electrical activity in epileptic rats, thus explaining its effectiveness in treating epilepsy. PMID:25206567

  5. Transcranial electrical stimulator producing high amplitude pulses and pulse trains.

    PubMed

    Suihko, V; Eskola, H

    1998-01-01

    Transcranial electrical stimulation can be used for clinical investigations of the central nervous system and for monitoring of motor nerve tracts during surgical operations. We wished to reduce the pain involved with the transcranial electrical stimulation and to improve the usefulness of the method for monitoring during surgical operations. A dedicated transcranial electrical stimulator was designed having special features to reduce the pain sensation and the nerve blocking effect of anaesthetics. It provides constant current and constant voltage stimulation pulses with very short duration and high amplitude. The pulse length is adjustable in the range of 15 to 125 microseconds, while the maximum amplitude is 100 V and 1 A for voltage and current stimulation modes, respectively. Special features included high-repetition-rate pulse trains (50-2000 pulses s-1) and a three-electrode stimulation configuration. We suggest that the electrical transcranial stimulation has the potential to be a relatively painless method for routine clinical investigations and a reliable method for monitoring during surgery. PMID:9807743

  6. Transcranial magnetic stimulation in disorders of consciousness.

    PubMed

    Lapitska, Natallia; Gosseries, Olivia; Delvaux, Valérie; Overgaard, Morten; Nielsen, Feldbaek; Maertens de Noordhout, Alain; Moonen, Gustave; Laureys, Steven

    2009-01-01

    We have reviewed the literature on transcranial magnetic stimulation studies in patients with brain death, coma, vegetative, minimally conscious, and locked-in states. Transcranial magnetic stimulation permits non-invasive study of brain excitability and may extend our understanding of the underlying mechanisms of these disorders. However, use of this technique in severe brain damage remains methodologically ill-defined and must be further validated prior to clinical application in these challenging patients. PMID:20157993

  7. Comparison between neurostimulation techniques repetitive transcranial magnetic stimulation vs electroconvulsive therapy for the treatment of resistant depression: patient preference and cost-effectiveness

    PubMed Central

    Magnezi, Racheli; Aminov, Emanuel; Shmuel, Dikla; Dreifuss, Merav; Dannon, Pinhas

    2016-01-01

    Objectives Major depressive disorder (MDD) is a common disorder, widely distributed in the population, and is often associated with severe symptoms and functional impairment. It has been estimated that 30% of MDD patients do not benefit adequately from therapeutic interventions, including pharmacotherapy and psychotherapy. Treatment-resistant depression (TRD) is generally defined as a failure to achieve remission, despite therapeutic interventions. Aim The most effective treatment alternatives for TRD are hospitalization, electroconvulsive therapy (ECT), and transcranial magnetic stimulation (TMS). Here we compared the clinical effectiveness of ECT and TMS, including success rates, patient responses, side-effect profiles, and financial worthiness. Results We found that ECT (P<0.0001) was more effective than TMS (P<0.012) (not statistically significant in group effect) in TRD patients. However, ECT patients reported a higher percentage of side effects (P<0.01) and the TMS treatment scored better in terms of patient preference. The cost benefit of ECT was higher than that of TMS (US$2075 vs US$814). Patient’s preferences for treatment could be more intense in the TMS, if the TMS is included in the Health Maintenance Organization’s service list. Conclusion We propose that both of these treatment options should be available in psychiatric wards, thus expanding the therapeutic toolkit for TRD. PMID:27536079

  8. Transcranial Direct Current Stimulation in Stroke Recovery

    PubMed Central

    Schlaug, Gottfried; Renga, Vijay; Nair, Dinesh

    2009-01-01

    TDCS - Transcranial Direct Current Stimulation - is an emerging technique of non-invasive brain stimulation that has been found useful in examining cortical function in normal subjects and in facilitating treatments of various neurological disorders. A better understanding of adaptive as well as maladaptive post-stroke neuroplasticity and its modulation through non-invasive brain stimulation has opened up experimental treatment options using TDCS for patients recovering from stroke. We will review TDCS’s role as a facilitator of stroke recovery, the different modes of transcranial direct current stimulation, and the potential mechanisms underlying the neural effects of TDCS. PMID:19064743

  9. Nonconventional interventions for chronic post-traumatic stress disorder: Ketamine, repetitive trans-cranial magnetic stimulation (rTMS), and alternative approaches.

    PubMed

    Pradhan, Basant; Kluewer D'Amico, Jessica; Makani, Ramkrishna; Parikh, Tapan

    2016-01-01

    It is alarming that only 59% of those who have post-traumatic stress disorder (PTSD) respond to selective serotonin reuptake inhibitors. Many existing treatments, both pharmacological and nonpharmacological, do not directly target trauma memories that lay at the core of the PTSD pathogenesis. Notable exceptions are medications like ketamine and propranolol and trauma-focused psychotherapies like eye-movement desensitization and reprocessing therapy (developed by Shapiro) and Trauma Interventions using Mindfulness Based Extinction and Reconsolidation (TIMBER) for trauma memories (developed by Pradhan). Although the antidepressant effects of ketamine are no longer news, ketamine's effects on treatment refractory PTSD (TR-PTSD) is a recent concept. As TR-PTSD has a marked public health burden and significant limitations in terms of treatment interventions, a thorough assessment of current strategies is required. Research to bring clarity to the underlying pathophysiology and neurobiology of TR-PTSD delineating the chemical, structural, and circuitry abnormalities will take time. In the interim, in the absence of a 1-size-fits-all therapeutic approach, pragmatically parallel lines of research can be pursued using the pharmacological and nonpharmacological treatments that have a strong theoretical rationale for efficacy. This article aims to review the current literature on interventions for PTSD, most notably ketamine, trans-cranial magnetic stimulation treatment, yoga and mindfulness interventions, and TIMBER. We present an outline for their future use, alone as well as in combination, with a hope of providing additional insights as well as advocating for developing more effective therapeutic intervention for this treatment-resistant and debilitating condition. PMID:26162001

  10. Transcranial brain stimulation: closing the loop between brain and stimulation

    PubMed Central

    Karabanov, Anke; Thielscher, Axel; Siebner, Hartwig Roman

    2016-01-01

    Purpose of review To discuss recent strategies for boosting the efficacy of noninvasive transcranial brain stimulation to improve human brain function. Recent findings Recent research exposed substantial intra- and inter-individual variability in response to plasticity-inducing transcranial brain stimulation. Trait-related and state-related determinants contribute to this variability, challenging the standard approach to apply stimulation in a rigid, one-size-fits-all fashion. Several strategies have been identified to reduce variability and maximize the plasticity-inducing effects of noninvasive transcranial brain stimulation. Priming interventions or paired associative stimulation can be used to ‘standardize’ the brain-state and hereby, homogenize the group response to stimulation. Neuroanatomical and neurochemical profiling based on magnetic resonance imaging and spectroscopy can capture trait-related and state-related variability. Fluctuations in brain-states can be traced online with functional brain imaging and inform the timing or other settings of transcranial brain stimulation. State-informed open-loop stimulation is aligned to the expression of a predefined brain state, according to prespecified rules. In contrast, adaptive closed-loop stimulation dynamically adjusts stimulation settings based on the occurrence of stimulation-induced state changes. Summary Approaches that take into account trait-related and state-related determinants of stimulation-induced plasticity bear considerable potential to establish noninvasive transcranial brain stimulation as interventional therapeutic tool. PMID:27224087

  11. Transcranial Magnetic Stimulation for Status Epilepticus

    PubMed Central

    Zeiler, F. A.; Matuszczak, M.; Teitelbaum, J.; Gillman, L. M.; Kazina, C. J.

    2015-01-01

    Background. Our goal was to perform a systematic review on the use of repetitive transcranial magnetic stimulation (rTMS) in the treatment of status epilepticus (SE) and refractory status epilepticus (RSE). Methods. MEDLINE, BIOSIS, EMBASE, Global Health, Healthstar, Scopus, Cochrane Library, the International Clinical Trials Registry Platform, clinicaltrials.gov (inception to August 2015), and gray literature were searched. The strength of evidence was adjudicated using Oxford and GRADE methodology. Results. We identified 11 original articles. Twenty-one patients were described, with 13 adult and 8 pediatric. All studies were retrospective. Seizure reduction/control with rTMS occurred in 15 of the 21 patients (71.4%), with 5 (23.8%) and 10 (47.6%) displaying partial and complete responses, respectively. Seizures recurred after rTMS in 73.3% of the patients who had initially responded. All studies were an Oxford level 4, GRADE D level of evidence. Conclusions. Oxford level 4, GRADE D evidence exists to suggest a potential impact on seizure control with the use of rTMS for FSE and FRSE, though durability of the therapy is short-lived. Routine use of rTMS in this context cannot be recommended at this time. Further prospective study of this intervention is warranted. PMID:26682065

  12. Noninvasive transcranial brain stimulation and pain.

    PubMed

    Rosen, Allyson C; Ramkumar, Mukund; Nguyen, Tam; Hoeft, Fumiko

    2009-02-01

    Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are two noninvasive brain stimulation techniques that can modulate activity in specific regions of the cortex. At this point, their use in brain stimulation is primarily investigational; however, there is clear evidence that these tools can reduce pain and modify neurophysiologic correlates of the pain experience. TMS has also been used to predict response to surgically implanted stimulation for the treatment of chronic pain. Furthermore, TMS and tDCS can be applied with other techniques, such as event-related potentials and pharmacologic manipulation, to illuminate the underlying physiologic mechanisms of normal and pathological pain. This review presents a description and overview of the uses of two major brain stimulation techniques and a listing of useful references for further study. PMID:19126365

  13. Efficacy of Transcranial Magnetic Stimulation (TMS) in the Treatment of Schizophrenia: A Review of the Literature to Date

    PubMed Central

    Green Bernacki, Carolyn; Helmer, Amanda; Pinninti, Narsimha; O’reardon, John P.

    2015-01-01

    We reviewed the literature on transcranial magnetic stimulation and its uses and efficacy in schizophrenia. Multiple sources were examined on transcranial magnetic stimulation efficacy in relieving positive and negative symptoms of schizophrenia. Literature review was conducted via Ovid Medline and PubMed databases. We found multiple published studies and metaanalyses that give evidence that repetitive transcranial magnetic stimulation can have benefit in relieving positive and negative symptoms of schizophrenia, particularly auditory hallucinations. These findings should encourage the psychiatric community to expand research into other applications for which transcranial magnetic stimulation may be used to treat patients with psychiatric disability. PMID:26351619

  14. Quetiapine and repetitive transcranial magnetic stimulation ameliorate depression-like behaviors and up-regulate the proliferation of hippocampal-derived neural stem cells in a rat model of depression: The involvement of the BDNF/ERK signal pathway.

    PubMed

    Chen, Yi-huan; Zhang, Rui-guo; Xue, Fen; Wang, Hua-ning; Chen, Yun-chun; Hu, Guang-tao; Peng, Ye; Peng, Zheng-wu; Tan, Qing-rong

    2015-09-01

    Quetiapine (QUE) and repetitive transcranial magnetic stimulation (rTMS) have been considered to be possible monotherapies for depression or adjunctive therapies for the treatment of the resistant depression, but the underlying mechanisms remain unclear. The present study aimed to assess the effects of combined QUE and rTMS treatment on depressive-like behaviors, hippocampal proliferation, and the in vivo and in vitro expressions of phosphorylated extracellular signal-regulated protein kinase (pERK1/2) and brain-derived neurotrophic factor (BDNF) in male Sprague-Dawley rats. The administration of QUE and rTMS was determined not only to reverse the depressive-like behaviors of rats exposed to chronic unpredictable stress (CUS) but also to restore the protein expressions of pERK1/2 and BDNF and cell proliferation in the hippocampus. Additionally, QUE and rTMS promoted the proliferation and increased the expression of pERK1/2 and BDNF in hippocampal-derived neural stem cells (NSCs), and these effects were abolished by U0126. Taken together, these results suggest that the antidepressive-like effects of QUE and rTMS might be related to the activation of the BDNF/ERK signaling pathway and the up-regulation of cell proliferation in the hippocampus. PMID:26176197

  15. [Transcranial and invasive brain stimulation for depression].

    PubMed

    Plewnia, C; Padberg, F

    2012-08-01

    Considering the substantial proportion of depressed patients which does not sufficiently benefit from antidepressant pharmacotherapy or psychotherapy, there is increasing interest in non-pharmacological antidepressant strategies. Thus, a whole array of stimulation approaches has been developed as potential new antidepressant interventions. These methods include transcranial convulsive and non-convulsive approaches, e.g. electroconvulsive therapy (ECT), magnetic seizure therapy (MST), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) as well as invasive techniques, e.g. deep brain stimulation (DBS), vagus nerve stimulation (VNS) and epidural cortical stimulation (ECS). Each method represents a specific therapeutic approach with distinct targets within neural networks involved in the pathophysiology of depression. The ECT procedure is an established treatment with the highest efficacy of all antidepressant interventions and TMS reaches the highest level of evidence among the novel neurostimulation approaches and may be clinically used. However, the field yields a promising rapid development which may substantially enrich the armamentarium of antidepressant interventions in the near future. PMID:22843027

  16. The Impact of Accelerated Right Prefrontal High-Frequency Repetitive Transcranial Magnetic Stimulation (rTMS) on Cue-Reactivity: An fMRI Study on Craving in Recently Detoxified Alcohol-Dependent Patients

    PubMed Central

    Herremans, Sarah C.; Van Schuerbeek, Peter; De Raedt, Rudi; Matthys, Frieda; Buyl, Ronald; De Mey, Johan; Baeken, Chris

    2015-01-01

    In alcohol-dependent patients craving is a difficult-to-treat phenomenon. It has been suggested that high-frequency (HF) repetitive transcranial magnetic stimulation (rTMS) may have beneficial effects. However, exactly how this application exerts its effect on the underlying craving neurocircuit is currently unclear. In an effort to induce alcohol craving and to maximize detection of HF-rTMS effects to cue-induced alcohol craving, patients were exposed to a block and event-related alcohol cue-reactivity paradigm while being scanned with fMRI. Hence, we assessed the effect of right dorsolateral prefrontal cortex (DLPFC) stimulation on cue-induced and general alcohol craving, and the related craving neurocircuit. Twenty-six recently detoxified alcohol-dependent patients were included. First, we evaluated the impact of one sham-controlled stimulation session. Second, we examined the effect of accelerated right DLPFC HF-rTMS treatment: here patients received 15 sessions in an open label accelerated design, spread over 4 consecutive days. General craving significantly decreased after 15 active HF-rTMS sessions. However, cue-induced alcohol craving was not altered. Our brain imaging results did not show that the cue-exposure affected the underlying craving neurocircuit after both one and fifteen active HF-rTMS sessions. Yet, brain activation changes after one and 15 HF-rTMS sessions, respectively, were observed in regions associated with the extended reward system and the default mode network, but only during the presentation of the event-related paradigm. Our findings indicate that accelerated HF-rTMS applied to the right DLPFC does not manifestly affect the craving neurocircuit during an alcohol-related cue-exposure, but instead it may influence the attentional network. PMID:26295336

  17. Repetitive Transcranial Magnetic Stimulation Over the Dorsolateral Prefrontal Cortex for Treating Posttraumatic Stress Disorder: An Exploratory Meta-Analysis of Randomized, Double-Blind and Sham-Controlled Trials

    PubMed Central

    Berlim, Marcelo T; Van den Eynde, Frederique

    2014-01-01

    Objective Repetitive transcranial magnetic stimulation (rTMS) applied to the dorsolateral prefrontal cortex (DLPFC) has yielded promising results as a treatment for posttraumatic stress disorder (PTSD). However, to date, no quantitative review of its clinical utility has been published. Method: We searched for randomized and sham-controlled trials from 1995 to March 2013 using MEDLINE, Embase, PsycINFO, CENTRAL, and SCOPUS. We then performed an exploratory random effects meta-analysis. Results: Studies on rTMS applied to the right DLPFC included 64 adults with PTSD. The pooled Hedges g effect size for pre and post changes in clinician-rated and self-reported PTSD symptoms were, respectively, 1.65 (P < 0.001) and 1.91 (P < 0.001), indicating significant and large-sized differences in outcome favouring active rTMS. Also, there were significant pre and post decreases with active rTMS in overall anxiety (Hedges g = 1.24; P = 0.02) and depressive (Hedges g = 0.85; P < 0.001) symptoms. Dropout rates at study end did not differ between active and sham rTMS groups. Regarding rTMS applied to the left DLPFC, there is only one study published to date (using a high frequency protocol), and its results showed that active rTMS seems to be superior overall to sham rTMS. Conclusions: Our exploratory meta-analysis shows that active rTMS applied to the DLPFC seems to be effective and acceptable for treating PTSD. However, the small number of subjects included in the analyses limits the generalizability of these findings. Future studies should include larger samples and deliver optimized stimulation parameters. PMID:25565694

  18. Stimulating Conversation: Enhancement of Elicited Propositional Speech in a Patient with Chronic Non-Fluent Aphasia following Transcranial Magnetic Stimulation

    ERIC Educational Resources Information Center

    Hamilton, Roy H.; Sanders, Linda; Benson, Jennifer; Faseyitan, Olufunsho; Norise, Catherine; Naeser, Margaret; Martin, Paula; Coslett, H. Branch

    2010-01-01

    Although evidence suggests that patients with left hemisphere strokes and non-fluent aphasia who receive 1Hz repetitive transcranial magnetic stimulation (rTMS) over the intact right inferior frontal gyrus experience persistent benefits in naming, it remains unclear whether the effects of rTMS in these patients generalize to other language…

  19. Numerical dosimetry of transcranial magnetic stimulation coils

    NASA Astrophysics Data System (ADS)

    Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2014-03-01

    Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique capable of stimulating neurons by means of electromagnetic induction. TMS can be used to map brain function and shows promise for the diagnosis and treatment of neurological and psychiatric disorders. Calculation of fields induced in the brain are necessary to accurately identify stimulated neural tissue during TMS. This allows the development of novel TMS coil designs capable of stimulating deeper brain regions and increasing the localization of stimulation that can be achieved. We have performed numerical calculations of magnetic and electric field with high-resolution anatomically realistic human head models to find these stimulated brain regions for a variety of proposed TMS coil designs. The realistic head models contain heterogeneous tissue structures and electrical conductivities, yielding superior results to those obtained from the simplified homogeneous head models that are commonly employed. The attenuation of electric field as a function of depth in the brain and the localization of stimulating field have been methodically investigated. In addition to providing a quantitative comparison of different TMS coil designs the variation of induced field between subjects has been investigated. We also show the differences in induced fields between adult, adolescent and child head models to preemptively identify potential safety issues in the application of pediatric TMS.

  20. Adjunctive treatment with high frequency repetitive transcranial magnetic stimulation for the behavioral and psychological symptoms of patients with Alzheimer's disease: a randomized, double-blind, sham-controlled study

    PubMed Central

    WU, Yue; XU, Wenwei; LIU, Xiaowei; XU, Qing; TANG, Li; WU, Shuyan

    2015-01-01

    Background Behavioral and psychological symptoms of dementia (BPSD) occur in 70-90% of patients at different stages of Alzheimer’s Disease (AD), but the available methods for managing these problems are of limited effectiveness. Aim Assess the effects of high-frequency repetitive transcranial magnetic stimulation (rTMS), applied over the left dorsolateral prefrontal cortex (DLPFC), on BPSD and cognitive function in persons with AD. Methods Fifty-four patients with AD and accompanying BPSD were randomly divided into an intervention group (n=27) and a control group (n=27). In addition to standard antipsychotic treatment, the intervention group was treated with 20Hz rTMS five days a week for four weeks, while the control group was treated with sham rTMS.The Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD), the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog), and the Treatment Emergent Symptom Scale (TESS) were administered by raters who were blind to the group assignment of patients before and after four weeks of treatment. Results Twenty-six subjects from each group completed the study. After four weeks of antipsychotic treatment with adjunctive real or sham rTMS treatment, the mean (sd) total BEHAVE-AD scores and mean total ADAS-Cog scores of both groups significantly decreased from baseline. After adjusting for baseline values, the intervention group had significantly lower scores (i.e., greater improvement) than the control group on the BEHAVE-AD total score, on five of the seven BEHAVE-AD factor scores (activity disturbances, diurnal rhythm, aggressiveness, affective disturbances, anxieties and phobias), on the ADAS-Cog total score, and on all four ADAS-Cog factor scores (memory, language, constructional praxis, and attention). The proportion of individuals whose behavioral symptoms met a predetermined level of improvement (i.e., a drop in BEHAVE-AD total score of > 30% from baseline) in the intervention group was greater than that

  1. Spinal evoked potentials following transcranial magnetic stimulation.

    PubMed

    Nemoto, J; Sasaki, T; Kikuchi, Y; Konno, Y; Sakuma, J; Kodama, N

    2001-06-01

    Motor evoked potentials by magnetic stimulation is less invasive and causes no pain as opposed to high current electric stimulation. However, the distribution of the magnetic field generated by the round coil has not been fully studied. In this report, we mapped the extent of the magnetic induction flux density, and then the evoked potentials from the spinal cord were investigated by transcranial magnetic stimulation. We also examined the origin of the evoked potentials obtained by the magnetic stimulation. The following results were obtained. The magnetic induction flux density was at its maximum at the edge of the coil. The potentials consisted of a first negative wave and subsequent multiphasic waves. The first negative wave was similar to a response of the subcorticospinal tract in the lower brain stem, while the subsequent multiphasic waves were similar to those of the pyramidal tract. Although magnetic stimulation has certain advantages over electric stimulation, several problems remain to be solved for the monitoring of motor functions in the clinical settings. PMID:11764415

  2. Novel transcranial magnetic stimulation coil for mice

    NASA Astrophysics Data System (ADS)

    March, Stephen; Stark, Spencer; Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2014-03-01

    Transcranial magnetic stimulation (TMS) shows potential for non-invasive treatment of various neurological disorders. Significant work has been performed on the design of coils used for TMS on human subjects but few reports have been made on the design of coils for use on the brains of animals such as mice. This work is needed as TMS studies utilizing mice can allow rapid preclinical development of TMS for human disorders but the coil designs developed for use on humans are inadequate for optimal stimulation of the much smaller mouse brain. A novel TMS coil has been developed with the goal of inducing strong and focused electric fields for the stimulation of small animals such as mice. Calculations of induced electric fields were performed utilizing an MRI derived inhomogeneous model of an adult male mouse. Mechanical and thermal analysis of this new TMS helmet-coil design have also been performed at anticipated TMS operating conditions to ensure mechanical stability of the new coil and establish expected linear attraction and rotational force values. Calculated temperature increases for typical stimulation periods indicate the helmet-coil system is capable of operating within established medical standards. A prototype of the coil has been fabricated and characterization results are presented.

  3. Dosimetry of typical transcranial magnetic stimulation devices

    NASA Astrophysics Data System (ADS)

    Lu, Mai; Ueno, Shoogo

    2010-05-01

    The therapeutic staff using transcranial magnetic stimulation (TMS) devices could be exposed to magnetic pulses. In this paper, dependence of induced currents in real human man model on different coil shapes, distance between the coil and man model as well as the rotation of the coil in space have been investigated by employing impedance method. It was found that the figure-of-eight coil has less leakage magnetic field and low current density induced in the body compared with the round coil. The TMS power supply cables play an important role in the induced current density in human body. The induced current density in TMS operator decreased as the coil rotates from parallel position to perpendicular position. Our present study shows that TMS operator should stand at least 110 cm apart from the coil.

  4. Transcranial magnetic stimulation (TMS) inhibits cortical dendrites.

    PubMed

    Murphy, Sean C; Palmer, Lucy M; Nyffeler, Thomas; Müri, René M; Larkum, Matthew E

    2016-01-01

    One of the leading approaches to non-invasively treat a variety of brain disorders is transcranial magnetic stimulation (TMS). However, despite its clinical prevalence, very little is known about the action of TMS at the cellular level let alone what effect it might have at the subcellular level (e.g. dendrites). Here, we examine the effect of single-pulse TMS on dendritic activity in layer 5 pyramidal neurons of the somatosensory cortex using an optical fiber imaging approach. We find that TMS causes GABAB-mediated inhibition of sensory-evoked dendritic Ca(2+) activity. We conclude that TMS directly activates fibers within the upper cortical layers that leads to the activation of dendrite-targeting inhibitory neurons which in turn suppress dendritic Ca(2+) activity. This result implies a specificity of TMS at the dendritic level that could in principle be exploited for investigating these structures non-invasively. PMID:26988796

  5. Transcranial direct current stimulation modulates pattern separation.

    PubMed

    Cappiello, Marcus; Xie, Weizhen; David, Alexander; Bikson, Marom; Zhang, Weiwei

    2016-08-01

    Maintaining similar memories in a distinct and nonoverlapping manner, known as pattern separation, is an important mnemonic process. The medial temporal lobe, especially the hippocampus, has been implicated in this crucial memory function. The present study thus examines whether it is possible to modulate pattern separation using bilateral transcranial direct current stimulation (tDCS) over the temporal lobes. Specifically, in this study, pattern separation was assessed using the Mnemonic Similarity Task following 15-min offline bilateral temporal lobe tDCS (left cathode and right anode or left anode and right cathode) or sham stimulation. In the Mnemonic Similarity Task, participants studied a series of sequentially presented visual objects. In the subsequent recognition memory test, participants viewed a series of sequentially presented objects that could be old images from study, novel foils, or lures that were visually similar to the studied images. Participants reported whether these images were exactly the same as, similar to, or different from the studied images. Following both active tDCS conditions, participants were less likely to identify lures as 'similar' compared with the sham condition, indicating a reduction in pattern separation resulting from temporal lobe tDCS. In contrast, no significant difference in overall accuracy was found for participants' discrimination of old and new images. Together, these results suggest that temporal lobe tDCS can selectively modulate the pattern separation function without changing participants' baseline recognition memory performance. PMID:27285728

  6. Transcranial direct current stimulation in psychiatric disorders

    PubMed Central

    Tortella, Gabriel; Casati, Roberta; Aparicio, Luana V M; Mantovani, Antonio; Senço, Natasha; D’Urso, Giordano; Brunelin, Jerome; Guarienti, Fabiana; Selingardi, Priscila Mara Lorencini; Muszkat, Débora; Junior, Bernardo de Sampaio Pereira; Valiengo, Leandro; Moffa, Adriano H; Simis, Marcel; Borrione, Lucas; Brunoni, André R

    2015-01-01

    The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation (tDCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally, we provide an overview of tDCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding tDCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding tDCS efficacy in psychiatry. PMID:25815258

  7. Transcranial magnetic stimulation (TMS) in the treatment of substance addiction

    PubMed Central

    Gorelick, David A.; Zangen, Abraham; George, Mark S.

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a non-invasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5–20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future. PMID:25069523

  8. Transcranial magnetic stimulation in the treatment of substance addiction.

    PubMed

    Gorelick, David A; Zangen, Abraham; George, Mark S

    2014-10-01

    Transcranial magnetic stimulation (TMS) is a noninvasive method of brain stimulation used to treat a variety of neuropsychiatric disorders, but is still in the early stages of study as addiction treatment. We identified 19 human studies using repetitive TMS (rTMS) to manipulate drug craving or use, which exposed a total of 316 adults to active rTMS. Nine studies involved tobacco, six alcohol, three cocaine, and one methamphetamine. The majority of studies targeted high-frequency (5-20 Hz; expected to stimulate neuronal activity) rTMS pulses to the dorsolateral prefrontal cortex. Only five studies were controlled clinical trials: two of four nicotine trials found decreased cigarette smoking; the cocaine trial found decreased cocaine use. Many aspects of optimal treatment remain unknown, including rTMS parameters, duration of treatment, relationship to cue-induced craving, and concomitant treatment. The mechanisms of rTMS potential therapeutic action in treating addictions are poorly understood, but may involve increased dopamine and glutamate function in corticomesolimbic brain circuits and modulation of neural activity in brain circuits that mediate cognitive processes relevant to addiction, such as response inhibition, selective attention, and reactivity to drug-associated cues. rTMS treatment of addiction must be considered experimental at this time, but appears to have a promising future. PMID:25069523

  9. Computational electromagnetic methods for transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Gomez, Luis J.

    Transcranial magnetic stimulation (TMS) is a noninvasive technique used both as a research tool for cognitive neuroscience and as a FDA approved treatment for depression. During TMS, coils positioned near the scalp generate electric fields and activate targeted brain regions. In this thesis, several computational electromagnetics methods that improve the analysis, design, and uncertainty quantification of TMS systems were developed. Analysis: A new fast direct technique for solving the large and sparse linear system of equations (LSEs) arising from the finite difference (FD) discretization of Maxwell's quasi-static equations was developed. Following a factorization step, the solver permits computation of TMS fields inside realistic brain models in seconds, allowing for patient-specific real-time usage during TMS. The solver is an alternative to iterative methods for solving FD LSEs, often requiring run-times of minutes. A new integral equation (IE) method for analyzing TMS fields was developed. The human head is highly-heterogeneous and characterized by high-relative permittivities (107). IE techniques for analyzing electromagnetic interactions with such media suffer from high-contrast and low-frequency breakdowns. The novel high-permittivity and low-frequency stable internally combined volume-surface IE method developed. The method not only applies to the analysis of high-permittivity objects, but it is also the first IE tool that is stable when analyzing highly-inhomogeneous negative permittivity plasmas. Design: TMS applications call for electric fields to be sharply focused on regions that lie deep inside the brain. Unfortunately, fields generated by present-day Figure-8 coils stimulate relatively large regions near the brain surface. An optimization method for designing single feed TMS coil-arrays capable of producing more localized and deeper stimulation was developed. Results show that the coil-arrays stimulate 2.4 cm into the head while stimulating 3

  10. Transcranial magnetic stimulation (TMS) inhibits cortical dendrites

    PubMed Central

    Murphy, Sean C; Palmer, Lucy M; Nyffeler, Thomas; Müri, René M; Larkum, Matthew E

    2016-01-01

    One of the leading approaches to non-invasively treat a variety of brain disorders is transcranial magnetic stimulation (TMS). However, despite its clinical prevalence, very little is known about the action of TMS at the cellular level let alone what effect it might have at the subcellular level (e.g. dendrites). Here, we examine the effect of single-pulse TMS on dendritic activity in layer 5 pyramidal neurons of the somatosensory cortex using an optical fiber imaging approach. We find that TMS causes GABAB-mediated inhibition of sensory-evoked dendritic Ca2+ activity. We conclude that TMS directly activates fibers within the upper cortical layers that leads to the activation of dendrite-targeting inhibitory neurons which in turn suppress dendritic Ca2+ activity. This result implies a specificity of TMS at the dendritic level that could in principle be exploited for investigating these structures non-invasively. DOI: http://dx.doi.org/10.7554/eLife.13598.001 PMID:26988796

  11. Transcranial Direct Current Stimulation in Schizophrenia

    PubMed Central

    Agarwal, Sri Mahavir; Shivakumar, Venkataram; Bose, Anushree; Subramaniam, Aditi; Nawani, Hema; Chhabra, Harleen; Kalmady, Sunil V.; Narayanaswamy, Janardhanan C.

    2013-01-01

    Transcranial direct current stimulation (tDCS) is an upcoming treatment modality for patients with schizophrenia. A series of recent observations have demonstrated improvement in clinical status of schizophrenia patients with tDCS. This review summarizes the research work that has examined the effects of tDCS in schizophrenia patients with respect to symptom amelioration, cognitive enhancement and neuroplasticity evaluation. tDCS is emerging as a safe, rapid and effective treatment for various aspects of schizophrenia symptoms ranging from auditory hallucinations-for which the effect is most marked, to negative symptoms and cognitive symptoms as well. An interesting line of investigation involves using tDCS for altering and examining neuroplasticity in patients and healthy subjects and is likely to lead to new insights into the neurological aberrations and pathophysiology of schizophrenia. The mechanistic aspects of the technique are discussed in brief. Future work should focus on establishing the clinical efficacy of this novel technique and on evaluating this modality as an adjunct to cognitive enhancement protocols. Understanding the mechanism of action of tDCS as well as the determinants and neurobiological correlates of clinical response to tDCS remains an important goal, which will help us expand the clinical applications of tDCS for the treatment of patients with schizophrenia. PMID:24465247

  12. Quiet transcranial magnetic stimulation: Status and future directions.

    PubMed

    Peterchev, Angel V; Murphy, David L K; Goetz, Stefan M

    2015-01-01

    A significant limitation of transcranial magnetic stimulation (TMS) is that the magnetic pulse delivery is associated with a loud clicking sound as high as 140 dB resulting from electromagnetic forces. The loud noise significantly impedes both basic research and clinical applications of TMS. It effectively makes TMS less focal since every click activates auditory cortex, brainstem, and other connected regions, synchronously with the magnetic pulse. The repetitive clicking sound can induce neuromodulation that can interfere with and confound the intended effects at the TMS target. As well, there are known concerns regarding blinding of TMS studies, hearing loss, induction of tinnitus, as well as tolerability. Addressing this need, we are developing a quiet TMS (qTMS) device that incorporates two key concepts: First, the dominant frequency components of the TMS pulse sound (typically 2-5 kHz) are shifted to higher frequencies that are above the human hearing upper threshold of about 20 kHz. Second, the TMS coil is designed electrically and mechanically to generate suprathreshold electric field pulses while minimizing the sound emitted at audible frequencies (<; 20 kHz). The enhanced acoustic properties of the coil are accomplished with a novel, layered coil design. We summarize a proof-of-concept qTMS prototype demonstrating noise loudness reduction by 19 dB(A) with ultrabrief pulses at conventional amplitudes. Further, we outline next steps to accomplish further sound reduction and suprathreshold pulse amplitudes. PMID:26736241

  13. Transcranial magnetic stimulation (TMS) in stroke: Ready for clinical practice?

    PubMed

    Smith, Marie-Claire; Stinear, Cathy M

    2016-09-01

    The use of transcranial magnetic stimulation (TMS) in stroke research has increased dramatically over the last decade with two emerging and potentially useful functions identified. Firstly, the use of single pulse TMS as a tool for predicting recovery of motor function after stroke, and secondly, the use of repetitive TMS (rTMS) as a treatment adjunct aimed at modifying the excitability of the motor cortex in preparation for rehabilitation. This review discusses recent advances in the use of TMS in both prediction and treatment after stroke. Prediction of recovery after stroke is a complex process and the use of TMS alone is not sufficient to provide accurate prediction for an individual after stroke. However, when applied in conjunction with other tools such as clinical assessment and MRI, accuracy of prediction using TMS is increased. rTMS temporarily modulates cortical excitability after stroke. Very few rTMS studies are completed in the acute or sub-acute stages after stroke and the translation of altered cortical excitability into gains in motor function are modest, with little evidence of long term effects. Although gains have been made in both of these areas, further investigation is needed before these techniques can be applied in routine clinical care. PMID:27394378

  14. Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)

    PubMed Central

    George, Mark S; Aston-Jones, Gary

    2010-01-01

    Although the preceding chapters discuss much of the new knowledge of neurocircuitry of neuropsychiatric diseases, and an invasive approach to treatment, this chapter describes and reviews the noninvasive methods of testing circuit-based theories and treating neuropsychiatric diseases that do not involve implanting electrodes into the brain or on its surface. These techniques are transcranial magnetic stimulation, vagus nerve stimulation, and transcranial direct current stimulation. Two of these approaches have FDA approval as therapies. PMID:19693003

  15. Repetitive magnetic stimulation induces plasticity of inhibitory synapses

    PubMed Central

    Lenz, Maximilian; Galanis, Christos; Müller-Dahlhaus, Florian; Opitz, Alexander; Wierenga, Corette J.; Szabó, Gábor; Ziemann, Ulf; Deller, Thomas; Funke, Klaus; Vlachos, Andreas

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is used as a therapeutic tool in neurology and psychiatry. While repetitive magnetic stimulation (rMS) has been shown to induce plasticity of excitatory synapses, it is unclear whether rMS can also modify structural and functional properties of inhibitory inputs. Here we employed 10-Hz rMS of entorhinohippocampal slice cultures to study plasticity of inhibitory neurotransmission on CA1 pyramidal neurons. Our experiments reveal a rMS-induced reduction in GABAergic synaptic strength (2–4 h after stimulation), which is Ca2+-dependent and accompanied by the remodelling of postsynaptic gephyrin scaffolds. Furthermore, we present evidence that 10-Hz rMS predominantly acts on dendritic, but not somatic inhibition. Consistent with this finding, a reduction in clustered gephyrin is detected in CA1 stratum radiatum of rTMS-treated anaesthetized mice. These results disclose that rTMS induces coordinated Ca2+-dependent structural and functional changes of specific inhibitory postsynapses on principal neurons. PMID:26743822

  16. Repetitive magnetic stimulation induces plasticity of inhibitory synapses.

    PubMed

    Lenz, Maximilian; Galanis, Christos; Müller-Dahlhaus, Florian; Opitz, Alexander; Wierenga, Corette J; Szabó, Gábor; Ziemann, Ulf; Deller, Thomas; Funke, Klaus; Vlachos, Andreas

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is used as a therapeutic tool in neurology and psychiatry. While repetitive magnetic stimulation (rMS) has been shown to induce plasticity of excitatory synapses, it is unclear whether rMS can also modify structural and functional properties of inhibitory inputs. Here we employed 10-Hz rMS of entorhinohippocampal slice cultures to study plasticity of inhibitory neurotransmission on CA1 pyramidal neurons. Our experiments reveal a rMS-induced reduction in GABAergic synaptic strength (2-4 h after stimulation), which is Ca(2+)-dependent and accompanied by the remodelling of postsynaptic gephyrin scaffolds. Furthermore, we present evidence that 10-Hz rMS predominantly acts on dendritic, but not somatic inhibition. Consistent with this finding, a reduction in clustered gephyrin is detected in CA1 stratum radiatum of rTMS-treated anaesthetized mice. These results disclose that rTMS induces coordinated Ca(2+)-dependent structural and functional changes of specific inhibitory postsynapses on principal neurons. PMID:26743822

  17. Transcranial Magnetic Stimulation and Volitional Quadriceps Activation

    PubMed Central

    Gibbons, Christopher E.; Pietrosimone, Brian G.; Hart, Joseph M.; Saliba, Susan A.; Ingersoll, Christopher D.

    2010-01-01

    Abstract Context: Quadriceps-activation deficits have been reported after meniscectomy. Transcranial magnetic stimulation (TMS) in conjunction with maximal contractions affects quadriceps activation in patients after meniscectomy. Objective: To determine the effect of single-pulsed TMS on quadriceps central activation ratio (CAR) in patients after meniscectomy. Design: Randomized controlled clinical trial. Setting: University laboratory. Patients or Other Participants: Twenty participants who had partial meniscectomy and who had a CAR less than 85% were assigned randomly to the TMS group (7 men, 4 women; age  =  38.1 ± 16.2 years, height  =  176.8 ± 11.5 cm, mass  =  91.8 ± 27.5 kg, postoperative time  =  36.7 ± 34.9 weeks) or the control group (7 men, 2 women; age  =  38.2 ± 17.5 years, height  =  176.5 ± 7.9 cm, mass  =  86.2 ± 15.3 kg, postoperative time  =  36.6 ± 37.4 weeks). Intervention(s): Participants in the experimental group received TMS over the motor cortex that was contralateral to the involved leg and performed 3 maximal quadriceps contractions with the involved leg. The control group performed 3 maximal quadriceps contractions without the TMS. Main Outcome Measure(s): Quadriceps activation was assessed using the CAR, which was measured in 70° of knee flexion at baseline and at 0, 10, 30, and 60 minutes posttest. The CAR was expressed as a percentage of full activation. Results: Differences in CAR were detected over time (F4,72  =  3.025, P  = .02). No interaction (F4,72  =  1.457, P  =  .22) or between-groups differences (F1,18  =  0.096, P  =  .76) were found for CAR. Moderate CAR effect sizes were found at 10 (Cohen d  =  0.54, 95% confidence interval [CI]  =  −0.33, 1.37) and 60 (Cohen d  =  0.50, 95% CI  =  −0.37, 1.33) minutes in the TMS group compared with CAR at baseline. Strong effect sizes were found for CAR at 10 (Cohen d  =  0.82, 95% CI

  18. Use of Transcranial Magnetic Stimulation in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Oberman, Lindsay M.; Rotenberg, Alexander; Pascual-Leone, Alvaro

    2015-01-01

    The clinical, social and financial burden of autism spectrum disorder (ASD) is staggering. We urgently need valid and reliable biomarkers for diagnosis and effective treatments targeting the often debilitating symptoms. Transcranial magnetic stimulation (TMS) is beginning to be used by a number of centers worldwide and may represent a novel…

  19. Modulating Human Auditory Processing by Transcranial Electrical Stimulation

    PubMed Central

    Heimrath, Kai; Fiene, Marina; Rufener, Katharina S.; Zaehle, Tino

    2016-01-01

    Transcranial electrical stimulation (tES) has become a valuable research tool for the investigation of neurophysiological processes underlying human action and cognition. In recent years, striking evidence for the neuromodulatory effects of transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation has emerged. While the wealth of knowledge has been gained about tES in the motor domain and, to a lesser extent, about its ability to modulate human cognition, surprisingly little is known about its impact on perceptual processing, particularly in the auditory domain. Moreover, while only a few studies systematically investigated the impact of auditory tES, it has already been applied in a large number of clinical trials, leading to a remarkable imbalance between basic and clinical research on auditory tES. Here, we review the state of the art of tES application in the auditory domain focussing on the impact of neuromodulation on acoustic perception and its potential for clinical application in the treatment of auditory related disorders. PMID:27013969

  20. Modulating Human Auditory Processing by Transcranial Electrical Stimulation.

    PubMed

    Heimrath, Kai; Fiene, Marina; Rufener, Katharina S; Zaehle, Tino

    2016-01-01

    Transcranial electrical stimulation (tES) has become a valuable research tool for the investigation of neurophysiological processes underlying human action and cognition. In recent years, striking evidence for the neuromodulatory effects of transcranial direct current stimulation, transcranial alternating current stimulation, and transcranial random noise stimulation has emerged. While the wealth of knowledge has been gained about tES in the motor domain and, to a lesser extent, about its ability to modulate human cognition, surprisingly little is known about its impact on perceptual processing, particularly in the auditory domain. Moreover, while only a few studies systematically investigated the impact of auditory tES, it has already been applied in a large number of clinical trials, leading to a remarkable imbalance between basic and clinical research on auditory tES. Here, we review the state of the art of tES application in the auditory domain focussing on the impact of neuromodulation on acoustic perception and its potential for clinical application in the treatment of auditory related disorders. PMID:27013969

  1. Transcranial Alternating Current and Random Noise Stimulation: Possible Mechanisms

    PubMed Central

    Antal, Andrea; Herrmann, Christoph S.

    2016-01-01

    Background. Transcranial alternating current stimulation (tACS) is a relatively recent method suited to noninvasively modulate brain oscillations. Technically the method is similar but not identical to transcranial direct current stimulation (tDCS). While decades of research in animals and humans has revealed the main physiological mechanisms of tDCS, less is known about the physiological mechanisms of tACS. Method. Here, we review recent interdisciplinary research that has furthered our understanding of how tACS affects brain oscillations and by what means transcranial random noise stimulation (tRNS) that is a special form of tACS can modulate cortical functions. Results. Animal experiments have demonstrated in what way neurons react to invasively and transcranially applied alternating currents. Such findings are further supported by neural network simulations and knowledge from physics on entraining physical oscillators in the human brain. As a result, fine-grained models of the human skull and brain allow the prediction of the exact pattern of current flow during tDCS and tACS. Finally, recent studies on human physiology and behavior complete the picture of noninvasive modulation of brain oscillations. Conclusion. In future, the methods may be applicable in therapy of neurological and psychiatric disorders that are due to malfunctioning brain oscillations. PMID:27242932

  2. Transcranial cortical stimulation in the treatment of obsessive-compulsive disorders: efficacy studies.

    PubMed

    Saba, Ghassen; Moukheiber, Albert; Pelissolo, Antoine

    2015-05-01

    Repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation methods that became widely used as therapeutic tools during the past two decades especially in cases of depression and schizophrenia. Low frequency rTMS and cathodal effect of tDCS inhibits cortical functioning while high frequency and anodal effect of tDCS have the opposite effect. Prolonged and repetitive application of either methods leads to changes in excitability of the human cortex that outlast the period of stimulation. Both rTMS and tDCS induce functional changes in the brain-modulating neural activity at cortical level. This paper reviews rTMS and tDCS effects in clinical trials for obsessive-compulsive disorder (OCD). Low frequency rTMS, particularly targeting the supplementary motor area and the orbital frontal cortex, seems to be the most promising in terms of therapeutic efficacy while older studies targeting the prefrontal dorsal cortex were not as successful. tDCS clearly needs to be investigated in large scale and sufficiently powered randomized control studies. From a general point of view, these non-invasive techniques hold promise as novel therapeutic tools for OCD patients. PMID:25825002

  3. Possible Mechanisms Underlying the Therapeutic Effects of Transcranial Magnetic Stimulation

    PubMed Central

    Chervyakov, Alexander V.; Chernyavsky, Andrey Yu.; Sinitsyn, Dmitry O.; Piradov, Michael A.

    2015-01-01

    Transcranial magnetic stimulation (TMS) is an effective method used to diagnose and treat many neurological disorders. Although repetitive TMS (rTMS) has been used to treat a variety of serious pathological conditions including stroke, depression, Parkinson’s disease, epilepsy, pain, and migraines, the pathophysiological mechanisms underlying the effects of long-term TMS remain unclear. In the present review, the effects of rTMS on neurotransmitters and synaptic plasticity are described, including the classic interpretations of TMS effects on synaptic plasticity via long-term potentiation and long-term depression. We also discuss the effects of rTMS on the genetic apparatus of neurons, glial cells, and the prevention of neuronal death. The neurotrophic effects of rTMS on dendritic growth and sprouting and neurotrophic factors are described, including change in brain-derived neurotrophic factor concentration under the influence of rTMS. Also, non-classical effects of TMS related to biophysical effects of magnetic fields are described, including the quantum effects, the magnetic spin effects, genetic magnetoreception, the macromolecular effects of TMS, and the electromagnetic theory of consciousness. Finally, we discuss possible interpretations of TMS effects according to dynamical systems theory. Evidence suggests that a rTMS-induced magnetic field should be considered a separate physical factor that can be impactful at the subatomic level and that rTMS is capable of significantly altering the reactivity of molecules (radicals). It is thought that these factors underlie the therapeutic benefits of therapy with TMS. Future research on these mechanisms will be instrumental to the development of more powerful and reliable TMS treatment protocols. PMID:26136672

  4. Default Mode Network Mechanisms of Transcranial Magnetic Stimulation in Depression

    PubMed Central

    Liston, Conor; Chen, Ashley C.; Zebley, Benjamin D.; Drysdale, Andrew T.; Gordon, Rebecca; Leuchter, Bruce; Voss, Henning U.; Casey, B.J.; Etkin, Amit; Dubin, Marc J.

    2014-01-01

    Background Repetitive transcranial magnetic stimulation (TMS) of the dorsolateral prefrontal cortex (DLPFC) is an established treatment for depression, but its underlying mechanism of action remains unknown. Abnormalities in two large-scale neuronal networks—the frontoparietal central executive network (CEN) and the medial prefrontal-medial parietal default mode network (DMN)—are consistent findings in depression and potential therapeutic targets for TMS. Here, we assessed the impact of TMS on activity in these networks and their relation to treatment response. Methods We used resting state functional magnetic resonance imaging (rs-fMRI) to measure functional connectivity within and between the DMN and CEN in 17 depressed patients, before and after a five-week course of TMS. Motivated by prior reports, we focused on connectivity seeded from the DLPFC and the subgenual cingulate, a key region closely aligned with the DMN in depression. Connectivity was also compared to a cohort of 35 healthy controls. Results Prior to treatment, functional connectivity in depressed patients was abnormally elevated within the DMN and diminished within the CEN, and connectivity between these two networks was altered. TMS normalized depression-related subgenual hyperconnectivity in the DMN but did not alter connectivity in the CEN. TMS also induced anticorrelated connectivity between the DLPFC and medial prefrontal DMN nodes. Baseline subgenual connectivity predicted subsequent clinical improvement. Conclusions TMS selectively modulates functional connectivity both within and between the CEN and DMN, and modulation of subgenual cingulate connectivity may play an important mechanistic role in alleviating depression. The results also highlight potential neuroimaging biomarkers for predicting treatment response. PMID:24629537

  5. Assessing and Stabilizing Aberrant Neuroplasticity in Autism Spectrum Disorder: The Potential Role of Transcranial Magnetic Stimulation

    PubMed Central

    Desarkar, Pushpal; Rajji, Tarek K.; Ameis, Stephanie H.; Daskalakis, Zafiris Jeff

    2015-01-01

    Exciting developments have taken place in the neuroscience research in autism spectrum disorder (ASD), and results from these studies indicate that brain in ASD is associated with aberrant neuroplasticity. Transcranial magnetic stimulation (TMS) has rapidly evolved to become a widely used, safe, and non-invasive neuroscientific tool to investigate a variety of neurophysiological processes, including neuroplasticity. The diagnostic and therapeutic potential of TMS in ASD is beginning to be realized. In this article, we briefly reviewed evidence of aberrant neuroplasticity in ASD, suggested future directions in assessing neuroplasticity using repetitive TMS (rTMS), and discussed the potential of rTMS in rectifying aberrant neuroplasticity in ASD. PMID:26441685

  6. Transcranial direct current stimulation modulates efficiency of reading processes

    PubMed Central

    Thomson, Jennifer M.; Doruk, Deniz; Mascio, Bryan; Fregni, Felipe; Cerruti, Carlo

    2015-01-01

    Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that offers promise as an investigative method for understanding complex cognitive operations such as reading. This study explores the ability of a single session of tDCS to modulate reading efficiency and phonological processing performance within a group of healthy adults. Half the group received anodal or cathodal stimulation, on two separate days, of the left temporo-parietal junction while the other half received anodal or cathodal stimulation of the right homologue area. Pre- and post-stimulation assessment of reading efficiency and phonological processing was carried out. A larger pre-post difference in reading efficiency was found for participants who received right anodal stimulation compared to participants who received left anodal stimulation. Further, there was a significant post-stimulation increase in phonological processing speed following right hemisphere anodal stimulation. Implications for models of reading and reading impairment are discussed. PMID:25852513

  7. Transcranial magnetic stimulation for the treatment of major depression

    PubMed Central

    Janicak, Philip G; Dokucu, Mehmet E

    2015-01-01

    Major depression is often difficult to diagnose accurately. Even when the diagnosis is properly made, standard treatment approaches (eg, psychotherapy, medications, or their combination) are often inadequate to control acute symptoms or maintain initial benefit. Additional obstacles involve safety and tolerability problems, which frequently preclude an adequate course of treatment. This leaves an important gap in our ability to properly manage major depression in a substantial proportion of patients, leaving them vulnerable to ensuing complications (eg, employment-related disability, increased risk of suicide, comorbid medical disorders, and substance abuse). Thus, there is a need for more effective and better tolerated approaches. Transcranial magnetic stimulation is a neuromodulation technique increasingly used to partly fill this therapeutic void. In the context of treating depression, we critically review the development of transcranial magnetic stimulation, focusing on the results of controlled and pragmatic trials for depression, which consider its efficacy, safety, and tolerability. PMID:26170668

  8. Transcranial Magnetic Stimulation and Deep Brain Stimulation in the treatment of alcohol dependence

    PubMed Central

    Alba-Ferrara, L.; Fernandez, F.; Salas, R.; de Erausquin, G. A.

    2013-01-01

    Alcohol dependence is a major social, economic, and public health problem. Alcoholism can lead to damage of the gastrointestinal, nervous, cardiovascular, and respiratory systems and it can be lethal, costing hundreds of billions to the health care system. Despite the existence of cognitive-behavioral therapy, psychosocial interventions, and spiritually integrated treatment to treat it, alcohol dependence has a high relapse rate and poor prognosis, albeit with high interindividual variability. In this review, we discuss the use of two neuromodulation techniques, namely repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), and their advantages and disadvantages compared to first-line pharmacological treatment for alcohol dependence. We also discuss rTMS and DBS targets for alcohol dependence treatment, considering experimental animal and human evidence, with careful consideration of methodological issues preventing the identification of feasible targets for neuromodulation treatments, as well as inter-individual variability factors influencing alcoholism prognosis. Lastly, we anticipate future research aiming to tailor the treatment to each individual patient by combining neurofunctional, neuroanatomical and neurodisruptive techniques optimizing the outcome. PMID:25598743

  9. Electromyographic silent period after transcranial brain stimulation in Huntington's disease.

    PubMed

    Priori, A; Berardelli, A; Inghilleri, M; Polidori, L; Manfredi, M

    1994-03-01

    The silent period evoked by transcranial (TCS) and nerve stimulation was studied in the hand muscles in 13 patients with Huntington's disease and in 11 normal subjects. The duration of the silent period after TCS was longer in patients and correlated significantly with the severity of chorea; in contrast, the duration of the silent period after nerve stimulation was similar in patients and controls. The prolongation of the cortical silent period suggests that the duration of the silent period is a functional correlate reflecting basal ganglia influence over the motor cortex. PMID:8196679

  10. Closed-Loop Control of Epilepsy by Transcranial Electrical Stimulation

    PubMed Central

    Berényi, Antal; Belluscio, Mariano; Mao, Dun; Buzsáki, György

    2016-01-01

    Many neurological and psychiatric diseases are associated with clinically detectable, altered brain dynamics. The aberrant brain activity, in principle, can be restored through electrical stimulation. In epilepsies, abnormal patterns emerge intermittently, and therefore, a closed-loop feedback brain control that leaves other aspects of brain functions unaffected is desirable. Here, we demonstrate that seizure-triggered, feedback transcranial electrical stimulation (TES) can dramatically reduce spike-and-wave episodes in a rodent model of generalized epilepsy. Closed-loop TES can be an effective clinical tool to reduce pathological brain patterns in drug-resistant patients. PMID:22879515

  11. Transcranial direct current stimulation: electrode montage in stroke.

    PubMed

    Mahmoudi, Hooman; Borhani Haghighi, Afshin; Petramfar, Peyman; Jahanshahi, Sepehr; Salehi, Zahra; Fregni, Felipe

    2011-01-01

    Neurophysiological and computer modelling studies have shown that electrode montage is a critical parameter to determine the neuromodulatory effects of transcranial direct current stimulation (tDCS). We tested these results clinically by systematically investigating optimal tDCS electrode montage in stroke. Ten patients received in a counterbalanced and randomised order the following conditions of stimulation (i) anodal stimulation of affected M1 (primary motor cortex) and cathodal stimulation of unaffected M1 ('bilateral tDCS'); (ii) anodal stimulation of affected M1 and cathodal stimulation of contralateral supraorbital area ('anodal tDCS'); (iii) cathodal stimulation of unaffected M1 and anodal stimulation of contralateral supraorbital area ('cathodal tDCS'); (iv) anodal stimulation of affected M1 and cathodal stimulation of contralateral deltoid muscle ('extra-cephalic tDCS') and (v) sham stimulation. We used the Jebsen-Taylor Test (JTT) as a widely accepted measure of upper limb function. Bilateral tDCS, anodal tDCS and cathodal tDCS were shown to be associated with significant improvements on the JTT. Placing the reference electrode in an extracephalic position and use of sham stimulation did not induce any significant effects. This small sham controlled cross-over clinical trial is important to provide additional data on the clinical effects of tDCS in stroke and for planning and designing future large tDCS trials in patients with stroke. PMID:21110732

  12. Optimal Coil Orientation for Transcranial Magnetic Stimulation

    PubMed Central

    Richter, Lars; Neumann, Gunnar; Oung, Stephen; Schweikard, Achim; Trillenberg, Peter

    2013-01-01

    We study the impact of coil orientation on the motor threshold (MT) and present an optimal coil orientation for stimulation of the foot. The result can be compared to results of models that predict this orientation from electrodynamic properties of the media in the skull and from orientations of cells, respectively. We used a robotized TMS system for precise coil placement and recorded motor-evoked potentials with surface electrodes on the abductor hallucis muscle of the right foot in 8 healthy control subjects. First, we performed a hot-spot search in standard (lateral) orientation and then rotated the coil in steps of 10° or 20°. At each step we estimated the MT. For navigated stimulation and for correlation with the underlying anatomy a structural MRI scan was obtained. Optimal coil orientation was 33.1±18.3° anteriorly in relation to the standard lateral orientation. In this orientation the threshold was 54±18% in units of maximum stimulator output. There was a significant difference of 8.0±5.9% between the MTs at optimal and at standard orientation. The optimal coil orientations were significantly correlated with the direction perpendicular to the postcentral gyrus (). Robotized TMS facilitates sufficiently precise coil positioning and orientation to study even small variations of the MT with coil orientation. The deviations from standard orientation are more closely matched by models based on field propagation in media than by models based on orientations of pyramidal cells. PMID:23593200

  13. Modeling direct activation of corticospinal axons using transcranial electrical stimulation.

    PubMed

    Suihko, V

    1998-06-01

    Corticospinal axons can be directly activated using anodal transcranial electrical stimulation. The purpose of this work was to find the location of the direct activation. The response to stimulation was modeled with a spherical head model and an active model of a corticospinal nerve. The nerve model had a deep bend at a location corresponding to a corticospinal fiber entering the midbrain. The threshold activation initiated close to brain surface; the exact location depended on whether the cell body located in the surface layers of the brain or in the bank of the central sulcus. The stimulation time constant was 44 micros. When the stimulus amplitude was increased, the site of activation shifted gradually to deeper level, until the activation initiated directly at the bend causing a half millisecond latency jump at spinal level. These results support the theory that the corticospinal axons can be directly activated at deep locations using anodal transcranial electrical stimulation. However, the high amplitude needed for the direct activation suggests that not only the bends on the fibers, but also the shape of surrounding volume conductor (intracranial cavity) favor activation at this location. PMID:9741790

  14. Transcranial magnetic stimulation of the brain: guidelines for pain treatment research.

    PubMed

    Klein, Max M; Treister, Roi; Raij, Tommi; Pascual-Leone, Alvaro; Park, Lawrence; Nurmikko, Turo; Lenz, Fred; Lefaucheur, Jean-Pascal; Lang, Magdalena; Hallett, Mark; Fox, Michael; Cudkowicz, Merit; Costello, Ann; Carr, Daniel B; Ayache, Samar S; Oaklander, Anne Louise

    2015-09-01

    Recognizing that electrically stimulating the motor cortex could relieve chronic pain sparked development of noninvasive technologies. In transcranial magnetic stimulation (TMS), electromagnetic coils held against the scalp influence underlying cortical firing. Multiday repetitive transcranial magnetic stimulation (rTMS) can induce long-lasting, potentially therapeutic brain plasticity. Nearby ferromagnetic or electronic implants are contraindications. Adverse effects are minimal, primarily headaches. Single provoked seizures are very rare. Transcranial magnetic stimulation devices are marketed for depression and migraine in the United States and for various indications elsewhere. Although multiple studies report that high-frequency rTMS of the motor cortex reduces neuropathic pain, their quality has been insufficient to support Food and Drug Administration application. Harvard's Radcliffe Institute therefore sponsored a workshop to solicit advice from experts in TMS, pain research, and clinical trials. They recommended that researchers standardize and document all TMS parameters and improve strategies for sham and double blinding. Subjects should have common well-characterized pain conditions amenable to motor cortex rTMS and studies should be adequately powered. They recommended standardized assessment tools (eg, NIH's PROMIS) plus validated condition-specific instruments and consensus-recommended metrics (eg, IMMPACT). Outcomes should include pain intensity and qualities, patient and clinician impression of change, and proportions achieving 30% and 50% pain relief. Secondary outcomes could include function, mood, sleep, and/or quality of life. Minimum required elements include sample sources, sizes, and demographics, recruitment methods, inclusion and exclusion criteria, baseline and posttreatment means and SD, adverse effects, safety concerns, discontinuations, and medication-usage records. Outcomes should be monitored for at least 3 months after initiation

  15. Transcranial magnetic stimulation of the brain: guidelines for pain treatment research

    PubMed Central

    Klein, Max M.; Treister, Roi; Raij, Tommi; Pascual-Leone, Alvaro; Park, Lawrence; Nurmikko, Turo; Lenz, Fred; Lefaucheur, Jean-Pascal; Lang, Magdalena; Hallett, Mark; Fox, Michael; Cudkowicz, Merit; Costello, Ann; Carr, Daniel B.; Ayache, Samar S.; Oaklander, Anne Louise

    2015-01-01

    Abstract Recognizing that electrically stimulating the motor cortex could relieve chronic pain sparked development of noninvasive technologies. In transcranial magnetic stimulation (TMS), electromagnetic coils held against the scalp influence underlying cortical firing. Multiday repetitive transcranial magnetic stimulation (rTMS) can induce long-lasting, potentially therapeutic brain plasticity. Nearby ferromagnetic or electronic implants are contraindications. Adverse effects are minimal, primarily headaches. Single provoked seizures are very rare. Transcranial magnetic stimulation devices are marketed for depression and migraine in the United States and for various indications elsewhere. Although multiple studies report that high-frequency rTMS of the motor cortex reduces neuropathic pain, their quality has been insufficient to support Food and Drug Administration application. Harvard's Radcliffe Institute therefore sponsored a workshop to solicit advice from experts in TMS, pain research, and clinical trials. They recommended that researchers standardize and document all TMS parameters and improve strategies for sham and double blinding. Subjects should have common well-characterized pain conditions amenable to motor cortex rTMS and studies should be adequately powered. They recommended standardized assessment tools (eg, NIH's PROMIS) plus validated condition-specific instruments and consensus-recommended metrics (eg, IMMPACT). Outcomes should include pain intensity and qualities, patient and clinician impression of change, and proportions achieving 30% and 50% pain relief. Secondary outcomes could include function, mood, sleep, and/or quality of life. Minimum required elements include sample sources, sizes, and demographics, recruitment methods, inclusion and exclusion criteria, baseline and posttreatment means and SD, adverse effects, safety concerns, discontinuations, and medication-usage records. Outcomes should be monitored for at least 3 months after

  16. Repetitive Noninvasive Brain Stimulation to Modulate Cognitive Functions in Schizophrenia: A Systematic Review of Primary and Secondary Outcomes.

    PubMed

    Hasan, Alkomiet; Strube, Wolfgang; Palm, Ulrich; Wobrock, Thomas

    2016-07-01

    Despite many years of research, there is still an urgent need for new therapeutic options for the treatment of cognitive deficits in schizophrenia. Noninvasive brain stimulation (NIBS) has been proposed to be such a novel add-on treatment option. The main objective of this review was to systematically evaluate the cognitive effects of repetitive NIBS in schizophrenia. As most studies have not been specifically designed to investigate cognition as primary outcome, we have focused on both, primary and secondary outcomes. The PubMed/MEDLINE database (1985-2015) was systematically searched for interventional studies investigating the effects of repetitive NIBS on schizophrenia symptoms. All interventional clinical trials using repetitive transcranial stimulation, transcranial theta burst stimulation, and transcranial direct current stimulation for the treatment of schizophrenia were extracted and analyzed with regard to cognitive measures as primary or secondary outcomes. Seventy-six full-text articles were assessed for eligibility of which 33 studies were included in the qualitative synthesis. Of these 33 studies, only 4 studies included cognition as primary outcome, whereas 29 studies included cognitive measures as secondary outcomes. A beneficial effect of frontal NIBS could not be clearly established. No evidence for a cognitive disruptive effect of NIBS (temporal lobe) in schizophrenia could be detected. Finally, a large heterogeneity between studies in terms of inclusion criteria, stimulation parameters, applied cognitive measures, and follow-up intervals was observed. This review provides the first systematic overview regarding cognitive effects of repetitive NIBS in schizophrenia. PMID:27460623

  17. Transcranial static magnetic field stimulation of the human motor cortex.

    PubMed

    Oliviero, Antonio; Mordillo-Mateos, Laura; Arias, Pablo; Panyavin, Ivan; Foffani, Guglielmo; Aguilar, Juan

    2011-10-15

    The aim of the present study was to investigate in healthy humans the possibility of a non-invasive modulation of motor cortex excitability by the application of static magnetic fields through the scalp. Static magnetic fields were obtained by using cylindrical NdFeB magnets. We performed four sets of experiments. In Experiment 1, we recorded motor potentials evoked by single-pulse transcranial magnetic stimulation (TMS) of the motor cortex before and after 10 min of transcranial static magnetic field stimulation (tSMS) in conscious subjects. We observed an average reduction of motor cortex excitability of up to 25%, as revealed by TMS, which lasted for several minutes after the end of tSMS, and was dose dependent (intensity of the magnetic field) but not polarity dependent. In Experiment 2, we confirmed the reduction of motor cortex excitability induced by tSMS using a double-blind sham-controlled design. In Experiment 3, we investigated the duration of tSMS that was necessary to modulate motor cortex excitability. We found that 10 min of tSMS (compared to 1 min and 5 min) were necessary to induce significant effects. In Experiment 4, we used transcranial electric stimulation (TES) to establish that the tSMS-induced reduction of motor cortex excitability was not due to corticospinal axon and/or spinal excitability, but specifically involved intracortical networks. These results suggest that tSMS using small static magnets may be a promising tool to modulate cerebral excitability in a non-invasive, painless, and reversible way. PMID:21807616

  18. Cognitive enhancement by transcranial laser stimulation and acute aerobic exercise.

    PubMed

    Hwang, Jungyun; Castelli, Darla M; Gonzalez-Lima, F

    2016-08-01

    This is the first randomized, controlled study comparing the cognitive effects of transcranial laser stimulation and acute aerobic exercise on the same cognitive tasks. We examined whether transcranial infrared laser stimulation of the prefrontal cortex, acute high-intensity aerobic exercise, or the combination may enhance performance in sustained attention and working memory tasks. Sixty healthy young adults were randomly assigned to one of the following four treatments: (1) low-level laser therapy (LLLT) with infrared laser to two forehead sites while seated (total 8 min, 1064 nm continuous wave, 250 mW/cm(2), 60 J/cm(2) per site of 13.6 cm(2)); (2) acute exercise (EX) of high-intensity (total 20 min, with 10-min treadmill running at 85-90 % VO2max); (3) combined treatment (LLLT + EX); or (4) sham control (CON). Participants were tested for prefrontal measures of sustained attention with the psychomotor vigilance task (PVT) and working memory with the delayed match-to-sample task (DMS) before and after the treatments. As compared to CON, both LLLT and EX reduced reaction time in the PVT [F(1.56) = 4.134, p = 0.01, η (2)  = 0.181] and increased the number of correct responses in the DMS [F(1.56) = 4.690, p = 0.005, η (2)  = 0.201], demonstrating a significant enhancing effect of LLLT and EX on cognitive performance. LLLT + EX effects were similar but showed no significantly greater improvement on PVT and DMS than LLLT or EX alone. The transcranial infrared laser stimulation and acute aerobic exercise treatments were similarly effective for cognitive enhancement, suggesting that they augment prefrontal cognitive functions similarly. PMID:27220529

  19. Standardization of transcranial magnetic stimulation in the horse.

    PubMed

    Nollet, H; Van Ham, L; Dewulf, J; Vanderstraeten, G; Deprez, P

    2003-11-01

    The influence of coil position on the peak-to-peak amplitude and onset latency of transcranial magnetic motor evoked potentials (MMEPs) in the extensor carpi radialis and cranial tibial muscles of horses was evaluated. Seven different stimulating coil positions were obtained by constructing a frame on the forehead. Two stimulation intensities (80% and 100% of maximal stimulator output) and two different coil currents (clockwise and counter-clockwise) were tested. For both recording sites MMEPs with the shortest onset latency and the largest peak-to-peak amplitude were detected when the coil was placed in the median of the forehead. There was no significant difference between left and right side recordings. The direction of the current flow in the coil had no influence on the onset latency of the MMEPs. PMID:14550735

  20. Does hemispheric lateralization influence therapeutic effects of transcranial direct current stimulation?

    PubMed Central

    Kwon, Yong Hyun; Kang, Kyung Woo; Lee, Na Kyung; Son, Sung Min

    2016-01-01

    This study investigated the effect of transcranial direct current stimulation (tDCS) polarity depending on lateralized function of task property in normal individuals performing visuomotor and simple repetitive tasks. Thirty healthy participants with no neurological disorders were recruited to participate in this study. Participants were randomly allocated into active or control condition. For the active condition, tDCS intensity was 2 mA with stimulation applied for 15 minutes to the right hemisphere (tDCS condition). For the sham control, electrodes were placed in the same position, but the stimulator was turned off after 30 seconds (sham condition). The tapping and tracking task tests were performed before and after for both conditions. Univariate analysis revealed significant difference only in the tracking task. For direct comparison of both tasks within each group, the tracking task had significantly higher Z score than the tapping task in the tDCS group (P < 0.05). Thus, our study indicates that stimulation of the right hemisphere using tDCS can effectively improve visuomotor (tracking) task over simple repetitive (tapping) task. PMID:26981100

  1. Neural dynamics during repetitive visual stimulation

    NASA Astrophysics Data System (ADS)

    Tsoneva, Tsvetomira; Garcia-Molina, Gary; Desain, Peter

    2015-12-01

    Objective. Steady-state visual evoked potentials (SSVEPs), the brain responses to repetitive visual stimulation (RVS), are widely utilized in neuroscience. Their high signal-to-noise ratio and ability to entrain oscillatory brain activity are beneficial for their applications in brain-computer interfaces, investigation of neural processes underlying brain rhythmic activity (steady-state topography) and probing the causal role of brain rhythms in cognition and emotion. This paper aims at analyzing the space and time EEG dynamics in response to RVS at the frequency of stimulation and ongoing rhythms in the delta, theta, alpha, beta, and gamma bands. Approach.We used electroencephalography (EEG) to study the oscillatory brain dynamics during RVS at 10 frequencies in the gamma band (40-60 Hz). We collected an extensive EEG data set from 32 participants and analyzed the RVS evoked and induced responses in the time-frequency domain. Main results. Stable SSVEP over parieto-occipital sites was observed at each of the fundamental frequencies and their harmonics and sub-harmonics. Both the strength and the spatial propagation of the SSVEP response seem sensitive to stimulus frequency. The SSVEP was more localized around the parieto-occipital sites for higher frequencies (>54 Hz) and spread to fronto-central locations for lower frequencies. We observed a strong negative correlation between stimulation frequency and relative power change at that frequency, the first harmonic and the sub-harmonic components over occipital sites. Interestingly, over parietal sites for sub-harmonics a positive correlation of relative power change and stimulation frequency was found. A number of distinct patterns in delta (1-4 Hz), theta (4-8 Hz), alpha (8-12 Hz) and beta (15-30 Hz) bands were also observed. The transient response, from 0 to about 300 ms after stimulation onset, was accompanied by increase in delta and theta power over fronto-central and occipital sites, which returned to baseline

  2. Enhancing language performance with non-invasive brain stimulation--a transcranial direct current stimulation study in healthy humans.

    PubMed

    Sparing, Roland; Dafotakis, Manuel; Meister, Ingo G; Thirugnanasambandam, Nivethida; Fink, Gereon R

    2008-01-15

    In humans, transcranial direct current stimulation (tDCS) can be used to induce, depending on polarity, increases or decreases of cortical excitability by polarization of the underlying brain tissue. Cognitive enhancement as a result of tDCS has been reported. The purpose of this study was to test whether weak tDCS (current density, 57 microA/cm(2)) can be used to modify language processing. Fifteen healthy subjects performed a visual picture naming task before, during and after tDCS applied over the posterior perisylvian region (PPR), i.e. an area which includes Wernicke's area [BA 22]. Four different sessions were carried out: (1) anodal and (2) cathodal stimulation of left PPR and, for control, (3) anodal stimulation of the homologous region of the right hemisphere and (4) sham stimulation. We found that subjects responded significantly faster following anodal tDCS to the left PPR (p<0.01). No decreases in performance were detected. Our finding of a transient improvement in a language task following the application of tDCS together with previous studies which investigated the modulation of picture naming latency by transcranial magnetic stimulation (TMS) and repetitive TMS (rTMS) suggest that tDCS applied to the left PPR (including Wernicke's area [BA 22]) can be used to enhance language processing in healthy subjects. Whether this safe, low cost, and easy to use brain stimulation technique can be used to ameliorate deficits of picture naming in aphasic patients needs further investigations. PMID:17804023

  3. Cerebellar transcranial direct current stimulation in neurological disease.

    PubMed

    Ferrucci, Roberta; Bocci, Tommaso; Cortese, Francesca; Ruggiero, Fabiana; Priori, Alberto

    2016-01-01

    Several studies have highlighted the therapeutic potential of transcranial direct current stimulation (tDCS) in patients with neurological diseases, including dementia, epilepsy, post-stroke dysfunctions, movement disorders, and other pathological conditions. Because of this technique's ability to modify cerebellar excitability without significant side effects, cerebellar tDCS is a new, interesting, and powerful tool to induce plastic modifications in the cerebellum. In this report, we review a number of interesting studies on the application of cerebellar tDCS for various neurological conditions (ataxia, Parkinson's disease, dystonia, essential tremor) and the possible mechanism by which the stimulation acts on the cerebellum. Study findings indicate that cerebellar tDCS is a promising therapeutic tool in treating several neurological disorders; however, this method's efficacy appears to be limited, given the current data. PMID:27595007

  4. Effect of transcranial magnetic stimulation on force of finger pinch

    NASA Astrophysics Data System (ADS)

    Odagaki, Masato; Fukuda, Hiroshi; Hiwaki, Osamu

    2009-04-01

    Transcranial magnetic stimulation (TMS) is used to explore many aspects of brain function, and to treat neurological disorders. Cortical motor neuronal activation by TMS over the primary motor cortex (M1) produces efferent signals that pass through the corticospinal tracts. Motor-evoked potentials (MEPs) are observed in muscles innervated by the stimulated motor cortex. TMS can cause a silent period (SP) following MEP in voluntary electromyography (EMG). The present study examined the effects of TMS eliciting MEP and SP on the force of pinching using two fingers. Subjects pinched a wooden block with the thumb and index finger. TMS was applied to M1 during the pinch task. EMG of first dorsal interosseous muscles and pinch forces were measured. Force output increased after the TMS, and then oscillated. The results indicated that the motor control system to keep isotonic forces of the muscles participated in the finger pinch was disrupted by the TMS.

  5. Electrode positioning and montage in transcranial direct current stimulation.

    PubMed

    DaSilva, Alexandre F; Volz, Magdalena Sarah; Bikson, Marom; Fregni, Felipe

    2011-01-01

    Transcranial direct current stimulation (tDCS) is a technique that has been intensively investigated in the past decade as this method offers a non-invasive and safe alternative to change cortical excitability. The effects of one session of tDCS can last for several minutes, and its effects depend on polarity of stimulation, such as that cathodal stimulation induces a decrease in cortical excitability, and anodal stimulation induces an increase in cortical excitability that may last beyond the duration of stimulation. These effects have been explored in cognitive neuroscience and also clinically in a variety of neuropsychiatric disorders--especially when applied over several consecutive sessions. One area that has been attracting attention of neuroscientists and clinicians is the use of tDCS for modulation of pain-related neural networks. Modulation of two main cortical areas in pain research has been explored: primary motor cortex and dorsolateral prefrontal cortex. Due to the critical role of electrode montage, in this article, we show different alternatives for electrode placement for tDCS clinical trials on pain; discussing advantages and disadvantages of each method of stimulation. PMID:21654618

  6. Improved transcranial magnetic stimulation coil design with realistic head modeling

    NASA Astrophysics Data System (ADS)

    Crowther, Lawrence; Hadimani, Ravi; Jiles, David

    2013-03-01

    We are investigating Transcranial magnetic stimulation (TMS) as a noninvasive technique based on electromagnetic induction which causes stimulation of the neurons in the brain. TMS can be used as a pain-free alternative to conventional electroconvulsive therapy (ECT) which is still widely implemented for treatment of major depression. Development of improved TMS coils capable of stimulating subcortical regions could also allow TMS to replace invasive deep brain stimulation (DBS) which requires surgical implantation of electrodes in the brain. Our new designs allow new applications of the technique to be established for a variety of diagnostic and therapeutic applications of psychiatric disorders and neurological diseases. Calculation of the fields generated inside the head is vital for the use of this method for treatment. In prior work we have implemented a realistic head model, incorporating inhomogeneous tissue structures and electrical conductivities, allowing the site of neuronal activation to be accurately calculated. We will show how we utilize this model in the development of novel TMS coil designs to improve the depth of penetration and localization of stimulation produced by stimulator coils.

  7. Measurement of evoked electroencephalography induced by transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Iramina, Keiji; Maeno, Takashi; Nonaka, Yukio; Ueno, Shoogo

    2003-05-01

    This study focused on the measurement of evoked potentials induced by transcranial magnetic stimulation (TMS) for observing the neuronal connectivity in the brain. We developed an electroencephalography (EEG) measurement system to eliminate the electromagnetic interaction emitted from TMS. EEG activities 5 ms after TMS stimulation were measured. Using this artifact free amplifier, we investigated the intensity dependence of brain activation induced by TMS. When the stimulus intensity was changed at three levels, TMS-evoked EEG responses were measured. Several components of the evoked potential appeared at 9 ms, 20 ms, and 50 ms after stimulation. A large response appeared at about 9 ms after cerebellar TMS. There was a significant dependence of these responses on the stimulus intensity. During right-hand side motor area stimulation, there was no clear peak of the wave forms within 10 ms latency. Occipital stimulation caused more evoked responses to spread to the center of the brain than at other areas of stimulation. The evoked signal by TMS was possibly conducted posteriorly to anteriorly along the pathways of the neuronal fiber exiting the cerebellum into the cerebral cortex.

  8. Anodal motor cortex stimulation paired with movement repetition increases anterograde interference but not savings.

    PubMed

    Leow, Li-Ann; Hammond, Geoff; de Rugy, Aymar

    2014-10-01

    Retention of motor adaptation is evident in savings, where initial learning improves subsequent learning, and anterograde interference, where initial learning impairs subsequent learning. Previously, we proposed that use-dependent movement biases induced by movement repetition contribute to anterograde interference, but not to savings. Here, we evaluate this proposal by limiting or extending movement repetition while stimulating the motor cortex (M1) with anodal transcranial direct current stimulation (tDCS), a brain stimulation technique known to increase use-dependent plasticity when applied during movement repetition. Participants first adapted to a counterclockwise rotation of visual feedback imposed either abruptly (extended repetition) or gradually (limited repetition) in a first block (A1), during which either sham or anodal tDCS (2 mA) was applied over M1. Anterograde interference was then assessed in a second block (B) with a clockwise rotation, and savings in a third block (A2) with a counterclockwise rotation. Anodal M1 tDCS elicited more anterograde interference than sham stimulation with extended but not with limited movement repetition. Conversely, anodal M1 tDCS did not affect savings with either limited or extended repetition of the adapted movement. Crucially, the effect of anodal M1 tDCS on anterograde interference did not require large errors evoked by an abrupt perturbation schedule, as anodal M1 tDCS combined with extended movement repetition within a gradual perturbation schedule similarly increased anterograde interference but not savings. These findings demonstrate that use-dependent plasticity contributes to anterograde interference but not to savings. PMID:25160706

  9. Gender Differences in Current Received during Transcranial Electrical Stimulation

    PubMed Central

    Russell, Michael; Goodman, Theodore; Wang, Qiang; Groshong, Bennett; Lyeth, Bruce G.

    2014-01-01

    Low current transcranial electrical stimulation (tCS) is an effective but somewhat inconsistent tool for augmenting neuromodulation. In this study, we used 3D MRI guided electrical transcranial stimulation modeling to estimate the range of current intensities received at cortical brain tissues. Combined T1, T2, and proton density MRIs from 24 adult subjects (12 male and 12 female) were modeled with virtual electrodes placed at F3, F4, C3, and C4. Two sizes of electrodes 20 mm round and 50 mm × 45 mm were examined at 0.5, 1, and 2 mA input currents. The intensity of current received was sampled in a 1-cm sphere placed at the cortex directly under each scalp electrode. There was a 10-fold difference in the amount of current received by individuals. A large gender difference was observed with female subjects receiving significantly less current at targeted parietal cortex than male subjects when stimulated at identical current levels (P < 0.05). Larger electrodes delivered somewhat larger amounts of current than the smaller ones (P < 0.01). Electrodes in the frontal regions delivered less current than those in the parietal region (P < 0.05). There were large individual differences in current levels that the subjects received. Analysis of the cranial bone showed that the gender difference and the frontal parietal differences are due to differences in cranial bone. Males have more cancelous parietal bone and females more dense parietal bone (P < 0.01). These differences should be considered when planning tCS studies and call into question earlier reports of gender differences due to hormonal influences. PMID:25177301

  10. Modulation of cortical oscillatory activity during transcranial magnetic stimulation.

    PubMed

    Brignani, Debora; Manganotti, Paolo; Rossini, Paolo M; Miniussi, Carlo

    2008-05-01

    Transcranial magnetic stimulation (TMS) can transiently modulate cortical excitability, with a net effect depending on the stimulation frequency (< or =1 Hz inhibition vs. > or =5 Hz facilitation, at least for the motor cortex). This possibility has generated interest in experiments aiming to improve deficits in clinical settings, as well as deficits in the cognitive domain. The aim of the present study was to investigate the on-line effects of low frequency (1 Hz) TMS on the EEG oscillatory activity in the healthy human brain, focusing particularly on the outcome of these modulatory effects in relation to the duration of the TMS stimulation. To this end, we used the event-related desynchronization/synchronization (ERD/ERS) approach to determine the patterns of oscillatory activity during two consecutive trains of sham and real TMS. Each train of stimulation was delivered to the left primary motor cortex (MI) of healthy subjects over a period of 10 min, while EEG rhythms were simultaneously recorded. Results indicated that TMS induced an increase in the power of brain rhythms that was related to the period of the stimulation, i.e. the synchronization of the alpha band increased with the duration of the stimulation, and this increase was inversely correlated with motor-evoked potentials (MEPs) amplitude. In conclusion, low frequency TMS over primary motor cortex induces a synchronization of the background oscillatory activity on the stimulated region. This induced modulation in brain oscillations seems to increase coherently with the duration of stimulation, suggesting that TMS effects may involve short-term modification of the neural circuitry sustaining MEPs characteristics. PMID:17557296

  11. Water diffusion reveals networks that modulate multiregional morphological plasticity after repetitive brain stimulation

    PubMed Central

    Abe, Mitsunari; Fukuyama, Hidenao; Mima, Tatsuya

    2014-01-01

    Repetitive brain stimulation protocols induce plasticity in the stimulated site in brain slice models. Recent evidence from network models has indicated that additional plasticity-related changes occur in nonstimulated remote regions. Despite increasing use of brain stimulation protocols in experimental and clinical settings, the neural substrates underlying the additional effects in remote regions are unknown. Diffusion-weighted MRI (DWI) probes water diffusion and can be used to estimate morphological changes in cortical tissue that occur with the induction of plasticity. Using DWI techniques, we estimated morphological changes induced by application of repetitive transcranial magnetic stimulation (rTMS) over the left primary motor cortex (M1). We found that rTMS altered water diffusion in multiple regions including the left M1. Notably, the change in water diffusion was retained longest in the left M1 and remote regions that had a correlation of baseline fluctuations in water diffusion before rTMS. We conclude that synchronization of water diffusion at rest between stimulated and remote regions ensures retention of rTMS-induced changes in water diffusion in remote regions. Synchronized fluctuations in the morphology of cortical microstructures between stimulated and remote regions might identify networks that allow retention of plasticity-related morphological changes in multiple regions after brain stimulation protocols. These results increase our understanding of the effects of brain stimulation-induced plasticity on multiregional brain networks. DWI techniques could provide a tool to evaluate treatment effects of brain stimulation protocols in patients with brain disorders. PMID:24619090

  12. Neuroprotection trek--the next generation: neuromodulation I. Techniques--deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation

    NASA Technical Reports Server (NTRS)

    Andrews, Russell J.

    2003-01-01

    Neuromodulation denotes controlled electrical stimulation of the central or peripheral nervous system. The three forms of neuromodulation described in this paper-deep brain stimulation, vagus nerve stimulation, and transcranial magnetic stimulation-were chosen primarily for their demonstrated or potential clinical usefulness. Deep brain stimulation is a completely implanted technique for improving movement disorders, such as Parkinson's disease, by very focal electrical stimulation of the brain-a technique that employs well-established hardware (electrode and pulse generator/battery). Vagus nerve stimulation is similar to deep brain stimulation in being well-established (for the treatment of refractory epilepsy), completely implanted, and having hardware that can be considered standard at the present time. Vagus nerve stimulation differs from deep brain stimulation, however, in that afferent stimulation of the vagus nerve results in diffuse effects on many regions throughout the brain. Although use of deep brain stimulation for applications beyond movement disorders will no doubt involve placing the stimulating electrode(s) in regions other than the thalamus, subthalamus, or globus pallidus, the use of vagus nerve stimulation for applications beyond epilepsy-for example, depression and eating disorders-is unlikely to require altering the hardware significantly (although stimulation protocols may differ). Transcranial magnetic stimulation is an example of an external or non-implanted, intermittent (at least given the current state of the hardware) stimulation technique, the clinical value of which for neuromodulation and neuroprotection remains to be determined.

  13. Transcranial direct current stimulation influences the cardiac autonomic nervous control.

    PubMed

    Montenegro, Rafael Ayres; Farinatti, Paulo de Tarso Veras; Fontes, Eduardo Bodnariuc; Soares, Pedro Paulo da Silva; Cunha, Felipe Amorim da; Gurgel, Jonas Lírio; Porto, Flávia; Cyrino, Edilson Serpeloni; Okano, Alexandre Hideki

    2011-06-15

    To investigate whether the manipulation of brain excitability by transcranial direct current stimulation (tDCS) modulates the heart rate variability (HRV), the effect of tDCS applied at rest on the left temporal lobe in athletes (AG) and non-athletes (NAG) was evaluated. The HRV parameters (natural logarithms of LF, HF, and LF/HF) was assessed in 20 healthy men before, and immediately after tDCS and sham stimulation. After anodal tDCS in AG the parasympathetic activity (HF(log)) increased (P<0.01) and the sympathetic activity (LF(log)) and sympatho-vagal balance (LF/HF(log)) decreased (P<0.01), whereas no significant effects were detected in NAG (P>0.05). No significant changes in HRV indexes were provoked by sham stimulation in both AG and NAG (P>0.05). In conclusion, tDCS applied on the left temporal lobe significantly increased the overall HRV in AG, enhancing the parasympathetic and decreasing the sympathetic modulation of heart rate. Consequently the sympatho-vagal balance decreased at rest in AG but not in NAG. Releasing a weak electric current to stimulate selected brain areas may induce favorable effects on the autonomic control to the heart in highly fit subjects. PMID:21527314

  14. Deep brain transcranial magnetic stimulation using variable "Halo coil" system

    NASA Astrophysics Data System (ADS)

    Meng, Y.; Hadimani, R. L.; Crowther, L. J.; Xu, Z.; Qu, J.; Jiles, D. C.

    2015-05-01

    Transcranial Magnetic Stimulation has the potential to treat various neurological disorders non-invasively and safely. The "Halo coil" configuration can stimulate deeper regions of the brain with lower surface to deep-brain field ratio compared to other coil configurations. The existing "Halo coil" configuration is fixed and is limited in varying the site of stimulation in the brain. We have developed a new system based on the current "Halo coil" design along with a graphical user interface system that enables the larger coil to rotate along the transverse plane. The new system can also enable vertical movement of larger coil. Thus, this adjustable "Halo coil" configuration can stimulate different regions of the brain by adjusting the position and orientation of the larger coil on the head. We have calculated magnetic and electric fields inside a MRI-derived heterogeneous head model for various positions and orientations of the coil. We have also investigated the mechanical and thermal stability of the adjustable "Halo coil" configuration for various positions and orientations of the coil to ensure safe operation of the system.

  15. Is the human mirror neuron system plastic? Evidence from a transcranial magnetic stimulation study.

    PubMed

    Mehta, Urvakhsh Meherwan; Waghmare, Avinash V; Thirthalli, Jagadisha; Venkatasubramanian, Ganesan; Gangadhar, Bangalore N

    2015-10-01

    Virtual lesions in the mirror neuron network using inhibitory low-frequency (1Hz) transcranial magnetic stimulation (TMS) have been employed to understand its spatio-functional properties. However, no studies have examined the influence of neuro-enhancement by using excitatory high-frequency (20Hz) repetitive transcranial magnetic stimulation (HF-rTMS) on these networks. We used three forms of TMS stimulation (HF-rTMS, single and paired pulse) to investigate whether the mirror neuron system facilitates the motor system during goal-directed action observation relative to inanimate motion (motor resonance), a marker of putative mirror neuron activity. 31 healthy individuals were randomized to receive single-sessions of true or sham HF-rTMS delivered to the left inferior frontal gyrus - a component of the human mirror system. Motor resonance was assessed before and after HF-rTMS using three TMS cortical reactivity paradigms: (a) 120% of resting motor threshold (RMT), (b) stimulus intensity set to evoke motor evoked potential of 1-millivolt amplitude (SI1mV) and (c) a short latency paired pulse paradigm. Two-way RMANOVA showed a significant group (true versus sham) X occasion (pre- and post-HF-rTMS motor resonance) interaction effect for SI1mV [F(df)=6.26 (1, 29), p=0.018] and 120% RMT stimuli [F(df)=7.01 (1, 29), p=0.013] indicating greater enhancement of motor resonance in the true HF-rTMS group than the sham-group. This suggests that HF-rTMS could adaptively modulate properties of the mirror neuron system. This neuro-enhancement effect is a preliminary step that can open translational avenues for novel brain stimulation therapeutics targeting social-cognition deficits in schizophrenia and autism. PMID:26194133

  16. Use of Transcranial Magnetic Stimulation in Autism Spectrum Disorders

    PubMed Central

    Oberman, Lindsay M.; Rotenberg, Alexander; Pascual-Leone, Alvaro

    2015-01-01

    The clinical, social and financial burden of Autism Spectrum Disorder (ASD) is staggering. We urgently need valid and reliable biomarkers for diagnosis and effective treatments targeting the often debilitating symptoms. Transcranial Magnetic Stimulation (TMS) is beginning to be used by a number of centers worldwide and may represent a novel technique with both diagnostic and therapeutic potential. Here we critically review the current scientific evidence for the use of TMS in ASD. Though preliminary data suggests promise, there is simply not enough evidence yet to conclusively support the clinical widespread use of TMS in ASD, neither diagnostically nor therapeutically. Carefully designed and properly controlled clinical trials are warranted to evaluate the true potential of TMS in ASD. PMID:24127165

  17. Transcranial direct current stimulation (tDCS) and language

    PubMed Central

    Monti, Alessia; Ferrucci, Roberta; Fumagalli, Manuela; Mameli, Francesca; Cogiamanian, Filippo; Ardolino, Gianluca; Priori, Alberto

    2013-01-01

    Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique inducing prolonged brain excitability changes and promoting cerebral plasticity, is a promising option for neurorehabilitation. Here, we review progress in research on tDCS and language functions and on the potential role of tDCS in the treatment of post-stroke aphasia. Currently available data suggest that tDCS over language-related brain areas can modulate linguistic abilities in healthy individuals and can improve language performance in patients with aphasia. Whether the results obtained in experimental conditions are functionally important for the quality of life of patients and their caregivers remains unclear. Despite the fact that important variables are yet to be determined, tDCS combined with rehabilitation techniques seems a promising therapeutic option for aphasia. PMID:23138766

  18. The Corticospinal System and Transcranial Magnetic Stimulation in Stroke

    PubMed Central

    Perez, Monica A.; Cohen, Leonardo G.

    2016-01-01

    During the last decades, transcranial magnetic stimulation (TMS) has been used as a noninvasive method to investigate motor cortical reorganization and neuroplasticity in humans after stroke. An increasing number of studies in the field of motor control have used TMS to gain an understanding of the different aspects of stroke cortical physiology and motor recovery. This review addresses the effects of corticospinal tract (CST) lesions in humans and nonhuman primates on the functional organization of the motor system. We review information on the physiological mechanisms by which the CST contributes to normal motor control and to central nervous system reorganization following stroke when the CST is injured as measured using TMS. Insight into these physiological mechanisms has led to the development of scientifically sound interventional proposals in the field of neurorehabilitation. PMID:19740731

  19. Sustained excitability elevations induced by transcranial DC motor cortex stimulation in humans.

    PubMed

    Nitsche, M A; Paulus, W

    2001-11-27

    The authors show that in the human transcranial direct current stimulation is able to induce sustained cortical excitability elevations. As revealed by transcranial magnetic stimulation, motor cortical excitability increased approximately 150% above baseline for up to 90 minutes after the end of stimulation. The feasibility of inducing long-lasting excitability modulations in a noninvasive, painless, and reversible way makes this technique a potentially valuable tool in neuroplasticity modulation. PMID:11723286

  20. Electronically Switchable Sham Transcranial Magnetic Stimulation (TMS) System

    PubMed Central

    Hoeft, Fumiko; Wu, Daw-An; Hernandez, Arvel; Glover, Gary H.; Shimojo, Shinsuke

    2008-01-01

    Transcranial magnetic stimulation (TMS) is increasingly being used to demonstrate the causal links between brain and behavior in humans. Further, extensive clinical trials are being conducted to investigate the therapeutic role of TMS in disorders such as depression. Because TMS causes strong peripheral effects such as auditory clicks and muscle twitches, experimental artifacts such as subject bias and placebo effect are clear concerns. Several sham TMS methods have been developed, but none of the techniques allows one to intermix real and sham TMS on a trial-by-trial basis in a double-blind manner. We have developed an attachment that allows fast, automated switching between Standard TMS and two types of control TMS (Sham and Reverse) without movement of the coil or reconfiguration of the setup. We validate the setup by performing mathematical modeling, search-coil and physiological measurements. To see if the stimulus conditions can be blinded, we conduct perceptual discrimination and sensory perception studies. We verify that the physical properties of the stimulus are appropriate, and that successive stimuli do not contaminate each other. We find that the threshold for motor activation is significantly higher for Reversed than for Standard stimulation, and that Sham stimulation entirely fails to activate muscle potentials. Subjects and experimenters perform poorly at discriminating between Sham and Standard TMS with a figure-of-eight coil, and between Reverse and Standard TMS with a circular coil. Our results raise the possibility of utilizing this technique for a wide range of applications. PMID:18398456

  1. Comparison of Coil Designs for Transcranial Magnetic Stimulation on Mice

    NASA Astrophysics Data System (ADS)

    Rastogi, Priyam; Hadimani, Ravi; Jiles, David

    2015-03-01

    Transcranial magnetic stimulation (TMS) is a non-invasive treatment for neurological disorders using time varying magnetic field. The electric field generated by the time varying magnetic field is used to depolarize the brain neurons which can lead to measurable effects. TMS provides a surgical free method for the treatment of neurological brain disorders like depression, post-traumatic stress disorder, traumatic brain injury and Parkinson's disease. Before using TMS on human subjects, it is appropriate that its effects are verified on animals such as mice. The magnetic field intensity and stimulated region of the brain can be controlled by the shape, position and current in the coils. There are few reports on the designs of the coils for mice. In this paper, different types of coils are developed and compared using an anatomically realistic mouse model derived from MRI images. Parameters such as focality, depth of the stimulation, electric field strength on the scalp and in the deep brain regions, are taken into account. These parameters will help researchers to determine the most suitable coil design according to their need. This should result in improvements in treatment of specific disorders. Carver Charitable Trust.

  2. Prefrontal transcranial direct current stimulation facilitates affective flexibility.

    PubMed

    Aboulafia-Brakha, Tatiana; Manuel, Aurelie L; Ptak, Radek

    2016-06-01

    Performance on paradigms involving switching between emotional and non-emotional task-sets (affective flexibility) predicts emotion regulation abilities and is impaired in patients with different emotional disorders. A better understanding of how neurostimulation techniques such as transcranial direct current stimulation (tDCS) influence affective switching may provide support for the improvement of rehabilitation programs. In the current study healthy volunteers received anodal tDCS over the right dorsolateral prefrontal cortex (DLPFC), the left DLPFC or sham stimulation while performing an affective-switching task. Participants had to repeat or switch between facial judgments of emotional expressions (emotional task-set) or gender (non-emotional task-set). Right tDCS resulted in faster responses in the gender task only when it followed a judgment of emotion. These effects were not observed following left tDCS. Further, switching away from emotion was easier for the right compared to left tDCS group (reduced switch costs for gender), while switching away from gender toward emotion was easier for the left compared to the right group (reduced switch-costs for emotion). In sum, tDCS over the DLPFC may modulate affective flexibility and right stimulation may be particularly helpful to facilitate disengagement from emotional task-sets. The usefulness of tDCS-trained affective switching may be further investigated on larger therapeutic protocols targeting emotional disorders. PMID:27039163

  3. Enhanced visual perception with occipital transcranial magnetic stimulation.

    PubMed

    Mulckhuyse, Manon; Kelley, Todd A; Theeuwes, Jan; Walsh, Vincent; Lavie, Nilli

    2011-10-01

    Transcranial magnetic stimulation (TMS) over the occipital pole can produce an illusory percept of a light flash (or 'phosphene'), suggesting an excitatory effect. Whereas previous reported effects produced by single-pulse occipital pole TMS are typically disruptive, here we report the first demonstration of a location-specific facilitatory effect on visual perception in humans. Observers performed a spatial cueing orientation discrimination task. An orientation target was presented in one of two peripheral placeholders. A single pulse below the phosphene threshold applied to the occipital pole 150 or 200 ms before stimulus onset was found to facilitate target discrimination in the contralateral compared with the ipsilateral visual field. At the 150-ms time window contralateral TMS also amplified cueing effects, increasing both facilitation effects for valid cues and interference effects for invalid cues. These results are the first to show location-specific enhanced visual perception with single-pulse occipital pole stimulation prior to stimulus presentation, suggesting that occipital stimulation can enhance the excitability of visual cortex to subsequent perception. PMID:21848918

  4. Enhancing Working Memory Training with Transcranial Direct Current Stimulation.

    PubMed

    Au, Jacky; Katz, Benjamin; Buschkuehl, Martin; Bunarjo, Kimberly; Senger, Thea; Zabel, Chelsea; Jaeggi, Susanne M; Jonides, John

    2016-09-01

    Working memory (WM) is a fundamental cognitive ability that supports complex thought but is limited in capacity. Thus, WM training interventions have become very popular as a means of potentially improving WM-related skills. Another promising intervention that has gained increasing traction in recent years is transcranial direct current stimulation (tDCS), a noninvasive form of brain stimulation that can modulate cortical excitability and temporarily increase brain plasticity. As such, it has the potential to boost learning and enhance performance on cognitive tasks. This study assessed the efficacy of tDCS to supplement WM training. Sixty-two participants were randomized to receive either right prefrontal, left prefrontal, or sham stimulation with concurrent visuospatial WM training over the course of seven training sessions. Results showed that tDCS enhanced training performance, which was strikingly preserved several months after training completion. Furthermore, we observed stronger effects when tDCS was spaced over a weekend break relative to consecutive daily training, and we also demonstrated selective transfer in the right prefrontal group to nontrained tasks of visual and spatial WM. These findings shed light on how tDCS may be leveraged as a tool to enhance performance on WM-intensive learning tasks. PMID:27167403

  5. Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine

    PubMed Central

    Andreou, Anna P.; Holland, Philip R.; Akerman, Simon; Summ, Oliver; Fredrick, Joe

    2016-01-01

    A single pulse of transcranial magnetic stimulation has been shown to be effective for the acute treatment of migraine with and without aura. Here we aimed to investigate the potential mechanisms of action of transcranial magnetic stimulation, using a transcortical approach, in preclinical migraine models. We tested the susceptibility of cortical spreading depression, the experimental correlate of migraine aura, and further evaluated the response of spontaneous and evoked trigeminovascular activity of second order trigemontothalamic and third order thalamocortical neurons in rats. Single pulse transcranial magnetic stimulation significantly inhibited both mechanical and chemically-induced cortical spreading depression when administered immediately post-induction in rats, but not when administered preinduction, and when controlled by a sham stimulation. Additionally transcranial magnetic stimulation significantly inhibited the spontaneous and evoked firing rate of third order thalamocortical projection neurons, but not second order neurons in the trigeminocervical complex, suggesting a potential modulatory effect that may underlie its utility in migraine. In gyrencephalic cat cortices, when administered post-cortical spreading depression, transcranial magnetic stimulation blocked the propagation of cortical spreading depression in two of eight animals. These results are the first to demonstrate that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and further highlight a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura. PMID:27246325

  6. Transcranial magnetic stimulation and potential cortical and trigeminothalamic mechanisms in migraine.

    PubMed

    Andreou, Anna P; Holland, Philip R; Akerman, Simon; Summ, Oliver; Fredrick, Joe; Goadsby, Peter J

    2016-07-01

    A single pulse of transcranial magnetic stimulation has been shown to be effective for the acute treatment of migraine with and without aura. Here we aimed to investigate the potential mechanisms of action of transcranial magnetic stimulation, using a transcortical approach, in preclinical migraine models. We tested the susceptibility of cortical spreading depression, the experimental correlate of migraine aura, and further evaluated the response of spontaneous and evoked trigeminovascular activity of second order trigemontothalamic and third order thalamocortical neurons in rats. Single pulse transcranial magnetic stimulation significantly inhibited both mechanical and chemically-induced cortical spreading depression when administered immediately post-induction in rats, but not when administered preinduction, and when controlled by a sham stimulation. Additionally transcranial magnetic stimulation significantly inhibited the spontaneous and evoked firing rate of third order thalamocortical projection neurons, but not second order neurons in the trigeminocervical complex, suggesting a potential modulatory effect that may underlie its utility in migraine. In gyrencephalic cat cortices, when administered post-cortical spreading depression, transcranial magnetic stimulation blocked the propagation of cortical spreading depression in two of eight animals. These results are the first to demonstrate that cortical spreading depression can be blocked in vivo using single pulse transcranial magnetic stimulation and further highlight a novel thalamocortical modulatory capacity that may explain the efficacy of magnetic stimulation in the treatment of migraine with and without aura. PMID:27246325

  7. Coil Design Considerations for Deep Transcranial Magnetic Stimulation

    PubMed Central

    Deng, Zhi-De; Lisanby, Sarah H.; Peterchev, Angel V.

    2014-01-01

    Objectives To explore the field characteristics and design tradeoffs of coils for deep transcranial magnetic stimulation (dTMS). Methods We simulated parametrically two dTMS coil designs on a spherical head model using the finite element method, and compare them with five commercial TMS coils, including two that are FDA approved for the treatment of depression (ferromagnetic-core figure-8 and H1 coil). Results Smaller coils have a focality advantage over larger coils; however, this advantage diminishes with increasing target depth. Smaller coils have the disadvantage of producing stronger field in the superficial cortex and requiring more energy. When the coil dimensions are large relative to the head size, the electric field decay in depth becomes linear, indicating that, at best, the electric field attenuation is directly proportional to the depth of the target. Ferromagnetic cores improve electrical efficiency for targeting superficial brain areas; however magnetic saturation reduces the effectiveness of the core for deeper targets, especially for highly focal coils. Distancing winding segments from the head, as in the H1 coil, increases the required stimulation energy. Conclusions Among standard commercial coils, the double cone coil offers high energy efficiency and balance between stimulated volume and superficial field strength. Direct TMS of targets at depths of ~ 4 cm or more results in superficial stimulation strength that exceeds the upper limit in current rTMS safety guidelines. Approaching depths of ~ 6 cm is almost certainly unsafe considering the excessive superficial stimulation strength and activated brain volume. Significance Coil design limitations and tradeoffs are important for rational and safe exploration of dTMS. PMID:24411523

  8. Individual differences in transcranial electrical stimulation current density

    PubMed Central

    Russell, Michael J; Goodman, Theodore; Pierson, Ronald; Shepherd, Shane; Wang, Qiang; Groshong, Bennett; Wiley, David F

    2013-01-01

    Transcranial electrical stimulation (TCES) is effective in treating many conditions, but it has not been possible to accurately forecast current density within the complex anatomy of a given subject's head. We sought to predict and verify TCES current densities and determine the variability of these current distributions in patient-specific models based on magnetic resonance imaging (MRI) data. Two experiments were performed. The first experiment estimated conductivity from MRIs and compared the current density results against actual measurements from the scalp surface of 3 subjects. In the second experiment, virtual electrodes were placed on the scalps of 18 subjects to model simulated current densities with 2 mA of virtually applied stimulation. This procedure was repeated for 4 electrode locations. Current densities were then calculated for 75 brain regions. Comparison of modeled and measured external current in experiment 1 yielded a correlation of r = .93. In experiment 2, modeled individual differences were greatest near the electrodes (ten-fold differences were common), but simulated current was found in all regions of the brain. Sites that were distant from the electrodes (e.g. hypothalamus) typically showed two-fold individual differences. MRI-based modeling can effectively predict current densities in individual brains. Significant variation occurs between subjects with the same applied electrode configuration. Individualized MRI-based modeling should be considered in place of the 10-20 system when accurate TCES is needed. PMID:24285948

  9. Transcranial Current Stimulation of the Temporoparietal Junction Improves Lie Detection

    PubMed Central

    Sowden, Sophie; Wright, Gordon R.T.; Banissy, Michael J.; Catmur, Caroline; Bird, Geoffrey

    2015-01-01

    Summary The ability to detect deception is of vital importance in human society, playing a crucial role in communication, cooperation, and trade between societies, businesses, and individuals. However, numerous studies have shown, remarkably consistently, that we are only slightly above chance when it comes to detecting deception [1]. Here we investigate whether inconsistency between one’s own opinion and the stated opinion of another impairs judgment of the veracity of that statement, in the same way that one’s own mental, affective, and action states, when inconsistent, can interfere with representation of those states in another [2]. Within the context of lie detection, individuals may be less accurate when judging the veracity of another’s opinion when it is inconsistent with their own opinion. Here we present a video-mediated lie-detection task to confirm this prediction: individuals correctly identified truths or lies less often when the other’s expressed opinion was inconsistent with their own (experiment 1). Transcranial direct current stimulation (tDCS) of the temporoparietal junction (TPJ) has previously been shown to improve the ability to selectively represent the self or another [3–5]. We therefore predicted that TPJ stimulation would enable lie detectors to inhibit their own views, enhance those of the other, and improve their ability to determine whether another was presenting their true opinion. Experiment 2 confirmed this second prediction: anodal tDCS of the TPJ improved lie detection specifically when one’s own and others’ views were conflicting. PMID:26344092

  10. Transcranial Current Stimulation of the Temporoparietal Junction Improves Lie Detection.

    PubMed

    Sowden, Sophie; Wright, Gordon R T; Banissy, Michael J; Catmur, Caroline; Bird, Geoffrey

    2015-09-21

    The ability to detect deception is of vital importance in human society, playing a crucial role in communication, cooperation, and trade between societies, businesses, and individuals. However, numerous studies have shown, remarkably consistently, that we are only slightly above chance when it comes to detecting deception. Here we investigate whether inconsistency between one's own opinion and the stated opinion of another impairs judgment of the veracity of that statement, in the same way that one's own mental, affective, and action states, when inconsistent, can interfere with representation of those states in another. Within the context of lie detection, individuals may be less accurate when judging the veracity of another's opinion when it is inconsistent with their own opinion. Here we present a video-mediated lie-detection task to confirm this prediction: individuals correctly identified truths or lies less often when the other's expressed opinion was inconsistent with their own (experiment 1). Transcranial direct current stimulation (tDCS) of the temporoparietal junction (TPJ) has previously been shown to improve the ability to selectively represent the self or another. We therefore predicted that TPJ stimulation would enable lie detectors to inhibit their own views, enhance those of the other, and improve their ability to determine whether another was presenting their true opinion. Experiment 2 confirmed this second prediction: anodal tDCS of the TPJ improved lie detection specifically when one's own and others' views were conflicting. PMID:26344092

  11. Transcranial magnetic stimulation for the treatment of depression.

    PubMed

    George, Mark S

    2010-11-01

    Repeated daily left prefrontal transcranial magnetic stimulation (TMS) was first proposed as a potential treatment for depression in 1993. Multiple studies from researchers around the world since then have repeatedly demonstrated that TMS has antidepressant effects greater than sham treatment, and that these effects are clinically meaningful. A large industry-sponsored trial, published in 2007, resulted in US FDA approval in October 2008. Most recently, a large NIH-sponsored trial, with a more rigorous sham technique, found that a course of treatment (3-5 weeks) was statistically and clinically significant in reducing depression. However, consistently showing statistically and clinically significant antidepressant effects, and gaining regulatory approval, is merely the beginning for this new treatment. As with any new treatment involving a radically different approach, there are many unanswered questions about TMS, and the field is still rapidly evolving. These unanswered questions include the appropriate scalp location, understanding the mechanisms of action, refining the 'dose' (frequency, train, number of stimuli/day and pattern of delivery), understanding whether and how TMS can be combined with medications or talking/exposure therapy, or both, and how to deliver maintenance TMS. This article summarizes the available clinical information, and discusses key areas where more research is needed. TMS reflects a paradigm shift in treating depression. It is a safe, relatively noninvasive, focal brain stimulation treatment that does not involve seizures or implanted wires, and does not have drug-drug interactions or systemic side effects. PMID:20977332

  12. Characteristics of bowl-shaped coils for transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Yamamoto, Keita; Suyama, Momoko; Takiyama, Yoshihiro; Kim, Dongmin; Saitoh, Youichi; Sekino, Masaki

    2015-05-01

    Transcranial magnetic stimulation (TMS) has recently been used as a method for the treatment of neurological and psychiatric diseases. Daily TMS sessions can provide continuous therapeutic effectiveness, and the installation of TMS systems at patients' homes has been proposed. A figure-eight coil, which is normally used for TMS therapy, induces a highly localized electric field; however, it is challenging to achieve accurate coil positioning above the targeted brain area using this coil. In this paper, a bowl-shaped coil for stimulating a localized but wider area of the brain is proposed. The coil's electromagnetic characteristics were analyzed using finite element methods, and the analysis showed that the bowl-shaped coil induced electric fields in a wider area of the brain model than a figure-eight coil. The expanded distribution of the electric field led to greater robustness of the coil to the coil-positioning error. To improve the efficiency of the coil, the relationship between individual coil design parameters and the resulting coil characteristics was numerically analyzed. It was concluded that lengthening the outer spherical radius and narrowing the width of the coil were effective methods for obtaining a more effective and more uniform distribution of the electric field.

  13. Determinants of the electric field during transcranial direct current stimulation.

    PubMed

    Opitz, Alexander; Paulus, Walter; Will, Susanne; Antunes, Andre; Thielscher, Axel

    2015-04-01

    Transcranial direct current stimulation (tDCS) causes a complex spatial distribution of the electric current flow in the head which hampers the accurate localization of the stimulated brain areas. In this study we show how various anatomical features systematically shape the electric field distribution in the brain during tDCS. We constructed anatomically realistic finite element (FEM) models of two individual heads including conductivity anisotropy and different skull layers. We simulated a widely employed electrode montage to induce motor cortex plasticity and moved the stimulating electrode over the motor cortex in small steps to examine the resulting changes of the electric field distribution in the underlying cortex. We examined the effect of skull thickness and composition on the passing currents showing that thinner skull regions lead to higher electric field strengths. This effect is counteracted by a larger proportion of higher conducting spongy bone in thicker regions leading to a more homogenous current over the skull. Using a multiple regression model we could identify key factors that determine the field distribution to a significant extent, namely the thicknesses of the cerebrospinal fluid and the skull, the gyral depth and the distance to the anode and cathode. These factors account for up to 50% of the spatial variation of the electric field strength. Further, we demonstrate that individual anatomical factors can lead to stimulation "hotspots" which are partly resistant to electrode positioning. Our results give valuable novel insights in the biophysical foundation of tDCS and highlight the importance to account for individual anatomical factors when choosing an electrode montage. PMID:25613437

  14. Transcranial magnetic stimulation in autism spectrum disorder: Challenges, promise, and roadmap for future research.

    PubMed

    Oberman, Lindsay M; Enticott, Peter G; Casanova, Manuel F; Rotenberg, Alexander; Pascual-Leone, Alvaro; McCracken, James T

    2016-02-01

    Autism Spectrum Disorder (ASD) is a behaviorally defined complex neurodevelopmental syndrome characterized by impairments in social communication, by the presence of restricted and repetitive behaviors, interests and activities, and by abnormalities in sensory reactivity. Transcranial magnetic stimulation (TMS) is a promising, emerging tool for the study and potential treatment of ASD. Recent studies suggest that TMS measures provide rapid and noninvasive pathophysiological ASD biomarkers. Furthermore, repetitive TMS (rTMS) may represent a novel treatment strategy for reducing some of the core and associated ASD symptoms. However, the available literature on the TMS use in ASD is preliminary, composed of studies with methodological limitations. Thus, off-label clinical rTMS use for therapeutic interventions in ASD without an investigational device exemption and outside of an IRB approved research trial is premature pending further, adequately powered and controlled trials. Leaders in this field have gathered annually for a two-day conference (prior to the 2014 and 2015 International Meeting for Autism Research, IMFAR) to share recent progress, promote collaboration across laboratories, and establish consensus on protocols. Here we review the literature in the use of TMS in ASD in the context of the unique challenges required for the study and exploration of treatment strategies in this population. We also suggest future directions for this field of investigations. While its true potential in ASD has yet to be delineated, TMS represents an innovative research tool and a novel, possibly transformative approach to the treatment of neurodevelopmental disorders. PMID:26536383

  15. Lasting EEG/MEG Aftereffects of Rhythmic Transcranial Brain Stimulation: Level of Control Over Oscillatory Network Activity.

    PubMed

    Veniero, Domenica; Vossen, Alexandra; Gross, Joachim; Thut, Gregor

    2015-01-01

    A number of rhythmic protocols have emerged for non-invasive brain stimulation (NIBS) in humans, including transcranial alternating current stimulation (tACS), oscillatory transcranial direct current stimulation (otDCS), and repetitive (also called rhythmic) transcranial magnetic stimulation (rTMS). With these techniques, it is possible to match the frequency of the externally applied electromagnetic fields to the intrinsic frequency of oscillatory neural population activity ("frequency-tuning"). Mounting evidence suggests that by this means tACS, otDCS, and rTMS can entrain brain oscillations and promote associated functions in a frequency-specific manner, in particular during (i.e., online to) stimulation. Here, we focus instead on the changes in oscillatory brain activity that persist after the end of stimulation. Understanding such aftereffects in healthy participants is an important step for developing these techniques into potentially useful clinical tools for the treatment of specific patient groups. Reviewing the electrophysiological evidence in healthy participants, we find aftereffects on brain oscillations to be a common outcome following tACS/otDCS and rTMS. However, we did not find a consistent, predictable pattern of aftereffects across studies, which is in contrast to the relative homogeneity of reported online effects. This indicates that aftereffects are partially dissociated from online, frequency-specific (entrainment) effects during tACS/otDCS and rTMS. We outline possible accounts and future directions for a better understanding of the link between online entrainment and offline aftereffects, which will be key for developing more targeted interventions into oscillatory brain activity. PMID:26696834

  16. Lasting EEG/MEG Aftereffects of Rhythmic Transcranial Brain Stimulation: Level of Control Over Oscillatory Network Activity

    PubMed Central

    Veniero, Domenica; Vossen, Alexandra; Gross, Joachim; Thut, Gregor

    2015-01-01

    A number of rhythmic protocols have emerged for non-invasive brain stimulation (NIBS) in humans, including transcranial alternating current stimulation (tACS), oscillatory transcranial direct current stimulation (otDCS), and repetitive (also called rhythmic) transcranial magnetic stimulation (rTMS). With these techniques, it is possible to match the frequency of the externally applied electromagnetic fields to the intrinsic frequency of oscillatory neural population activity (“frequency-tuning”). Mounting evidence suggests that by this means tACS, otDCS, and rTMS can entrain brain oscillations and promote associated functions in a frequency-specific manner, in particular during (i.e., online to) stimulation. Here, we focus instead on the changes in oscillatory brain activity that persist after the end of stimulation. Understanding such aftereffects in healthy participants is an important step for developing these techniques into potentially useful clinical tools for the treatment of specific patient groups. Reviewing the electrophysiological evidence in healthy participants, we find aftereffects on brain oscillations to be a common outcome following tACS/otDCS and rTMS. However, we did not find a consistent, predictable pattern of aftereffects across studies, which is in contrast to the relative homogeneity of reported online effects. This indicates that aftereffects are partially dissociated from online, frequency-specific (entrainment) effects during tACS/otDCS and rTMS. We outline possible accounts and future directions for a better understanding of the link between online entrainment and offline aftereffects, which will be key for developing more targeted interventions into oscillatory brain activity. PMID:26696834

  17. Enhancement of human cognitive performance using transcranial magnetic stimulation (TMS)

    PubMed Central

    Luber, Bruce; Lisanby, and Sarah H.

    2014-01-01

    Here we review the usefulness of transcranial magnetic stimulation (TMS) in modulating cortical networks in ways that might produce performance enhancements in healthy human subjects. To date over sixty studies have reported significant improvements in speed and accuracy in a variety of tasks involving perceptual, motor, and executive processing. Two basic categories of enhancement mechanisms are suggested by this literature: direct modulation of a cortical region or network that leads to more efficient processing, and addition-by-subtraction, which is disruption of processing which competes or distracts from task performance. Potential applications of TMS cognitive enhancement, including research into cortical function, rehabilitation therapy in neurological and psychiatric illness, and accelerated skill acquisition in healthy individuals are discussed, as are methods of optimizing the magnitude and duration of TMS-induced performance enhancement, such as improvement of targeting through further integration of brain imaging with TMS. One technique, combining multiple sessions of TMS with concurrent TMS/task performance to induce Hebbian-like learning, appears to be promising for prolonging enhancement effects. While further refinements in the application of TMS to cognitive enhancement can still be made, and questions remain regarding the mechanisms underlying the observed effects, this appears to be a fruitful area of investigation that may shed light on the basic mechanisms of cognitive function and their therapeutic modulation. PMID:23770409

  18. Enhancing the mirror illusion with transcranial direct current stimulation.

    PubMed

    Jax, Steven A; Rosa-Leyra, Diana L; Coslett, H Branch

    2015-05-01

    Visual feedback has a strong impact on upper-extremity movement production. One compelling example of this phenomena is the mirror illusion (MI), which has been used as a treatment for post-stroke movement deficits (mirror therapy). Previous research indicates that the MI increases primary motor cortex excitability, and this change in excitability is strongly correlated with the mirror's effects on behavioral performance of neurologically-intact controls. Based on evidence that primary motor cortex excitability can also be increased using transcranial direct current stimulation (tDCS), we tested whether bilateral tDCS to the primary motor cortices (anode right-cathode left and anode left-cathode right) would modify the MI. We measured the MI using a previously-developed task in which participants make reaching movements with the unseen arm behind a mirror while viewing the reflection of the other arm. When an offset in the positions of the two limbs relative to the mirror is introduced, reaching errors of the unseen arm are biased by the reflected arm's position. We found that active tDCS in the anode right-cathode left montage increased the magnitude of the MI relative to sham tDCS and anode left-cathode right tDCS. We take these data as a promising indication that tDCS could improve the effect of mirror therapy in patients with hemiparesis. PMID:25796410

  19. Transcranial magnetic stimulation and amyotrophic lateral sclerosis: pathophysiological insights

    PubMed Central

    Vucic, Steve; Ziemann, Ulf; Eisen, Andrew; Hallett, Mark; Kiernan, Matthew C

    2013-01-01

    Amyotrophic lateral sclerosis (ALS) is a rapidly progressive neurodegenerative disorder of the motor neurons in the motor cortex, brainstem and spinal cord. A combination of upper and lower motor neuron dysfunction comprises the clinical ALS phenotype. Although the ALS phenotype was first observed by Charcot over 100 years ago, the site of ALS onset and the pathophysiological mechanisms underlying the development of motor neuron degeneration remain to be elucidated. Transcranial magnetic stimulation (TMS) enables non-invasive assessment of the functional integrity of the motor cortex and its corticomotoneuronal projections. To date, TMS studies have established motor cortical and corticospinal dysfunction in ALS, with cortical hyperexcitability being an early feature in sporadic forms of ALS and preceding the clinical onset of familial ALS. Taken together, a central origin of ALS is supported by TMS studies, with an anterograde transsynaptic mechanism implicated in ALS pathogenesis. Of further relevance, TMS techniques reliably distinguish ALS from mimic disorders, despite a compatible peripheral disease burden, thereby suggesting a potential diagnostic utility of TMS in ALS. This review will focus on the mechanisms underlying the generation of TMS measures used in assessment of cortical excitability, the contribution of TMS in enhancing the understanding of ALS pathophysiology and the potential diagnostic utility of TMS techniques in ALS. PMID:23264687

  20. Prognostication of Bell's palsy using transcranial magnetic stimulation.

    PubMed

    Rimpiläinen, I; Eskola, H; Laippala, P; Laranne, J; Karma, P

    1997-01-01

    Transcranial magnetic stimulation (TMS) provides a method to noninvasive excitation of the facial nerve in its intracranial segment close to the internal acoustic meatus. Thus, the site of facial nerve activation with TMS is proximal to or within the site of the lesion in Bell's palsy. To evaluate the prognostic capability of TMS in unilateral Bell's palsy we examined 137 patients with this method, and compared the results with electroneuronography (ENoG). Within 0-4 days from the onset of palsy, the patients with elicitable TMS responses recovered better than those in whom TMS responses were not elicitable. If TMS was performed 5-9 days or 10-28 days after the onset of palsy, it did not provide any prognostic information. Based on amplitude side-to-side differences, ENoG did not contribute prognostic information during the first 9 days from the onset of palsy. Later on, 10-28 days after the onset of palsy, ENoG showed an increased capability to discriminate the patients with poor prognosis. Thus, elicitable facial motor response with TMS predicts good prognosis of Bell's palsy at an early stage whereas poor response with ENoG predicts less favorable prognosis at a later stage. PMID:9288286

  1. Transcranial Magnetic Stimulation: Decomposing the Processes Underlying Action Preparation.

    PubMed

    Bestmann, Sven; Duque, Julie

    2016-08-01

    Preparing actions requires the operation of several cognitive control processes that influence the state of the motor system to ensure that the appropriate behavior is ultimately selected and executed. For example, some form of competition resolution ensures that the right action is chosen among alternatives, often in the presence of conflict; at the same time, impulse control ought to be deployed to prevent premature responses. Here we review how state-changes in the human motor system during action preparation can be studied through motor-evoked potentials (MEPs) elicited by transcranial magnetic stimulation over the contralateral primary motor cortex (M1). We discuss how the physiological fingerprints afforded by MEPs have helped to decompose some of the dynamic and effector-specific influences on the motor system during action preparation. We focus on competition resolution, conflict and impulse control, as well as on the influence of higher cognitive decision-related variables. The selected examples demonstrate the usefulness of MEPs as physiological readouts for decomposing the influence of distinct, but often overlapping, control processes on the human motor system during action preparation. PMID:26163320

  2. Simultaneous EEG monitoring during transcranial direct current stimulation.

    PubMed

    Schestatsky, Pedro; Morales-Quezada, Leon; Fregni, Felipe

    2013-01-01

    Transcranial direct current stimulation (tDCS) is a technique that delivers weak electric currents through the scalp. This constant electric current induces shifts in neuronal membrane excitability, resulting in secondary changes in cortical activity. Although tDCS has most of its neuromodulatory effects on the underlying cortex, tDCS effects can also be observed in distant neural networks. Therefore, concomitant EEG monitoring of the effects of tDCS can provide valuable information on the mechanisms of tDCS. In addition, EEG findings can be an important surrogate marker for the effects of tDCS and thus can be used to optimize its parameters. This combined EEG-tDCS system can also be used for preventive treatment of neurological conditions characterized by abnormal peaks of cortical excitability, such as seizures. Such a system would be the basis of a non-invasive closed-loop device. In this article, we present a novel device that is capable of utilizing tDCS and EEG simultaneously. For that, we describe in a step-by-step fashion the main procedures of the application of this device using schematic figures, tables and video demonstrations. Additionally, we provide a literature review on clinical uses of tDCS and its cortical effects measured by EEG techniques. PMID:23851401

  3. Effect of Transcranial Magnetic Stimulation on Neuronal Networks

    NASA Astrophysics Data System (ADS)

    Unsal, Ahmet; Hadimani, Ravi; Jiles, David

    2013-03-01

    The human brain contains around 100 billion nerve cells controlling our day to day activities. Consequently, brain disorders often result in impairments such as paralysis, loss of coordination and seizure. It has been said that 1 in 5 Americans suffer some diagnosable mental disorder. There is an urgent need to understand the disorders, prevent them and if possible, develop permanent cure for them. As a result, a significant amount of research activities is being directed towards brain research. Transcranial Magnetic Stimulation (TMS) is a promising tool for diagnosing and treating brain disorders. It is a non-invasive treatment method that produces a current flow in the brain which excites the neurons. Even though TMS has been verified to have advantageous effects on various brain related disorders, there have not been enough studies on the impact of TMS on cells. In this study, we are investigating the electrophysiological effects of TMS on one dimensional neuronal culture grown in a circular pathway. Electrical currents are produced on the neuronal networks depending on the directionality of the applied field. This aids in understanding how neuronal networks react under TMS treatment.

  4. [Transcranial direct current stimulation: new clinical roadmaps for psychiatric research].

    PubMed

    Heeren, Alexandre; Coussement, Charlotte; Colon, Élisabeth

    Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has undergone intensive research over the past decade with promising results. tDCS is based on the application of weak, direct current over the scalp, leading to cortical hypo- or hyperpolarization according to the specified parameters. Recent studies have shown that tDCS is able to induce potent changes in cortical excitability as well as to elicit long-lasting modifications in brain activity. Over the last decade, tDCS physiological mechanisms of action have been intensively investigated. This research has given support for the investigation of tDCS applications in a wide range of clinical populations, including patients with post-stroke motor and language deficits, chronic pain, and tinnitus. Recently, its efficacy to treat psychiatric conditions has been explored increasingly. In this review, we will gather clinical studies involving tDCS to ameliorate psychiatric symptoms and discuss reasonable next steps in this direction. PMID:27615184

  5. Transcranial magnetic stimulation in schizophrenia: the contribution of neuroimaging.

    PubMed

    Du, Zhong-de; Wang, R; Prakash, Ravi; Chaudhury, S; Dayananda, G

    2012-01-01

    At the most basic level, the Transcranial Magnetic Stimulation(TMS) is a neuro-scientific tool that exerts its action by influencing the neo-cortical functions. However, in-spite of so many well-evidenced roles of TMS in neuropsychiatric conditions, its exact mechanism of action remains to be known. More intriguing are its therapeutic effects in Schizophrenia at the Cerebral-level. In this review, we adopt a neuro-imaging approach for this exploration. We review the present literature for the studies in Schizophrenia which have used a combination of rTMS with 1) Electroenchephalogram (EEG) 2)The functional Magnetic Resonance Imaging (fMRI) and the 3) Positron Emission Tomography (PET)/ Single-Photon Emission Computed Tomography. The TMS-EEG combination provides direct effects of TMS on the electro- magnetic field (EMF) of brain. The TMS-fMRI/PET/SPECT combinations are very effective in exploring the functional connectivity in brains of Schizophrenia patients as well as in performing rTMS guided neuro-navigation. Our review suggests that TMS combined with other neuroimaging modalities are needed for a better clarification of its neural actions. PMID:23409741

  6. Safety of Transcranial Direct Current Stimulation: Evidence Based Update 2016.

    PubMed

    Bikson, Marom; Grossman, Pnina; Thomas, Chris; Zannou, Adantchede Louis; Jiang, Jimmy; Adnan, Tatheer; Mourdoukoutas, Antonios P; Kronberg, Greg; Truong, Dennis; Boggio, Paulo; Brunoni, André R; Charvet, Leigh; Fregni, Felipe; Fritsch, Brita; Gillick, Bernadette; Hamilton, Roy H; Hampstead, Benjamin M; Jankord, Ryan; Kirton, Adam; Knotkova, Helena; Liebetanz, David; Liu, Anli; Loo, Colleen; Nitsche, Michael A; Reis, Janine; Richardson, Jessica D; Rotenberg, Alexander; Turkeltaub, Peter E; Woods, Adam J

    2016-01-01

    This review updates and consolidates evidence on the safety of transcranial Direct Current Stimulation (tDCS). Safety is here operationally defined by, and limited to, the absence of evidence for a Serious Adverse Effect, the criteria for which are rigorously defined. This review adopts an evidence-based approach, based on an aggregation of experience from human trials, taking care not to confuse speculation on potential hazards or lack of data to refute such speculation with evidence for risk. Safety data from animal tests for tissue damage are reviewed with systematic consideration of translation to humans. Arbitrary safety considerations are avoided. Computational models are used to relate dose to brain exposure in humans and animals. We review relevant dose-response curves and dose metrics (e.g. current, duration, current density, charge, charge density) for meaningful safety standards. Special consideration is given to theoretically vulnerable populations including children and the elderly, subjects with mood disorders, epilepsy, stroke, implants, and home users. Evidence from relevant animal models indicates that brain injury by Direct Current Stimulation (DCS) occurs at predicted brain current densities (6.3-13 A/m(2)) that are over an order of magnitude above those produced by conventional tDCS. To date, the use of conventional tDCS protocols in human trials (≤40 min, ≤4 milliamperes, ≤7.2 Coulombs) has not produced any reports of a Serious Adverse Effect or irreversible injury across over 33,200 sessions and 1000 subjects with repeated sessions. This includes a wide variety of subjects, including persons from potentially vulnerable populations. PMID:27372845

  7. Transcranial random noise stimulation mitigates increased difficulty in an arithmetic learning task.

    PubMed

    Popescu, Tudor; Krause, Beatrix; Terhune, Devin B; Twose, Olivia; Page, Thomas; Humphreys, Glyn; Cohen Kadosh, Roi

    2016-01-29

    Proficiency in arithmetic learning can be achieved by using a multitude of strategies, the most salient of which are procedural learning (applying a certain set of computations) and rote learning (direct retrieval from long-term memory). Here we investigated the effect of transcranial random noise stimulation (tRNS), a non-invasive brain stimulation method previously shown to enhance cognitive training, on both types of learning in a 5-day sham-controlled training study, under two conditions of task difficulty, defined in terms of item repetition. On the basis of previous research implicating the prefrontal and posterior parietal cortex in early and late stages of arithmetic learning, respectively, sham-controlled tRNS was applied to bilateral prefrontal cortex for the first 3 days and to the posterior parietal cortex for the last 2 days of a 5-day training phase. The training involved learning to solve arithmetic problems by applying a calculation algorithm; both trained and untrained problems were used in a brief testing phase at the end of the training phase. Task difficulty was manipulated between subjects by using either a large ("easy" condition) or a small ("difficult" condition) number of repetition of problems during training. Measures of attention and working memory were acquired before and after the training phase. As compared to sham, participants in the tRNS condition displayed faster reaction times and increased learning rate during the training phase; as well as faster reaction times for both trained and untrained (new) problems, which indicated a transfer effect after the end of training. All stimulation effects reached significance only in the "difficult" condition when number of repetition was lower. There were no transfer effects of tRNS on attention or working memory. The results support the view that tRNS can produce specific facilitative effects on numerical cognition--specifically, on arithmetic learning. They also highlight the importance of

  8. Transcranial random noise stimulation mitigates increased difficulty in an arithmetic learning task

    PubMed Central

    Popescu, Tudor; Krause, Beatrix; Terhune, Devin B.; Twose, Olivia; Page, Thomas; Humphreys, Glyn; Cohen Kadosh, Roi

    2016-01-01

    Proficiency in arithmetic learning can be achieved by using a multitude of strategies, the most salient of which are procedural learning (applying a certain set of computations) and rote learning (direct retrieval from long-term memory). Here we investigated the effect of transcranial random noise stimulation (tRNS), a non-invasive brain stimulation method previously shown to enhance cognitive training, on both types of learning in a 5-day sham-controlled training study, under two conditions of task difficulty, defined in terms of item repetition. On the basis of previous research implicating the prefrontal and posterior parietal cortex in early and late stages of arithmetic learning, respectively, sham-controlled tRNS was applied to bilateral prefrontal cortex for the first 3 days and to the posterior parietal cortex for the last 2 days of a 5-day training phase. The training involved learning to solve arithmetic problems by applying a calculation algorithm; both trained and untrained problems were used in a brief testing phase at the end of the training phase. Task difficulty was manipulated between subjects by using either a large (“easy” condition) or a small (“difficult” condition) number of repetition of problems during training. Measures of attention and working memory were acquired before and after the training phase. As compared to sham, participants in the tRNS condition displayed faster reaction times and increased learning rate during the training phase; as well as faster reaction times for both trained and untrained (new) problems, which indicated a transfer effect after the end of training. All stimulation effects reached significance only in the “difficult” condition when number of repetition was lower. There were no transfer effects of tRNS on attention or working memory. The results support the view that tRNS can produce specific facilitative effects on numerical cognition – specifically, on arithmetic learning. They also highlight

  9. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study.

    PubMed

    Drumond Marra, Hellen Livia; Myczkowski, Martin Luiz; Maia Memória, Cláudia; Arnaut, Débora; Leite Ribeiro, Philip; Sardinha Mansur, Carlos Gustavo; Lancelote Alberto, Rodrigo; Boura Bellini, Bianca; Alves Fernandes da Silva, Adriano; Tortella, Gabriel; Ciampi de Andrade, Daniel; Teixeira, Manoel Jacobsen; Forlenza, Orestes Vicente; Marcolin, Marco Antonio

    2015-01-01

    Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. PMID:26160997

  10. Theoretical Analysis of Transcranial Magneto-Acoustical Stimulation with Hodgkin-Huxley Neuron Model.

    PubMed

    Yuan, Yi; Chen, Yudong; Li, Xiaoli

    2016-01-01

    Transcranial magneto-acoustical stimulation (TMAS) is a novel stimulation technology in which an ultrasonic wave within a magnetostatic field generates an electric current in an area of interest in the brain to modulate neuronal activities. As a key part of the neural network, neurons transmit information in the nervous system. However, the effect of TMAS on the neuronal firing pattern remains unknown. To address this problem, we investigated the stimulatory mechanism of TMAS on neurons, by using a Hodgkin-Huxley neuron model. The simulation results indicated that the magnetostatic field intensity and ultrasonic power affect the amplitude and interspike interval of neuronal action potential under a continuous wave ultrasound. The simulation results also showed that the ultrasonic power, duty cycle and repetition frequency can alter the firing pattern of neural action potential under pulsed wave ultrasound. This study may help to reveal and explain the biological mechanism of TMAS and to provide a theoretical basis for TMAS in the treatment or rehabilitation of neuropsychiatric disorders. PMID:27148032

  11. Intra- and interobserver variability of language mapping by navigated transcranial magnetic brain stimulation

    PubMed Central

    2013-01-01

    Background Repetitive navigated transcranial magnetic stimulation (rTMS) has been used for studying language organization in healthy volunteers and patients, and to detect cortical areas involved in language processing. However, little is known about the reliability of this method. To determine the reliability of rTMS language mapping, we conducted both an interobserver and an intraobserver investigation. Methods Ten right-handed healthy subjects underwent language mapping by rTMS and the same object-naming task three times. Intraobserver and interobserver reliability of seven different error types were tested by two investigators. Analysis was performed blinded to the previous results and stimulated cortical sites. Results Overall, the results of both the interobserver and the intraobserver investigations show variable accordance. This is demonstrated by comparing the error rates of all different error types of the three examinations. Considering the most important error type, “no response”, there is only small variability in inter- and intraobserver mapping. Conclusions With our current protocol, interobserver and intraobserver comparisons only corresponded partially. Thus, although rTMS seems a promising method for preoperative planning as well as neuropsychological research, the current protocol needs further improvement. PMID:24304865

  12. The effect of practice on random number generation task: a transcranial direct current stimulation study.

    PubMed

    Capone, Fioravante; Capone, Gianluca; Ranieri, Federico; Di Pino, Giovanni; Oricchio, Gianluca; Di Lazzaro, Vincenzo

    2014-10-01

    Random number generation (RNG) is a procedurally-simple task related to specific executive functions, such as updating and monitoring of information and inhibition of automatic responses. The effect of practice on executive functions has been widely investigated, however little is known on the impact of practice on RNG. Transcranial direct current stimulation (tDCS) allows to modulate, non-invasively, brain activity and to enhance the effects of training on executive functions. Hence, this study aims to investigate the effect of practice on RNG and to explore the possibility to influence it by tDCS applied over dorsolateral prefrontal cortex. Twenty-six healthy volunteers have been evaluated within single session and between different sessions of RNG using several measures of randomness, which are informative of separable cognitive components servicing random behavior. We found that repetition measures significantly change within single session, seriation measures significantly change both within and between sessions, while cycling measures are not affected by practice. tDCS does not produce any additional effect, however a sub-analysis limited to the first session revealed an increasing trend in seriation measure after anodal compared to cathodal stimulation. Our findings support the hypothesis that practice selectively and consistently influences specific cognitive components related to random behavior, while tDCS transiently affects RNG performance. PMID:24811195

  13. Transcranial Magnetic Stimulation to Address Mild Cognitive Impairment in the Elderly: A Randomized Controlled Study

    PubMed Central

    Drumond Marra, Hellen Livia; Myczkowski, Martin Luiz; Maia Memória, Cláudia; Arnaut, Débora; Leite Ribeiro, Philip; Sardinha Mansur, Carlos Gustavo; Lancelote Alberto, Rodrigo; Boura Bellini, Bianca; Alves Fernandes da Silva, Adriano; Tortella, Gabriel; Ciampi de Andrade, Daniel; Teixeira, Manoel Jacobsen; Forlenza, Orestes Vicente; Marcolin, Marco Antonio

    2015-01-01

    Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique with potential to improve memory. Mild cognitive impairment (MCI), which still lacks a specific therapy, is a clinical syndrome associated with increased risk of dementia. This study aims to assess the effects of high-frequency repetitive TMS (HF rTMS) on everyday memory of the elderly with MCI. We conducted a double-blinded randomized sham-controlled trial using rTMS over the left dorsolateral prefrontal cortex (DLPFC). Thirty-four elderly outpatients meeting Petersen's MCI criteria were randomly assigned to receive 10 sessions of either active TMS or sham, 10 Hz rTMS at 110% of motor threshold, 2,000 pulses per session. Neuropsychological assessment at baseline, after the last session (10th) and at one-month follow-up, was applied. ANOVA on the primary efficacy measure, the Rivermead Behavioural Memory Test, revealed a significant group-by-time interaction (p = 0.05), favoring the active group. The improvement was kept after one month. Other neuropsychological tests were heterogeneous. rTMS at 10 Hz enhanced everyday memory in elderly with MCI after 10 sessions. These findings suggest that rTMS might be effective as a therapy for MCI and probably a tool to delay deterioration. PMID:26160997

  14. Electromagnetic characteristics of eccentric figure-eight coils for transcranial magnetic stimulation: A numerical study

    NASA Astrophysics Data System (ADS)

    Kato, Takuya; Sekino, Masaki; Matsuzaki, Taiga; Nishikawa, Atsushi; Saitoh, Youichi; Ohsaki, Hiroyuki

    2012-04-01

    Repetitive transcranial magnetic stimulation (rTMS) is effective for treatment of several neurological and psychiatric diseases. We proposed an eccentric figure-eight coil, which induces strong eddy currents in the target brain tissue. In this study, numerical analyses were carried out to obtain magnetic field distribution of the eccentric figure-eight coil and eddy current in the brain. The analyses were performed with various coil design parameters, such as the outer and inner diameters and number of turns, to investigate the influence of these parameters on the coil characteristics. Increases in the inner diameter, outer diameter, and number of turns caused increases in the maximum eddy current densities. Coil inductance, working voltage, and heat generation also became higher with the increases in these design parameters. In order to develop a compact stimulator system for use at home, we need to obtain strong eddy current density, keeping the working voltage as low as possible. Our results show that it is effective to enlarge the outer diameter.

  15. Theoretical Analysis of Transcranial Magneto-Acoustical Stimulation with Hodgkin-Huxley Neuron Model

    PubMed Central

    Yuan, Yi; Chen, Yudong; Li, Xiaoli

    2016-01-01

    Transcranial magneto-acoustical stimulation (TMAS) is a novel stimulation technology in which an ultrasonic wave within a magnetostatic field generates an electric current in an area of interest in the brain to modulate neuronal activities. As a key part of the neural network, neurons transmit information in the nervous system. However, the effect of TMAS on the neuronal firing pattern remains unknown. To address this problem, we investigated the stimulatory mechanism of TMAS on neurons, by using a Hodgkin-Huxley neuron model. The simulation results indicated that the magnetostatic field intensity and ultrasonic power affect the amplitude and interspike interval of neuronal action potential under a continuous wave ultrasound. The simulation results also showed that the ultrasonic power, duty cycle and repetition frequency can alter the firing pattern of neural action potential under pulsed wave ultrasound. This study may help to reveal and explain the biological mechanism of TMAS and to provide a theoretical basis for TMAS in the treatment or rehabilitation of neuropsychiatric disorders. PMID:27148032

  16. Transcranial Direct Current Stimulation for Treating Depression in a Patient With Right Hemispheric Dominance: A Case Study.

    PubMed

    Shiozawa, Pedro; da Silva, Mailu Enokibara; Cordeiro, Quirino

    2015-09-01

    We report the case of a 66-year-old male patient with major depressive disorder for the last 6 months. The patient had been diagnosed with dyslexia during childhood and was left-handed. The intervention protocol consisted in 10 consecutive daily transcranial direct current stimulation sessions. However, after 5 days of stimulation, the patient presented with intensification of depressive symptoms and panic attacks. It was hypothetized that the intensification of symptoms may have been due to stimulation protocol itself. Considering the patient was left-handed and presented comorbidity with dyslexia, there was a plausible hypothesis of right hemispheric dominance. This was corroborated by the Edinburgh Handedness Scale. In fact, dyslexic patients present right hemisphere dominance more frequently. The patient also presented a single photon emission computed tomography with a hypoperfusion area over the left posterior parietal lobe. After the patients agreement, a 10-day experimental repetitive transcranial magnetic stimulation low-frequency protocol over the left dorsolateral prefrontal cortex was started to inhibit the area, which was hypothetically hyperactivated following the rationale of right dominance. The patient presented amelioration of depressive and anxious symptoms. Given the hemispheric reversal we show in the present case study, however, it seems that therapies that are beneficial to right-handers could be detrimental to left-handers. PMID:25203287

  17. Investigating Representations of Facial Identity in Human Ventral Visual Cortex with Transcranial Magnetic Stimulation

    PubMed Central

    Gilaie-Dotan, Sharon; Silvanto, Juha; Schwarzkopf, Dietrich S.; Rees, Geraint

    2010-01-01

    The occipital face area (OFA) is face-selective. This enhanced activation to faces could reflect either generic face and shape-related processing or high-level conceptual processing of identity. Here we examined these two possibilities using a state-dependent transcranial magnetic stimulation (TMS) paradigm. The lateral occipital (LO) cortex which is activated non-selectively by various types of objects served as a control site. We localized OFA and LO on a per-participant basis using functional MRI. We then examined whether TMS applied to either of these regions affected the ability of participants to decide whether two successively presented and physically different face images were of the same famous person or different famous people. TMS was applied during the delay between first and second face presentations to investigate whether neuronal populations in these regions played a causal role in mediating the behavioral effects of identity repetition. Behaviorally we found a robust identity repetition effect, with shorter reaction times (RTs) when identity was repeated, regardless of the fact that the pictures were physically different. Surprisingly, TMS applied over LO (but not OFA) modulated overall RTs, compared to the No-TMS condition. But critically, we found no effects of TMS to either area that were modulated by identity repetition. Thus, we found no evidence to suggest that OFA or LO contain neuronal representations selective for the identity of famous faces which play a causal role in identity processing. Instead, these brain regions may be involved in the processing of more generic features of their preferred stimulus categories. PMID:20631842

  18. Subcortical effects of transcranial direct current stimulation in the rat.

    PubMed

    Bolzoni, F; Bączyk, M; Jankowska, E

    2013-08-15

    Transcranial direct current stimulation (tDCS) affects neurons at both cortical and subcortical levels. The subcortical effects involve several descending motor systems but appeared to be relatively weak, as only small increases in the amplitude of subcortically initiated descending volleys and a minute shortening of latencies of these volleys were found. The aim of the present study was therefore to evaluate the consequences of facilitation of these volleys on the ensuing muscle activation. The experiments were carried out on deeply anaesthetized rats without neuromuscular blockade. Effects of tDCS were tested on EMG potentials recorded from neck muscles evoked by weak (20-60 μA) single, double or triple stimuli applied in the medial longitudinal fascicle (MLF) or in the red nucleus (RN). Short latencies of these potentials were compatible with monosynaptic or disynaptic actions of reticulospinal and disynaptic or trisynaptic actions of rubrospinal neurons on neck motoneurons. Despite only weak effects on indirect descending volleys, the EMG responses from both the MLF and the RN were potently facilitated by cathodal tDCS and depressed by anodal tDCS. Both the facilitation and the depression developed relatively rapidly (within the first minute) but both outlasted tDCS and were present for up to 1 h after tDCS. The study thus demonstrates long-lasting effects of tDCS on subcortical neurons in the rat, albeit evoked by an opposite polarity of tDCS to that found to be effective on subcortical neurons in the cat investigated in the preceding study, or for cortical neurons in the humans. PMID:23774279

  19. Cerebellar Transcranial Direct Current Stimulation (ctDCS)

    PubMed Central

    Grimaldi, Giuliana; Argyropoulos, Georgios P.; Bastian, Amy; Cortes, Mar; Davis, Nicholas J.; Edwards, Dylan J.; Ferrucci, Roberta; Fregni, Felipe; Galea, Joseph M.; Hamada, Masahi; Manto, Mario; Miall, R. Chris; Morales-Quezada, Leon; Pope, Paul A.; Priori, Alberto; Rothwell, John; Tomlinson, S. Paul; Celnik, Pablo

    2016-01-01

    The cerebellum is critical for both motor and cognitive control. Dysfunction of the cerebellum is a component of multiple neurological disorders. In recent years, interventions have been developed that aim to excite or inhibit the activity and function of the human cerebellum. Transcranial direct current stimulation of the cerebellum (ctDCS) promises to be a powerful tool for the modulation of cerebellar excitability. This technique has gained popularity in recent years as it can be used to investigate human cerebellar function, is easily delivered, is well tolerated, and has not shown serious adverse effects. Importantly, the ability of ctDCS to modify behavior makes it an interesting approach with a potential therapeutic role for neurological patients. Through both electrical and non-electrical effects (vascular, metabolic) ctDCS is thought to modify the activity of the cerebellum and alter the output from cerebellar nuclei. Physiological studies have shown a polarity-specific effect on the modulation of cerebellar–motor cortex connectivity, likely via cerebellar–thalamocortical pathways. Modeling studies that have assessed commonly used electrode montages have shown that the ctDCS-generated electric field reaches the human cerebellum with little diffusion to neighboring structures. The posterior and inferior parts of the cerebellum (i.e., lobules VI-VIII) seem particularly susceptible to modulation by ctDCS. Numerous studies have shown to date that ctDCS can modulate motor learning, and affect cognitive and emotional processes. Importantly, this intervention has a good safety profile; similar to when applied over cerebral areas. Thus, investigations have begun exploring ctDCS as a viable intervention for patients with neurological conditions. PMID:25406224

  20. Noninvasive transcranial focused ultrasonic-magnetic stimulation for modulating brain oscillatory activity

    NASA Astrophysics Data System (ADS)

    Yuan, Yi; Chen, Yudong; Li, Xiaoli

    2016-02-01

    A novel technique, transcranial focused ultrasonic-magnetic stimulation (tFUMS), has been developed for noninvasive brain modulation in vivo. tFUMS has a higher spatial resolution (<2 mm) and a higher penetration depth than other noninvasive neuromodulation methods. The in vivo animal experimental results show that tFUMS can not only increase the power of local field potentials and the firing rate of the neurons, but also enhance the effect of transcranial focused ultrasound stimulation on the neuromodulation. The results demonstrate that tFUMS can modulate brain oscillatory activities by stimulating brain tissues.

  1. Effects of Transcranial Direct Current Stimulation (tDCS) on Behaviour and Electrophysiology of Language Production

    ERIC Educational Resources Information Center

    Wirth, Miranka; Rahman, Rasha Abdel; Kuenecke, Janina; Koenig, Thomas; Horn, Helge; Sommer, Werner; Dierks, Thomas

    2011-01-01

    Excitatory anodal transcranial direct current stimulation (A-tDCS) over the left dorsal prefrontal cortex (DPFC) has been shown to improve language production. The present study examined neurophysiological underpinnings of this effect. In a single-blinded within-subject design, we traced effects of A-tDCS compared to sham stimulation over the left…

  2. The stimulated social brain: effects of transcranial direct current stimulation on social cognition.

    PubMed

    Sellaro, Roberta; Nitsche, Michael A; Colzato, Lorenza S

    2016-04-01

    Transcranial direct current stimulation (tDCS) is an increasingly popular noninvasive neuromodulatory tool in the fields of cognitive and clinical neuroscience and psychiatry. It is an inexpensive, painless, and safe brain-stimulation technique that has proven to be effective in modulating cognitive and sensory-perceptual functioning in healthy individuals and clinical populations. Importantly, recent findings have shown that tDCS may also be an effective and promising tool for probing the neural mechanisms of social cognition. In this review, we present the state-of-the-art of the field of tDCS research in social cognition. By doing so, we aim to gather knowledge of the potential of tDCS to modulate social functioning and social decision making in healthy humans, and to inspire future research investigations. PMID:27206250

  3. A measure of acoustic noise generated from transcranial magnetic stimulation coils.

    PubMed

    Dhamne, Sameer C; Kothare, Raveena S; Yu, Camilla; Hsieh, Tsung-Hsun; Anastasio, Elana M; Oberman, Lindsay; Pascual-Leone, Alvaro; Rotenberg, Alexander

    2014-01-01

    The intensity of sound emanating from the discharge of magnetic coils used in repetitive transcranial magnetic stimulation (rTMS) can potentially cause acoustic trauma. Per Occupational Safety and Health Administration (OSHA) standards for safety of noise exposure, hearing protection is recommended beyond restricted levels of noise and time limits. We measured the sound pressure levels (SPLs) from four rTMS coils with the goal of assessing if the acoustic artifact levels are of sufficient amplitude to warrant protection from acoustic trauma per OSHA standards. We studied the SPLs at two frequencies (5 and 10 Hz), three machine outputs (MO) (60, 80 and 100%), and two distances from the coil (5 and 10 cm). We found that the SPLs were louder at closer proximity from the coil and directly dependent on the MO. We also found that in all studied conditions, SPLs were lower than the OSHA permissible thresholds for short (<15 min) acoustic exposure, but at extremes of use, may generate sufficient noise to warrant ear protection with prolonged (>8 h) exposure. PMID:24582370

  4. Transcranial magnetic stimulation: a new tool in the fight against depression

    PubMed Central

    Grunhaus, Leon; Dannon, Pinhas N.; Gershon, Ari A.

    2002-01-01

    Since its introduction to the clinical realm in 1985, transcranial magnetic stimulation (TMS) has rapidly developed into a tool for exploring central nervous system function in both health and disease. The antidepressant effects of TMS were initially observed in 1993. Since then, a solid body of evidence has accumulated suggesting antidepressant effects for both slow TMS (sTMS) and repetitive TMS (rTMS). This review is divided into four parts. First, it addresses the basic concepts governing TMS, and then, second, it discusses the technical parameters involved in administering TMS. Knowledge of these parameters is necessary for understanding how TMS is administered, and how manipulation of the technique impacts on the results obtained. Third, we review the most relevant studies on the antidepressant effects of sTMS and rTMS published to date. Finally, we discuss cortical excitability and how the understanding of this basic neurophysiological function of cortical neurons can be used for monitoring the effects of TMS. In our discussion, we conclude that the time has arrived for TMS to be offered to depressed patients as a treatment. PMID:22033886

  5. Low-frequency transcranial magnetic stimulation is beneficial for enhancing synaptic plasticity in the aging brain

    PubMed Central

    Zhang, Zhan-chi; Luan, Feng; Xie, Chun-yan; Geng, Dan-dan; Wang, Yan-yong; Ma, Jun

    2015-01-01

    In the aging brain, cognitive function gradually declines and causes a progressive reduction in the structural and functional plasticity of the hippocampus. Transcranial magnetic stimulation is an emerging and novel neurological and psychiatric tool used to investigate the neurobiology of cognitive function. Recent studies have demonstrated that low-frequency transcranial magnetic stimulation (≤1 Hz) ameliorates synaptic plasticity and spatial cognitive deficits in learning-impaired mice. However, the mechanisms by which this treatment improves these deficits during normal aging are still unknown. Therefore, the current study investigated the effects of transcranial magnetic stimulation on the brain-derived neurotrophic factor signal pathway, synaptic protein markers, and spatial memory behavior in the hippocampus of normal aged mice. The study also investigated the downstream regulator, Fyn kinase, and the downstream effectors, synaptophysin and growth-associated protein 43 (both synaptic markers), to determine the possible mechanisms by which transcranial magnetic stimulation regulates cognitive capacity. Transcranial magnetic stimulation with low intensity (110% average resting motor threshold intensity, 1 Hz) increased mRNA and protein levels of brain-derived neurotrophic factor, tropomyosin receptor kinase B, and Fyn in the hippocampus of aged mice. The treatment also upregulated the mRNA and protein expression of synaptophysin and growth-associated protein 43 in the hippocampus of these mice. In conclusion, brain-derived neurotrophic factor signaling may play an important role in sustaining and regulating structural synaptic plasticity induced by transcranial magnetic stimulation in the hippocampus of aging mice, and Fyn may be critical during this regulation. These responses may change the structural plasticity of the aging hippocampus, thereby improving cognitive function. PMID:26199608

  6. Modulation of corticospinal excitability by transcranial magnetic stimulation in children and adolescents with autism spectrum disorder.

    PubMed

    Oberman, Lindsay M; Pascual-Leone, Alvaro; Rotenberg, Alexander

    2014-01-01

    The developmental pathophysiology of autism spectrum disorders (ASD) is currently not fully understood. However, multiple lines of evidence suggest that the behavioral phenotype may result from dysfunctional inhibitory control over excitatory synaptic plasticity. Consistent with this claim, previous studies indicate that adults with Asperger's Syndrome show an abnormally extended modulation of corticospinal excitability following a train of repetitive transcranial magnetic stimulation (rTMS). As ASD is a developmental disorder, the current study aimed to explore the effect of development on the duration of modulation of corticospinal excitability in children and adolescents with ASD. Additionally, as the application of rTMS to the understanding and treatment of pediatric neurological and psychiatric disorders is an emerging field, this study further sought to provide evidence for the safety and tolerability of rTMS in children and adolescents with ASD. Corticospinal excitability was measured by applying single pulses of TMS to the primary motor cortex both before and following a 40 s train of continuous theta burst stimulation. 19 high-functioning males ages 9-18 with ASD participated in this study. Results from this study reveal a positive linear relationship between age and duration of modulation of rTMS after-effects. Specifically we found that the older participants had a longer lasting response. Furthermore, though the specific protocol employed typically suppresses corticospinal excitability in adults, more than one third of our sample had a paradoxical facilitatory response to the stimulation. Results support the safety and tolerability of rTMS in pediatric clinical populations. Data also support published theories implicating aberrant plasticity and GABAergic dysfunction in this population. PMID:25165441

  7. Modulation of corticospinal excitability by transcranial magnetic stimulation in children and adolescents with autism spectrum disorder

    PubMed Central

    Oberman, Lindsay M.; Pascual-Leone, Alvaro; Rotenberg, Alexander

    2014-01-01

    The developmental pathophysiology of autism spectrum disorders (ASD) is currently not fully understood. However, multiple lines of evidence suggest that the behavioral phenotype may result from dysfunctional inhibitory control over excitatory synaptic plasticity. Consistent with this claim, previous studies indicate that adults with Asperger’s Syndrome show an abnormally extended modulation of corticospinal excitability following a train of repetitive transcranial magnetic stimulation (rTMS). As ASD is a developmental disorder, the current study aimed to explore the effect of development on the duration of modulation of corticospinal excitability in children and adolescents with ASD. Additionally, as the application of rTMS to the understanding and treatment of pediatric neurological and psychiatric disorders is an emerging field, this study further sought to provide evidence for the safety and tolerability of rTMS in children and adolescents with ASD. Corticospinal excitability was measured by applying single pulses of TMS to the primary motor cortex both before and following a 40 s train of continuous theta burst stimulation. 19 high-functioning males ages 9–18 with ASD participated in this study. Results from this study reveal a positive linear relationship between age and duration of modulation of rTMS after-effects. Specifically we found that the older participants had a longer lasting response. Furthermore, though the specific protocol employed typically suppresses corticospinal excitability in adults, more than one third of our sample had a paradoxical facilitatory response to the stimulation. Results support the safety and tolerability of rTMS in pediatric clinical populations. Data also support published theories implicating aberrant plasticity and GABAergic dysfunction in this population. PMID:25165441

  8. The Effectiveness of Transcranial Brain Stimulation in Improving Clinical Signs of Hyperkinetic Movement Disorders

    PubMed Central

    Obeso, Ignacio; Cerasa, Antonio; Quattrone, Aldo

    2016-01-01

    Repetitive transcranial magnetic stimulation (rTMS) is a safe and painless method for stimulating cortical neurons. In neurological realm, rTMS has prevalently been applied to understand pathophysiological mechanisms underlying movement disorders. However, this tool has also the potential to be translated into a clinically applicable therapeutic use. Several available studies supported this hypothesis, but differences in protocols, clinical enrollment, and variability of rTMS effects across individuals complicate better understanding of efficient clinical protocols. The aim of this present review is to discuss to what extent the evidence provided by the therapeutic use of rTMS may be generalized. In particular, we attempted to define optimal cortical regions and stimulation protocols that have been demonstrated to maximize the effectiveness seen in the actual literature for the three most prevalent hyperkinetic movement disorders: Parkinson's disease (PD) with levodopa-induced dyskinesias (LIDs), essential tremor (ET) and dystonia. A total of 28 rTMS studies met our search criteria. Despite clinical and methodological differences, overall these studies demonstrated that therapeutic applications of rTMS to “normalize” pathologically decreased or increased levels of cortical activity have given moderate progress in patient's quality of life. Moreover, the present literature suggests that altered pathophysiology in hyperkinetic movement disorders establishes motor, premotor or cerebellar structures as candidate regions to reset cortico-subcortical pathways back to normal. Although rTMS has the potential to become a powerful tool for ameliorating the clinical outcome of hyperkinetic neurological patients, until now there is not a clear consensus on optimal protocols for these motor disorders. Well-controlled multicenter randomized clinical trials with high numbers of patients are urgently required. PMID:26778947

  9. The Role of Pulse Shape in Motor Cortex Transcranial Magnetic Stimulation Using Full-Sine Stimuli

    PubMed Central

    Delvendahl, Igor; Gattinger, Norbert; Berger, Thomas; Gleich, Bernhard; Siebner, Hartwig R.; Mall, Volker

    2014-01-01

    A full-sine (biphasic) pulse waveform is most commonly used for repetitive transcranial magnetic stimulation (TMS), but little is known about how variations in duration or amplitude of distinct pulse segments influence the effectiveness of a single TMS pulse to elicit a corticomotor response. Using a novel TMS device, we systematically varied the configuration of full-sine pulses to assess the impact of configuration changes on resting motor threshold (RMT) as measure of stimulation effectiveness with single-pulse TMS of the non-dominant motor hand area (M1). In young healthy volunteers, we (i) compared monophasic, half-sine, and full-sine pulses, (ii) applied two-segment pulses consisting of two identical half-sines, and (iii) manipulated amplitude, duration, and current direction of the first or second full-sine pulse half-segments. RMT was significantly higher using half-sine or monophasic pulses compared with full-sine. Pulses combining two half-sines of identical polarity and duration were also characterized by higher RMT than full-sine stimuli resulting. For full-sine stimuli, decreasing the amplitude of the half-segment inducing posterior-anterior oriented current in M1 resulted in considerably higher RMT, whereas varying the amplitude of the half-segment inducing anterior-posterior current had a smaller effect. These findings provide direct experimental evidence that the pulse segment inducing a posterior-anterior directed current in M1 contributes most to corticospinal pathway excitation. Preferential excitation of neuronal target cells in the posterior-anterior segment or targeting of different neuronal structures by the two half-segments can explain this result. Thus, our findings help understanding the mechanisms of neural stimulation by full-sine TMS. PMID:25514673

  10. Modulating Memory Performance in Healthy Subjects with Transcranial Direct Current Stimulation Over the Right Dorsolateral Prefrontal Cortex

    PubMed Central

    Smirni, Daniela; Turriziani, Patrizia; Mangano, Giuseppa Renata; Cipolotti, Lisa; Oliveri, Massimiliano

    2015-01-01

    Objective The role of the Dorsolateral Prefrontal Cortex (DLPFC) in recognition memory has been well documented in lesion, neuroimaging and repetitive Transcranial Magnetic Stimulation (rTMS) studies. The aim of the present study was to investigate the effects of transcranial Direct Current Stimulation (tDCS) over the left and the right DLPFC during the delay interval of a non-verbal recognition memory task. Method 36 right-handed young healthy subjects participated in the study. The experimental task was an Italian version of Recognition Memory Test for unknown faces. Study included two experiments: in a first experiment, each subject underwent one session of sham tDCS and one session of left or right cathodal tDCS; in a second experiment each subject underwent one session of sham tDCS and one session of left or right anodal tDCS. Results Cathodal tDCS over the right DLPFC significantly improved non verbal recognition memory performance, while cathodal tDCS over the left DLPFC had no effect. Anodal tDCS of both the left and right DLPFC did not modify non verbal recognition memory performance. Conclusion Complementing the majority of previous studies, reporting long term memory facilitations following left prefrontal anodal tDCS, the present findings show that cathodal tDCS of the right DLPFC can also improve recognition memory in healthy subjects. PMID:26679936

  11. Validation of finite element model of transcranial electrical stimulation using scalp potentials: implications for clinical dose

    NASA Astrophysics Data System (ADS)

    Datta, Abhishek; Zhou, Xiang; Su, Yuzhou; Parra, Lucas C.; Bikson, Marom

    2013-06-01

    Objective. During transcranial electrical stimulation, current passage across the scalp generates voltage across the scalp surface. The goal was to characterize these scalp voltages for the purpose of validating subject-specific finite element method (FEM) models of current flow. Approach. Using a recording electrode array, we mapped skin voltages resulting from low-intensity transcranial electrical stimulation. These voltage recordings were used to compare the predictions obtained from the high-resolution model based on the subject undergoing transcranial stimulation. Main results. Each of the four stimulation electrode configurations tested resulted in a distinct distribution of scalp voltages; these spatial maps were linear with applied current amplitude (0.1 to 1 mA) over low frequencies (1 to 10 Hz). The FEM model accurately predicted the distinct voltage distributions and correlated the induced scalp voltages with current flow through cortex. Significance. Our results provide the first direct model validation for these subject-specific modeling approaches. In addition, the monitoring of scalp voltages may be used to verify electrode placement to increase transcranial electrical stimulation safety and reproducibility.

  12. Determination of stimulation focality in heterogeneous head models during transcranial magnetic stimulation (TMS)

    NASA Astrophysics Data System (ADS)

    Lee, Erik; Hadimani, Ravi; Jiles, David

    2015-03-01

    Transcranial Magnetic Stimulation (TMS) is an increasingly popular tool used by both the scientific and medical community to understand and treat the brain. TMS has the potential to help people with a wide range of diseases such as Parkinson's, Alzheimer's, and PTSD, while currently being used to treat people with chronic, drug-resistant depression. Through computer simulations, we are able to see the electric field that TMS induces in anatomical human models, but there is no measure to quantify this electric field in a way that relates to a specific patient undergoing TMS therapy. We propose a way to quantify the focality of the induced electric field in a heterogeneous head model during TMS by relating the surface area of the brain being stimulated to the total volume of the brain being stimulated. This figure would be obtained by conducting finite element analysis (FEA) simulations of TMS therapy on a patient specific head model. Using this figure to assist in TMS therapy will allow clinicians and researchers to more accurately stimulate the desired region of a patient's brain and be more equipped to do comparative studies on the effects of TMS across different patients. This work was funded by the Carver Charitable Trust.

  13. Facilitatory effect of paired-pulse stimulation by transcranial magnetic stimulation with biphasic wave-form.

    PubMed

    Julkunen, Petro; Järnefelt, Gustaf; Savolainen, Petri; Laine, Jarmo; Karhu, Jari

    2016-08-01

    Transcranial magnetic stimulation (TMS) is used to probe corticospinal excitability by stimulating the motor cortex. Our aim was to enhance the effects of biphasic TMS by coupling a suprathreshold test pulse and a following subthreshold priming pulse to induce short-interval intracortical facilitation (SICF), which is conventionally produced with monophasic TMS. Biphasic TMS could potentially induce the SICF effect with better energy-efficiency and with lower stimulus intensities. This would make the biphasic paired-pulses better applicable in patients with reduced cortical excitability. A prototype stimulator was built to produce biphasic paired-pulses. Resting motor thresholds (rMTs) from the right and left hand abductor pollicis brevis muscles, and the right tibialis anterior muscle of eight healthy volunteers were determined using single-pulse paradigm with neuronavigated TMS. The rMTs and MEPs were measured using single-pulses and three paired-pulse setups (interstimulus interval, ISI of 3, 7 or 15ms). The rMTs were lower and MEPs were higher with biphasic paired-pulses compared to single-pulses. The SICF effect was greatest at 3ms ISI. This suggests that the application of biphasic paired-pulses to enhance stimulation effects is possible. PMID:27215172

  14. A new brain stimulation method: Noninvasive transcranial magneto–acoustical stimulation

    NASA Astrophysics Data System (ADS)

    Yuan, Yi; Chen, Yu-Dong; Li, Xiao-Li

    2016-08-01

    We investigate transcranial magneto–acoustical stimulation (TMAS) for noninvasive brain neuromodulation in vivo. TMAS as a novel technique uses an ultrasound wave to induce an electric current in the brain tissue in the static magnetic field. It has the advantage of high spatial resolution and penetration depth. The mechanism of TMAS onto a neuron is analyzed by combining the TMAS principle and Hodgkin–Huxley neuron model. The anesthetized rats are stimulated by TMAS, resulting in the local field potentials which are recorded and analyzed. The simulation results show that TMAS can induce neuronal action potential. The experimental results indicate that TMAS can not only increase the amplitude of local field potentials but also enhance the effect of focused ultrasound stimulation on the neuromodulation. In summary, TMAS can accomplish brain neuromodulation, suggesting a potentially powerful noninvasive stimulation method to interfere with brain rhythms for diagnostic and therapeutic purposes. Project supported by the National Natural Science Foundation of China (Grant Nos. 61503321 and 61273063) and the Natural Science Foundation of Hebei Province, China (Grant No. F2014203161).

  15. Cathodal transcranial direct current stimulation in children with dystonia: a sham-controlled study.

    PubMed

    Young, Scott J; Bertucco, Matteo; Sanger, Terence D

    2014-02-01

    Increased motor cortex excitability is a common finding in dystonia, and transcranial direct current stimulation can reduce motor cortex excitability. In an earlier study, we found that cathodal direct-current stimulation decreased motor overflow for some children with dystonia. To investigate this observation further, we performed a sham-controlled, double-blind, crossover study of 14 children with dystonia. We found a significant reduction in overflow following real stimulation, when participants performed the experimental task with the hand contralateral to the cathode. While these results suggest that cathodal stimulation may help some children to reduce involuntary overflow, the size of the effect is small. Further research will need to investigate ways to increase the magnitude of the effect of cathodal transcranial direct current stimulation. PMID:23760989

  16. Voltage-sensitive dye imaging of transcranial magnetic stimulation-induced intracortical dynamics

    PubMed Central

    Kozyrev, Vladislav; Eysel, Ulf T.; Jancke, Dirk

    2014-01-01

    Transcranial magnetic stimulation (TMS) is widely used in clinical interventions and basic neuroscience. Additionally, it has become a powerful tool to drive plastic changes in neuronal networks. However, highly resolved recordings of the immediate TMS effects have remained scarce, because existing recording techniques are limited in spatial or temporal resolution or are interfered with by the strong TMS-induced electric field. To circumvent these constraints, we performed optical imaging with voltage-sensitive dye (VSD) in an animal experimental setting using anaesthetized cats. The dye signals reflect gradual changes in the cells' membrane potential across several square millimeters of cortical tissue, thus enabling direct visualization of TMS-induced neuronal population dynamics. After application of a single TMS pulse across visual cortex, brief focal activation was immediately followed by synchronous suppression of a large pool of neurons. With consecutive magnetic pulses (10 Hz), widespread activity within this “basin of suppression” increased stepwise to suprathreshold levels and spontaneous activity was enhanced. Visual stimulation after repetitive TMS revealed long-term potentiation of evoked activity. Furthermore, loss of the “deceleration–acceleration” notch during the rising phase of the response, as a signature of fast intracortical inhibition detectable with VSD imaging, indicated weakened inhibition as an important driving force of increasing cortical excitability. In summary, our data show that high-frequency TMS changes the balance between excitation and inhibition in favor of an excitatory cortical state. VSD imaging may thus be a promising technique to trace TMS-induced changes in excitability and resulting plastic processes across cortical maps with high spatial and temporal resolutions. PMID:25187557

  17. Voltage-sensitive dye imaging of transcranial magnetic stimulation-induced intracortical dynamics.

    PubMed

    Kozyrev, Vladislav; Eysel, Ulf T; Jancke, Dirk

    2014-09-16

    Transcranial magnetic stimulation (TMS) is widely used in clinical interventions and basic neuroscience. Additionally, it has become a powerful tool to drive plastic changes in neuronal networks. However, highly resolved recordings of the immediate TMS effects have remained scarce, because existing recording techniques are limited in spatial or temporal resolution or are interfered with by the strong TMS-induced electric field. To circumvent these constraints, we performed optical imaging with voltage-sensitive dye (VSD) in an animal experimental setting using anaesthetized cats. The dye signals reflect gradual changes in the cells' membrane potential across several square millimeters of cortical tissue, thus enabling direct visualization of TMS-induced neuronal population dynamics. After application of a single TMS pulse across visual cortex, brief focal activation was immediately followed by synchronous suppression of a large pool of neurons. With consecutive magnetic pulses (10 Hz), widespread activity within this "basin of suppression" increased stepwise to suprathreshold levels and spontaneous activity was enhanced. Visual stimulation after repetitive TMS revealed long-term potentiation of evoked activity. Furthermore, loss of the "deceleration-acceleration" notch during the rising phase of the response, as a signature of fast intracortical inhibition detectable with VSD imaging, indicated weakened inhibition as an important driving force of increasing cortical excitability. In summary, our data show that high-frequency TMS changes the balance between excitation and inhibition in favor of an excitatory cortical state. VSD imaging may thus be a promising technique to trace TMS-induced changes in excitability and resulting plastic processes across cortical maps with high spatial and temporal resolutions. PMID:25187557

  18. UNANSWERED QUESTIONS IN THE TRANSCRANIAL MAGNETIC STIMULATION TREATMENT OF PATIENTS WITH DEPRESSION.

    PubMed

    Morvai, Szabolcs; Nagy, Attila; Kovács, Attila; Móre, Csaba E; Berecz, Roland; Frecska, Ede

    2016-01-30

    According to the WHO fact sheet depression is a common mental disorder affecting 350 million people of all ages worldwide. Transcranial Magnetic Stimulation (TMS) is a technique which allows the investigator to stimulate and study cortical functions in healthy subjects and patients suffering from various mental and neurological disorders. In the early 1990s, studies revealed that it is possible to evoke long term mood changes in healthy volunteers by rapid rate repetitive, TMS (rTMS) over the frontal cortex. Subsequent studies involving depressed patients found frontal cortical rTMS administered daily to be clinically effective. In the past two decades, numerous trials examined the therapeutic potential of rTMS application in the treatment of mood disorders with constantly evolving treatment protocols. The aim of this paper is to review the literature of the past two decades, focusing on trials addressing the efficacy and safety of rTMS in depressed patients. Our primary goal is to evaluate the results in order to direct future studies which may help investigators in the development of treatment protocols suitable in hospital settings. The time is not far when TMS devices will be used routinely by practitioners primarily for therapeutic purpose rather than clinical research. To our knowledge, a widely accepted "gold standard" that would offer the highest efficacy, with the best tolerability has not been established yet. In order to approach this goal, the most important factors to be addressed by further studies are: localization, frequency, intensity, concurrent medication, maintenance treatments, number of pulses, trains, unilateral, or bilateral mode of application. PMID:26987235

  19. The neural response to transcranial magnetic stimulation of the human motor cortex. II. Thalamocortical contributions.

    PubMed

    Van Der Werf, Ysbrand D; Sadikot, Abbas F; Strafella, Antonio P; Paus, Tomás

    2006-11-01

    Beta oscillations (15-30 Hz) constitute an important electrophysiological signal recorded in the resting state over the human precentral gyrus. The brain circuitry involved in generating the beta oscillations is not well understood but appears to involve both cortical and subcortical structures. We have shown that single pulses of transcranial magnetic stimulation (TMS) applied over the primary motor cortex consistently elicit a brief beta oscillation. Reducing the local cortical excitability using low-frequency repetitive TMS does not change the amplitude of the induced beta oscillation (Van Der Werf and Paus in Exp Brain Res DOI 10.1007/s00221-006-0551-2). Here, we investigated the possible involvement of the thalamus in the cortically expressed beta response to single-pulse TMS. We included eight patients with Parkinson's disease who had undergone unilateral surgical lesioning of the ventrolateral nucleus of the thalamus. We administered 50 single pulses of TMS, at an intensity of 120% of resting motor threshold, over the left and right primary motor cortex and, at the same time, recorded the electroencephalogram (EEG) using a 60-electrode cap. We were able to perform analyses on seven EEG data sets and found that stimulation of the unoperated hemisphere (with thalamus) resulted in higher amplitudes of the single-trial induced beta oscillations than in the operated hemisphere (with thalamotomy). The beta oscillation obtained in response to pulses applied over the unoperated hemisphere was also higher than that obtained in healthy controls. We suggest that (1) the beta oscillatory response to pulses of TMS applied over the primary motor cortex is higher in Parkinson's disease patients, (2) thalamotomy serves to reduce the abnormally high TMS-induced beta oscillations, and (3) the motor thalamus facilitates the cortically generated oscillation, through cortico-subcortico-cortical feedback loops. PMID:16832683

  20. Combined transcranial alternating current stimulation and continuous theta burst stimulation: a novel approach for neuroplasticity induction.

    PubMed

    Goldsworthy, Mitchell R; Vallence, Ann-Maree; Yang, Ruiting; Pitcher, Julia B; Ridding, Michael C

    2016-02-01

    Non-invasive brain stimulation can induce functionally relevant plasticity in the human cortex, making it potentially useful as a therapeutic tool. However, the induced changes are highly variable between individuals, potentially limiting research and clinical utility. One factor that might contribute to this variability is the level of cortical inhibition at the time of stimulation. The alpha rhythm (~ 8-13 Hz) recorded with electroencephalography (EEG) is thought to reflect pulsatile cortical inhibition; therefore, targeting non-invasive brain stimulation to particular phases of the alpha rhythm may provide an approach to enhance plasticity induction. Transcranial alternating current stimulation (tACS) has been shown to entrain cortical oscillations in a frequency-specific manner. We investigated whether the neuroplastic response to continuous theta burst stimulation (cTBS) was enhanced by timing bursts of stimuli to the peak or the trough of a tACS-imposed alpha rhythm. While motor evoked potentials (MEPs) were unaffected when cTBS was applied in-phase with the peak of the tACS-imposed oscillation, MEP depression was enhanced when cTBS was applied in-phase with the trough. This enhanced MEP depression was dependent on the individual peak frequency of the endogenous alpha rhythm recorded with EEG prior to stimulation, and was strongest in those participants classified as non-responders to standard cTBS. These findings suggest that tACS may be used in combination with cTBS to enhance the plasticity response. Furthermore, the peak frequency of endogenous alpha, as measured with EEG, may be used as a simple marker to pre-select those individuals likely to benefit from this approach. PMID:26663460

  1. Laser stimulation of auditory neurons at high repetition rate

    NASA Astrophysics Data System (ADS)

    Izzo, Agnella D.; Littlefield, Philip; Walsh, Joseph T., Jr.; Webb, Jim; Ralph, Heather; Bendett, Mark; Jansen, E. Duco; Richter, Claus-Peter

    2007-02-01

    Pulsed, mid-infrared lasers can evoke neural activity from motor as well as sensory neurons in vivo. Lasers allow more selective spatial resolution of stimulation than the conventional electrical stimulation. To date, few studies have examined pulsed, mid-infrared neural stimulation and very little of the available optical parameter space has been studied. We found that pulse durations as short as 20 ?s elicit a compound action potential from the gerbil cochlea. Moreover, stimulation thresholds are not a function of absolute energy or absolute power deposited. Compound action potential peak-to-peak amplitude remained constant over extended periods of stimulation. Stimulation occurred up six hours continuously and up to 50 Hz in repetition rate. Single fiber experiments were made using repetition rates of up to 1 kHz. Action potentials occurred 2.5-4 ms after the laser pulse. Maximum rates of discharge were up to 250 action potentials per second. With increasing stimulation rate (300 Hz), the action potentials did not respond strictly after the light pulse. The results from these experiments are important for designing the next generation of neuroprostheses, specifically cochlear implants.

  2. Moving Forward by Stimulating the Brain: Transcranial Direct Current Stimulation in Post-Stroke Hemiparesis

    PubMed Central

    Peters, Heather T.; Edwards, Dylan J.; Wortman-Jutt, Susan; Page, Stephen J.

    2016-01-01

    Stroke remains a leading cause of disability worldwide, with a majority of survivors experiencing long term decrements in motor function that severely undermine quality of life. While many treatment approaches and adjunctive strategies exist to remediate motor impairment, many are only efficacious or feasible for survivors with active hand and wrist function, a population who constitute only a minority of stroke survivors. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, has been increasingly utilized to increase motor function following stroke as it is able to be used with stroke survivors of varying impairment levels, is portable, is relatively inexpensive and has few side effects and contraindications. Accordingly, in recent years the number of studies investigating its efficacy when utilized as an adjunct to motor rehabilitation regimens has drastically increased. While many of these trials have reported positive and promising efficacy, methodologies vary greatly between studies, including differences in stimulation parameters, outcome measures and the nature of physical practice. As such, an urgent need remains, centering on the need to investigate these methodological differences and synthesize the most current evidence surrounding the application of tDCS for post-stroke motor rehabilitation. Accordingly, the purpose of this paper is to provide a detailed overview of the most recent tDCS literature (published 2014-2015), while highlighting these variations in methodological approach, as well to elucidate the mechanisms associated with tDCS and post-stroke motor re-learning and neuroplasticity. PMID:27555811

  3. Moving Forward by Stimulating the Brain: Transcranial Direct Current Stimulation in Post-Stroke Hemiparesis.

    PubMed

    Peters, Heather T; Edwards, Dylan J; Wortman-Jutt, Susan; Page, Stephen J

    2016-01-01

    Stroke remains a leading cause of disability worldwide, with a majority of survivors experiencing long term decrements in motor function that severely undermine quality of life. While many treatment approaches and adjunctive strategies exist to remediate motor impairment, many are only efficacious or feasible for survivors with active hand and wrist function, a population who constitute only a minority of stroke survivors. Transcranial direct current stimulation (tDCS), a type of non-invasive brain stimulation, has been increasingly utilized to increase motor function following stroke as it is able to be used with stroke survivors of varying impairment levels, is portable, is relatively inexpensive and has few side effects and contraindications. Accordingly, in recent years the number of studies investigating its efficacy when utilized as an adjunct to motor rehabilitation regimens has drastically increased. While many of these trials have reported positive and promising efficacy, methodologies vary greatly between studies, including differences in stimulation parameters, outcome measures and the nature of physical practice. As such, an urgent need remains, centering on the need to investigate these methodological differences and synthesize the most current evidence surrounding the application of tDCS for post-stroke motor rehabilitation. Accordingly, the purpose of this paper is to provide a detailed overview of the most recent tDCS literature (published 2014-2015), while highlighting these variations in methodological approach, as well to elucidate the mechanisms associated with tDCS and post-stroke motor re-learning and neuroplasticity. PMID:27555811

  4. Classification of methods in transcranial electrical stimulation (tES) and evolving strategy from historical approaches to contemporary innovations.

    PubMed

    Guleyupoglu, Berkan; Schestatsky, Pedro; Edwards, Dylan; Fregni, Felipe; Bikson, Marom

    2013-10-15

    Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES. PMID:23954780

  5. Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

    PubMed Central

    Guleyupoglu, Berkan; Schestatsky, Pedro; Edwards, Dylan; Fregni, Felipe; Bikson, Marom

    2013-01-01

    Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of trans-cranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES. PMID:23954780

  6. Transcranial Alternating Current Stimulation with Sawtooth Waves: Simultaneous Stimulation and EEG Recording

    PubMed Central

    Dowsett, James; Herrmann, Christoph S.

    2016-01-01

    Transcranial alternating current stimulation (tACS) has until now mostly been administered as an alternating sinusoidal wave. Despite modern tACS stimulators being able to deliver alternating current with any arbitrary shape there has been no systematic exploration into the relative benefits of different waveforms. As tACS is a relatively new technique there is a huge parameter space of unexplored possibilities which may prove superior or complimentary to the traditional sinusoidal waveform. Here, we begin to address this with an investigation into the effects of sawtooth wave tACS on individual alpha power. Evidence from animal models suggests that the gradient and direction of an electric current should be important factors for the subsequent neural firing rate; we compared positive and negative ramp sawtooth waves to test this. An additional advantage of sawtooth waves is that the resulting artifact in the electroencephalogram (EEG) recording is significantly simpler to remove than a sine wave; accordingly we were able to observe alpha oscillations both during and after stimulation. We found that positive ramp sawtooth, but not negative ramp sawtooth, significantly enhanced alpha power during stimulation relative to sham (p < 0.01). In addition we tested for an after-effect of both sawtooth and sinusoidal stimulation on alpha power but in this case did not find any significant effect. This preliminary study paves the way for further investigations into the effect of the gradient and direction of the current in tACS which could significantly improve the usefulness of this technique. PMID:27065835

  7. Transcranial Alternating Current Stimulation with Sawtooth Waves: Simultaneous Stimulation and EEG Recording.

    PubMed

    Dowsett, James; Herrmann, Christoph S

    2016-01-01

    Transcranial alternating current stimulation (tACS) has until now mostly been administered as an alternating sinusoidal wave. Despite modern tACS stimulators being able to deliver alternating current with any arbitrary shape there has been no systematic exploration into the relative benefits of different waveforms. As tACS is a relatively new technique there is a huge parameter space of unexplored possibilities which may prove superior or complimentary to the traditional sinusoidal waveform. Here, we begin to address this with an investigation into the effects of sawtooth wave tACS on individual alpha power. Evidence from animal models suggests that the gradient and direction of an electric current should be important factors for the subsequent neural firing rate; we compared positive and negative ramp sawtooth waves to test this. An additional advantage of sawtooth waves is that the resulting artifact in the electroencephalogram (EEG) recording is significantly simpler to remove than a sine wave; accordingly we were able to observe alpha oscillations both during and after stimulation. We found that positive ramp sawtooth, but not negative ramp sawtooth, significantly enhanced alpha power during stimulation relative to sham (p < 0.01). In addition we tested for an after-effect of both sawtooth and sinusoidal stimulation on alpha power but in this case did not find any significant effect. This preliminary study paves the way for further investigations into the effect of the gradient and direction of the current in tACS which could significantly improve the usefulness of this technique. PMID:27065835

  8. Polarity-Dependent Misperception of Subjective Visual Vertical during and after Transcranial Direct Current Stimulation (tDCS)

    PubMed Central

    Santos-Pontelli, Taiza E. G.; Rimoli, Brunna P.; Favoretto, Diandra B.; Mazin, Suleimy C.; Truong, Dennis Q.; Leite, Joao P.; Pontes-Neto, Octavio M.; Babyar, Suzanne R.; Reding, Michael; Bikson, Marom; Edwards, Dylan J.

    2016-01-01

    Pathologic tilt of subjective visual vertical (SVV) frequently has adverse functional consequences for patients with stroke and vestibular disorders. Repetitive transcranial magnetic stimulation (rTMS) of the supramarginal gyrus can produce a transitory tilt on SVV in healthy subjects. However, the effect of transcranial direct current stimulation (tDCS) on SVV has never been systematically studied. We investigated whether bilateral tDCS over the temporal-parietal region could result in both online and offline SVV misperception in healthy subjects. In a randomized, sham-controlled, single-blind crossover pilot study, thirteen healthy subjects performed tests of SVV before, during and after the tDCS applied over the temporal-parietal region in three conditions used on different days: right anode/left cathode; right cathode/left anode; and sham. Subjects were blind to the tDCS conditions. Montage-specific current flow patterns were investigated using computational models. SVV was significantly displaced towards the anode during both active stimulation conditions when compared to sham condition. Immediately after both active conditions, there were rebound effects. Longer lasting after-effects towards the anode occurred only in the right cathode/left anode condition. Current flow models predicted the stimulation of temporal-parietal regions under the electrodes and deep clusters in the posterior limb of the internal capsule. The present findings indicate that tDCS over the temporal-parietal region can significantly alter human SVV perception. This tDCS approach may be a potential clinical tool for the treatment of SVV misperception in neurological patients. PMID:27031726

  9. Failure of activation of spinal motoneurones after muscle fatigue in healthy subjects studied by transcranial magnetic stimulation

    PubMed Central

    Andersen, Birgit; Westlund, Barbro; Krarup, Christian

    2003-01-01

    During a sustained maximal effort a progressive decline in the ability to drive motoneurones (MNs) develops. We used the recently developed triple stimulation technique (TST) to study corticospinal conduction after fatiguing exercise in healthy subjects. This method employs a collision technique to estimate the proportion of motor units activated by a transcranial magnetic stimulus. Following a sustained contraction of the abductor digiti minimi muscle at 50 % maximal force maintained to exhaustion there was an immediate reduction of the TST response from >95% to about 60%. This effect recovered to control levels within 1 min and implies that a decreased number of spinal MNs were excited. Additional TST experiments after maximal and submaximal efforts showed that the decrease in size of the TST response was related to duration and strength of exercise. Motor evoked potentials (MEPs) after conventional transcranial magnetic stimulation (TMS) and responses to peripheral nerve stimulation were recorded following the same fatigue protocol. The size of both the MEPs and the peripheral responses increased after the contraction and were in direct contrast to the decrease in size of the TST response. This points to increased probability of repetitive spinal MN activation during fatigue even if some MNs in the pool failed to discharge. Silent period duration following cortical stimulation lengthened by an average of 55 ms after the contraction and recovered within a time course similar to that of the TST response depression. Overall, the results suggest that the outflow from the motor cortex could become insufficient to drive all spinal MNs to discharge when the muscle is fatigued and that complex interactions between failure of activation and compensatory mechanisms to maintain motor unit activation occur during sustained voluntary activity. When inability to maintain force occurs during submaximal effort, failure of activation of motor units is predominant. PMID:12824449

  10. Polarity-Dependent Misperception of Subjective Visual Vertical during and after Transcranial Direct Current Stimulation (tDCS).

    PubMed

    Santos-Pontelli, Taiza E G; Rimoli, Brunna P; Favoretto, Diandra B; Mazin, Suleimy C; Truong, Dennis Q; Leite, Joao P; Pontes-Neto, Octavio M; Babyar, Suzanne R; Reding, Michael; Bikson, Marom; Edwards, Dylan J

    2016-01-01

    Pathologic tilt of subjective visual vertical (SVV) frequently has adverse functional consequences for patients with stroke and vestibular disorders. Repetitive transcranial magnetic stimulation (rTMS) of the supramarginal gyrus can produce a transitory tilt on SVV in healthy subjects. However, the effect of transcranial direct current stimulation (tDCS) on SVV has never been systematically studied. We investigated whether bilateral tDCS over the temporal-parietal region could result in both online and offline SVV misperception in healthy subjects. In a randomized, sham-controlled, single-blind crossover pilot study, thirteen healthy subjects performed tests of SVV before, during and after the tDCS applied over the temporal-parietal region in three conditions used on different days: right anode/left cathode; right cathode/left anode; and sham. Subjects were blind to the tDCS conditions. Montage-specific current flow patterns were investigated using computational models. SVV was significantly displaced towards the anode during both active stimulation conditions when compared to sham condition. Immediately after both active conditions, there were rebound effects. Longer lasting after-effects towards the anode occurred only in the right cathode/left anode condition. Current flow models predicted the stimulation of temporal-parietal regions under the electrodes and deep clusters in the posterior limb of the internal capsule. The present findings indicate that tDCS over the temporal-parietal region can significantly alter human SVV perception. This tDCS approach may be a potential clinical tool for the treatment of SVV misperception in neurological patients. PMID:27031726

  11. Predicting the behavioral impact of transcranial direct current stimulation: issues and limitations.

    PubMed

    de Berker, Archy O; Bikson, Marom; Bestmann, Sven

    2013-01-01

    The transcranial application of weak currents to the human brain has enjoyed a decade of widespread use, providing a simple and powerful tool for non-invasively altering human brain function. However, our understanding of current delivery and its impact upon neural circuitry leaves much to be desired. We argue that the credibility of conclusions drawn with transcranial direct current stimulation (tDCS) is contingent upon realistic explanations of how tDCS works, and that our present understanding of tDCS limits the technique's use to localize function in the human brain. We outline two central issues where progress is required: the localization of currents, and predicting their functional consequence. We encourage experimenters to eschew simplistic explanations of mechanisms of transcranial current stimulation. We suggest the use of individualized current modeling, together with computational neurostimulation to inform mechanistic frameworks in which to interpret the physiological impact of tDCS. We hope that through mechanistically richer descriptions of current flow and action, insight into the biological processes by which transcranial currents influence behavior can be gained, leading to more effective stimulation protocols and empowering conclusions drawn with tDCS. PMID:24109445

  12. Anodal transcranial direct current stimulation over the supramarginal gyrus facilitates pitch memory.

    PubMed

    Schaal, Nora K; Williamson, Victoria J; Banissy, Michael J

    2013-11-01

    Functional neuroimaging studies have shown activation of the supramarginal gyrus during pitch memory tasks. A previous transcranial direct current stimulation study using cathodal stimulation over the left supramarginal gyrus reported a detrimental effect on short-term pitch memory performance, indicating an important role of the supramarginal gyrus in pitch memory. The current study aimed to determine whether pitch memory could be improved following anodal stimulation of the left supramarginal gyrus. The performances of non-musicians on two pitch memory tasks (pitch recognition and recall) and a visual memory control task following anodal or sham transcranial direct current stimulation were compared. The results show that, post-stimulation, the anodal group but not the control group performed significantly better on both pitch memory tasks; performance did not differ on the face memory task. These findings provide strong support for the causal involvement of the left supramarginal gyrus in the pitch memory process, and highlight the potential efficacy of transcranial direct current stimulation as a tool to improve pitch memory. PMID:23968283

  13. I-wave periodicity transcranial magnetic stimulation (iTMS) on corticospinal excitability. A systematic review of the literature.

    PubMed

    Kidgell, D J; Mason, J; Frazer, A; Pearce, A J

    2016-05-13

    Repetitive transcranial magnetic stimulation (rTMS) is an established technique that can modulate excitability of the motor cortex and corticospinal tract, beyond the duration of the stimulation itself. More recently, a newer repetitive technique, known as I-wave periodicity TMS (iTMS) has been purported to show increases in corticospinal excitability following at least 10 min of iTMS duration. The aim of this study was to use a systematic review to search the literature from January 2000 to October 2015 with regard to corticospinal outcomes following iTMS intervention. We also rated the quality of studies and assessed the risk of bias by applying the Downs and Black checklist and the Cochrane Collaboration Risk of Bias Tool respectively. From an initial yield of 144, 11 studies were included. Studies were found to be of moderate quality, however a high risk of bias was identified. Despite these issues, evidence from the studies presented in this review so far indicates that iTMS is effective in increasing corticospinal excitability. However, further studies are required from other groups to validate the findings to date. Additional research is required to reduce the variability in corticospinal excitability and also to functional outcomes along with corticospinal excitability following iTMS. PMID:26917270

  14. Interaction of transcutaneous spinal stimulation and transcranial magnetic stimulation in human leg muscles.

    PubMed

    Roy, François D; Bosgra, Dillen; Stein, Richard B

    2014-06-01

    Transcutaneous spinal stimulation is a noninvasive method that can activate dorsal and/or ventral roots depending on the location and intensity of stimulation. Reflex root-evoked potentials (REPs) were studied in muscles that traditionally evoke large (soleus) and small H-reflexes (tibialis anterior), as well as muscles where H-reflexes are difficult to study (hamstrings). This study characterizes the interaction of the REP and the motor-evoked potential (MEP). Transcranial magnetic stimulation (TMS) delivered 11-25 ms before spinal stimulation resulted in more than linear summation of the two responses. Because of overlap, the modulation was quantified after subtracting the contribution of the conditioning MEP or REP. At rest, the mean-rectified soleus response was facilitated by up to ~250 μV (21-times the MEP or 161% of the REP). The increases were more reliable during a voluntary contraction (up to ~300 μV, 517% of the MEP or 181% of the REP). At the 13-ms interval, the mean-rectified response in the pre-contracted hamstrings was increased by 227% of the MEP or 300% of the REP. In some subjects, TMS could also eliminate the post-activation depression produced using two spinal stimuli, confirming that the interaction can extend to presynaptic spinal neurons. The spatiotemporal facilitation in tibialis anterior was not significant. However, the large MEP was facilitated when the spinal stimulus preceded TMS by 100-150 ms, presumably because of rebound excitation. These strong interactions may be important for inducing motor plasticity and improved training procedures for recovery after neurological damage. PMID:24531641

  15. Bihemispheric Transcranial Direct Current Stimulation Enhances Effector-Independent Representations of Motor Synergy and Sequence Learning

    PubMed Central

    Husain, Masud; Wiestler, Tobias; Diedrichsen, Jörn

    2014-01-01

    Complex manual tasks—everything from buttoning up a shirt to playing the piano—fundamentally involve two components: (1) generating specific patterns of muscle activity (here, termed “synergies”); and (2) stringing these into purposeful sequences. Although transcranial direct current stimulation (tDCS) of the primary motor cortex (M1) has been found to increase the learning of motor sequences, it is unknown whether it can similarly facilitate motor synergy learning. Here, we determined the effects of tDCS on the learning of motor synergies using a novel hand configuration task that required the production of difficult muscular activation patterns. Bihemispheric tDCS was applied to M1 of healthy, right-handed human participants during 4 d of repetitive left-hand configuration training in a double-blind design. tDCS augmented synergy learning, leading subsequently to faster and more synchronized execution. This effect persisted for at least 4 weeks after training. Qualitatively similar tDCS-associated improvements occurred during training of finger sequences in a separate subject cohort. We additionally determined whether tDCS only improved the acquisition of motor memories for specific synergies/sequences or whether it also facilitated more general parts of the motor representations, which could be transferred to novel movements. Critically, we observed that tDCS effects generalized to untrained hand configurations and untrained finger sequences (i.e., were nonspecific), as well as to the untrained hand (i.e., were effector-independent). Hence, bihemispheric tDCS may be a promising adjunct to neurorehabilitative training regimes, in which broad transfer to everyday tasks is highly desirable. PMID:24431461

  16. Safety of Transcranial Magnetic Stimulation in Parkinson’s Disease: A Review of the Literature

    PubMed Central

    VonLoh, Matthew; Chen, Robert; Kluger, Benzi

    2013-01-01

    Background Transcranial magnetic stimulation (TMS) has been used in both physiological studies and, more recently, the therapy of Parkinson’s Disease (PD). Prior TMS studies in healthy subjects and other patient populations demonstrate a slight risk of seizures and other adverse events. Our goal was to estimate these risks and document other safety concerns specific to PD patients. Methods We performed an English-Language literature search through PudMed to review all TMS studies involving PD patients. We documented any seizures or other adverse events associated with these studies. Crude risks were calculated per subject and per session of TMS. Results We identified 84 single pulse (spTMS) and/or paired pulse (ppTMS) TMS studies involving 1091 patients and 77 repetitive TMS (rTMS) studies involving 1137 patients. Risk of adverse events was low in all protocols. spTMS and ppTMS risk per patient for any adverse event was 0.0018 (95% CI: 0.0002 – 0.0066) per patient and no seizures were encountered. Risk of an adverse event from rTMS was 0.040 (95% CI: 0.029 – 0.053) per patient and no seizures were reported. Other adverse events included transient headaches, scalp pain, tinnitus, nausea, increase in pre-existing pain, and muscle jerks. Transient worsening of Parkinsonian symptoms was noted in one study involving rTMS of the supplementary motor area (SMA). Conclusion We conclude that current TMS and rTMS protocols do not pose significant risks to PD patients. We would recommend that TMS users in this population follow the most recent safety guidelines but do not warrant additional precautions. PMID:23473718

  17. Long-lasting analgesic effect of transcranial direct current stimulation in treatment of chronic endometriosis pain.

    PubMed

    Rostami, Reza; Badran, Bashar W; Kazemi, Reza; Habibnezhad, Mohammad; George, Mark S

    2015-12-01

    Approximately 10-20% of women of reproductive age suffer from endometriosis, with 70-90% of these women reporting chronic pain symptoms that persist during their menstrual cycle. We are presenting a case in which a novel form of noninvasive brain stimulation called transcranial direct current stimulation was used as an intervention in a 32-year-old woman with persistent, chronic pain symptoms caused by endometriosis for 20 years. Ten daily, 20-min sessions of 2-mA anodal transcranial direct current stimulation were applied over the left primary motor cortex. Acutely, visual analog scale pain symptoms were reduced by 60%. There were also significant decreases in modules of the Endometriosis Health Profile. At the 4-month follow-up, the patient still expressed an overall decrease in pain symptoms of 30%. PMID:26419900

  18. Movement-generated afference paired with transcranial magnetic stimulation: an associative stimulation paradigm

    PubMed Central

    2014-01-01

    Background A peripheral nerve stimulus can enhance or suppress the evoked response to transcranial magnetic stimulation (TMS) depending on the latency of the preceding peripheral nerve stimulation (PNS) pulse. Similarly, somatosensory afference from the passively moving limb can transiently alter corticomotor excitability, in a phase-dependent manner. The repeated association of PNS with TMS is known to modulate corticomotor excitability; however, it is unknown whether repeated passive-movement associative stimulation (MAS) has similar effects. Methods In a proof-of-principle study, using a cross-over design, seven healthy subjects received in separate sessions: (1) TMS (120% of the resting motor threshold-RMT, optimal site for Flexor Carpi Radialis) with muscle at rest; (2) TMS paired with cyclic passive movement during extension cyclic passive movement (400 pairs, 1 Hz), with the intervention order randomly assigned. Normality was tested using the Kolmogorov-Smirnov test, then compared to pre-intervention baseline using repeated measures ANOVA with a Dunnet multiple comparisons test. Results MAS led to a progressive and significant decrease in the motor evoked potential (MEP) amplitude over the intervention (R2 = 0.6665, P < 0.0001), which was not evident with TMS alone (R2 = 0.0068, P = 0.641). Post-intervention excitability reduction, only present with MAS intervention, remained for 20min (0-10min = 68.2 ± 4.9%, P < 0.05; 10-20min = 73.3 ± 9.7%, P < 0.05). Conclusion The association of somatosensory afference from the moving limb with TMS over primary motor cortex in healthy subjects can be used to modulate corticomotor excitability, and may have therapeutic implications. PMID:24597619

  19. Non-invasive brain stimulation in early rehabilitation after stroke.

    PubMed

    Blesneag, A V; Popa, L; Stan, A D

    2015-01-01

    The new tendency in rehabilitation involves non-invasive tools that, if applied early after stroke, promote neurorecovery. Repetitive transcranial magnetic stimulation and transcranial direct current stimulation may correct the disruption of cortical excitability and effectively contribute to the restoration of movement and speech. The present paper analyses the results of non-invasive brain stimulation (NIBS) trials, highlighting different aspects related to the repetitive transcranial magnetic stimulation frequency, transcranial direct current stimulation polarity, the period and stimulation places in acute and subacute ischemic strokes. The risk of adverse events, the association with motor or language recovery specific training, and the cumulative positive effect evaluation are also discussed. PMID:26361512

  20. Modulation of neurophysiological auditory processing measures by bilateral transcranial direct current stimulation in schizophrenia.

    PubMed

    Dunn, Walter; Rassovsky, Yuri; Wynn, Jonathan K; Wu, Allan D; Iacoboni, Marco; Hellemann, Gerhard; Green, Michael F

    2016-07-01

    This study used bilateral transcranial direct current stimulation (tDCS) to target neural generators of auditory Mismatch Negativity (MMN) and oddball P300 in schizophrenia patients. tDCS was applied to the pre-frontal cortex in a parallel between-group design. There was a significant main effect of stimulation resulting in modulation of MMN amplitude. This effect was mainly driven by a non-significant, but large, effect-size decrease in MMN amplitude with anodal stimulation. This is the first study to demonstrate that tDCS is able to engage and modulate an EEG-based auditory processing measure in schizophrenia. PMID:27132485

  1. [Non-invasive brain stimulation in neurology : Transcranial direct current stimulation to enhance cognitive functioning].

    PubMed

    Antonenko, D; Flöel, A

    2016-08-01

    Transcranial direct current stimulation (tDCS) has been successfully used in neuroscientific research to modulate cognitive functions. Recent studies suggested that improvement of behavioral performance is associated with tDCS-induced modulation of neuronal activity and connectivity. Thus, tDCS may also represent a promising tool for reconstitution of cognitive functions in the context of memory decline related to Alzheimer's disease or aphasia following stroke; however, evidence from randomized sham-controlled clinical trials is still scarce. Initial results of tDCS-induced behavioral improvement in patients with Alzheimer's dementia and its precursors indicated that an intense memory training combined with tDCS may be effective. Early interventions in the stage of mild cognitive impairment could be crucial but further evidence is needed to substantiate this. In patients with aphasia following stroke tDCS was applied to the left and right hemispheres, with varying results depending on the severity of the symptoms and polarity of the stimulation. Patients with mild aphasia can benefit from tDCS of the language dominant hemisphere while in patients with severe aphasia tDCS of right hemispheric homologous brain language areas may be particularly relevant. Moreover, recent studies suggested that an intervention in the subacute phase of aphasia could be most promising. In summary, tDCS could provide the exciting possibility to reconstitute cognitive functions in patients with neurological disorders. Future studies have to elucidate whether tDCS can be used in the clinical routine to prevent further cognitive decline in neurodegenerative diseases and whether beneficial effects from experimental studies translate into long-term improvement in activities of daily life. PMID:27167887

  2. Short-term reliability of transcranial magnetic stimulation motor maps in upper limb amputees.

    PubMed

    Hétu, S; Gagné, M; Reilly, K T; Mercier, C

    2011-05-01

    The aim of this study was to verify the short-term reliability of transcranial magnetic stimulation (TMS) parameters for a damaged stump muscle in upper-limb amputees (n=6). The motor threshold, response latency and map center of gravity in the mediolateral plane showed good reliability, whereas the map volume measure was less stable. The stability of most TMS measures across time supports the use of TMS in studying cortical plasticity in amputees. PMID:21393001

  3. Transcranial magnetic stimulation: studying the brain-behaviour relationship by induction of 'virtual lesions'.

    PubMed Central

    Pascual-Leone, A; Bartres-Faz, D; Keenan, J P

    1999-01-01

    Transcranial magnetic stimulation (TMS) provides a non-invasive method of induction of a focal current in the brain and transient modulation of the function of the targeted cortex. Despite limited understanding about focality and mechanisms of action, TMS provides a unique opportunity of studying brain-behaviour relations in normal humans. TMS can enhance the results of other neuroimaging techniques by establishing the causal link between brain activity and task performance, and by exploring functional brain connectivity. PMID:10466148

  4. A novel numerical meshless approach for electric potential estimation in transcranial stimulation

    NASA Astrophysics Data System (ADS)

    Ala, Guido; Fasshauer, Gregory E.; Francomano, Elisa; Ganci, Salvatore; McCourt, Michael J.; Vitabile, Salvatore

    2015-12-01

    In this paper, a first application of the method of fundamental solutions in estimating the electric potential and the spatial current density distribution in the brain due to transcranial stimulation, is presented. The coupled boundary value p roblems for the electric potential are solved in a meshless way, so avoiding the use of grid based numerical methods. A multi-spherical geometry is considered and numerical results are discussed.

  5. Language function distribution in left-handers: A navigated transcranial magnetic stimulation study.

    PubMed

    Tussis, Lorena; Sollmann, Nico; Boeckh-Behrens, Tobias; Meyer, Bernhard; Krieg, Sandro M

    2016-02-01

    Recent studies suggest that in left-handers, the right hemisphere (RH) is more involved in language function when compared to right-handed subjects. Since data on lesion-based approaches is lacking, we aimed to investigate language distribution of left-handers by repetitive navigated transcranial magnetic stimulation (rTMS). Thus, rTMS was applied to the left hemisphere (LH) and RH in 15 healthy left-handers during an object-naming task, and resulting naming errors were categorized. Then, we calculated error rates (ERs=number of errors per number of stimulations) for both hemispheres separately and defined a laterality score as the quotient of the LH ER - RH ER through the LH ER + RH ER (abbreviated as (L-R)/(L+R)). In this context, (L-R)/(L+R)>0 indicates that the LH is dominant, whereas (L-R)/(L+R)<0 shows that the RH is dominant. No significant difference in ERs was found between hemispheres (all errors: mean LH 18.0±11.7%, mean RH 18.1±12.2%, p=0.94; all errors without hesitation: mean LH 12.4±9.8%, mean RH 12.9±10.0%, p=0.65; no responses: mean LH 9.3±9.2%, mean RH 11.5±10.3%, p=0.84). However, a significant difference between the results of (L-R)/(L+R) of left-handers and right-handers (source data of another study) for all errors (mean 0.01±0.14 vs. 0.19±0.20, p=0.0019) and all errors without hesitation (mean -0.02±0.20 vs. 0.19±0.28, p=0.0051) was revealed, whereas the comparison for no responses did not show a significant difference (mean: -0.004±0.27 vs. 0.09±0.44, p=0.64). Accordingly, left-handers present a comparatively equal language distribution across both hemispheres with language dominance being nearly equally distributed between hemispheres in contrast to right-handers. PMID:26792365

  6. Assessment of corticospinal function in spinal cord injury using transcranial motor cortex stimulation: a review.

    PubMed

    McKay, W B; Stokic, D S; Dimitrijevic, M R

    1997-08-01

    Other than clinical examination, few methods exist for assessing the functional condition of descending long tracts of the spinal cord in humans. This review covers neurophysiological examination of the corticospinal system using transcranial electrical and magnetic motor cortex stimulation. The neurophysiological basis for the motor evoked potentials (MEPs) and the differences between the two methods are discussed followed by a review of their use in individuals with spinal cord injury (SCI). Transcranial motor cortex stimulation is used to monitor descending spinal cord tract condition during spinal surgeries and could be useful for assessing central nervous system trauma, especially in the unconscious multitrauma patient. In the chronic phase of SCI, recordings of MEPs have enabled the estimation of central conduction times that relate to the condition of axons passing through the injured segment of the spinal cord. They were found to correlate well with clinical examination scores but as predictors of outcome, the reports have been mixed. The use of transcranial motor cortex stimulation to modify segmental reflexes and in combination with volitional attempts have also provided evidence of conduction across the lesion in paralyzed SCI subjects. However, MEPs can be absent in some SCI individuals who may be able to volitionally activate muscles below the level of the spinal cord lesion. Such findings are useful in elucidating the neural mechanisms underlying the performance of a volitional movement and may serve to guide and monitor the effects of future treatments for paralysis in SCI and other neurological disorders. PMID:9300564

  7. Safety, ethical considerations, and application guidelines for the use of transcranial magnetic stimulation in clinical practice and research☆

    PubMed Central

    Rossi, Simone; Hallett, Mark; Rossini, Paolo M.; Pascual-Leone, Alvaro

    2011-01-01

    This article is based on a consensus conference, which took place in Certosa di Pontignano, Siena (Italy) on March 7–9, 2008, intended to update the previous safety guidelines for the application of transcranial magnetic stimulation (TMS) in research and clinical settings. Over the past decade the scientific and medical community has had the opportunity to evaluate the safety record of research studies and clinical applications of TMS and repetitive TMS (rTMS). In these years the number of applications of conventional TMS has grown impressively, new paradigms of stimulation have been developed (e.g., patterned repetitive TMS) and technical advances have led to new device designs and to the real-time integration of TMS with electroencephalography (EEG), positron emission tomography (PET) and functional magnetic resonance imaging (fMRI). Thousands of healthy subjects and patients with various neurological and psychiatric diseases have undergone TMS allowing a better assessment of relative risks. The occurrence of seizures (i.e., the most serious TMS-related acute adverse effect) has been extremely rare, with most of the few new cases receiving rTMS exceeding previous guidelines, often in patients under treatment with drugs which potentially lower the seizure threshold. The present updated guidelines review issues of risk and safety of conventional TMS protocols, address the undesired effects and risks of emerging TMS interventions, the applications of TMS in patients with implanted electrodes in the central nervous system, and safety aspects of TMS in neuroimaging environments. We cover recommended limits of stimulation parameters and other important precautions, monitoring of subjects, expertise of the rTMS team, and ethical issues. While all the recommendations here are expert based, they utilize published data to the extent possible. PMID:19833552

  8. Friends, not foes: Magnetoencephalography as a tool to uncover brain dynamics during transcranial alternating current stimulation

    PubMed Central

    Neuling, Toralf; Ruhnau, Philipp; Fuscà, Marco; Demarchi, Gianpaolo; Herrmann, Christoph S.; Weisz, Nathan

    2015-01-01

    Brain oscillations are supposedly crucial for normal cognitive functioning and alterations are associated with cognitive dysfunctions. To demonstrate their causal role on behavior, entrainment approaches in particular aim at driving endogenous oscillations via rhythmic stimulation. Within this context, transcranial electrical stimulation, especially transcranial alternating current stimulation (tACS), has received renewed attention. This is likely due to the possibility of defining oscillatory stimulation properties precisely. Also, measurements comparing pre-tACS with post-tACS electroencephalography (EEG) have shown impressive modulations. However, the period during tACS has remained a blackbox until now, due to the enormous stimulation artifact. By means of application of beamforming to magnetoencephalography (MEG) data, we successfully recovered modulations of the amplitude of brain oscillations during weak and strong tACS. Additionally, we demonstrate that also evoked responses to visual and auditory stimuli can be recovered during tACS. The main contribution of the present study is to provide critical evidence that during ongoing tACS, subtle modulations of oscillatory brain activity can be reconstructed even at the stimulation frequency. Future tACS experiments will be able to deliver direct physiological insights in order to further the understanding of the contribution of brain oscillations to cognition and behavior. PMID:26080310

  9. [Transcranial alternating current stimulation. Entrainment and function control of neuronal networks].

    PubMed

    Vosskuhl, J; Strüber, D; Herrmann, C S

    2015-12-01

    Transcranial alternating current stimulation (tACS) is a new technique for the modulation of oscillatory brain activity as measured in the electroencephalogram (EEG). In contrast to well-established stimulation techniques, such as transcranial direct current stimulation and transcranial magnetic stimulation, tACS applies a sinusoidal alternating current at a specific frequency. This enables the modulation of the amplitude and frequency of endogenous brain oscillations as well as related cognitive processes. Therefore, the use of tACS has the possibility to evaluate well-known correlations between brain oscillations and cognitive processes in terms of causality. Such causal relationships have been documented in numerous neurocognitive studies on sensory, motor and perceptual processes; however, the clinical application of tACS is still in its infancy. In principle, any pathology that can reliably be connected with brain oscillations of a defined frequency is treatable. A current main focus of clinical research is on symptoms of Parkinson's disease and to a lesser degree, tinnitus. For an effective application of tACS it is important to choose the electrode positions as well as the frequency, intensity and duration of the stimulation in a theory-based and symptom-related manner. A successful therapeutic intervention requires the persistence of the tACS effect after stimulation has ceased. A mechanism that offers not only an explanation to the origin of persistent tACS effects but is also of high therapeutic benefit is neural plasticity. Therefore, one current focus of research aims at a better understanding of tACS after effects. PMID:26440521

  10. Invasive and transcranial photoacoustic imaging of the vascular response to brain electrical stimulation

    NASA Astrophysics Data System (ADS)

    Tsytsarev, Vassiliy; Yao, Junjie; Hu, Song; Li, Li; Favazza, Christopher P.; Maslov, Konstantin I.; Wang, Lihong V.

    2010-02-01

    Advances in the brain functional imaging greatly facilitated the understanding of neurovascular coupling. For monitoring of the microvascular response to the brain electrical stimulation in vivo we used optical-resolution photoacoustic microscopy (OR-PAM) through the cranial openings as well as transcranially. Both types of the vascular response, vasoconstriction and vasodilatation, were clearly observed with good spatial and temporal resolution. Obtained results confirm one of the primary points of the neurovascular coupling theory that blood vessels could present vasoconstriction or vasodilatation in response to electrical stimulation, depending on the balance between inhibition and excitation of the different parts of the elements of the neurovascular coupling system.

  11. Simultaneous transcranial magnetic stimulation and single neuron recording in alert non-human primates

    PubMed Central

    Mueller, Jerel K.; Grigsby, Erinn M.; Prevosto, Vincent; Petraglia, Frank W.; Rao, Hrishikesh; Deng, Zhi-De; Peterchev, Angel V.; Sommer, Marc A.; Egner, Tobias; Platt, Michael L.; Grill, Warren M.

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a widely used, noninvasive method for stimulating nervous tissue, yet its mechanisms of effect are poorly understood. Here we report novel methods for studying the influence of TMS on single neurons in the brain of alert non-human primates. We designed a TMS coil that focuses its effect near the tip of a recording electrode and recording electronics that enable direct acquisition of neuronal signals at the site of peak stimulus strength minimally perturbed by stimulation artifact in intact, awake monkeys (Macaca mulatta). We recorded action potentials within ~1 ms after 0.4 ms TMS pulses and observed changes in activity that differed significantly for active stimulation as compared to sham stimulation. The methodology is compatible with standard equipment in primate laboratories, allowing for easy implementation. Application of these new tools will facilitate the refinement of next generation TMS devices, experiments, and treatment protocols. PMID:24974797

  12. Cortical distribution of speech and language errors investigated by visual object naming and navigated transcranial magnetic stimulation.

    PubMed

    Krieg, Sandro M; Sollmann, Nico; Tanigawa, Noriko; Foerschler, Annette; Meyer, Bernhard; Ringel, Florian

    2016-05-01

    Navigated transcranial magnetic stimulation (nTMS) gains increasing importance in presurgical language mapping. Although bipolar direct cortical stimulation (DCS) is regarded as the gold standard for intraoperative mapping of language-related areas, it cannot be used to map the healthy human brain due to its invasive character. Therefore, the present study employed a non-invasive virtual-lesion modality to provide a causality-confirmed cortical language map of the healthy human brain by repetitive nTMS (rTMS) with functional specifications beyond language-positive/language-negative distinction. Fifty right-handed healthy volunteers underwent rTMS language mapping of the left hemisphere combined with an object-naming task. The induced errors were categorized and frequency maps were calculated. Moreover, a principal component analysis (PCA) was performed on the basis of language-positive cortical regions for each error category. The left hemisphere was stimulated at 258-789 sites (median: 361.5 sites), and 12-241 naming errors (median: 72.5 errors) were observed. In male subjects, a total number of 2091 language errors were elicited by 9579 stimulation trains, which is equal to an error rate of 21.8 %. Within females, 10,238 stimulation trains elicited 2032 language errors (19.8 %). PCA revealed that the inferior parietal lobe (IPL) and middle frontal gyrus (MFG) were causally involved in object naming as a semantic center and an executive control center. For the first time, this study provides causality-based data and a model that approximates the distribution of language-related cortical areas grouped for different functional aspects of single-word production processes by PCA. PMID:25894631

  13. Effect of transcranial direct current stimulation combined with gait and mobility training on functionality in children with cerebral palsy: study protocol for a double-blind randomized controlled clinical trial

    PubMed Central

    2013-01-01

    Background The project proposes three innovative intervention techniques (treadmill training, mobility training with virtual reality and transcranial direct current stimulation that can be safely administered to children with cerebral palsy. The combination of transcranial stimulation and physical therapy resources will provide the training of a specific task with multiple rhythmic repetitions of the phases of the gait cycle, providing rich sensory stimuli with a modified excitability threshold of the primary motor cortex to enhance local synaptic efficacy and potentiate motor learning. Methods/design A prospective, double-blind, randomized, controlled, analytical, clinical trial will be carried out.Eligible participants will be children with cerebral palsy classified on levels I, II and III of the Gross Motor Function Classification System between four and ten years of age. The participants will be randomly allocated to four groups: 1) gait training on a treadmill with placebo transcranial stimulation; 2) gait training on a treadmill with active transcranial stimulation; 3) mobility training with virtual reality and placebo transcranial stimulation; 4) mobility training with virtual reality and active transcranial stimulation. Transcranial direct current stimulation will be applied with the anodal electrode positioned in the region of the dominant hemisphere over C3, corresponding to the primary motor cortex, and the cathode positioned in the supraorbital region contralateral to the anode. A 1 mA current will be applied for 20 minutes. Treadmill training and mobility training with virtual reality will be performed in 30-minute sessions five times a week for two weeks (total of 10 sessions). Evaluations will be performed on four occasions: one week prior to the intervention; one week following the intervention; one month after the end of the intervention;and 3 months after the end of the intervention. The evaluations will involve three-dimensional gait analysis

  14. Efficiency test of filtering methods for the removal of transcranial magnetic stimulation artifacts on human electroencephalography with artificially transcranial magnetic stimulation-corrupted signals

    NASA Astrophysics Data System (ADS)

    Zilber, Nicolas A.; Katayama, Yoshinori; Iramina, Keiji; Erich, Wintermantel

    2010-05-01

    A new approach is proposed to test the efficiency of methods, such as the Kalman filter and the independent component analysis (ICA), when applied to remove the artifacts induced by transcranial magnetic stimulation (TMS) from electroencephalography (EEG). By using EEG recordings corrupted by TMS induction, the shape of the artifacts is approximately described with a model based on an equivalent circuit simulation. These modeled artifacts are subsequently added to other EEG signals—this time not influenced by TMS. The resulting signals prove of interest since we also know their form without the pseudo-TMS artifacts. Therefore, they enable us to use a fit test to compare the signals we obtain after removing the artifacts with the original signals. This efficiency test turned out very useful in comparing the methods between them, as well as in determining the parameters of the filtering that give satisfactory results with the automatic ICA.

  15. Using Transcranial Magnetic Stimulation to Evaluate the Motor Pathways After an Intraoperative Spinal Cord Injury and to Predict the Recovery of Intraoperative Transcranial Electrical Motor Evoked Potentials: A Case Report.

    PubMed

    Grover, Helen J; Thornton, Rachel; Lutchman, Lennel N; Blake, Julian C

    2016-06-01

    The authors report a case of unilateral loss of intraoperative transcranial electrical motor evoked potentials (TES MEP) associated with a spinal cord injury during scoliosis correction and the subsequent use of extraoperative transcranial magnetic stimulation to monitor the recovery of spinal cord function. The authors demonstrate the absence of TES MEPs and absent transcranial magnetic stimulation responses in the immediate postoperative period, and document the partial recovery of transcranial magnetic stimulation responses, which corresponded to partial recovery of TES MEPs. Intraoperative TES MEPs were enhanced using spatial facilitation technique, which enabled the patient to undergo further surgery to stabilize the spine and correct her scoliosis. This case report supports evidence of the use of extraoperative transcranial magnetic stimulation to predict the presence of intraoperative TES responses and demonstrates the usefulness of spatial facilitation to monitor TES MEPs in a patient with a preexisting spinal cord injury. PMID:26061481

  16. Are Participants Aware of the Type and Intensity of Transcranial Direct Current Stimulation?

    PubMed

    Tang, Matthew F; Hammond, Geoffrey R; Badcock, David R

    2016-01-01

    Transcranial direct current stimulation (tDCS) is commonly used to alter cortical excitability but no experimental study has yet determined whether human participants are able to distinguish between the different types (anodal, cathodal, and sham) of stimulation. If they can then they are not blind to experimental conditions. We determined whether participants could identify different types of stimulation (anodal, cathodal, and sham) and current strengths after experiencing the sensations of stimulation during current onset and offset (which are associated with the most intense sensations) in Experiment 1 and also with a prolonged period of stimulation in Experiment 2. We first familiarized participants with anodal, cathodal, and sham stimulation at both 1 and 2 mA over either primary motor or visual cortex while their sensitivity to small changes in visual stimuli was assessed. The different stimulation types were then applied for a short (Experiment 1) or extended (Experiment 2) period with participants indicating the type and strength of the stimulation on the basis of the evoked sensations. Participants were able to identify the intensity of stimulation with shorter, but not longer periods, of stimulation at better than chance levels but identification of the different stimulation types was at chance levels. This result suggests that even after exposing participants to stimulation, and ensuring they are fully aware of the existence of a sham condition, they are unable to identify the type of stimulation from transient changes in stimulation intensity or from more prolonged stimulation. Thus participants are able to identify intensity of stimulation but not the type of stimulation. PMID:26863314

  17. Transcranial direct current stimulation in the male mouse to promote recovery after stroke.

    PubMed

    Pikhovych, Anton; Walter, Helene L; Mahabir, Esther; Fink, Gereon Rudolf; Graf, Rudolf; Schroeter, Michael; Rueger, Maria Adele

    2016-06-01

    Transcranial direct current stimulation (tDCS) constitutes a promising approach for promoting recovery of function after stroke, although the underlying neurobiological mechanisms are unclear. To conduct translational research in animal models, stimulation parameters should not lead to neuronal lesions. Liebetanz et al. recommend charge densities for cathodal stimulation in rats, but parameters for mice are not established. We established tDCS in the wild-type mouse, enabling studies with genetically-engineered mice (GEM). tDCS equipment was adapted to fit the mouse skull. Using different polarities and charge densities, tDCS was safe to apply in the mouse where the charge density was below 198 kC/m(2) for single or repeated stimulations. These findings are crucial for future investigations of the neurobiological mechanisms underlying tDCS using GEM. PMID:26442519

  18. Non-invasive transcranial direct current stimulation for the study and treatment of neuropathic pain.

    PubMed

    Knotkova, Helena; Cruciani, Ricardo A

    2010-01-01

    In the last decade, radiological neuroimaging techniques have enhanced the study of mechanisms involved in the development and maintenance of neuropathic pain. Recent findings suggest that neuropathic pain in certain pain syndromes (e.g., complex regional pain syndrome/reflex sympathic dystrophy, phantom-limb pain) is associated with a functional reorganization and hyperexitability of the somatosensory and motor cortex. Studies showing that the reversal of cortical reorganization in patients with spontaneous or provoked pain is accompanied by pain relief stimulated the search for novel alternatives how to modulate the cortical excitability as a strategy to relieve pain. Recently, non-invasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) were proposed as suitable methods for modulation of cortical excitability. Both techniques (TMS and tDCS) have been clinically investigated in healthy volunteers as well as in patients with various clinical pathologies and variety of pain syndromes. Although there is less evidence on tDCS as compared with TMS, the findings on tDCS in patients with pain are promising, showing an analgesic effect of tDCS, and observations up to date justify the use of tDCS for the treatment of pain in selected patient populations. tDCS has been shown to be very safe if utilized within the current protocols. In addition, tDCS has been proven to be easy to apply, portable and not expensive, which further enhances great clinical potential of this technique. PMID:20336445

  19. High-Frequency Transcranial Random Noise Stimulation Enhances Perception of Facial Identity.

    PubMed

    Romanska, Aleksandra; Rezlescu, Constantin; Susilo, Tirta; Duchaine, Bradley; Banissy, Michael J

    2015-11-01

    Recently, a number of studies have demonstrated the utility of transcranial current stimulation as a tool to facilitate a variety of cognitive and perceptual abilities. Few studies, though, have examined the utility of this approach for the processing of social information. Here, we conducted 2 experiments to explore whether a single session of high-frequency transcranial random noise stimulation (tRNS) targeted at lateral occipitotemporal cortices would enhance facial identity perception. In Experiment 1, participants received 20 min of active high-frequency tRNS or sham stimulation prior to completing the tasks examining facial identity perception or trustworthiness perception. Active high-frequency tRNS facilitated facial identity perception, but not trustworthiness perception. Experiment 2 assessed the spatial specificity of this effect by delivering 20 min of active high-frequency tRNS to lateral occipitotemporal cortices or sensorimotor cortices prior to participants completing the same facial identity perception task used in Experiment 1. High-frequency tRNS targeted at lateral occipitotemporal cortices enhanced performance relative to motor cortex stimulation. These findings show that high-frequency tRNS to lateral occipitotemporal cortices produces task-specific and site-specific enhancements in face perception. PMID:25662714

  20. Image-Guided Transcranial Focused Ultrasound Stimulates Human Primary Somatosensory Cortex

    NASA Astrophysics Data System (ADS)

    Lee, Wonhye; Kim, Hyungmin; Jung, Yujin; Song, In-Uk; Chung, Yong An; Yoo, Seung-Schik

    2015-03-01

    Focused ultrasound (FUS) has recently been investigated as a new mode of non-invasive brain stimulation, which offers exquisite spatial resolution and depth control. We report on the elicitation of explicit somatosensory sensations as well as accompanying evoked electroencephalographic (EEG) potentials induced by FUS stimulation of the human somatosensory cortex. As guided by individual-specific neuroimage data, FUS was transcranially delivered to the hand somatosensory cortex among healthy volunteers. The sonication elicited transient tactile sensations on the hand area contralateral to the sonicated hemisphere, with anatomical specificity of up to a finger, while EEG recordings revealed the elicitation of sonication-specific evoked potentials. Retrospective numerical simulation of the acoustic propagation through the skull showed that a threshold of acoustic intensity may exist for successful cortical stimulation. The neurological and neuroradiological assessment before and after the sonication, along with strict safety considerations through the individual-specific estimation of effective acoustic intensity in situ and thermal effects, showed promising initial safety profile; however, equal/more rigorous precautionary procedures are advised for future studies. The transient and localized stimulation of the brain using image-guided transcranial FUS may serve as a novel tool for the non-invasive assessment and modification of region-specific brain function.

  1. Image-guided transcranial focused ultrasound stimulates human primary somatosensory cortex.

    PubMed

    Lee, Wonhye; Kim, Hyungmin; Jung, Yujin; Song, In-Uk; Chung, Yong An; Yoo, Seung-Schik

    2015-01-01

    Focused ultrasound (FUS) has recently been investigated as a new mode of non-invasive brain stimulation, which offers exquisite spatial resolution and depth control. We report on the elicitation of explicit somatosensory sensations as well as accompanying evoked electroencephalographic (EEG) potentials induced by FUS stimulation of the human somatosensory cortex. As guided by individual-specific neuroimage data, FUS was transcranially delivered to the hand somatosensory cortex among healthy volunteers. The sonication elicited transient tactile sensations on the hand area contralateral to the sonicated hemisphere, with anatomical specificity of up to a finger, while EEG recordings revealed the elicitation of sonication-specific evoked potentials. Retrospective numerical simulation of the acoustic propagation through the skull showed that a threshold of acoustic intensity may exist for successful cortical stimulation. The neurological and neuroradiological assessment before and after the sonication, along with strict safety considerations through the individual-specific estimation of effective acoustic intensity in situ and thermal effects, showed promising initial safety profile; however, equal/more rigorous precautionary procedures are advised for future studies. The transient and localized stimulation of the brain using image-guided transcranial FUS may serve as a novel tool for the non-invasive assessment and modification of region-specific brain function. PMID:25735418

  2. Transcranial direct current stimulation enhances recovery of stereopsis in adults with amblyopia.

    PubMed

    Spiegel, Daniel P; Li, Jinrong; Hess, Robert F; Byblow, Winston D; Deng, Daming; Yu, Minbin; Thompson, Benjamin

    2013-10-01

    Amblyopia is a neurodevelopmental disorder of vision caused by abnormal visual experience during early childhood that is often considered to be untreatable in adulthood. Recently, it has been shown that a novel dichoptic videogame-based treatment for amblyopia can improve visual function in adult patients, at least in part, by reducing inhibition of inputs from the amblyopic eye to the visual cortex. Non-invasive anodal transcranial direct current stimulation has been shown to reduce the activity of inhibitory cortical interneurons when applied to the primary motor or visual cortex. In this double-blind, sham-controlled cross-over study we tested the hypothesis that anodal transcranial direct current stimulation of the visual cortex would enhance the therapeutic effects of dichoptic videogame-based treatment. A homogeneous group of 16 young adults (mean age 22.1 ± 1.1 years) with amblyopia were studied to compare the effect of dichoptic treatment alone and dichoptic treatment combined with visual cortex direct current stimulation on measures of binocular (stereopsis) and monocular (visual acuity) visual function. The combined treatment led to greater improvements in stereoacuity than dichoptic treatment alone, indicating that direct current stimulation of the visual cortex boosts the efficacy of dichoptic videogame-based treatment. This intervention warrants further evaluation as a novel therapeutic approach for adults with amblyopia. PMID:23857313

  3. High-Frequency Transcranial Random Noise Stimulation Enhances Perception of Facial Identity

    PubMed Central

    Romanska, Aleksandra; Rezlescu, Constantin; Susilo, Tirta; Duchaine, Bradley; Banissy, Michael J.

    2015-01-01

    Recently, a number of studies have demonstrated the utility of transcranial current stimulation as a tool to facilitate a variety of cognitive and perceptual abilities. Few studies, though, have examined the utility of this approach for the processing of social information. Here, we conducted 2 experiments to explore whether a single session of high-frequency transcranial random noise stimulation (tRNS) targeted at lateral occipitotemporal cortices would enhance facial identity perception. In Experiment 1, participants received 20 min of active high-frequency tRNS or sham stimulation prior to completing the tasks examining facial identity perception or trustworthiness perception. Active high-frequency tRNS facilitated facial identity perception, but not trustworthiness perception. Experiment 2 assessed the spatial specificity of this effect by delivering 20 min of active high-frequency tRNS to lateral occipitotemporal cortices or sensorimotor cortices prior to participants completing the same facial identity perception task used in Experiment 1. High-frequency tRNS targeted at lateral occipitotemporal cortices enhanced performance relative to motor cortex stimulation. These findings show that high-frequency tRNS to lateral occipitotemporal cortices produces task-specific and site-specific enhancements in face perception. PMID:25662714

  4. Monitoring transcranial direct current stimulation induced changes in cortical excitability during the serial reaction time task.

    PubMed

    Ambrus, Géza Gergely; Chaieb, Leila; Stilling, Roman; Rothkegel, Holger; Antal, Andrea; Paulus, Walter

    2016-03-11

    The measurement of the motor evoked potential (MEP) amplitudes using single pulse transcranial magnetic stimulation (TMS) is a common method to observe changes in motor cortical excitability. The level of cortical excitability has been shown to change during motor learning. Conversely, motor learning can be improved by using anodal transcranial direct current stimulation (tDCS). In the present study, we aimed to monitor cortical excitability changes during an implicit motor learning paradigm, a version of the serial reaction time task (SRTT). Responses from the first dorsal interosseous (FDI) and forearm flexor (FLEX) muscles were recorded before, during and after the performance of the SRTT. Online measurements were combined with anodal, cathodal or sham tDCS for the duration of the SRTT. Negative correlations between the amplitude of online FDI MEPs and SRTT reaction times (RTs) were observed across the learning blocks in the cathodal condition (higher average MEP amplitudes associated with lower RTs) but no significant differences in the anodal and sham conditions. tDCS did not have an impact on SRTT performance, as would be predicted based on previous studies. The offline before-after SRTT MEP amplitudes showed an increase after anodal and a tendency to decrease after cathodal stimulation, but these changes were not significant. The combination of different interventions during tDCS might result in reduced efficacy of the stimulation that in future studies need further attention. PMID:26826607

  5. Image-Guided Transcranial Focused Ultrasound Stimulates Human Primary Somatosensory Cortex

    PubMed Central

    Lee, Wonhye; Kim, Hyungmin; Jung, Yujin; Song, In-Uk; Chung, Yong An; Yoo, Seung-Schik

    2015-01-01

    Focused ultrasound (FUS) has recently been investigated as a new mode of non-invasive brain stimulation, which offers exquisite spatial resolution and depth control. We report on the elicitation of explicit somatosensory sensations as well as accompanying evoked electroencephalographic (EEG) potentials induced by FUS stimulation of the human somatosensory cortex. As guided by individual-specific neuroimage data, FUS was transcranially delivered to the hand somatosensory cortex among healthy volunteers. The sonication elicited transient tactile sensations on the hand area contralateral to the sonicated hemisphere, with anatomical specificity of up to a finger, while EEG recordings revealed the elicitation of sonication-specific evoked potentials. Retrospective numerical simulation of the acoustic propagation through the skull showed that a threshold of acoustic intensity may exist for successful cortical stimulation. The neurological and neuroradiological assessment before and after the sonication, along with strict safety considerations through the individual-specific estimation of effective acoustic intensity in situ and thermal effects, showed promising initial safety profile; however, equal/more rigorous precautionary procedures are advised for future studies. The transient and localized stimulation of the brain using image-guided transcranial FUS may serve as a novel tool for the non-invasive assessment and modification of region-specific brain function. PMID:25735418

  6. Transcranial Direct Current Stimulation in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder (ADHD): A Pilot Study.

    PubMed

    Bandeira, Igor Dórea; Guimarães, Rachel Silvany Quadros; Jagersbacher, João Gabriel; Barretto, Thiago Lima; de Jesus-Silva, Jéssica Regina; Santos, Samantha Nunes; Argollo, Nayara; Lucena, Rita

    2016-06-01

    Studies investigating the possible benefits of transcranial direct current stimulation on left dorsolateral prefrontal cortex in children and adolescents with attention-deficit hyperactivity disorder (ADHD) have not been performed. This study assesses the effect of transcranial direct current stimulation in children and adolescents with ADHD on neuropsychological tests of visual attention, visual and verbal working memory, and inhibitory control. An auto-matched clinical trial was performed involving transcranial direct current stimulation in children and adolescents with ADHD, using SNAP-IV and subtests Vocabulary and Cubes of the Wechsler Intelligence Scale for Children III (WISC-III). Subjects were assessed before and after transcranial direct current stimulation sessions with the Digit Span subtest of the WISC-III, inhibitory control subtest of the NEPSY-II, Corsi cubes, and the Visual Attention Test (TAVIS-3). There were 9 individuals with ADHD according to Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. There was statistically significant difference in some aspects of TAVIS-3 tests and the inhibitory control subtest of NEPSY-II. Transcranial direct current stimulation can be related to a more efficient processing speed, improved detection of stimuli, and improved ability to switch between an ongoing activity and a new one. PMID:26879095

  7. Multiple blocks of intermittent and continuous theta-burst stimulation applied via transcranial magnetic stimulation differently affect sensory responses in rat barrel cortex

    PubMed Central

    Thimm, Andreas; Funke, Klaus

    2015-01-01

    Cortical sensory processing varies with cortical state and the balance of inhibition to excitation. Repetitive transcranial magnetic stimulation (rTMS) has been shown to modulate human cortical excitability. In a rat model, we recently showed that intermittent theta-burst stimulation (iTBS) applied to the corpus callosum, to activate primarily supragranular cortical pyramidal cells but fewer subcortical neurons, strongly reduced the cortical expression of parvalbumin (PV), indicating reduced activity of fast-spiking interneurons. Here, we used the well-studied rodent barrel cortex system to test how iTBS and continuous TBS (cTBS) modulate sensory responses evoked by either single or double stimuli applied to the principal (PW) and/or adjacent whisker (AW) in urethane-anaesthetized rats. Compared to sham stimulation, iTBS but not cTBS particularly enhanced late (>18 ms) response components of multi-unit spiking and local field potential responses in layer 4 but not the very early response (<18 ms). Similarly, only iTBS diminished the suppression of the second response evoked by paired PW or AW–PW stimulation at 20 ms intervals. The effects increased with each of the five iTBS blocks applied. With cTBS a mild effect similar to that of iTBS was first evident after 4–5 stimulation blocks. Enhanced cortical c-Fos and zif268 expression but reduced PV and GAD67 expression was found only after iTBS, indicating increased cortical activity due to lowered inhibition. We conclude that iTBS but less cTBS may primarily weaken a late recurrent-type cortical inhibition mediated via a subset of PV+ interneurons, enabling stronger late response components believed to contribute to the perception of sensory events. PMID:25504571

  8. Safety of Transcranial Direct Current Stimulation in Alcohol-Induced Psychotic Disorder with Comorbid Psoriasis

    PubMed Central

    Shivakumar, Venkataram; Agarwal, Sri Mahavir; Bose, Anushree; Kandasamy, Arun; Rao, Naren P.; Narayanaswamy, Janardhanan C.; Venkatasubramanian, Ganesan

    2016-01-01

    Transcranial Direct Current Stimulation (tDCS) involves application of weak direct electric currents (up to 2mA) using scalp electrodes with resultant neuroplasticity modulation by altering the cortical excitability. Though the side effect profile of tDCS is benign and less severe, the utility and safety of tDCS in dermatological conditions remains a concern. In this context, we report the safe administration of tDCS in a subject with substance induced psychosis and co-morbid psoriasis. PMID:27011409

  9. Transcranial direct current stimulation improves neurorehabilitation of task-specific dystonia: a pilot study.

    PubMed

    Rosset-Llobet, Jaume; Fàbregas-Molas, Sílvia; Pascual-Leone, Alvaro

    2014-03-01

    Sensory-motor returning (SMR) can help the symptoms of task-specific focal hand dystonia. However, effects vary across patients and take many sessions. Here, we present proof of principle evidence that transcranial direct current stimulation (tDCS) can enhance these effects. We compared the effects of a combined tDCS-SMR protocol (n=4 patients) with the efficacy of SMR alone (n=30 patients). All 4 patients treated with the combined protocol showed greater improvement than those undergoing SMR alone. Results encourage a larger, parallel-group clinical trial with sham tDCS control. PMID:24647456

  10. Contactless remote induction of shear waves in soft tissues using a transcranial magnetic stimulation device

    NASA Astrophysics Data System (ADS)

    Grasland-Mongrain, Pol; Miller-Jolicoeur, Erika; Tang, An; Catheline, Stefan; Cloutier, Guy

    2016-03-01

    This study presents the first observation of shear waves induced remotely within soft tissues. It was performed through the combination of a transcranial magnetic stimulation device and a permanent magnet. A physical model based on Maxwell and Navier equations was developed. Experiments were performed on a cryogel phantom and a chicken breast sample. Using an ultrafast ultrasound scanner, shear waves of respective amplitudes of 5 and 0.5 μm were observed. Experimental and numerical results were in good agreement. This study constitutes the framework of an alternative shear wave elastography method.

  11. Methods of high current magnetic field generator for transcranial magnetic stimulation application

    NASA Astrophysics Data System (ADS)

    Bouda, N. R.; Pritchard, J.; Weber, R. J.; Mina, M.

    2015-05-01

    This paper describes the design procedures and underlying concepts of a novel High Current Magnetic Field Generator (HCMFG) with adjustable pulse width for transcranial magnetic stimulation applications. This is achieved by utilizing two different switching devices, the MOSFET and insulated gate bipolar transistor (IGBT). Results indicate that currents as high as ±1200 A can be generated with inputs of +/-20 V. Special attention to tradeoffs between field generators utilizing IGBT circuits (HCMFG1) and MOSFET circuits (HCMFG2) was considered. The theory of operation, design, experimental results, and electronic setup are presented and analyzed.

  12. Methods of high current magnetic field generator for transcranial magnetic stimulation application

    SciTech Connect

    Bouda, N. R. Pritchard, J.; Weber, R. J.; Mina, M.

    2015-05-07

    This paper describes the design procedures and underlying concepts of a novel High Current Magnetic Field Generator (HCMFG) with adjustable pulse width for transcranial magnetic stimulation applications. This is achieved by utilizing two different switching devices, the MOSFET and insulated gate bipolar transistor (IGBT). Results indicate that currents as high as ±1200 A can be generated with inputs of +/−20 V. Special attention to tradeoffs between field generators utilizing IGBT circuits (HCMFG{sub 1}) and MOSFET circuits (HCMFG{sub 2}) was considered. The theory of operation, design, experimental results, and electronic setup are presented and analyzed.

  13. Subject-specific optimization of channel currents for multichannel transcranial magnetic stimulation.

    PubMed

    Cline, Christopher C; Johnson, Nessa N; He, Bin

    2015-08-01

    The goal of this work is to develop a focal transcranial magnetic stimulation (TMS) system using a multichannel coil array for high-resolution neuromodulation. We proposed a novel spatially-distributed stimulation strategy to significantly improve the focality of TMS. Computer simulations were conducted to evaluate the proposed approach and test the merits of multichannel TMS. Three different multichannel coil arrays were modeled in addition to a conventional figure-8 coil for comparison. Simulations were performed on finite element head models of six subjects constructed from anatomical MR images via an automated pipeline. Multichannel TMS arrays exhibited significantly more focal induced electric field magnitudes compared to the figure-8 coil. Additionally, electrical steering of stimulation sites without physical movement of the coil array was demonstrated. PMID:26736698

  14. Assessment and modulation of neuroplasticity in rehabilitation with transcranial magnetic stimulation

    PubMed Central

    Bashir, Shahid; Mizrahi, Ilan; Weaver, Kayleen; Fregni, Felipe; Pascual-Leone, Alvaro

    2013-01-01

    Despite intensive efforts towards the improvement of outcomes after acquired brain injury functional recovery is often limited. One reasons is the challenge in assessing and guiding plasticity after brain injury. In this context, Transcranial Magnetic Stimulation (TMS) - a noninvasive tool of brain stimulation - could play a major role. TMS has shown to be a reliable tool to measure plastic changes in the motor cortex associated with interventions in the motor system; such as motor training and motor cortex stimulation. In addition, as illustrated by the experience in promoting recovery from stroke, TMS a promising therapeutic tool to minimize motor, speech, cognitive, and mood deficits. In this review, we will focus on stroke to discuss how TMS can provide insights into the mechanisms of neurological recovery, and can be used for measurement and modulation of plasticity after an acquired brain insult. PMID:21172687

  15. New perspectives in transcranial magnetic stimulation: epilepsy, consciousness and the perturbational approach.

    PubMed

    Manganotti, Paolo; Del Felice, Alessandra

    2013-01-01

    Transcranial magnetic stimulation (TMS) evolved from a simple method to stimulate the motor cortex to an invaluable tool for multiple diagnostic, research, and therapeutic applications. A further development of this noninvasive brain stimulation technique is concomitant electroencephalographic (EEG) recording during TMS. The theoretical underpinnings and the technological innovation of TMS-EEG co-registration have opened new ways to study brain excitability in neurological conditions previously investigated with conventional EEG alone. A further advance in TMS research applications is the perturbational approach: magnetic pulses can interfere not only with dynamic, often pathological rhythms in epilepsy or altered consciousness states, but also modulate physiological states such as sleep and sleep deprivation. So applied, TMS-EEG co-registration can reveal different neurophysiological and behavioral patterns in the awake state, sleep or sleep deprivation. In this review, we discuss the use of TMS and TMS-EEG co-registration in epilepsy, a still rather limited although promising area of study. PMID:23001632

  16. Modulation of Total Sleep Time by Transcranial Direct Current Stimulation (tDCS).

    PubMed

    Frase, Lukas; Piosczyk, Hannah; Zittel, Sulamith; Jahn, Friederike; Selhausen, Peter; Krone, Lukas; Feige, Bernd; Mainberger, Florian; Maier, Jonathan G; Kuhn, Marion; Klöppel, Stefan; Normann, Claus; Sterr, Annette; Spiegelhalder, Kai; Riemann, Dieter; Nitsche, Michael A; Nissen, Christoph

    2016-09-01

    Arousal and sleep are fundamental physiological processes, and their modulation is of high clinical significance. This study tested the hypothesis that total sleep time (TST) in humans can be modulated by the non-invasive brain stimulation technique transcranial direct current stimulation (tDCS) targeting a 'top-down' cortico-thalamic pathway of sleep-wake regulation. Nineteen healthy participants underwent a within-subject, repeated-measures protocol across five nights in the sleep laboratory with polysomnographic monitoring (adaptation, baseline, three experimental nights). tDCS was delivered via bi-frontal target electrodes and bi-parietal return electrodes before sleep (anodal 'activation', cathodal 'deactivation', and sham stimulation). Bi-frontal anodal stimulation significantly decreased TST, compared with cathodal and sham stimulation. This effect was location specific. Bi-frontal cathodal stimulation did not significantly increase TST, potentially due to ceiling effects in good sleepers. Exploratory resting-state EEG analyses before and after the tDCS protocols were consistent with the notion of increased cortical arousal after anodal stimulation and decreased cortical arousal after cathodal stimulation. The study provides proof-of-concept that TST can be decreased by non-invasive bi-frontal anodal tDCS in healthy humans. Further elucidating the 'top-down' pathway of sleep-wake regulation is expected to increase knowledge on the fundamentals of sleep-wake regulation and to contribute to the development of novel treatments for clinical conditions of disturbed arousal and sleep. PMID:27143601

  17. Neuroplastic effects of transcranial near-infrared stimulation (tNIRS) on the motor cortex

    PubMed Central

    Chaieb, Leila; Antal, Andrea; Masurat, Florentin; Paulus, Walter

    2015-01-01

    Near-infrared light stimulation of the brain has been claimed to improve deficits caused by traumatic brain injury and stroke. Here, we exploit the effect of transcranial near-infrared stimulation (tNIRS) as a tool to modulate cortical excitability in the healthy human brain. tNIRS was applied at a wavelength of 810 nm for 10 min over the hand area of the primary motor cortex (M1). Both single-pulse and paired-pulse measures of transcranial magnetic stimulation (TMS) were used to assess levels of cortical excitability in the corticospinal pathway and intracortical circuits. The serial reaction time task (SRTT) was used to investigate the possible effect of tNIRS on implicit learning. By evaluating the mean amplitude of single-pulse TMS elicited motor-evoked-potentials (MEPs) a significant decrease of the amplitude was observed up to 30 min post-stimulation, compared to baseline. Furthermore, the short interval cortical inhibition (SICI) was increased and facilitation (ICF) decreased significantly after tNIRS. The results from the SRTT experiment show that there was no net effect of stimulation on the performance of the participants. Results of a study questionnaire demonstrated that tNIRS did not induce serious side effects apart from light headache and fatigue. Nevertheless, 66% were able to detect the difference between active and sham stimulation conditions. In this study we provide further evidence that tNIRS is suitable as a tool for influencing cortical excitability and activity in the healthy human brain. PMID:26082699

  18. Involvement of the human dorsal premotor cortex in unimanual motor control: an interference approach using transcranial magnetic stimulation.

    PubMed

    Cincotta, Massimo; Borgheresi, Alessandra; Balestrieri, Fabrizio; Giovannelli, Fabio; Rossi, Simone; Ragazzoni, Aldo; Zaccara, Gaetano; Ziemann, Ulf

    2004-09-01

    Unilateral movements are enabled through a distributed network of motor cortical areas but the relative contribution from the parts of this network is largely unknown. Failure of this network potentially results in mirror activation of the primary motor cortex (M1) ipsilateral to the intended movement. Here we tested the role of the right dorsal premotor cortex (dPMC) in 11 healthy subjects by disrupting its activity with 20 Hz repetitive transcranial magnetic stimulation (rTMS) whilst the subjects exerted a unilateral contraction of the left first dorsal interosseous (FDI). We found that disruption of right dPMC enhanced mirror activation of the ipsilateral left M1, as probed by motor evoked potential (MEP) amplitude to the right FDI. This was not the case with sham rTMS, when rTMS was directed to the right M1, or with rTMS of the right dPMC but without contraction of the left FDI. Findings suggest that activity in the dPMC contributes to the suppression of mirror movements during intended unilateral movements. PMID:15331150

  19. Effects of Transcranial Magnetic Stimulation on Body Perception: No Evidence for Specificity of the Right Temporo-Parietal Junction.

    PubMed

    Daltrozzo, Jerome; Kotchoubey, Boris; Gueler, Fatma; Karim, Ahmed A

    2016-09-01

    Previous data suggest that the right temporo-parietal junction (rTPJ) may have a specific role in abnormal body perception (ABP), including out-of-body experience. We tested this hypothesis with inhibitory (1 Hz) and excitatory (15 Hz) repetitive transcranial magnetic stimulation (rTMS) of the rTPJ and a control site (CS, 5 cm posterior to the rTPJ along the lateral sulcus direction in Brodmann area 19R) in 35 healthy adults. ABP frequency was higher with 1 Hz than with 15 Hz rTMS but unaffected by the rTMS site (rTPJ/CS). Response to an own-body transformation task were delayed with 1 Hz compared to 15 Hz rTMS but also unaffected by rTMS site. ABP from rTMS at both sites induced electroencephalographic power decrease in all frequencies at left anterior and central cortical sites. Our data suggest that inhibitory rTMS can lead to ABP. However, the rTPJ may not play a specific role in this process. PMID:27215619

  20. Transcranial magnetic stimulation at 1 Hertz improves clinical symptoms in children with Tourette syndrome for at least 6 months.

    PubMed

    Le, Kai; Liu, Ling; Sun, Manli; Hu, Ling; Xiao, Nong

    2013-02-01

    Tourette syndrome (TS) is characterized by multiple motor and phonic tics. Repetitive transcranial magnetic stimulation (rTMS) targeting the supplemental motor area (SMA) can reduce tic severity. Here, we investigated whether 1 Hz rTMS targeted to the SMA could improve symptoms in children with TS. Twenty-five children with TS (aged under 16 years) received 20 daily sessions of rTMS to the SMA at a frequency of 1 Hz, 110% of resting motor threshold (RMT). Clinical assessment and physiological measures of the left and right RMT were conducted at different times during treatment and follow-up. After four weeks of treatment we observed statistically significant reductions on the Yale Global Tic Severity Scale, Clinical Global Impression Scale, Swanson, Nolan and Pelham Rating Scale, version IV for attention-deficit hyperactivity disorder, Children's Depression Inventory, Spence Children's Anxiety Scale and a novel Attention Test. In addition, symptom improvement correlated with an increase of both right and left RMT and was stable at six months follow-up. Therefore, we found that 1 Hz rTMS to the SMA can improve clinical symptoms in children with TS for at least six months. PMID:23238046

  1. Transcranial direct current stimulation improves seizure control in patients with Rasmussen encephalitis.

    PubMed

    Tekturk, Pinar; Erdogan, Ezgi Tuna; Kurt, Adnan; Kocagoncu, Ece; Kucuk, Zeynep; Kinay, Demet; Yapici, Zuhal; Aksu, Serkan; Baykan, Betul; Karamursel, Sacit

    2016-03-01

    Rasmussen encephalitis is associated with severe seizures that are unresponsive to antiepileptic drugs, as well as immunosuppressants. Transcranial direct current stimulation (t-DCS) is a non-invasive and safe method tried mostly for focal epilepsies with different aetiologies. To date, there is only one published study with two case reports describing the effect of t-DCS in Rasmussen encephalitis. Our aim was to investigate the effect of t-DCS on seizures in Rasmussen encephalitis and to clarify its safety. Five patients (mean age: 19; three females), diagnosed with Rasmussen encephalitis were included in this study. Patients received first cathodal, then anodal (2 mA for 30 minutes on three consecutive days for non-sham stimulations), and finally sham stimulation with two-month intervals, respectively. Three patients received classic (DC) cathodal t-DCS whereas two patients received cathodal stimulation with amplitude modulation at 12 Hz. Afterwards, all patients received anodal stimulation with amplitude modulation at 12 Hz. In the last part of the trial, sham stimulation (a 60-second stimulation with gradually decreasing amplitude to zero in the last 15 seconds) was applied to three patients. Maximum current density was 571 mA/m2 using 70 mm x 50 mm wet sponge electrodes with 2-mA maximum, current controlled stimulator, and maximum charge density was 1028 C/m2 for a 30-minute stimulation period. After cathodal stimulation, all but one patient had a greater than 50% decrease in seizure frequency. Two patients who received modulated cathodal t-DCS had better results. The longest positive effect lasted for one month. A second trial with modulated anodal stimulation and a third with sham stimulation were not effective. No adverse effect was reported with all types of stimulations. Both classic and modulated cathodal t-DCS may be suitable alternative methods for improving seizure outcome in Rasmussen encephalitis patients. PMID:26842560

  2. Contribution of transcranial oscillatory stimulation to research on neural networks: an emphasis on hippocampo-neocortical rhythms

    PubMed Central

    Marshall, Lisa; Binder, Sonja

    2013-01-01

    EEG rhythms reflect the synchronized activity of underlying biological neuronal network oscillations, and certain predominant frequencies are typically linked to certain behavioral states. For instance, slow wave activity characterized by sleep slow oscillation (SO) emerges normally during slow-wave sleep (SWS). In this mini-review we will first give a background leading up to the present day association between specific oscillations and their functional relevance for learning and memory consolidation. Following, some principles on oscillatory activity are summarized and finally results of studies employing slowly oscillating transcranial electric stimulation are given. We underscore that oscillatory transcranial electric stimulation presents a tool to study principles of cortical network function. PMID:24133431

  3. Variability of behavioural responses to transcranial magnetic stimulation: Origins and predictors.

    PubMed

    Nicolo, Pierre; Ptak, Radek; Guggisberg, Adrian G

    2015-07-01

    Transcranial magnetic stimulation (TMS) may modulate the excitability of local cortical stimulation sites and distant functionally interconnected regions for minutes, hours or even days. The effects of TMS suggest that it not only acts on activity of the stimulated area, but also on its connections with remote areas. Due to these properties one of the main rationales for the application of TMS in stroke patients is to improve imbalance in interhemispheric inhibition. However, given that TMS may have excitatory or inhibitory effects the impact of stimulation is not easy to predict. In this review, we discuss the different factors that determine the magnitude and quality of physiological and behavioural responses to TMS. Whether TMS is mainly excitatory or inhibitory not only depends on the parameters of stimulation such as pulse frequency and duration, but also on baseline activity of neural tissue before stimulation, or even on cognitive factors such as attention. A major challenge for the application of TMS as therapy method is to identify predictors of positive effects in individual patients. Neuroimaging studies measuring hemodynamic or electrophysiological responses show that changes in interhemispheric competition or adaptations of functional networks in patients with focal brain lesions may predict the individual response to brain stimulation. Such techniques have the potential to select the most appropriate among different intervention methods for an individual patient. PMID:25619851

  4. Dynamic modulation of intrinsic functional connectivity by transcranial direct current stimulation.

    PubMed

    Sehm, Bernhard; Schäfer, Alexander; Kipping, Judy; Margulies, Daniel; Conde, Virginia; Taubert, Marco; Villringer, Arno; Ragert, Patrick

    2012-12-01

    Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique capable of modulating cortical excitability and thereby influencing behavior and learning. Recent evidence suggests that bilateral tDCS over both primary sensorimotor cortices (SM1) yields more prominent effects on motor performance in both healthy subjects and chronic stroke patients than unilateral tDCS over SM1. To better characterize the underlying neural mechanisms of this effect, we aimed to explore changes in resting-state functional connectivity during both stimulation types. In a randomized single-blind crossover design, 12 healthy subjects underwent functional magnetic resonance imaging at rest before, during, and after 20 min of unilateral, bilateral, and sham tDCS stimulation over SM1. Eigenvector centrality mapping (ECM) was used to investigate tDCS-induced changes in functional connectivity patterns across the whole brain. Uni- and bilateral tDCS over SM1 resulted in functional connectivity changes in widespread brain areas compared with sham stimulation both during and after stimulation. Whereas bilateral tDCS predominantly modulated changes in primary and secondary motor as well as prefrontal regions, unilateral tDCS affected prefrontal, parietal, and cerebellar areas. No direct effect was seen under the stimulating electrode in the unilateral condition. The time course of changes in functional connectivity in the respective brain areas was nonlinear and temporally dispersed. These findings provide evidence toward a network-based understanding regarding the underpinnings of specific tDCS interventions. PMID:22993265

  5. Weighing the Cost and Benefit of Transcranial Direct Current Stimulation on Different Reading Subskills.

    PubMed

    Younger, Jessica W; Randazzo Wagner, Melissa; Booth, James R

    2016-01-01

    Adults struggling with low reading skills are underserved by limited available treatments. While brain stimulation techniques such as transcranial direct current stimulation (tDCS) has the potential to improve a variety of cognitive functions, little work has been done examining its potential to treat reading disabilities. Research on the effects of tDCS on reading abilities has been somewhat inconsistent perhaps in part due to discrepancies between studies in the nature of the tasks. In the current study, we examined the effect of tDCS to the left inferior parietal lobe (L IPL) on two reading tasks in low-to-average readers. We compared performance on a sight word efficiency (SWE) task and a rhyme judgment task before and after either stimulation to the L IPL, right superior parietal lobe (R SPL), or sham stimulation. Readers who received stimulation to the L IPL showed greater improvements on the SWE task, but less improvement on the rhyme judgment task compared to the R SPL and sham groups. This study demonstrates for the first time both a positive and negative effect of stimulation under the same stimulation parameters within the same participants. The results highlight the need to consider multiple tasks when assessing the potential of using tDCS as a treatment. PMID:27375421

  6. Weighing the Cost and Benefit of Transcranial Direct Current Stimulation on Different Reading Subskills

    PubMed Central

    Younger, Jessica W.; Randazzo Wagner, Melissa; Booth, James R.

    2016-01-01

    Adults struggling with low reading skills are underserved by limited available treatments. While brain stimulation techniques such as transcranial direct current stimulation (tDCS) has the potential to improve a variety of cognitive functions, little work has been done examining its potential to treat reading disabilities. Research on the effects of tDCS on reading abilities has been somewhat inconsistent perhaps in part due to discrepancies between studies in the nature of the tasks. In the current study, we examined the effect of tDCS to the left inferior parietal lobe (L IPL) on two reading tasks in low-to-average readers. We compared performance on a sight word efficiency (SWE) task and a rhyme judgment task before and after either stimulation to the L IPL, right superior parietal lobe (R SPL), or sham stimulation. Readers who received stimulation to the L IPL showed greater improvements on the SWE task, but less improvement on the rhyme judgment task compared to the R SPL and sham groups. This study demonstrates for the first time both a positive and negative effect of stimulation under the same stimulation parameters within the same participants. The results highlight the need to consider multiple tasks when assessing the potential of using tDCS as a treatment. PMID:27375421

  7. The contribution of interindividual factors to variability of response in transcranial direct current stimulation studies

    PubMed Central

    Li, Lucia M.; Uehara, Kazumasa; Hanakawa, Takashi

    2015-01-01

    There has been an explosion of research using transcranial direct current stimulation (tDCS) for investigating and modulating human cognitive and motor function in healthy populations. It has also been used in many studies seeking to improve deficits in disease populations. With the slew of studies reporting “promising results” for everything from motor recovery after stroke to boosting memory function, one could be easily seduced by the idea of tDCS being the next panacea for all neurological ills. However, huge variability exists in the reported effects of tDCS, with great variability in the effect sizes and even contradictory results reported. In this review, we consider the interindividual factors that may contribute to this variability. In particular, we discuss the importance of baseline neuronal state and features, anatomy, age and the inherent variability in the injured brain. We additionally consider how interindividual variability affects the results of motor-evoked potential (MEP) testing with transcranial magnetic stimulation (TMS), which, in turn, can lead to apparent variability in response to tDCS in motor studies. PMID:26029052

  8. Inspiratory resistances facilitate the diaphragm response to transcranial stimulation in humans

    PubMed Central

    Locher, Chrystèle; Raux, Mathieu; Fiamma, Marie-Noelle; Morélot-Panzini, Capucine; Zelter, Marc; Derenne, Jean-Philippe; Similowski, Thomas; Straus, Christian

    2006-01-01

    Background Breathing in humans is dually controlled for metabolic (brainstem commands) and behavioral purposes (suprapontine commands) with reciprocal modulation through spinal integration. Whereas the ventilatory response to chemical stimuli arises from the brainstem, the compensation of mechanical loads in awake humans is thought to involve suprapontine mechanisms. The aim of this study was to test this hypothesis by examining the effects of inspiratory resistive loading on the response of the diaphragm to transcranial magnetic stimulation. Results Six healthy volunteers breathed room air without load (R0) and then against inspiratory resistances (5 and 20 cmH2O/L/s, R5 and R20). Ventilatory variables were recorded. Transcranial magnetic stimulation (TMS) was performed during early inspiration (I) or late expiration (E), giving rise to motor evoked potentials (MEPs) in the diaphragm (Di) and abductor pollicis brevis (APB). Breathing frequency significantly decreased during R20 without any other change. Resistive breathing had no effect on the amplitude of Di MEPs, but shortened their latency (R20: -0.903 ms, p = 0.03) when TMS was superimposed on inspiration. There was no change in APB MEPs. Conclusion Inspiratory resistive breathing facilitates the diaphragm response to TMS while it does not increase the automatic drive to breathe. We interpret these findings as a neurophysiological substratum of the suprapontine nature of inspiratory load compensation in awake humans. PMID:16875504

  9. Modulation of Cortical Inhibitory Circuits after Cathodal Transcranial Direct Current Stimulation over the Primary Motor Cortex

    PubMed Central

    Sasaki, Ryoki; Miyaguchi, Shota; Kotan, Shinichi; Kojima, Sho; Kirimoto, Hikari; Onishi, Hideaki

    2016-01-01

    Here, we aimed to evaluate whether cathodal transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) and primary somatosensory cortex (S1) can modulate cortical inhibitory circuits. Sixteen healthy subjects participated in this study. Cathodal tDCS was positioned over the left M1 (M1 cathodal) or left S1 (S1 cathodal) with an intensity of 1 mA for 10 min. Sham tDCS was applied for 10 min over the left M1 (sham). Motor evoked potentials (MEPs) elicited by transcranial magnetic stimulation (TMS) were recorded from the right abductor pollicis brevis (APB) muscle before the intervention (pre) and 10 and 30 min after the intervention (post 1 and post 2, respectively). Cortical inhibitory circuits were evaluated using short-interval intracortical inhibition (SICI) and short-latency afferent inhibition (SAI). M1 cathodal decreased single-pulse MEP amplitudes at post 1 and decreased SAI at post 1 and post 2; however, SICI did not exhibit any change. S1 cathodal and sham did not show any changes in MEP amplitudes at any of the three time points. These results demonstrated that cathodal tDCS over the M1 not only decreases the M1 excitability but also affects the cortical inhibitory circuits related to SAI. PMID:26869909

  10. Different Current Intensities of Anodal Transcranial Direct Current Stimulation Do Not Differentially Modulate Motor Cortex Plasticity

    PubMed Central

    Kidgell, Dawson J.; Daly, Robin M.; Young, Kayleigh; Lum, Jarrod; Tooley, Gregory; Jaberzadeh, Shapour; Zoghi, Maryam; Pearce, Alan J.

    2013-01-01

    Transcranial direct current stimulation (tDCS) is a noninvasive technique that modulates the excitability of neurons within the motor cortex (M1). Although the aftereffects of anodal tDCS on modulating cortical excitability have been described, there is limited data describing the outcomes of different tDCS intensities on intracortical circuits. To further elucidate the mechanisms underlying the aftereffects of M1 excitability following anodal tDCS, we used transcranial magnetic stimulation (TMS) to examine the effect of different intensities on cortical excitability and short-interval intracortical inhibition (SICI). Using a randomized, counterbalanced, crossover design, with a one-week wash-out period, 14 participants (6 females and 8 males, 22–45 years) were exposed to 10 minutes of anodal tDCS at 0.8, 1.0, and 1.2 mA. TMS was used to measure M1 excitability and SICI of the contralateral wrist extensor muscle at baseline, immediately after and 15 and 30 minutes following cessation of anodal tDCS. Cortical excitability increased, whilst SICI was reduced at all time points following anodal tDCS. Interestingly, there were no differences between the three intensities of anodal tDCS on modulating cortical excitability or SICI. These results suggest that the aftereffect of anodal tDCS on facilitating cortical excitability is due to the modulation of synaptic mechanisms associated with long-term potentiation and is not influenced by different tDCS intensities. PMID:23577272

  11. Studying Effects of Transcranial Alternating Current Stimulation on Hearing and Auditory Scene Analysis.

    PubMed

    Riecke, Lars

    2016-01-01

    Recent studies have shown that perceptual detection of near-threshold auditory events may depend on the relative timing of the event and ongoing brain oscillations. Furthermore, transcranial alternating current stimulation (tACS), a non-invasive and silent brain stimulation technique, can entrain cortical alpha oscillations and thereby provide some experimental control over their timing. The present research investigates the potential of delta/theta-tACS to modulate hearing and auditory scene analysis. Detection of near-threshold auditory stimuli, which are modulated at 4 Hz and presented at various moments (phase lags) during ongoing tACS (two synchronous 4-Hz alternating currents applied transcranially to the two cerebral hemispheres), is measured in silence or in a masker. Results indicate that performance fluctuates as a function of phase lag and these fluctuations can be explained best by a sinusoid at the tACS frequency. This suggests that tACS may amplify/attenuate sounds that are temporally coherent/anticoherent with tACS-entrained cortical oscillations. PMID:27080678

  12. Spontaneously Fluctuating Motor Cortex Excitability in Alternating Hemiplegia of Childhood: A Transcranial Magnetic Stimulation Study

    PubMed Central

    Stern, William M.; Desikan, Mahalekshmi; Hoad, Damon; Jaffer, Fatima; Strigaro, Gionata; Sander, Josemir W.; Rothwell, John C.; Sisodiya, Sanjay M.

    2016-01-01

    Background Alternating hemiplegia of childhood is a very rare and serious neurodevelopmental syndrome; its genetic basis has recently been established. Its characteristic features include typically-unprovoked episodes of hemiplegia and other transient or more persistent neurological abnormalities. Methods We used transcranial magnetic stimulation to assess the effect of the condition on motor cortex neurophysiology both during and between attacks of hemiplegia. Nine people with alternating hemiplegia of childhood were recruited; eight were successfully tested using transcranial magnetic stimulation to study motor cortex excitability, using single and paired pulse paradigms. For comparison, data from ten people with epilepsy but not alternating hemiplegia, and ten healthy controls, were used. Results One person with alternating hemiplegia tested during the onset of a hemiplegic attack showed progressively diminishing motor cortex excitability until no response could be evoked; a second person tested during a prolonged bilateral hemiplegic attack showed unusually low excitability. Three people tested between attacks showed asymptomatic variation in cortical excitability, not seen in controls. Paired pulse paradigms, which probe intracortical inhibitory and excitatory circuits, gave results similar to controls. Conclusions We report symptomatic and asymptomatic fluctuations in motor cortex excitability in people with alternating hemiplegia of childhood, not seen in controls. We propose that such fluctuations underlie hemiplegic attacks, and speculate that the asymptomatic fluctuation we detected may be useful as a biomarker for disease activity. PMID:26999520

  13. Transcranial electrical brain stimulation modulates neuronal tuning curves in perception of numerosity and duration

    PubMed Central

    Javadi, Amir Homayoun; Brunec, Iva K.; Walsh, Vincent; Penny, Will D.; Spiers, Hugo J.

    2014-01-01

    Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation method with many putative applications and reported to effectively modulate behaviour. However, its effects have yet to be considered at a computational level. To address this we modelled the tuning curves underlying the behavioural effects of stimulation in a perceptual task. Participants judged which of the two serially presented images contained more items (numerosity judgement task) or was presented longer (duration judgement task). During presentation of the second image their posterior parietal cortices (PPCs) were stimulated bilaterally with opposite polarities for 1.6 s. We also examined the impact of three stimulation conditions on behaviour: anodal right-PPC and cathodal left-PPC (rA-lC), reverse order (lA-rC) and no-stimulation condition. Behavioural results showed that participants were more accurate in numerosity and duration judgement tasks when they were stimulated with lA-rC and rA-lC stimulation conditions respectively. Simultaneously, a decrease in performance on numerosity and duration judgement tasks was observed when the stimulation condition favoured the other task. Thus, our results revealed a double-dissociation of laterality and task. Importantly, we were able to model the effects of stimulation on behaviour. Our computational modelling showed that participants' superior performance was attributable to a narrower tuning curve — smaller standard deviation of detection noise. We believe that this approach may prove useful in understanding the impact of brain stimulation on other cognitive domains. PMID:25130301

  14. Transcranial direct current stimulation reverses neurophysiological and behavioural effects of focal inhibition of human pharyngeal motor cortex on swallowing

    PubMed Central

    Vasant, Dipesh H; Mistry, Satish; Michou, Emilia; Jefferson, Samantha; Rothwell, John C; Hamdy, Shaheen

    2014-01-01

    The human cortical swallowing system exhibits bilateral but functionally asymmetric representation in health and disease as evidenced by both focal cortical inhibition (pre-conditioning with 1 Hz repetitive transcranial magnetic stimulation; rTMS) and unilateral stroke, where disruption of the stronger (dominant) pharyngeal projection alters swallowing neurophysiology and behaviour. Moreover, excitatory neurostimulation protocols capable of reversing the disruptive effects of focal cortical inhibition have demonstrated therapeutic promise in post-stroke dysphagia when applied contralaterally. In healthy participants (n = 15, 8 males, mean age (±SEM) 35 ± 9 years), optimal parameters of transcranial direct current stimulation (tDCS) (anodal, 1.5 mA, 10 min) were applied contralaterally after 1 Hz rTMS pre-conditioning to the strongest pharyngeal projection. Swallowing neurophysiology was assessed in both hemispheres by intraluminal recordings of pharyngeal motor-evoked responses (PMEPs) to single-pulse TMS as a measure of cortical excitability. Swallowing behaviour was examined using a pressure-based reaction time protocol. Measurements were made before and for up to 60 min post intervention. Subjects were randomised to active or sham tDCS after 1 Hz rTMS on separate days and data were compared using repeated measures ANOVA. Active tDCS increased PMEPs bilaterally (F1,14 = 7.4, P = 0.017) reversing the inhibitory effects of 1 Hz rTMS in the pre-conditioned hemisphere (F1,14 = 10.1, P = 0.007). Active tDCS also enhanced swallowing behaviour, increasing the number of correctly timed challenge swallows compared to sham (F1,14 = 6.3, P = 0.025). Thus, tDCS to the contralateral pharyngeal motor cortex reverses the neurophysiological and behavioural effects of focal cortical inhibition on swallowing in healthy individuals and has therapeutic potential for dysphagia rehabilitation. PMID:24247983

  15. Targeting the neurophysiology of cognitive systems with transcranial alternating current stimulation (tACS)

    PubMed Central

    Fröhlich, Flavio; Sellers, Kristin K.; Cordle, Asa L.

    2015-01-01

    Cognitive impairment represents one of the most debilitating and most difficult symptom to treat of many psychiatric illnesses. Human neurophysiology studies have suggested specific pathologies of cortical network activity correlate with cognitive impairment. However, we lack (1) demonstration of causal relationships between specific network activity patterns and cognitive capabilities and (2) treatment modalities that directly target impaired network dynamics of cognition. Transcranial alternating current stimulation (tACS), a novel non-invasive brain stimulation approach, may provide a crucial tool to tackle these challenges. We here propose that tACS can be used to elucidate the causal role of cortical synchronization in cognition and, eventually, to enhance pathologically weakened synchrony that may underlie cognitive deficits. To accelerate such development of tACS as a treatment for cognitive deficits, we discuss studies on tACS and cognition (all performed in healthy participants) according to the Research Domain Criteria (RDoC) of the National Institute of Mental Health. PMID:25547149

  16. The Ferrier Lecture 2004 What can transcranial magnetic stimulation tell us about how the brain works?

    PubMed Central

    Cowey, Alan

    2005-01-01

    Transcranial magnetic stimulation (TMS) is a technique whereby parts of the cerebral cortex and underlying white matter can be excited by a brief electrical current induced by a similarly brief, rapidly fluctuating magnetic field which is itself produced by rapidly discharging a current through an insulated coil held against the scalp. When combined with magnetic resonance structural and functional images of the subject's brain, the stimulation can be directed at specific cortical areas. Over a period of only 15 years, TMS has revealed hitherto unsuspected aspects of brain function, such as the role of distant parts of the brain in recovery from stroke, and has helped to resolve several previously intractable disputes, such as the neuronal basis of conscious awareness. This article describes and discusses the origins and nature of TMS, its applications and limitations, and its especial usefulness in conjunction with other techniques of evaluating or imaging brain activity. PMID:16147516

  17. Transcranial direct current stimulation of the motor cortex in waking resting state induces motor imagery.

    PubMed

    Speth, Jana; Speth, Clemens; Harley, Trevor A

    2015-11-01

    This study investigates if anodal and cathodal transcranial direct current stimulation (tDCS) of areas above the motor cortex (C3) influences spontaneous motor imagery experienced in the waking resting state. A randomized triple-blinded design was used, combining neurophysiological techniques with tools of quantitative mentation report analysis from cognitive linguistics. The results indicate that while spontaneous motor imagery rarely occurs under sham stimulation, general and athletic motor imagery (classified as athletic disciplines), is induced by anodal tDCS. This insight may have implications beyond basic consciousness research. Motor imagery and corresponding motor cortical activation have been shown to benefit later motor performance. Electrophysiological manipulations of motor imagery could in the long run be used for rehabilitative tDCS protocols benefitting temporarily immobile clinical patients who cannot perform specific motor imagery tasks - such as dementia patients, infants with developmental and motor disorders, and coma patients. PMID:26204566

  18. A practical guide to diagnostic transcranial magnetic stimulation: Report of an IFCN committee

    PubMed Central

    Groppa, S.; Oliviero, A.; Eisen, A.; Quartarone, A.; Cohen, L.G.; Mall, V.; Kaelin-Lang, A.; Mima, T.; Rossi, S.; Thickbroom, G.W.; Rossini, P.M.; Ziemann, U.; Valls-Solé, J.; Siebner, H.R.

    2016-01-01

    Transcranial magnetic stimulation (TMS) is an established neurophysiological tool to examine the integrity of the fast-conducting corticomotor pathways in a wide range of diseases associated with motor dysfunction. This includes but is not limited to patients with multiple sclerosis, amyotrophic lateral sclerosis, stroke, movement disorders, disorders affecting the spinal cord, facial and other cranial nerves. These guidelines cover practical aspects of TMS in a clinical setting. We first discuss the technical and physiological aspects of TMS that are relevant for the diagnostic use of TMS. We then lay out the general principles that apply to a standardized clinical examination of the fast-conducting corticomotor pathways with single-pulse TMS. This is followed by a detailed description of how to examine corticomotor conduction to the hand, leg, trunk and facial muscles in patients. Additional sections cover safety issues, the triple stimulation technique, and neuropediatric aspects of TMS. PMID:22349304

  19. Transcranial magnetic stimulation-induced 'visual echoes' are generated in early visual cortex.

    PubMed

    Jolij, Jacob; Lamme, Victor A F

    2010-11-01

    Transcranial magnetic stimulation (TMS) of the early visual areas can trigger perception of a flash of light, a so-called phosphene. Here we show that a very brief presentation of a stimulus can modulate features of a subsequent TMS-induced phosphene, to a level that participants mistake phosphenes for real stimuli, inducing 'visual echoes' of a previously seen stimulus. These 'echoes' are modulated by visual context at the moment of magnetic stimulation, showing that they are generated in early visual areas, and that the brain processes these 'echoes' as if they are factually presented stimuli. This shows that TMS can re-activate weak visual representations in early visual areas. Based on the pattern of contextual modulation of visual echoes, we theorize that perception of these echoes is not a passive reactivation of residual activity in early visual cortex, but an active interpretation of the combined activity of TMS-induced neural noise and cortical state. PMID:20732388

  20. Methodological Dimensions of Transcranial Brain Stimulation with the Electrical Current in Human

    PubMed Central

    Rostami, Maryam; Golesorkhi, Mehrshad; Ekhtiari, Hamed

    2013-01-01

    Transcranial current stimulation (TCS) is a neuromodulation method in which the patient is exposed to a mild electric current (direct or alternating) at 1-2 mA, resulting in an increase or a decrease in the brain excitability. This modification in neural activities can be used as a method for functional human brain mapping with causal inferences. This method might also facilitate the treatments of many neuropsychiatric disorders based on its inexpensive, simple, safe, noninvasive, painless, semi-focal excitatory and inhibitory effects. Given this, a comparison amongst different brain stimulation modalities has been made to determine the potential advantages of the TCS method. In addition, considerable methodological details on using TCS in basic and clinical neuroscience studies in human subjects have been introduced. Technical characteristics of TCS devices and their related accessories with regard to safety concerns have also been well articulated. Finally, some TCS application opportunities have been emphasized, including its potential use in the near future. PMID:25337348

  1. A Novel Transcranial Magnetic Stimulator Inducing Near Rectangular Pulses with Controllable Pulse Width (cTMS)

    PubMed Central

    Jalinous, Reza; Lisanby, Sarah H.

    2013-01-01

    A novel transcranial magnetic stimulation (TMS) device with controllable pulse width (PW) and near rectangular pulse shape (cTMS) is described. The cTMS device uses an insulated gate bipolar transistor (IGBT) with appropriate snubbers to switch coil currents up to 7 kA, enabling PW control from 5 μs to over 100 μs. The near-rectangular induced electric field pulses use 22–34% less energy and generate 67–72% less coil heating compared to matched conventional cosine pulses. CTMS is used to stimulate rhesus monkey motor cortex in vivo with PWs of 20 to 100 μs, demonstrating the expected decrease of threshold pulse amplitude with increasing PW. The technological solutions used in the cTMS prototype can expand functionality, and reduce power consumption and coil heating in TMS, enhancing its research and therapeutic applications. PMID:18232369

  2. A transcranial magnetic stimulator inducing near-rectangular pulses with controllable pulse width (cTMS).

    PubMed

    Peterchev, Angel V; Jalinous, Reza; Lisanby, Sarah H

    2008-01-01

    A novel transcranial magnetic stimulation (TMS) device with controllable pulse width (PW) and near-rectangular pulse shape (cTMS) is described. The cTMS device uses an insulated gate bipolar transistor (IGBT) with appropriate snubbers to switch coil currents up to 6 kA, enabling PW control from 5 micros to over 100 micros. The near-rectangular induced electric field pulses use 2%-34% less energy and generate 67%-72% less coil heating compared to matched conventional cosine pulses. CTMS is used to stimulate rhesus monkey motor cortex in vivo with PWs of 20 to 100 micros, demonstrating the expected decrease of threshold pulse amplitude with increasing PW. The technological solutions used in the cTMS prototype can expand functionality, and reduce power consumption and coil heating in TMS, enhancing its research and therapeutic applications. PMID:18232369

  3. An integrated framework for targeting functional networks via transcranial magnetic stimulation.

    PubMed

    Opitz, Alexander; Fox, Michael D; Craddock, R Cameron; Colcombe, Stan; Milham, Michael P

    2016-02-15

    Transcranial magnetic stimulation (TMS) is a powerful investigational tool for in vivo manipulation of regional or network activity, with a growing number of potential clinical applications. Unfortunately, the vast majority of targeting strategies remain limited by their reliance on non-realistic brain models and assumptions that anatomo-functional relationships are 1:1. Here, we present an integrated framework that combines anatomically realistic finite element models of the human head with resting functional MRI to predict functional networks targeted via TMS at a given coil location and orientation. Using data from the Human Connectome Project, we provide an example implementation focused on dorsolateral prefrontal cortex (DLPFC). Three distinct DLPFC stimulation zones were identified, differing with respect to the network to be affected (default, frontoparietal) and sensitivity to coil orientation. Network profiles generated for DLPFC targets previously published for treating depression revealed substantial variability across studies, highlighting a potentially critical technical issue. PMID:26608241

  4. Does Transcranial Direct Current Stimulation Improve Healthy Working Memory?: A Meta-analytic Review.

    PubMed

    Mancuso, Lauren E; Ilieva, Irena P; Hamilton, Roy H; Farah, Martha J

    2016-08-01

    Transcranial direct current stimulation (tDCS) has been reported to improve working memory (WM) performance in healthy individuals, suggesting its value as a means of cognitive enhancement. However, recent meta-analyses concluded that tDCS has little or no effect on WM in healthy participants. In this article, we review reasons why these meta-analyses may have underestimated the effect of tDCS on WM and report a more comprehensive and arguably more sensitive meta-analysis. Consistent with our interest in enhancement, we focused on anodal stimulation. Thirty-one articles matched inclusion criteria and were included in four primary meta-analyses assessing the WM effects of anodal stimulation over the left and right dorsolateral pFC (DLPFC) and right parietal lobe as well as left DLPFC stimulation coupled with WM training. These analyses revealed a small but significant effect of left DLPFC stimulation coupled with WM training. Left DLPFC stimulation alone also enhanced WM performance, but the effect was reduced to nonsignificance after correction for publication bias. No other effects were significant, including a variety of tested moderators. Additional meta-analyses were undertaken with study selection criteria based on previous meta-analyses, to reassess the findings from these studies using the analytic methods of this study. These analyses revealed a mix of significant and nonsignificant small effects. We conclude that the primary WM enhancement potential of tDCS probably lies in its use during training. PMID:27054400

  5. Transcranial direct current stimulation over posterior parietal cortex modulates visuospatial localization

    PubMed Central

    Wright, Jessica M.; Krekelberg, Bart

    2014-01-01

    Visual localization is based on the complex interplay of bottom-up and top-down processing. Based on previous work, the posterior parietal cortex (PPC) is assumed to play an essential role in this interplay. In this study, we investigated the causal role of the PPC in visual localization. Specifically, our goal was to determine whether modulation of the PPC via transcranial direct current stimulation (tDCS) could induce visual mislocalization similar to that induced by an exogenous attentional cue (Wright, Morris, & Krekelberg, 2011). We placed one stimulation electrode over the right PPC and the other over the left PPC (dual tDCS) and varied the polarity of the stimulation. We found that this manipulation altered visual localization; this supports the causal involvement of the PPC in visual localization. Notably, mislocalization was more rightward when the cathode was placed over the right PPC than when the anode was placed over the right PPC. This mislocalization was found within a few minutes of stimulation onset, it dissipated during stimulation, but then resurfaced after stimulation offset and lasted for another 10–15 min. On the assumption that excitability is reduced beneath the cathode and increased beneath the anode, these findings support the view that each hemisphere biases processing to the contralateral hemifield and that the balance of activation between the hemispheres contributes to position perception (Kinsbourne, 1977; Szczepanski, Konen, & Kastner, 2010). PMID:25104830

  6. From amusic to musical?--Improving pitch memory in congenital amusia with transcranial alternating current stimulation.

    PubMed

    Schaal, Nora K; Pfeifer, Jasmin; Krause, Vanessa; Pollok, Bettina

    2015-11-01

    Brain imaging studies highlighted structural differences in congenital amusia, a life-long perceptual disorder that is associated with pitch perception and pitch memory deficits. A functional anomaly characterized by decreased low gamma oscillations (30-40 Hz range) in the right dorsolateral prefrontal cortex (DLPFC) during pitch memory has been revealed recently. Thus, the present study investigates whether applying transcranial alternating current stimulation (tACS) at 35 Hz to the right DLPFC would improve pitch memory. Nine amusics took part in two tACS sessions (either 35 Hz or 90 Hz) and completed a pitch and visual memory task before and during stimulation. 35 Hz stimulation facilitated pitch memory significantly. No modulation effects were found with 90 Hz stimulation or on the visual task. While amusics showed a selective impairment of pitch memory before stimulation, the performance during 35 Hz stimulation was not significantly different to healthy controls anymore. Taken together, the study shows that modulating the right DLPFC with 35 Hz tACS in congenital amusia selectively improves pitch memory performance supporting the hypothesis that decreased gamma oscillations within the DLPFC are causally involved in disturbed pitch memory and highlight the potential use of tACS to interact with cognitive processes. PMID:26254878

  7. Electrified emotions: Modulatory effects of transcranial direct stimulation on negative emotional reactions to social exclusion.

    PubMed

    Riva, Paolo; Romero Lauro, Leonor J; Vergallito, Alessandra; DeWall, C Nathan; Bushman, Brad J

    2015-01-01

    Social exclusion, ostracism, and rejection can be emotionally painful because they thwart the need to belong. Building on studies suggesting that the right ventrolateral prefrontal cortex (rVLPFC) is associated with regulation of negative emotions, the present experiment tests the hypothesis that decreasing the cortical excitability of the rVLPFC may increase negative emotional reactions to social exclusion. Specifically, we applied cathodal transcranial direct current stimulation (tDCS) over the rVLPFC and predicted an increment of negative emotional reactions to social exclusion. In Study 1, participants were either socially excluded or included, while cathodal tDCS or sham stimulation was applied over the rVLPFC. Cathodal stimulation of rVLPFC boosted the typical negative emotional reaction caused by social exclusion. No effects emerged from participants in the inclusion condition. To test the specificity of tDCS effects over rVLPFC, in Study 2, participants were socially excluded and received cathodal tDCS or sham stimulation over a control region (i.e., the right posterior parietal cortex). No effects of tDCS stimulation were found. Our results showed that the rVLPFC is specifically involved in emotion regulation and suggest that cathodal stimulation can increase negative emotional responses to social exclusion. PMID:25139575

  8. Phase and Frequency-Dependent Effects of Transcranial Alternating Current Stimulation on Motor Cortical Excitability.

    PubMed

    Nakazono, Hisato; Ogata, Katsuya; Kuroda, Tsuyoshi; Tobimatsu, Shozo

    2016-01-01

    Transcranial alternating current stimulation (tACS) can entrain ongoing brain oscillations and modulate the motor system in a frequency-dependent manner. Recent animal studies have demonstrated that the phase of a sinusoidal current also has an important role in modulation of neuronal activity. However, the phase effects of tACS on the human motor system are largely unknown. Here, we systematically investigated the effects of tACS phase and frequency on the primary motor cortex (M1) by using motor evoked potentials (MEPs) with transcranial magnetic stimulation (TMS). First, we compared the phase effects (90°, 180°, 270° or 360°) of 10 and 20 Hz tACS on MEPs. The 20 Hz tACS significantly increased M1 excitability compared with the 10 Hz tACS at 90° phase only. Second, we studied the 90° phase effect on MEPs at different tACS frequencies (5, 10, 20 or 40 Hz). The 20 vs. 10 Hz difference was again observed, but the 90° phase in 5 and 40 Hz tACS did not influence M1 excitability. Third, the 90° phase effects of 10 and 20 Hz tACS were compared with sham stimulation. The 90° phase of 20 Hz tACS enhanced MEP amplitudes compared with sham stimulation, but there was no significant effect of 10 Hz tACS. Taken together, we assume that the differential 90° phase effects on 20 Hz and 10 Hz tACS can be attributed to the neural synchronization modulated by tACS. Our results further underline that phase and frequency are the important factors in the effects of tACS on M1 excitability. PMID:27607431

  9. Shaping pseudoneglect with transcranial cerebellar direct current stimulation and music listening.

    PubMed

    Picazio, Silvia; Granata, Chiara; Caltagirone, Carlo; Petrosini, Laura; Oliveri, Massimiliano

    2015-01-01

    Non-invasive brain stimulation modulates cortical excitability depending on the initial activation state of the structure being stimulated. Combination of cognitive with neurophysiological stimulations has been successfully employed to modulate responses of specific brain regions. The present research combined a neurophysiological pre-conditioning with a cognitive conditioning stimulation to modulate behavior. We applied this new state-dependency approach to investigate the cerebellar role in musical and spatial information processing, given that a link between musical perception and visuo-spatial abilities and a clear cerebellar involvement in music perception and visuo-spatial tasks have been reported. Cathodal, anodal or sham transcranial cerebellar Direct Current Stimulation (tcDCS) pre-conditioning was applied on the left cerebellar hemisphere followed by conditioning stimulation through music or white noise listening in a sample of healthy subjects performing a Line Bisection Task (LBT). The combination of the cathodal stimulation with music listening resulted in a marked attentional shift toward the right hemispace, compensating thus the natural leftward bias of the baseline condition (pseudoneglect). Conversely, the anodal or sham pre-conditioning stimulations combined with either music and white noise conditioning listening did not modulate spatial attention. The efficacy of the combined stimulation (cathodal pre-conditioning and music conditioning) and the absence of any effect of the single stimulations provide a strong support to the state-dependency theory. They propose that tcDCS in combination with music listening could act as a rehabilitative tool to improve cognitive functions in the presence of neglect or other spatial disorders. PMID:25859206

  10. Transcranial alternating current stimulation increases risk-taking behavior in the balloon analog risk task.

    PubMed

    Sela, Tal; Kilim, Adi; Lavidor, Michal

    2012-01-01

    The process of evaluating risks and benefits involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC). It has been proposed that in conflict and reward situations, theta-band (4-8 Hz) oscillatory activity in the frontal cortex may reflect an electrophysiological mechanism for coordinating neural networks monitoring behavior, as well as facilitating task-specific adaptive changes. The goal of the present study was to investigate the hypothesis that theta-band oscillatory balance between right and left frontal and prefrontal regions, with a predominance role to the right hemisphere (RH), is crucial for regulatory control during decision-making under risk. In order to explore this hypothesis, we used transcranial alternating current stimulation, a novel technique that provides the opportunity to explore the functional role of neuronal oscillatory activities and to establish a causal link between specific oscillations and functional lateralization in risky decision-making situations. For this aim, healthy participants were randomly allocated to one of three stimulation groups (LH stimulation/RH stimulation/Sham stimulation), with active AC stimulation delivered in a frequency-dependent manner (at 6.5 Hz; 1 mA peak-to-peak). During the AC stimulation, participants performed the Balloon Analog Risk Task. This experiment revealed that participants receiving LH stimulation displayed riskier decision-making style compared to sham and RH stimulation groups. However, there was no difference in decision-making behaviors between sham and RH stimulation groups. The current study extends the notion that DLPFC activity is critical for adaptive decision-making in the context of risk-taking and emphasis the role of theta-band oscillatory activity during risky decision-making situations. PMID:22347844

  11. Shaping pseudoneglect with transcranial cerebellar direct current stimulation and music listening

    PubMed Central

    Picazio, Silvia; Granata, Chiara; Caltagirone, Carlo; Petrosini, Laura; Oliveri, Massimiliano

    2015-01-01

    Non-invasive brain stimulation modulates cortical excitability depending on the initial activation state of the structure being stimulated. Combination of cognitive with neurophysiological stimulations has been successfully employed to modulate responses of specific brain regions. The present research combined a neurophysiological pre-conditioning with a cognitive conditioning stimulation to modulate behavior. We applied this new state-dependency approach to investigate the cerebellar role in musical and spatial information processing, given that a link between musical perception and visuo-spatial abilities and a clear cerebellar involvement in music perception and visuo-spatial tasks have been reported. Cathodal, anodal or sham transcranial cerebellar Direct Current Stimulation (tcDCS) pre-conditioning was applied on the left cerebellar hemisphere followed by conditioning stimulation through music or white noise listening in a sample of healthy subjects performing a Line Bisection Task (LBT). The combination of the cathodal stimulation with music listening resulted in a marked attentional shift toward the right hemispace, compensating thus the natural leftward bias of the baseline condition (pseudoneglect). Conversely, the anodal or sham pre-conditioning stimulations combined with either music and white noise conditioning listening did not modulate spatial attention. The efficacy of the combined stimulation (cathodal pre-conditioning and music conditioning) and the absence of any effect of the single stimulations provide a strong support to the state-dependency theory. They propose that tcDCS in combination with music listening could act as a rehabilitative tool to improve cognitive functions in the presence of neglect or other spatial disorders. PMID:25859206

  12. Low-frequency transcranial magnetic stimulation over left dorsal premotor cortex improves the dynamic control of visuospatially cued actions

    PubMed Central

    Ward, Nick S.; Bestmann, Sven; Hartwigsen, Gesa; Weiss, Michael M.; Christensen, Lars O.D.; Frackowiak, Richard S.J.; Rothwell, John C.; Siebner, Hartwig R.

    2013-01-01

    Left rostral dorsal premotor cortex (rPMd) and supramarginal gyrus (SMG) have been implicated in the dynamic control of actions. In 12 right-handed healthy individuals we applied 30 minutes of low-frequency (1Hz) repetitive transcranial magnetic stimulation (rTMS) over left rPMd to investigate the involvement of left rPMd and SMG in the rapid adjustment of actions guided by visuospatial cues. After rTMS, subjects underwent functional magnetic resonance imaging while making spatially congruent button presses with right or left index finger in response to a left- or right-sided target. Subjects were asked to covertly prepare motor responses as indicated by a directional cue presented one second before the target. On 20% of trials the cue was invalid requiring subjects to re-adjust their motor plan according to the target location. Compared to sham rTMS, real rTMS increased the number of correct responses in invalidly cued trials. After real rTMS, task-related activity of the stimulated left rPMd showed increased task-related coupling with activity in ipsilateral SMG and adjacent anterior intraparietal area (AIP). Individuals who showed a stronger increase in left-hemispheric premotor-parietal connectivity also made fewer errors on invalidly cued trials after rTMS. The results suggest that rTMS over left rPMd improved the ability to dynamically adjust visuospatial response mapping by strengthening left-hemispheric connectivity between rPMd and the SMG-AIP region. These results support the notion that left rPMd and SMG-AIP contribute towards dynamic control of actions, and demonstrate that low-frequency rTMS can enhance functional coupling between task-relevant brain regions and improve some aspects of motor performance. PMID:20610756

  13. Beta-frequency EEG activity increased during transcranial direct current stimulation.

    PubMed

    Song, Myeongseop; Shin, Yungjae; Yun, Kyongsik

    2014-12-17

    Transcranial direct current stimulation (tDCS) is a technique for noninvasively stimulating specific cortical regions of the brain with small (<2 mA) and constant direct current on the scalp. tDCS has been widely applied, not only for medical treatment, but also for cognitive and somatosensory function enhancement, motor learning improvement, and social behavioral change. However, the mechanism that underlies the effect of tDCS is unclear. In this study, we performed simultaneous electroencephalogram (EEG) monitoring during tDCS to understand the dynamic electrophysiological changes throughout the stimulation. A total of 10 healthy individuals participated in this experiment. We recorded EEGs with direct current stimulation, as well as during a 5-min resting state before and after the stimulation. All participants kept their eyes closed during the experiment. Anode and cathode patches of tDCS were placed on the left and the right dorsolateral prefrontal cortex, respectively. In addition, an EEG electrode was placed on the medial prefrontal cortex. The beta-frequency power increased promptly after starting the stimulation. The significant beta-power increase was maintained during the stimulation. Other frequency bands did not show any significant changes. The results indicate that tDCS of the left dorsolateral prefrontal cortex changed the brain to a ready state for efficient cognitive functioning by increasing the beta-frequency power. This is the first attempt to simultaneously stimulate the cortex and record the EEG and then systematically analyze the prestimulation, during-stimulation, and poststimulation EEG data. PMID:25383460

  14. Transcranial direct current stimulation (tDCS): does it have merit in stroke rehabilitation? A systematic review.

    PubMed

    Marquez, Jodie; van Vliet, Paulette; McElduff, Patrick; Lagopoulos, Jim; Parsons, Mark

    2015-04-01

    Transcranial direct current stimulation has been gaining increasing interest as a potential therapeutic treatment in stroke recovery. We performed a systematic review with meta-analysis of randomized controlled trials to collate the available evidence in adults with residual motor impairments as a result of stroke. The primary outcome was change in motor function or impairment as a result of transcranial direct current stimulation, using any reported electrode montage, with or without adjunct physical therapy. The search yielded 15 relevant studies comprising 315 subjects. Compared with sham, cortical stimulation did not produce statistically significant improvements in motor performance when measured immediately after the intervention (anodal stimulation: facilitation of the affected cortex: standardized mean difference = 0.05, P = 0.71; cathodal stimulation: inhibition of the nonaffected cortex: standardized mean difference = 0.39, P = 0.08; bihemispheric stimulation: standardized mean difference = 0.24, P = 0.39). When the data were analyzed according to stroke characteristics, statistically significant improvements were evident for those with chronic stroke (standardized mean difference = 0.45, P = 0.01) and subjects with mild-to-moderate stroke impairments (standardized mean difference = 0.37, P = 0.02). Transcranial direct current stimulation is likely to be effective in enhancing motor performance in the short term when applied selectively to patients with stroke. Given the range of stimulation variables and heterogeneous nature of stroke, this modality is still experimental and further research is required to determine its clinical merit in stroke rehabilitation. PMID:24148111

  15. Task-Specific Facilitation of Cognition by Anodal Transcranial Direct Current Stimulation of the Prefrontal Cortex.

    PubMed

    Pope, Paul A; Brenton, Jonathan W; Miall, R Chris

    2015-11-01

    We previously speculated that depression of cerebellar excitability using cathodal transcranial direct current stimulation (tDCS) might release extra cognitive resources via the disinhibition of activity in prefrontal cortex. The objective of the present study was to investigate whether anodal tDCS over the prefrontal cortex could similarly improve performance when cognitive demands are high. Sixty-three right-handed participants in 3 separate groups performed the Paced Auditory Serial Addition Task (PASAT) and the more difficult Paced Auditory Serial Subtraction Task (PASST), before and after 20 min of anodal, cathodal, or sham stimulation over the left dorsolateral prefrontal cortex (DLPFC). Performance was assessed in terms of the accuracy, latency, and variability of correct verbal responses. All behavioral measures significantly improved for the PASST after anodal DLPFC stimulation, but not the PASAT. There were smaller practice effects after cathodal and sham stimulation. Subjective ratings of attention and mental fatigue were unchanged by tDCS over time. We conclude that anodal stimulation over the left DLPFC can selectively improve performance on a difficult cognitive task involving arithmetic processing, verbal working memory, and attention. This result might be achieved by focally improving executive functions and/or cognitive capacity when tasks are difficult, rather than by improving levels of arousal/alertness. PMID:25979089

  16. Polarity Specific Suppression Effects of Transcranial Direct Current Stimulation for Tinnitus

    PubMed Central

    Van de Heyning, Paul; Vanneste, Sven

    2014-01-01

    Tinnitus is the perception of a sound in the absence of an external auditory stimulus and affects 10–15% of the Western population. Previous studies have demonstrated the therapeutic effect of anodal transcranial direct current stimulation (tDCS) over the left auditory cortex on tinnitus loudness, but the effect of this presumed excitatory stimulation contradicts with the underlying pathophysiological model of tinnitus. Therefore, we included 175 patients with chronic tinnitus to study polarity specific effects of a single tDCS session over the auditory cortex (39 anodal, 136 cathodal). To assess the effect of treatment, we used the numeric rating scale for tinnitus loudness and annoyance. Statistical analysis demonstrated a significant main effect for tinnitus loudness and annoyance, but for tinnitus annoyance anodal stimulation has a significantly more pronounced effect than cathodal stimulation. We hypothesize that the suppressive effect of tDCS on tinnitus loudness may be attributed to a disrupting effect of ongoing neural hyperactivity, independent of the inhibitory or excitatory effects and that the reduction of annoyance may be induced by influencing adjacent or functionally connected brain areas involved in the tinnitus related distress network. Further research is required to explain why only anodal stimulation has a suppressive effect on tinnitus annoyance. PMID:24812586

  17. Reducing aggressive responses to social exclusion using transcranial direct current stimulation.

    PubMed

    Riva, Paolo; Romero Lauro, Leonor J; DeWall, C Nathan; Chester, David S; Bushman, Brad J

    2015-03-01

    A vast body of research showed that social exclusion can trigger aggression. However, the neural mechanisms involved in regulating aggressive responses to social exclusion are still largely unknown. Transcranial direct current stimulation (tDCS) modulates the excitability of a target region. Building on studies suggesting that activity in the right ventrolateral pre-frontal cortex (rVLPFC) might aid the regulation or inhibition of social exclusion-related distress, we hypothesized that non-invasive brain polarization through tDCS over the rVLPFC would reduce behavioral aggression following social exclusion. Participants were socially excluded or included while they received tDCS or sham stimulation to the rVLPFC. Next, they received an opportunity to aggress. Excluded participants demonstrated cognitive awareness of their inclusionary status, yet tDCS (but not sham stimulation) reduced their behavioral aggression. Excluded participants who received tDCS stimulation were no more aggressive than included participants. tDCS stimulation did not influence socially included participants' aggression. Our findings provide the first causal test for the role of rVLPFC in modulating aggressive responses to social exclusion. Our findings suggest that modulating activity in a brain area (i.e. the rVLPFC) implicated in self-control and emotion regulation can break the link between social exclusion and aggression. PMID:24748546

  18. Improved reading measures in adults with dyslexia following transcranial direct current stimulation treatment.

    PubMed

    Heth, Inbahl; Lavidor, Michal

    2015-04-01

    To better understand the contribution of the dorsal system to word reading, we explored transcranial direct current stimulation (tDCS) effects when adults with developmental dyslexia received active stimulation over the visual extrastriate area MT/V5, which is dominated by magnocellular input. Stimulation was administered in 5 sessions spread over two weeks, and reading speed and accuracy as well as reading fluency were assessed before, immediately after, and a week after the end of the treatment. A control group of adults with developmental dyslexia matched for age, gender, reading level, vocabulary and block-design WAIS-III sub-tests and reading level was exposed to the same protocol but with sham stimulation. The results revealed that active, but not sham stimulation, significantly improved reading speed and fluency. This finding suggests that the dorsal stream may play a role in efficient retrieval from the orthographic input lexicon in the lexical route. It also underscores the potential of tDCS as an intervention tool for improving reading speed, at least in adults with developmental dyslexia. PMID:25701796

  19. Computational analysis shows why transcranial alternating current stimulation induces retinal phosphenes

    NASA Astrophysics Data System (ADS)

    Laakso, Ilkka; Hirata, Akimasa

    2013-08-01

    Objective. Transcranial alternating current stimulation (tACS), which is a novel technique for the manipulation of cortical oscillations, can generate subjective visual sensations (phosphenes). In this work, we computationally investigate the current that reaches the eyes from tACS electrodes in order to show that phosphenes induced by tACS are retinal in origin. Approach. The finite-element method is used for modelling the path of the current in an anatomically realistic model of the head for various electrode montages. The computational results are used for analysing previous experimental data to investigate the sensitivity of the eye to electrical stimulation. Main results. Depending on the locations of both the stimulating and reference electrodes, a small portion of the stimulation current chooses a path that goes through the eyes. Due to the sensitivity of the retina to electrical stimulation, even distant electrodes can produce a sufficiently strong current at the eyes for inducing retinal phosphenes. Significance. The interference from retinal phosphenes needs to be considered in the design of tACS experiments. The occurrence of phosphenes can be reduced by optimizing the locations of the electrodes, or potentially increasing the number of reference electrodes to two or more. Computational modelling is an effective tool for guiding the electrode positioning.

  20. Task-Specific Facilitation of Cognition by Anodal Transcranial Direct Current Stimulation of the Prefrontal Cortex

    PubMed Central

    Pope, Paul A.; Brenton, Jonathan W.; Miall, R. Chris

    2015-01-01

    We previously speculated that depression of cerebellar excitability using cathodal transcranial direct current stimulation (tDCS) might release extra cognitive resources via the disinhibition of activity in prefrontal cortex. The objective of the present study was to investigate whether anodal tDCS over the prefrontal cortex could similarly improve performance when cognitive demands are high. Sixty-three right-handed participants in 3 separate groups performed the Paced Auditory Serial Addition Task (PASAT) and the more difficult Paced Auditory Serial Subtraction Task (PASST), before and after 20 min of anodal, cathodal, or sham stimulation over the left dorsolateral prefrontal cortex (DLPFC). Performance was assessed in terms of the accuracy, latency, and variability of correct verbal responses. All behavioral measures significantly improved for the PASST after anodal DLPFC stimulation, but not the PASAT. There were smaller practice effects after cathodal and sham stimulation. Subjective ratings of attention and mental fatigue were unchanged by tDCS over time. We conclude that anodal stimulation over the left DLPFC can selectively improve performance on a difficult cognitive task involving arithmetic processing, verbal working memory, and attention. This result might be achieved by focally improving executive functions and/or cognitive capacity when tasks are difficult, rather than by improving levels of arousal/alertness. PMID:25979089

  1. Probing Corticospinal Recruitment Patterns and Functional Synergies with Transcranial Magnetic Stimulation

    PubMed Central

    Mathew, James; Kübler, Angelika; Bauer, Robert; Gharabaghi, Alireza

    2016-01-01

    Background: On the one hand, stimulating the motor cortex at different spots may activate the same muscle and result in a muscle-specific cortical map. Maps of different muscles, which are functionally coupled, may present with a large overlap but may also show a relevant variability. On the other hand, stimulation of the motor cortex at one spot with different stimulation intensities results in a characteristic input–output (IO) curve for one specific muscle but may simultaneously also activate different, functionally coupled muscles. A comparison of the cortical map overlap of synergistic muscles and their IO curves has not yet been carried out. Objective: The aim of this study was to probe functional synergies of forearm muscles with transcranial magnetic stimulation by harnessing the convergence and divergence of the corticospinal output. Methods: We acquired bihemispheric cortical maps and IO curves of the extensor carpi ulnaris, extensor carpi radialis, and extensor digitorum communis muscles by subjecting 11 healthy subjects to both monophasic and biphasic pulse waveforms. Results: The degree of synergy between pairs of forearm muscles was captured by the overlap of the cortical motor maps and the respective IO curves which were influenced by the pulse waveform. Monophasic and biphasic stimulation were particularly suitable for disentangling synergistic muscles in the right and left hemisphere, respectively. Conclusion: Combining IO curves and different pulse waveforms may provide complementary information on neural circuit dynamics and corticospinal recruitment patterns of synergistic muscles and their neuroplastic modulation. PMID:27458344

  2. Reducing aggressive responses to social exclusion using transcranial direct current stimulation

    PubMed Central

    Romero Lauro, Leonor J.; DeWall, C. Nathan; Chester, David S.; Bushman, Brad J.

    2015-01-01

    A vast body of research showed that social exclusion can trigger aggression. However, the neural mechanisms involved in regulating aggressive responses to social exclusion are still largely unknown. Transcranial direct current stimulation (tDCS) modulates the excitability of a target region. Building on studies suggesting that activity in the right ventrolateral pre-frontal cortex (rVLPFC) might aid the regulation or inhibition of social exclusion-related distress, we hypothesized that non-invasive brain polarization through tDCS over the rVLPFC would reduce behavioral aggression following social exclusion. Participants were socially excluded or included while they received tDCS or sham stimulation to the rVLPFC. Next, they received an opportunity to aggress. Excluded participants demonstrated cognitive awareness of their inclusionary status, yet tDCS (but not sham stimulation) reduced their behavioral aggression. Excluded participants who received tDCS stimulation were no more aggressive than included participants. tDCS stimulation did not influence socially included participants’ aggression. Our findings provide the first causal test for the role of rVLPFC in modulating aggressive responses to social exclusion. Our findings suggest that modulating activity in a brain area (i.e. the rVLPFC) implicated in self-control and emotion regulation can break the link between social exclusion and aggression. PMID:24748546

  3. Pitch Memory in Nonmusicians and Musicians: Revealing Functional Differences Using Transcranial Direct Current Stimulation.

    PubMed

    Schaal, N K; Krause, V; Lange, K; Banissy, M J; Williamson, V J; Pollok, B

    2015-09-01

    For music and language processing, memory for relative pitches is highly important. Functional imaging studies have shown activation of a complex neural system for pitch memory. One region that has been shown to be causally involved in the process for nonmusicians is the supramarginal gyrus (SMG). The present study aims at replicating this finding and at further examining the role of the SMG for pitch memory in musicians. Nonmusicians and musicians received cathodal transcranial direct current stimulation (tDCS) over the left SMG, right SMG, or sham stimulation, while completing a pitch recognition, pitch recall, and visual memory task. Cathodal tDCS over the left SMG led to a significant decrease in performance on both pitch memory tasks in nonmusicians. In musicians, cathodal stimulation over the left SMG had no effect, but stimulation over the right SMG impaired performance on the recognition task only. Furthermore, the results show a more pronounced deterioration effect for longer pitch sequences indicating that the SMG is involved in maintaining higher memory load. No stimulation effect was found in both groups on the visual control task. These findings provide evidence for a causal distinction of the left and right SMG function in musicians and nonmusicians. PMID:24770704

  4. A Preliminary Transcranial Magnetic Stimulation Study of Cortical Inhibition and Excitability in High-Functioning Autism and Asperger Disorder

    ERIC Educational Resources Information Center

    Enticott, Peter G.; Rinehart, Nicole J.; Tonge, Bruce J.; Bradshaw, John L.; Fitzgerald, Paul B.

    2010-01-01

    Aim: Controversy surrounds the distinction between high-functioning autism (HFA) and Asperger disorder, but motor abnormalities are associated features of both conditions. This study examined motor cortical inhibition and excitability in HFA and Asperger disorder using transcranial magnetic stimulation (TMS). Method: Participants were diagnosed by…

  5. Cortical Inhibition in Attention Deficit Hyperactivity Disorder: New Insights from the Electroencephalographic Response to Transcranial Magnetic Stimulation

    ERIC Educational Resources Information Center

    Bruckmann, Sarah; Hauk, Daniela; Roessner, Veit; Resch, Franz; Freitag, Christine M.; Kammer, Thomas; Ziemann, Ulf; Rothenberger, Aribert; Weisbrod, Matthias; Bender, Stephan

    2012-01-01

    Attention deficit hyperactivity disorder is one of the most frequent neuropsychiatric disorders in childhood. Transcranial magnetic stimulation studies based on muscle responses (motor-evoked potentials) suggested that reduced motor inhibition contributes to hyperactivity, a core symptom of the disease. Here we employed the N100 component of the…

  6. The Observation of Manual Grasp Actions Affects the Control of Speech: A Combined Behavioral and Transcranial Magnetic Stimulation Study

    ERIC Educational Resources Information Center

    Gentilucci, Maurizio; Campione, Giovanna Cristina; Volta, Riccardo Dalla; Bernardis, Paolo

    2009-01-01

    Does the mirror system affect the control of speech? This issue was addressed in behavioral and Transcranial Magnetic Stimulation (TMS) experiments. In behavioral experiment 1, participants pronounced the syllable /da/ while observing (1) a hand grasping large and small objects with power and precision grasps, respectively, (2) a foot interacting…

  7. Smoking Restores Impaired LTD-Like Plasticity in Schizophrenia: a Transcranial Direct Current Stimulation Study

    PubMed Central

    Strube, Wolfgang; Bunse, Tilmann; Nitsche, Michael A; Wobrock, Thomas; Aborowa, Richard; Misewitsch, Kristina; Herrmann, Maximiliane; Falkai, Peter; Hasan, Alkomiet

    2015-01-01

    Impaired neuroplastic responses following noninvasive brain stimulation have been reported repeatedly in schizophrenia patients. These findings have been associated with deficits in GABAergic, glutamatergic, and cholinergic neurotransmission. Although various neurophysiological studies have indicated a relationship between nicotine and neuroplasticity in healthy individuals, the present study is the first investigation into the impact of nicotine on LTD-like plasticity in patients with schizophrenia. Cortical excitability and cortical plasticity were explored in 30 schizophrenia patients (17 smoker, 13 nonsmoker) and 45 healthy controls (13 smoker, 32 nonsmoker) by using single-pulse transcranial magnetic stimulation (TMS) before and following cathodal transcranial direct current stimulation (tDCS) applied to the left primary motor cortex. Our analysis revealed abolished LTD-like plasticity in nonsmoking schizophrenia patients. However, these plasticity deficits were not present in smoking schizophrenia patients. In healthy controls, significant MEP reductions following cathodal tDCS were observed in nonsmoking individuals, but only trend-level reductions in smokers. In smoking schizophrenia patients, the severity of negative symptoms correlated positively with reduced neuroplasticity, whereas nonsmoking patients displayed the opposite effect. Taken together, the data of our study support the notion of an association between chronic smoking and the restitution of impaired LTD-like plasticity in schizophrenia patients. Although replication and further research are needed to better understand this relationship, our findings indicate that nicotine intake might stabilize the impaired inhibition–facilitation balance in the schizophrenic brain through a complex interaction between cortical plasticity, and GABAergic and cholinergic neurotransmission, and might explain the reduced prevalence of negative symptoms in this population. PMID:25308351

  8. Clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation.

    PubMed

    Pinchuk, Dmitry; Pinchuk, Olga; Sirbiladze, Konstantin; Shugar, Olga

    2013-01-01

    The clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation (tDCS) with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 - frequent episodic tension-type HAs, 10 - chronic tension-type HAs) and in 44 adolescents aged 11-16 years with chronic post-traumatic HAs after a mild head injury. Clinical effectiveness of tDCS with 70-150 μA current for 30-45 min via 6.25 cm(2) stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of HAs. PMID:23519166

  9. Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS)

    PubMed Central

    Breitling, Carolin; Zaehle, Tino; Dannhauer, Moritz; Bonath, Björn; Tegelbeckers, Jana; Flechtner, Hans-Henning; Krauel, Kerstin

    2016-01-01

    The use of transcranial direct current stimulation (tDCS) in patients with attention deficit hyperactivity disorder (ADHD) has been suggested as a promising alternative to psychopharmacological treatment approaches due to its local and network effects on brain activation. In the current study, we investigated the impact of tDCS over the right inferior frontal gyrus (rIFG) on interference control in 21 male adolescents with ADHD and 21 age matched healthy controls aged 13–17 years, who underwent three separate sessions of tDCS (anodal, cathodal, and sham) while completing a Flanker task. Even though anodal stimulation appeared to diminish commission errors in the ADHD group, the overall analysis revealed no significant effect of tDCS. Since participants showed a considerable learning effect from the first to the second session, performance in the first session was separately analyzed. ADHD patients receiving sham stimulation in the first session showed impaired interference control compared to healthy control participants whereas ADHD patients who were exposed to anodal stimulation, showed comparable performance levels (commission errors, reaction time variability) to the control group. These results suggest that anodal tDCS of the right inferior frontal gyrus could improve interference control in patients with ADHD. PMID:27147964

  10. Clinical Effectiveness of Primary and Secondary Headache Treatment by Transcranial Direct Current Stimulation

    PubMed Central

    Pinchuk, Dmitry; Pinchuk, Olga; Sirbiladze, Konstantin; Shugar, Olga

    2013-01-01

    The clinical effectiveness of primary and secondary headache treatment by transcranial direct current stimulation (tDCS) with various locations of stimulating electrodes on the scalp was analyzed retrospectively. The results of the treatment were analyzed in 90 patients aged from 19 to 54 years (48 patients had migraine without aura, 32 – frequent episodic tension-type HAs, 10 – chronic tension-type HAs) and in 44 adolescents aged 11–16 years with chronic post-traumatic HAs after a mild head injury. Clinical effectiveness of tDCS with 70–150 μA current for 30–45 min via 6.25 cm2 stimulating electrodes is comparable to that of modern pharmacological drugs, with no negative side effects. The obtained result has been maintained on average from 5 to 9 months. It has been demonstrated that effectiveness depends on localization of stimulating electrodes used for different types of HAs. PMID:23519166

  11. The effects of transcranial direct current stimulation over the dorsolateral prefrontal cortex on cognitive inhibition.

    PubMed

    Metzuyanim-Gorlick, Shlomit; Mashal, Nira

    2016-06-01

    The present study examines the effects of bilateral transcranial direct current stimulation (tDCS) over the dorsolateral prefrontal cortex (DLPFC) (anodal over left and cathodal over right DLPFC). This study describes the long-term effects of tDCS on cognitive inhibition, using the Hayling task. Twenty volunteers participated in the study and were assigned to either an active or a sham group. Participants heard sentences with the final word missing. They were asked then to complete the sentence with a word that either is appropriate in the context of the sentence (initiation condition) or is completely unrelated in this specific context (suppression condition). All participants performed a baseline Hayling task followed by six stimulation sessions. Subsequent to completion of these stimulations, we assessed immediately Hayling performance and re-assessed this performance 1 month. The results indicate a significant decrease in the number of errors in the active group, but only in the suppression condition that continued for 1 month after the sixth stimulation. The current findings suggest that tDCS can improve cognitive inhibition for the long-term in healthy adults and that the DLPFC has a special role in selecting the correct response and suppressing irrelevant semantic information. PMID:26821316

  12. Transcranial Direct Current Stimulation of the Left Dorsolateral Prefrontal Cortex Shifts Preference of Moral Judgments

    PubMed Central

    Kuehne, Maria; Heimrath, Kai; Heinze, Hans-Jochen; Zaehle, Tino

    2015-01-01

    Attitude to morality, reflecting cultural norms and values, is considered unique to human social behavior. Resulting moral behavior in a social environment is controlled by a widespread neural network including the dorsolateral prefrontal cortex (DLPFC), which plays an important role in decision making. In the present study we investigate the influence of neurophysiological modulation of DLPFC reactivity by means of transcranial direct current stimulation (tDCS) on moral reasoning. For that purpose we administered anodal, cathodal, and sham stimulation of the left DLPFC while subjects judged the appropriateness of hard moral personal dilemmas. In contrast to sham and cathodal stimulation, anodal stimulation induced a shift in judgment of personal moral dilemmas towards more non-utilitarian actions. Our results demonstrate that alterations of left DLPFC activity can change moral judgments and, in consequence, provide a causal link between left DLPFC activity and moral reasoning. Most important, the observed shift towards non-utilitarian actions suggests that moral decision making is not a permanent individual trait but can be manipulated; consequently individuals with boundless, uncontrollable, and maladaptive moral behavior, such as found in psychopathy, might benefit from neuromodulation-based approaches. PMID:25985442

  13. Polarity-dependent effects of transcranial direct current stimulation in obsessive-compulsive disorder.

    PubMed

    D'Urso, Giordano; Brunoni, Andre Russowsky; Anastasia, Annalisa; Micillo, Marco; de Bartolomeis, Andrea; Mantovani, Antonio

    2016-01-01

    About one third of patients with obsessive-compulsive disorder (OCD) fail to experience significant clinical benefit from currently available treatments. Hyperactivity of the presupplementary motor area (pre-SMA) has been detected in OCD patients, but it is not clear whether it is the primary cause or a secondary compensatory mechanism in OCD pathophysiology. Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique with polarity-dependent effects on motor cortical excitability. A 33-year-old woman with treatment-resistant OCD received 20 daily consecutive 2 mA/20 min tDCS sessions with the active electrode placed on the pre-SMA, according to the 10-20 EEG system, and the reference electrode on the right deltoid. The first 10 sessions were anodal, while the last 10 were cathodal. Symptoms severity was assessed using the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) severity score. In the end of anodal stimulation, OCD symptoms had worsened. Subsequent cathodal stimulation induced a dramatic clinical improvement, which led to an overall 30% reduction in baseline symptoms severity score on the Y-BOCS. Our study supports the hypothesis that pre-SMA hyperfunction might be responsible for OCD symptoms and shows that cathodal inhibitory tDCS over this area might be an option when dealing with treatment-resistant OCD. PMID:25971992

  14. Transcranial Magnetic Stimulation for Investigating Causal Brain-behavioral Relationships and their Time Course

    PubMed Central

    Sliwinska, Magdalena W.; Vitello, Sylvia; Devlin, Joseph T.

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a safe, non-invasive brain stimulation technique that uses a strong electromagnet in order to temporarily disrupt information processing in a brain region, generating a short-lived “virtual lesion.” Stimulation that interferes with task performance indicates that the affected brain region is necessary to perform the task normally. In other words, unlike neuroimaging methods such as functional magnetic resonance imaging (fMRI) that indicate correlations between brain and behavior, TMS can be used to demonstrate causal brain-behavior relations. Furthermore, by varying the duration and onset of the virtual lesion, TMS can also reveal the time course of normal processing. As a result, TMS has become an important tool in cognitive neuroscience. Advantages of the technique over lesion-deficit studies include better spatial-temporal precision of the disruption effect, the ability to use participants as their own control subjects, and the accessibility of participants. Limitations include concurrent auditory and somatosensory stimulation that may influence task performance, limited access to structures more than a few centimeters from the surface of the scalp, and the relatively large space of free parameters that need to be optimized in order for the experiment to work. Experimental designs that give careful consideration to appropriate control conditions help to address these concerns. This article illustrates these issues with TMS results that investigate the spatial and temporal contributions of the left supramarginal gyrus (SMG) to reading. PMID:25079670

  15. An investigation into the induced electric fields from transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Hadimani, Ravi; Lee, Erik; Duffy, Walter; Waris, Mohammed; Siddiqui, Waquar; Islam, Faisal; Rajamani, Mahesh; Nathan, Ryan; Jiles, David; David C Jiles Team; Walter Duffy Collaboration

    Transcranial magnetic stimulation (TMS) is a promising tool for noninvasive brain stimulation that has been approved by the FDA for the treatment of major depressive disorder. To stimulate the brain, TMS uses large, transient pulses of magnetic field to induce an electric field in the head. This transient magnetic field is large enough to cause the depolarization of cortical neurons and initiate a synaptic signal transmission. For this study, 50 unique head models were created from MRI images. Previous simulation studies have primarily used a single head model, and thus give a limited image of the induced electric field from TMS. This study uses finite element analysis simulations on 50 unique, heterogeneous head models to better investigate the relationship between TMS and the electric field induced in brain tissues. Results showed a significant variation in the strength of the induced electric field in the brain, which can be reasonably predicted by the distance from the TMS coil to the stimulated brain. Further, it was seen that some models had high electric field intensities in over five times as much brain volume as other models.

  16. Transcranial magnetic stimulation over human secondary somatosensory cortex disrupts perception of pain intensity

    PubMed Central

    Lockwood, Patricia L.; Iannetti, Gian Domenico; Haggard, Patrick

    2013-01-01

    Pain is a complex sensory experience resulting from the activity of a network of brain regions. However, the functional contribution of individual regions in this network remains poorly understood. We delivered single-pulse transcranial magnetic stimulation (TMS) to the contralateral primary somatosensory cortex (S1), secondary somatosensory cortex (S2) and vertex (control site) 120 msec after selective stimulation of nociceptive afferents using neodymium:yttrium–aluminium–perovskite (Nd:YAP) laser pulses causing painful sensations. Participants were required to judge either the intensity (medium/high) or the spatial location (proximal/distal) of the stimulus in a two-alternative forced choice paradigm. When TMS pulses were delivered over S2, participants' ability to judge pain intensity was disrupted, as compared to S1 and vertex (control) stimulation. Signal-detection analysis demonstrated a loss of sensitivity to stimulation intensity, rather than a shift in perceived pain level or response bias. We did not find any effect of TMS on the ability to localise nociceptive stimuli on the skin. The novel finding that TMS over S2 can disrupt perception of pain intensity suggests a causal role for S2 in encoding of pain intensity. PMID:23290634

  17. Improving Interference Control in ADHD Patients with Transcranial Direct Current Stimulation (tDCS).

    PubMed

    Breitling, Carolin; Zaehle, Tino; Dannhauer, Moritz; Bonath, Björn; Tegelbeckers, Jana; Flechtner, Hans-Henning; Krauel, Kerstin

    2016-01-01

    The use of transcranial direct current stimulation (tDCS) in patients with attention deficit hyperactivity disorder (ADHD) has been suggested as a promising alternative to psychopharmacological treatment approaches due to its local and network effects on brain activation. In the current study, we investigated the impact of tDCS over the right inferior frontal gyrus (rIFG) on interference control in 21 male adolescents with ADHD and 21 age matched healthy controls aged 13-17 years, who underwent three separate sessions of tDCS (anodal, cathodal, and sham) while completing a Flanker task. Even though anodal stimulation appeared to diminish commission errors in the ADHD group, the overall analysis revealed no significant effect of tDCS. Since participants showed a considerable learning effect from the first to the second session, performance in the first session was separately analyzed. ADHD patients receiving sham stimulation in the first session showed impaired interference control compared to healthy control participants whereas ADHD patients who were exposed to anodal stimulation, showed comparable performance levels (commission errors, reaction time variability) to the control group. These results suggest that anodal tDCS of the right inferior frontal gyrus could improve interference control in patients with ADHD. PMID:27147964

  18. The effects of theta transcranial alternating current stimulation (tACS) on fluid intelligence.

    PubMed

    Pahor, Anja; Jaušovec, Norbert

    2014-09-01

    The objective of the study was to explore the influence of transcranial alternating current stimulation (tACS) on resting brain activity and on measures of fluid intelligence. Theta tACS was applied to the left parietal and left frontal brain areas of healthy participants after which resting electroencephalogram (EEG) data was recorded. Following sham/active stimulation, the participants solved two tests of fluid intelligence while their EEG was recorded. The results showed that active theta tACS affected spectral power in theta and alpha frequency bands. In addition, active theta tACS improved performance on tests of fluid intelligence. This influence was more pronounced in the group of participants that received stimulation to the left parietal area than in the group of participants that received stimulation to the left frontal area. Left parietal tACS increased performance on the difficult test items of both tests (RAPM and PF&C) whereas left frontal tACS increased performance only on the easy test items of one test (RAPM). The observed behavioral tACS influences were also accompanied by changes in neuroelectric activity. The behavioral and neuroelectric data tentatively support the P-FIT neurobiological model of intelligence. PMID:24998643

  19. Transcranial magnetic stimulation for investigating causal brain-behavioral relationships and their time course.

    PubMed

    Sliwinska, Magdalena W; Vitello, Sylvia; Devlin, Joseph T

    2014-01-01

    Transcranial magnetic stimulation (TMS) is a safe, non-invasive brain stimulation technique that uses a strong electromagnet in order to temporarily disrupt information processing in a brain region, generating a short-lived "virtual lesion." Stimulation that interferes with task performance indicates that the affected brain region is necessary to perform the task normally. In other words, unlike neuroimaging methods such as functional magnetic resonance imaging (fMRI) that indicate correlations between brain and behavior, TMS can be used to demonstrate causal brain-behavior relations. Furthermore, by varying the duration and onset of the virtual lesion, TMS can also reveal the time course of normal processing. As a result, TMS has become an important tool in cognitive neuroscience. Advantages of the technique over lesion-deficit studies include better spatial-temporal precision of the disruption effect, the ability to use participants as their own control subjects, and the accessibility of participants. Limitations include concurrent auditory and somatosensory stimulation that may influence task performance, limited access to structures more than a few centimeters from the surface of the scalp, and the relatively large space of free parameters that need to be optimized in order for the experiment to work. Experimental designs that give careful consideration to appropriate control conditions help to address these concerns. This article illustrates these issues with TMS results that investigate the spatial and temporal contributions of the left supramarginal gyrus (SMG) to reading. PMID:25079670

  20. Lateralized effect of rapid-rate transcranial magnetic stimulation of the prefrontal cortex on mood.

    PubMed

    Pascual-Leone, A; Catalá, M D; Pascual-Leone Pascual, A

    1996-02-01

    We studied the effects of rapid-rate transcranial magnetic stimulation (rTMS) of different scalp positions on mood. Ten normal volunteers rated themselves before and after rTMS on five analog scales labeled "Tristeza" (Sadness), "Ansiedad" (Anxiety), "Alegria" (Happiness), "Cansancio" (Tiredness), and "Dolor/Malestar" (Pain/Discomfort). rTMS was applied to the right lateral prefrontal, left prefrontal, or midline frontal cortex in trains of 5 seconds' duration at 10 Hz and 110% of the subject's motor threshold intensity. Each stimulation position received 10 trains separated by a 25-second pause. No clinically apparent mood changes were evoked by rTMS to any of the scalp positions in any subject. However, left prefrontal rTMS resulted in a significant increase in the Sadness ratings (Tristeza) and a significant decrease in the Happiness ratings ("Alegria") as compared with right prefrontal and midfrontal cortex stimulation. These results show differential effects of rTMS of left and right prefrontal cortex stimulation on mood and illustrate the lateralized control of mood in normal volunteers. PMID:8614521

  1. Disturbance of visual search by stimulating to posterior parietal cortex in the brain using transcranial magnetic stimulation

    NASA Astrophysics Data System (ADS)

    Iramina, Keiji; Ge, Sheng; Hyodo, Akira; Hayami, Takehito; Ueno, Shoogo

    2009-04-01

    In this study, we applied a transcranial magnetic stimulation (TMS) to investigate the temporal aspect for the functional processing of visual attention. Although it has been known that right posterior parietal cortex (PPC) in the brain has a role in certain visual search tasks, there is little knowledge about the temporal aspect of this area. Three visual search tasks that have different difficulties of task execution individually were carried out. These three visual search tasks are the "easy feature task," the "hard feature task," and the "conjunction task." To investigate the temporal aspect of the PPC involved in the visual search, we applied various stimulus onset asynchronies (SOAs) and measured the reaction time of the visual search. The magnetic stimulation was applied on the right PPC or the left PPC by the figure-eight coil. The results show that the reaction times of the hard feature task are longer than those of the easy feature task. When SOA=150 ms, compared with no-TMS condition, there was a significant increase in target-present reaction time when TMS pulses were applied. We considered that the right PPC was involved in the visual search at about SOA=150 ms after visual stimulus presentation. The magnetic stimulation to the right PPC disturbed the processing of the visual search. However, the magnetic stimulation to the left PPC gives no effect on the processing of the visual search.

  2. Tagging motor memories with transcranial direct current stimulation allows later artificially-controlled retrieval.

    PubMed

    Nozaki, Daichi; Yokoi, Atsushi; Kimura, Takahiro; Hirashima, Masaya; Orban de Xivry, Jean-Jacques

    2016-01-01

    We demonstrate that human motor memories can be artificially tagged and later retrieved by noninvasive transcranial direct current stimulation (tDCS). Participants learned to adapt reaching movements to two conflicting dynamical environments that were each associated with a different tDCS polarity (anodal or cathodal tDCS) on the sensorimotor cortex. That is, we sought to determine whether divergent background activity levels within the sensorimotor cortex (anodal: higher activity; cathodal: lower activity) give rise to distinct motor memories. After a training session, application of each tDCS polarity automatically resulted in the retrieval of the motor memory corresponding to that polarity. These results reveal that artificial modulation of neural activity in the sensorimotor cortex through tDCS can act as a context for the formation and recollection of motor memories. PMID:27472899

  3. Transcranial Direct Current Stimulation (tDCS) and Aphasia: The Case of Mr. C

    PubMed Central

    Cherney, Leora R.; Babbitt, Edna M.; Hurwitz, Rosalind; Rogers, Lynn M.; Stinear, James; Wang, Xue; Harvey, Richard L.; Parrish, Todd

    2014-01-01

    Purpose To illustrate the ethical challenges that arose from investigating a novel treatment procedure, transcranial direct current stimulation (tDCS), in a research participant with aphasia. Method First, we reviewed the current evidence supporting the use of tDCS in aphasia research, highlighting methodological gaps in our knowledge of tDCS. Second, we examined the case of Mr. C, a person with chronic aphasia who participated in a research protocol investigating the impact of tDCS on aphasia treatment. Results We describe the procedures that he underwent and the resulting behavioral and neurophysiological outcomes bed. Finally, we share the steps that were taken to balance beneficence and nonmaleficence, and to ensure Mr. C’s autonomy. Conclusion: Researchers must consider not only the scientific integrity of their studies, but also potential ethical issues and consequences to the research participants. PMID:23340067

  4. How Transcranial Direct Current Stimulation Can Modulate Implicit Motor Sequence Learning and Consolidation: A Brief Review.

    PubMed

    Savic, Branislav; Meier, Beat

    2016-01-01

    The purpose of this review is to investigate how transcranial direct current stimulation (tDCS) can modulate implicit motor sequence learning and consolidation. So far, most of the studies have focused on the modulating effect of tDCS for explicit motor learning. Here, we focus explicitly on implicit motor sequence learning and consolidation in order to improve our understanding about the potential of tDCS to affect this kind of unconscious learning. Specifically, we concentrate on studies with the serial reaction time task (SRTT), the classical paradigm for measuring implicit motor sequence learning. The influence of tDCS has been investigated for the primary motor cortex, the premotor cortex, the prefrontal cortex, and the cerebellum. The results indicate that tDCS above the primary motor cortex gives raise to the most consistent modulating effects for both implicit motor sequence learning and consolidation. PMID:26903837

  5. How Transcranial Direct Current Stimulation Can Modulate Implicit Motor Sequence Learning and Consolidation: A Brief Review

    PubMed Central

    Savic, Branislav; Meier, Beat

    2016-01-01

    The purpose of this review is to investigate how transcranial direct current stimulation (tDCS) can modulate implicit motor sequence learning and consolidation. So far, most of the studies have focused on the modulating effect of tDCS for explicit motor learning. Here, we focus explicitly on implicit motor sequence learning and consolidation in order to improve our understanding about the potential of tDCS to affect this kind of unconscious learning. Specifically, we concentrate on studies with the serial reaction time task (SRTT), the classical paradigm for measuring implicit motor sequence learning. The influence of tDCS has been investigated for the primary motor cortex, the premotor cortex, the prefrontal cortex, and the cerebellum. The results indicate that tDCS above the primary motor cortex gives raise to the most consistent modulating effects for both implicit motor sequence learning and consolidation. PMID:26903837

  6. Transcranial direct current stimulation as a tool in the study of sensory-perceptual processing.

    PubMed

    Costa, Thiago L; Lapenta, Olivia M; Boggio, Paulo S; Ventura, Dora F

    2015-08-01

    Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulatory technique with increasing popularity in the fields of basic research and rehabilitation. It is an affordable and safe procedure that is beginning to be used in the clinic, and is a tool with potential to contribute to the understanding of neural mechanisms in the fields of psychology, neuroscience, and medical research. This review presents examples of investigations in the fields of perception, basic sensory processes, and sensory rehabilitation that employed tDCS. We highlight some of the most relevant efforts in this area and discuss possible limitations and gaps in contemporary tDCS research. Topics include the five senses, pain, and multimodal integration. The present work aims to present the state of the art of this field of research and to inspire future investigations of perception using tDCS. PMID:26139152

  7. Facilitated lexical ambiguity processing by transcranial direct current stimulation over the left inferior frontal cortex.

    PubMed

    Ihara, Aya S; Mimura, Takanori; Soshi, Takahiro; Yorifuji, Shiro; Hirata, Masayuki; Goto, Tetsu; Yoshinime, Toshiki; Umehara, Hiroaki; Fujimaki, Norio

    2015-01-01

    Previous studies suggest that the left inferior frontal cortex is involved in the resolution of lexical ambiguities for language comprehension. In this study, we hypothesized that processing of lexical ambiguities is improved when the excitability of the left inferior frontal cortex is enhanced. To test the hypothesis, we conducted an experiment with transcranial direct current stimulation (tDCS). We investigated the effect of anodal tDCS over the left inferior frontal cortex on behavioral indexes for semantic judgment on lexically ambiguous and unambiguous words within a context. Supporting the hypothesis, the RT was shorter in the anodal tDCS session than in the sham session for ambiguous words. The results suggest that controlled semantic retrieval and contextual selection were facilitated by anodal tDCS over the left inferior frontal cortex. PMID:25208744

  8. Effects of transcranial magnetic stimulation during voluntary and non-voluntary stepping movements in humans.

    PubMed

    Solopova, I A; Selionov, V A; Kazennikov, O V; Ivanenko, Y P

    2014-09-01

    Here, we compared motor evoked potentials (MEP) in response to transcranial magnetic stimulation of the motor cortex and the H-reflex during voluntary and vibration-induced air-stepping movements in humans. Both the MEPs (in mm biceps femoris, rectus femoris and tibialis anterior) and H-reflex (in m soleus) were significantly smaller during vibration-induced cyclic leg movements at matched amplitudes of angular motion and muscle activity. These findings highlight differences between voluntary and non-voluntary activation of the spinal pattern generator circuitry in humans, presumably due to an extra facilitatory effect of voluntary control/triggering of stepping on spinal motoneurons and interneurons. The results support the idea of active engagement of supraspinal motor areas in developing central pattern generator-modulating therapies. PMID:25038416

  9. Tagging motor memories with transcranial direct current stimulation allows later artificially-controlled retrieval

    PubMed Central

    Nozaki, Daichi; Yokoi, Atsushi; Kimura, Takahiro; Hirashima, Masaya; Orban de Xivry, Jean-Jacques

    2016-01-01

    We demonstrate that human motor memories can be artificially tagged and later retrieved by noninvasive transcranial direct current stimulation (tDCS). Participants learned to adapt reaching movements to two conflicting dynamical environments that were each associated with a different tDCS polarity (anodal or cathodal tDCS) on the sensorimotor cortex. That is, we sought to determine whether divergent background activity levels within the sensorimotor cortex (anodal: higher activity; cathodal: lower activity) give rise to distinct motor memories. After a training session, application of each tDCS polarity automatically resulted in the retrieval of the motor memory corresponding to that polarity. These results reveal that artificial modulation of neural activity in the sensorimotor cortex through tDCS can act as a context for the formation and recollection of motor memories. DOI: http://dx.doi.org/10.7554/eLife.15378.001 PMID:27472899

  10. Seizure in a nonpredisposed individual induced by single-pulse transcranial magnetic stimulation.

    PubMed

    Kratz, Oliver; Studer, Petra; Barth, Wolfgang; Wangler, Susanne; Hoegl, Thomas; Heinrich, Hartmut; Moll, Gunther H

    2011-03-01

    Seizure induction is a rare, but serious adverse effect of the otherwise very safe method of transcranial magnetic stimulation (TMS). There are only very few single case reports concerning seizure in single-pulse TMS. All of these reports describe individuals with neurological disorders or epileptogenic medication. To our knowledge, we are the first to describe a healthy subject who developed symptoms of a seizure after single-pulse TMS during motor threshold estimation. This case report provides evidence that single-pulse TMS may provoke a seizure even in the absence of neurological risk factors. Differential diagnoses of a classic neurological seizure, that is, convulsive syncope and psychogenic seizure, are discussed. Neurogenic seizure after TMS and convulsive syncope are the most probable hypotheses, although clear specification of this singular incident remains impossible. Therefore, to minimize the risk for such rare adverse effects, existing and new suggestions are combined to provide reasonable precautions to be taken before and during TMS application. PMID:20351571

  11. Application of Transcranial Direct Current Stimulation in Neurorehabilitation: The Modulatory Effect of Sleep

    PubMed Central

    Ebajemito, James K.; Furlan, Leonardo; Nissen, Christoph; Sterr, Annette

    2016-01-01

    The relationship between sleep disorders and neurological disorders is often reciprocal, such that sleep disorders are worsened by neurological symptoms and that neurological disorders are aggravated by poor sleep. Animal and human studies further suggest that sleep disruption not only worsens single neurological symptoms but may also lead to long-term negative outcomes. This suggests that sleep may play a fundamental role in neurorehabilitation and recovery. We further propose that sleep may not only alter the efficacy of behavioral treatments but also plasticity-enhancing adjunctive neurostimulation methods, such as transcranial direct current stimulation (tDCS). At present, sleep receives little attention in the fields of neurorehabilitation and neurostimulation. In this review, we draw together the strands of evidence from both fields of research to highlight the proposition that sleep is an important parameter to consider in the application of tDCS as a primary or adjunct rehabilitation intervention. PMID:27092103

  12. Effect of the Interindividual Variability on Computational Modeling of Transcranial Direct Current Stimulation

    PubMed Central

    Parazzini, Marta; Fiocchi, Serena; Liorni, Ilaria; Ravazzani, Paolo

    2015-01-01

    Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. This paper investigates how normal variations in anatomy may affect the current flow through the brain. This was done by applying electromagnetic computational methods to human models of different age and gender and by comparing the electric field and current density amplitude distributions within the tissues. Results of this study showed that the general trend of the spatial distributions of the field amplitude shares some gross characteristics among the different human models for the same electrode montages. However, the physical dimension of the subject and his/her morphological and anatomical characteristics somehow influence the detailed field distributions such as the field values. PMID:26265912

  13. Chronic Enhancement of Serotonin Facilitates Excitatory Transcranial Direct Current Stimulation-Induced Neuroplasticity.

    PubMed

    Kuo, Hsiao-I; Paulus, Walter; Batsikadze, Giorgi; Jamil, Asif; Kuo, Min-Fang; Nitsche, Michael A

    2016-04-01

    Serotonin affects memory formation via modulating long-term potentiation (LTP) and depression (LTD). Accordingly, acute selective serotonin reuptake inhibitor (SSRI) administration enhanced LTP-like plasticity induced by transcranial direct current stimulation (tDCS) in humans. However, it usually takes some time for SSRI to reduce clinical symptoms such as anxiety, negative mood, and related symptoms of depression and anxiety disorders. This might be related to an at least partially different effect of chronic serotonergic enhancement on plasticity, as compared with single-dose medication. Here we explored the impact of chronic application of the SSRI citalopram (CIT) on plasticity induced by tDCS in healthy humans in a partially double-blinded, placebo (PLC)-controlled, randomized crossover study. Furthermore, we explored the dependency of plasticity induction from the glutamatergic system via N-methyl-D-aspartate receptor antagonism. Twelve healthy subjects received PLC medication, combined with anodal or cathodal tDCS of the primary motor cortex. Afterwards, the same subjects took CIT (20 mg/day) consecutively for 35 days. During this period, four additional interventions were performed (CIT and PLC medication with anodal/cathodal tDCS, CIT and dextromethorphan (150 mg) with anodal/cathodal tDCS). Plasticity was monitored by motor-evoked potential amplitudes elicited by transcranial magnetic stimulation. Chronic application of CIT increased and prolonged the LTP-like plasticity induced by anodal tDCS for over 24 h, and converted cathodal tDCS-induced LTD-like plasticity into facilitation. These effects were abolished by dextromethorphan. Chronic serotonergic enhancement results in a strengthening of LTP-like glutamatergic plasticity, which might partially explain the therapeutic impact of SSRIs in depression and other neuropsychiatric diseases. PMID:26329381

  14. Polarity specific effects of transcranial direct current stimulation on interhemispheric inhibition.

    PubMed

    Tazoe, Toshiki; Endoh, Takashi; Kitamura, Taku; Ogata, Toru

    2014-01-01

    Transcranial direct current stimulation (tDCS) has been used as a useful interventional brain stimulation technique to improve unilateral upper-limb motor function in healthy humans, as well as in stroke patients. Although tDCS applications are supposed to modify the interhemispheric balance between the motor cortices, the tDCS after-effects on interhemispheric interactions are still poorly understood. To address this issue, we investigated the tDCS after-effects on interhemispheric inhibition (IHI) between the primary motor cortices (M1) in healthy humans. Three types of tDCS electrode montage were tested on separate days; anodal tDCS over the right M1, cathodal tDCS over the left M1, bilateral tDCS with anode over the right M1 and cathode over the left M1. Single-pulse and paired-pulse transcranial magnetic stimulations were given to the left M1 and right M1 before and after tDCS to assess the bilateral corticospinal excitabilities and mutual direction of IHI. Regardless of the electrode montages, corticospinal excitability was increased on the same side of anodal stimulation and decreased on the same side of cathodal stimulation. However, neither unilateral tDCS changed the corticospinal excitability at the unstimulated side. Unilateral anodal tDCS increased IHI from the facilitated side M1 to the unchanged side M1, but it did not change IHI in the other direction. Unilateral cathodal tDCS suppressed IHI both from the inhibited side M1 to the unchanged side M1 and from the unchanged side M1 to the inhibited side M1. Bilateral tDCS increased IHI from the facilitated side M1 to the inhibited side M1 and attenuated IHI in the opposite direction. Sham-tDCS affected neither corticospinal excitability nor IHI. These findings indicate that tDCS produced polarity-specific after-effects on the interhemispheric interactions between M1 and that those after-effects on interhemispheric interactions were mainly dependent on whether tDCS resulted in the facilitation or

  15. Transcranial Magnetic Stimulation in the Treatment of Chronic Widespread Pain: A Randomized, Controlled Study

    PubMed Central

    Avery, David H.; Zarkowski, Paul; Krashin, Daniel; Rho, Wang-ku; Wajdik, Chandra; Joesch, Jutta M.; Haynor, David R.; Buchwald, Dedra; Roy-Byrne, Peter

    2014-01-01

    Objective Our objective was to assess transcranial magnetic stimulation (TMS) in the treatment of chronic widespread pain (CWP). Methods Nineteen participants were randomized to two groups: one receiving active TMS (N=7) and another receiving sham stimulation (N=11) applied to the left dorsolateral prefrontal cortex. During sham stimulation, subjects heard a sound similar to the sound heard by those receiving the active treatment and received an active electrical stimulus to the scalp. The stimulation protocol consisted of 15 sessions completed within a 4-week period. Blind assessments were done at baseline and after each 5 sessions followed by blind assessments at 1 week, 1 month and 3 months after the last TMS sessions. The primary outcome variable was a pain measure, the Gracely Box Intensity Scale (BIRS). Results The percentage of subjects who guessed that they were receiving TMS was similar in the two groups. Both the TMS group and the sham group showed a statistically significant reduction in the BIRS scores from baseline during the acute phase of treatment and the follow-up phase. However, the TMS and sham groups did not differ in the change in the BIRS scores. Discussion Although some previous clinical studies and basic science studies of TMS in treating pain are promising, this study found no difference in the analgesic effect of TMS and sham stimulation. Future studies should utilize a sham condition that attempts to simulate the sound and sensation of the TMS stimulation. Stimulus location and other stimulus parameters should be explored in future studies. PMID:24755729

  16. Intensity, Duration, and Location of High-Definition Transcranial Direct Current Stimulation for Tinnitus Relief.

    PubMed

    Shekhawat, Giriraj Singh; Sundram, Frederick; Bikson, Marom; Truong, Dennis; De Ridder, Dirk; Stinear, Cathy M; Welch, David; Searchfield, Grant D

    2016-05-01

    Background and Objective Tinnitus is the perception of a phantom sound. The aim of this study was to compare current intensity (center anode 1 mA and 2 mA), duration (10 minutes and 20 minutes), and location (left temporoparietal area [LTA] and dorsolateral prefrontal cortex [DLPFC]) using 4 × 1 high-definition transcranial direct current stimulation (HD-tDCS) for tinnitus reduction.Methods Twenty-seven participants with chronic tinnitus (>2 years) and mean age of 53.5 years underwent 2 sessions of HD-tDCS of the LTA and DLPFC in a randomized order with a 1 week gap between site of stimulation. During each session, a combination of 4 different settings were used in increasing dose (1 mA, 10 minutes; 1 mA, 20 minutes; 2 mA, 10 minutes; and 2 mA, 20 minutes). The impact of different settings on tinnitus loudness and annoyance was documented.Results Twenty-one participants (77.78%) reported a minimum of 1 point reduction on tinnitus loudness or annoyance scales. There were significant changes in loudness and annoyance for duration of stimulation,F(1, 26) = 10.08,P< .005, and current intensity,F(1, 26) = 14.24,P= .001. There was no interaction between the location, intensity, and duration of stimulation. Higher intensity (2 mA) and longer duration (20 minutes) of stimulation were more effective.Conclusions A current intensity of 2 mA for 20-minute duration was the most effective setting used for tinnitus relief. The stimulation of the LTA and DLPFC were equally effective for suppressing tinnitus loudness and annoyance. PMID:26180052

  17. Transcranial direct current stimulation of the posterior parietal cortex modulates arithmetic learning.

    PubMed

    Grabner, Roland H; Rütsche, Bruno; Ruff, Christian C; Hauser, Tobias U

    2015-07-01

    The successful acquisition of arithmetic skills is an essential step in the development of mathematical competencies and has been associated with neural activity in the left posterior parietal cortex (PPC). It is unclear, however, whether this brain region plays a causal role in arithmetic skill acquisition and whether arithmetic learning can be modulated by means of non-invasive brain stimulation of this key region. In the present study we addressed these questions by applying transcranial direct current stimulation (tDCS) over the left PPC during a short-term training that simulates the typical path of arithmetic skill acquisition (specifically the transition from effortful procedural to memory-based problem-solving strategies). Sixty participants received either anodal, cathodal or sham tDCS while practising complex multiplication and subtraction problems. The stability of the stimulation-induced learning effects was assessed in a follow-up test 24 h after the training. Learning progress was modulated by tDCS. Cathodal tDCS (compared with sham) decreased learning rates during training and resulted in poorer performance which lasted over 24 h after stimulation. Anodal tDCS showed an operation-specific improvement for subtraction learning. Our findings extend previous studies by demonstrating that the left PPC is causally involved in arithmetic learning (and not only in arithmetic performance) and that even a short-term tDCS application can modulate the success of arithmetic knowledge acquisition. Moreover, our finding of operation-specific anodal stimulation effects suggests that the enhancing effects of tDCS on learning can selectively affect just one of several cognitive processes mediated by the stimulated area. PMID:25970697

  18. The effect of single-pulse transcranial magnetic stimulation and peripheral nerve stimulation on complexity of EMG signal: fractal analysis.

    PubMed

    Cukic, M; Oommen, J; Mutavdzic, D; Jorgovanovic, N; Ljubisavljevic, M

    2013-07-01

    The aim of this study was to examine whether single-pulse transcranial magnetic stimulation (spTMS) affects the pattern of corticospinal activity once voluntary drive has been restored after spTMS-induced EMG silence. We used fractal dimension (FD) to explore the 'complexity' of the electromyography (EMG) signal, and median frequency of the spectra (MDF) to examine changes in EMG spectral characteristics. FD and MDF of the raw EMG epochs immediately before were compared with those obtained from epochs after the EMG silence. Changes in FD and MDF after spTMS were examined with three levels of muscle contraction corresponding to weak (20-40%), moderate (40-60%) and strong (60-80% of maximal voluntary contraction) and three intensities of stimulation set at 10, 20 and 30% above the resting motor threshold. FD was calculated using the Higuchi fractal dimension algorithm. Finally, to discern the origin of FD changes between the CNS and muscle, we compared the effects of spTMS with the effects of peripheral nerve stimulation (PNS) on FD and MDF. The results show that spTMS induced significant decrease in both FD and MDF of EMG signal after stimulation. PNS did not have any significant effects on FD nor MDF. Changes in TMS intensity did not have any significant effect on FD or MDF after stimulation nor had the strength of muscle contraction. However, increase in contraction strength decreased FD before stimulation but only between weak and moderate contraction. The results suggest that the effects of spTMS on corticospinal activity, underlying voluntary motor output, outlast the TMS stimulus. It appears that the complexity of the EMG signal is reduced after spTMS, suggesting that TMS alters the dynamics of the ongoing corticospinal activity most likely temporarily synchronizing the neural network activity. Further studies are needed to confirm whether observed changes after TMS occur at the cortical level. PMID:23652725

  19. Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

    PubMed Central

    Herrold, Amy A.; Kletzel, Sandra L.; Harton, Brett C.; Chambers, R. Andrew; Jordan, Neil; Pape, Theresa Louise-Bender

    2014-01-01

    Alcohol use disorder (AUD), mild traumatic brain injury (mTBI), and posttraumatic stress disorder (PTSD) commonly co-occur (AUD + mTBI + PTSD). These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation (rTMS) is non-invasive and may be an ideal treatment for co-occurring AUD + mTBI + PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD + mTBI + PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD + mTBI + PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD + mTBI + PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together. PMID:25422632

  20. Risk of seizures in transcranial magnetic stimulation: a clinical review to inform consent process focused on bupropion

    PubMed Central

    Dobek, Christine E; Blumberger, Daniel M; Downar, Jonathan; Daskalakis, Zafiris J; Vila-Rodriguez, Fidel

    2015-01-01

    Objective When considering repetitive transcranial magnetic stimulation (rTMS) for major depressive disorder, clinicians often face a lack of detailed information on potential interactions between rTMS and pharmacotherapy. This is particularly relevant to patients receiving bupropion, a commonly prescribed antidepressant with lower risk of sexual side effects or weight increase, which has been associated with increased risk of seizure in particular populations. Our aim was to systematically review the information on seizures occurred with rTMS to identify the potential risk factors with attention to concurrent medications, particularly bupropion. Data sources We conducted a systematic review through the databases PubMed, PsycINFO, and EMBASE between 1980 and June 2015. Additional articles were found using reference lists of relevant articles. Reporting of data follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Study selection Two reviewers independently screened articles reporting the occurrence of seizures during rTMS. Articles reporting seizures in epilepsy during rTMS were excluded. A total of 25 rTMS-induced seizures were included in the final review. Data extraction Data were systematically extracted, and the authors of the applicable studies were contacted when appropriate to provide more detail about the seizure incidents. Results Twenty-five seizures were identified. Potential risk factors emerged such as sleep deprivation, polypharmacy, and neurological insult. High-frequency-rTMS was involved in a percentage of the seizures. None of these seizures reported had patients taking bupropion in the literature review. One rTMS-induced seizure was reported from the Food and Drug Administration in a sleep-deprived patient who was concurrently taking bupropion, sertraline, and amphetamine. Conclusion During the consent process, potential risk factors for an rTMS-induced seizure should be carefully screened for and discussed. Data

  1. Dynamics of EEG Rhythms Support Distinct Visual Selection Mechanisms in Parietal Cortex: A Simultaneous Transcranial Magnetic Stimulation and EEG Study

    PubMed Central

    Spadone, Sara; Tosoni, Annalisa; Sestieri, Carlo; Romani, Gian Luca; Della Penna, Stefania; Corbetta, Maurizio

    2015-01-01

    Using repetitive transcranial magnetic stimulation (rTMS), we have recently shown a functional anatomical distinction in human parietal cortex between regions involved in maintaining attention to a location [ventral intraparietal sulcus (vIPS)] and a region involved in shifting attention between locations [medial superior parietal lobule (mSPL)]. In particular, while rTMS interference over vIPS impaired target discrimination at contralateral attended locations, interference over mSPL affected performance following shifts of attention regardless of the visual field (Capotosto et al., 2013). Here, using rTMS interference in conjunction with EEG recordings of brain rhythms during the presentation of cues that indicate to either shift or maintain spatial attention, we tested whether this functional anatomical segregation involves different mechanisms of rhythm synchronization. The transient inactivation of vIPS reduced the amplitude of the expected parieto-occipital low-α (8–10 Hz) desynchronization contralateral to the cued location. Conversely, the transient inactivation of mSPL, compared with vIPS, reduced the high-α (10–12 Hz) desynchronization induced by shifting attention into both visual fields. Furthermore, rTMS induced a frequency-specific delay of task-related modulation of brain rhythms. Specifically, rTMS over vIPS or mSPL during maintenance (stay cues) or shifting (shift cues) of spatial attention, respectively, caused a delay of α parieto-occipital desynchronization. Moreover, rTMS over vIPS during stay cues caused a delay of δ (2–4 Hz) frontocentral synchronization. These findings further support the anatomo-functional subdivision of the dorsal attention network in subsystems devoted to shifting or maintaining covert visuospatial attention and indicate that these mechanisms operate in different frequency channels linking frontal to parieto-occipital visual regions. PMID:25589765

  2. Transcranial direct current stimulation as a treatment for patients with fibromyalgia: a randomized controlled trial.

    PubMed

    Fagerlund, Asbjørn J; Hansen, Odd A; Aslaksen, Per M

    2015-01-01

    Previous studies suggest that transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) reduces chronic pain levels. In this randomized controlled trial, we investigated the effects of 5 consecutive 20-minute sessions of 2-mA anodal tDCS directed to the M1 in 48 patients (45 females) with fibromyalgia. Changes in pain, stress, daily functioning, psychiatric symptoms, and health-related quality of life were measured. Pain and stress were measured 30 days before treatment, at each treatment, and 30 days after treatment by using short message service on mobile phones. Patients were randomized to the active or sham tDCS group by receiving individual treatment codes associated either with the sham or active tDCS in the stimulator. Adverse effects were registered using a standardized form. A small but significant improvement in pain was observed under the active tDCS condition but not under the sham condition. Fibromyalgia-related daily functioning improved in the active tDCS group compared with the sham group. The stimulation was well tolerated by the patients, and no significant difference in the adverse effects between the groups was observed. The results suggest that tDCS has the potential to induce statistically significant pain relief in patients with fibromyalgia, with no serious adverse effects, but small effect sizes indicate that the results are unlikely to reflect clinically important changes. PMID:25599302

  3. Activation and suppression of the trapezius muscle induced by transcranial magnetic stimulation.

    PubMed

    Strenge, H; Jahns, R

    1998-01-01

    Motor evoked potentials (MEPs) and silent periods (SPs) in the trapezius muscle induced by transcranial magnetic stimulation (TMS) were investigated in 15 healthy subjects. Stimuli were applied with a Novametrix Magnetic stimulator using a 14 cm circular coil 4 cm lateral to the vertex on the biauricular line. Surface electrodes were used for simultaneous bilateral electromyographic recordings of the trapezius. TMS invariably induced contralateral MEPs (latency 10.5 +/- 1.3 ms, mean +/- SD), with ipsilateral responses in 53% of the subjects (latency 11.1 +/- 2.5 ms). The mean duration of the SPs was approximately 90 ms on both sides. There were no significant side differences between any of the MEP or SP parameters. To study the influence of subcortical inhibition phenomena TMS induced responses were assessed following electrical mental nerve stimulation with interstimulus intervals (ISI) of 0-100 ms. MEP latencies significantly increased at ISI of 10-100 ms, whereas MEP amplitudes and SPs did not change. These findings may reflect a trigeminal induced exteroceptive suppression of trapezius muscle activity. PMID:9637939

  4. Ceiling effects prevent further improvement of transcranial stimulation in skilled musicians.

    PubMed

    Furuya, Shinichi; Klaus, Matthias; Nitsche, Michael A; Paulus, Walter; Altenmüller, Eckart

    2014-10-01

    The roles of the motor cortex in the acquisition and performance of skilled finger movements have been extensively investigated over decades. Yet it is still not known whether these roles of motor cortex are expertise-dependent. The present study addresses this issue by comparing the effects of noninvasive transcranial direction current stimulation (tDCS) on the fine control of sequential finger movements in highly trained pianists and musically untrained individuals. Thirteen pianists and 13 untrained controls performed timed-sequence finger movements with each of the right and left hands before and after receiving bilateral tDCS over the primary motor cortices. The results demonstrate an improvement of fine motor control in both hands in musically untrained controls, but deterioration in pianists following anodal tDCS over the contralateral cortex and cathodal tDCS over the ipsilateral cortex compared with the sham stimulation. However, this change in motor performance was not evident after stimulating with the opposite montage. These findings support the notion that changes in dexterous finger movements induced by bihemispheric tDCS are expertise-dependent. PMID:25297109

  5. Theoretical analysis of transcranial Hall-effect stimulation based on passive cable model

    NASA Astrophysics Data System (ADS)

    Yuan, Yi; Li, Xiao-Li

    2015-12-01

    Transcranial Hall-effect stimulation (THS) is a new stimulation method in which an ultrasonic wave in a static magnetic field generates an electric field in an area of interest such as in the brain to modulate neuronal activities. However, the biophysical basis of simulating the neurons remains unknown. To address this problem, we perform a theoretical analysis based on a passive cable model to investigate the THS mechanism of neurons. Nerve tissues are conductive; an ultrasonic wave can move ions embedded in the tissue in a static magnetic field to generate an electric field (due to Lorentz force). In this study, a simulation model for an ultrasonically induced electric field in a static magnetic field is derived. Then, based on the passive cable model, the analytical solution for the voltage distribution in a nerve tissue is determined. The simulation results showthat THS can generate a voltage to stimulate neurons. Because the THS method possesses a higher spatial resolution and a deeper penetration depth, it shows promise as a tool for treating or rehabilitating neuropsychiatric disorders. Project supported by the National Natural Science Foundation of China (Grant Nos. 61273063 and 61503321), the China Postdoctoral Science Foundation (Grant No. 2013M540215), the Natural Science Foundation of Hebei Province, China (Grant No. F2014203161), and the Youth Research Program of Yanshan University, China (Grant No. 02000134).

  6. The effect of 10 Hz transcranial alternating current stimulation (tACS) on corticomuscular coherence

    PubMed Central

    Wach, Claudia; Krause, Vanessa; Moliadze, Vera; Paulus, Walter; Schnitzler, Alfons; Pollok, Bettina

    2013-01-01

    Synchronous oscillatory activity at alpha (8–12 Hz), beta (13–30 Hz), and gamma (30–90 Hz) frequencies is assumed to play a key role for motor control. Corticomuscular coherence (CMC) represents an established measure of the pyramidal system's integrity. Transcranial alternating current stimulation (tACS) offers the possibility to modulate ongoing oscillatory activity. Behaviorally, 20 Hz tACS in healthy subjects has been shown to result in movement slowing. However, the neurophysiological changes underlying these effects are not entirely understood yet. The present study aimed at ascertaining the effects of tACS at 10 and 20 Hz in healthy subjects on CMC and local power of the primary sensorimotor cortex. Neuromagnetic activity was recorded during isometric contraction before and at two time points (2–10 min and 30–38 min) after tACS of the left primary motor cortex (M1), using a 306 channel whole head magnetoencephalography (MEG) system. Additionally, electromyography (EMG) of the right extensor digitorum communis (EDC) muscle was measured. TACS was applied at 10 and 20 Hz, respectively, for 10 min at 1 mA. Sham stimulation served as control condition. The data suggest that 10 Hz tACS significantly reduced low gamma band CMC during isometric contraction. This implies that tACS does not necessarily cause effects at stimulation frequency. Rather, the findings suggest cross-frequency interplay between alpha and low gamma band activity modulating functional interaction between motor cortex and muscle. PMID:24009573

  7. Transcranial magnetic stimulation and brain atrophy: a computer-based human brain model study

    PubMed Central

    Eden, Uri; Fregni, Felipe; Valero-Cabre, Antoni; Ramos-Estebanez, Ciro; Pronio-Stelluto, Valerie; Grodzinsky, Alan; Zahn, Markus; Pascual-Leone, Alvaro

    2012-01-01

    This paper is aimed at exploring the effect of cortical brain atrophy on the currents induced by transcranial magnetic stimulation (TMS). We compared the currents induced by various TMS conditions on several different MRI derived finite element head models of brain atrophy, incorporating both decreasing cortical volume and widened sulci. The current densities induced in the cortex were dependent upon the degree and type of cortical atrophy and were altered in magnitude, location, and orientation when compared to healthy head models. Predictive models of the degree of current density attenuation as a function of the scalp-to-cortex distance were analyzed, concluding that those which ignore the electromagnetic field–tissue interactions lead to inaccurate conclusions. Ultimately, the precise site and population of neural elements stimulated by TMS in an atrophic brain cannot be predicted based on healthy head models which ignore the effects of the altered cortex on the stimulating currents. Clinical applications of TMS should be carefully considered in light of these findings. PMID:18193208

  8. The site of impulse generation in transcranial magnetic stimulation of the facial nerve.

    PubMed

    Rimpiläinen, I; Pyykkö, I; Blomstedt, G; Kuurne, T; Karma, P

    1993-05-01

    The facial nerve can be stimulated in its intracranial course through transcranial magnetic stimulation (TMS). We studied the site of impulse generation produced by TMS by comparing the latencies of the muscle evoked potentials (MEPs) elicited with TMS and intracranial electrical stimulation (IES) of the facial nerve during neurosurgical posterior fossa procedures. In a series of 25 patients, the mean latency of the TMS elicited MEPs, recorded in the orbicularis oris muscle, was 5.0 ms (SD 0.58). Also IES of the distal part of the facial nerve in the internal acoustic meatus showed a mean latency of 5.0 ms (SD 0.68). Proximal IES in the root entry zone of the facial nerve, and intermediate IES between root entry zone and meatus, produced MEPs with significantly longer latencies compared to TMS and distal IES (p < 0.05). The findings suggest that the TMS induced facial nerve activation, leading to a MEP response, takes place within the internal acoustic meatus. PMID:8517138

  9. Cognitive Impairment After Sleep Deprivation Rescued by Transcranial Magnetic Stimulation Application in Octodon degus.

    PubMed

    Estrada, C; López, D; Conesa, A; Fernández-Gómez, F J; Gonzalez-Cuello, A; Toledo, F; Tunez, I; Blin, O; Bordet, R; Richardson, J C; Fernandez-Villalba, E; Herrero, M T

    2015-11-01

    Sleep is indispensable for maintaining regular daily life activities and is of fundamental physiological importance for cognitive performance. Sleep deprivation (SD) may affect learning capacity and the ability to form new memories, particularly with regard to hippocampus-dependent tasks. Transcranial magnetic stimulation (TMS) is a non-invasive procedure of electromagnetic induction that generates electric currents, activating nearby nerve cells in the stimulated cortical area. Several studies have looked into the potential therapeutic use of TMS. The present study was designed to evaluate how TMS could improve learning and memory functions following SD in Octodon degus. Thirty juvenile (18 months old) females were divided into three groups (control, acute, and chronic TMS treatment-with and without SD). TMS-treated groups were placed in plastic cylindrical cages designed to keep them immobile, while receiving head magnetic stimulation. SD was achieved by gently handling the animals to keep them awake during the night. Behavioral tests included radial arm maze (RAM), Barnes maze (BM), and novel object recognition. When TMS treatment was applied over several days, there was significant improvement of cognitive performance after SD, with no side effects. A single TMS session reduced the number of errors for the RAM test and improved latency and reduced errors for the BM test, which both evaluate spatial memory. Moreover, chronic TMS treatment brings about a significant improvement in both spatial and working memories. PMID:26194615

  10. Transcranial direct current stimulation over prefrontal cortex diminishes degree of risk aversion.

    PubMed

    Ye, Hang; Chen, Shu; Huang, Daqiang; Wang, Siqi; Jia, Yongmin; Luo, Jun

    2015-06-26

    Previous studies have established that transcranial direct current stimulation (tDCS) is a powerful technique for manipulating the activity of the human cerebral cortex. Many studies have found that weighing the risks and benefits in decision-making involves a complex neural network that includes the dorsolateral prefrontal cortex (DLPFC). We studied whether participants change the balance of risky and safe responses after receiving tDCS applied over the right and left prefrontal cortex. A total of 60 healthy volunteers performed a risk task while they received either anodal tDCS over the right prefrontal cortex, with cathodal over the left; anodal tDCS over the left prefrontal cortex, with cathodal over the right; or sham stimulation. The participants tended to choose less risky options after receiving sham stimulation, demonstrating that the task might be highly influenced by the "wealth effect". There was no statistically significant change after either right anodal/left cathodal or left anodal/right cathodal tDCS, indicating that both types of tDCS impact the participants' degrees of risk aversion, and therefore, counteract the wealth effect. We also found gender differences in the participants' choices. These findings extend the notion that DLPFC activity is critical for risk decision-making. Application of tDCS to the right/left DLPFC may impact a person's attitude to taking risks. PMID:25956033

  11. Modulation of executive control in dual tasks with transcranial direct current stimulation (tDCS).

    PubMed

    Strobach, Tilo; Soutschek, Alexander; Antonenko, Daria; Flöel, Agnes; Schubert, Torsten

    2015-02-01

    Executive processing in dual tasks is primarily associated with activation of the lateral prefrontal cortex (lPFC), which is demonstrated in functional imaging studies (e.g., Szameitat et al., 2006). However, a causal relation between lPFC activity and executive functions in dual tasks has not been demonstrated so far. Here, we used anodal transcranial direct current stimulation (atDCS [1 mA, 20 min] vs. sham stimulation [1 mA, 30s]) over the left inferior frontal junction under conditions of random and fixed task order in dual tasks as well as in single tasks in healthy young individuals (Experiment 1). We found that atDCS, if administered simultaneously to the task, improved performance in random-order dual tasks, but not in fixed-order dual tasks and single tasks. Moreover, dual-task performance under random-order conditions did not improve if atDCS was applied prior to the task performance. The identical procedure in Experiment 2 showed no difference in dual-task performance under random-task order conditions when we compared cathodal tDCS (ctDCS) with sham stimulation. Our findings suggest that dual-task performance is causally related to lPFC activation under conditions that require task-order decisions and high demands on executive functioning. Subsequent studies may now explore if atDCS leads to sustained improvements parallel to the training of dual tasks. PMID:25556813

  12. Bi-frontal transcranial alternating current stimulation in the ripple range reduced overnight forgetting

    PubMed Central

    Ambrus, Géza Gergely; Pisoni, Alberto; Primaßin, Annika; Turi, Zsolt; Paulus, Walter; Antal, Andrea

    2015-01-01

    High frequency oscillations in the hippocampal structures recorded during sleep have been proved to be essential for long-term episodic memory consolidation in both animals and in humans. The aim of this study was to test if transcranial Alternating Current Stimulation (tACS) of the dorsolateral prefrontal cortex (DLPFC) in the hippocampal ripple range, applied bi-frontally during encoding, could modulate declarative memory performance, measured immediately after encoding, and after a night's sleep. An associative word-pair learning test was used. During an evening encoding phase, participants received 1 mA 140 Hz tACS or sham stimulation over both DLPFCs for 10 min while being presented twice with a list of word-pairs. Cued recall performance was investigated 10 min after training and the morning following the training session. Forgetting from evening to morning was observed in the sham condition, but not in the 140 Hz stimulation condition. 140 Hz tACS during encoding may have an effect on the consolidation of declarative material. PMID:26441544

  13. Modulating activity in the orbitofrontal cortex changes trustees' cooperation: A transcranial direct current stimulation study.

    PubMed

    Wang, Guangrong; Li, Jianbiao; Yin, Xile; Li, Shuaiqi; Wei, Mengxing

    2016-04-15

    Trust is one of the most important factors in human society, as it pervades almost all domains of the society. The trusting behavior of trustors is dependent on the belief about the cooperative (reciprocal) level of trustees. Thence what are the motives underlying the cooperative behavior? An important explanation is that guilt aversion can motivate cooperative behavior. The right orbitofrontal cortex (OFC) is the guilt-specific region, while there is little understanding on the causal effect of this network. We explored the causal effect of the OFC on cooperative behavior using transcranial direct current stimulation (tDCS). Sixty participants played the trust game as trustees, and they received either anodal tDCS over the right OFC and simultaneously cathodal electrode over the right dorsolateral prefrontal cortex (DLPFC), or sham stimulation. Experimental results showed that participants as trustees transferred back more money in the tDCS treatment than sham stimulation. This suggests that the activity of the right OFC has causal effects on cooperative behavior. PMID:26808605

  14. The right temporoparietal junction in attention and social interaction: A transcranial magnetic stimulation study.

    PubMed

    Krall, Sarah C; Volz, Lukas J; Oberwelland, Eileen; Grefkes, Christian; Fink, Gereon R; Konrad, Kerstin

    2016-02-01

    The right temporoparietal junction (rTPJ) has been associated with the ability to reorient attention to unexpected stimuli and the capacity to understand others' mental states (theory of mind [ToM]/false belief). Using activation likelihood estimation meta-analysis we previously unraveled that the anterior rTPJ is involved in both, reorienting of attention and ToM, possibly indicating a more general role in attention shifting. Here, we used neuronavigated transcranial magnetic stimulation to directly probe the role of the rTPJ across attentional reorienting and false belief. Task performance in a visual cueing paradigm and false belief cartoon task was investigated after application of continuous theta burst stimulation (cTBS) over anterior rTPJ (versus vertex, for control). We found that attentional reorienting was significantly impaired after rTPJ cTBS compared with control. For the false belief task, error rates in trials demanding a shift in mental state significantly increased. Of note, a significant positive correlation indicated a close relation between the stimulation effect on attentional reorienting and false belief trials. Our findings extend previous neuroimaging evidence by indicating an essential overarching role of the anterior rTPJ for both cognitive functions, reorienting of attention and ToM. Hum Brain Mapp 37:796-807, 2016. © 2015 Wiley Periodicals, Inc. PMID:26610283

  15. Cellular and Molecular Mechanisms of Action of Transcranial Direct Current Stimulation: Evidence from In Vitro and In Vivo Models

    PubMed Central

    Pelletier, Simon J.

    2015-01-01

    Transcranial direct current stimulation is a noninvasive technique that has been experimentally tested for a number of psychiatric and neurological conditions. Preliminary observations suggest that this approach can indeed influence a number of cellular and molecular pathways that may be disease relevant. However, the mechanisms of action underlying its beneficial effects are largely unknown and need to be better understood to allow this therapy to be used optimally. In this review, we summarize the physiological responses observed in vitro and in vivo, with a particular emphasis on cellular and molecular cascades associated with inflammation, angiogenesis, neurogenesis, and neuroplasticity recruited by direct current stimulation, a topic that has been largely neglected in the literature. A better understanding of the neural responses to transcranial direct current stimulation is critical if this therapy is to be used in large-scale clinical trials with a view of being routinely offered to patients suffering from various conditions affecting the central nervous system. PMID:25522391

  16. Cellular and molecular mechanisms of action of transcranial direct current stimulation: evidence from in vitro and in vivo models.

    PubMed

    Pelletier, Simon J; Cicchetti, Francesca

    2015-01-01

    Transcranial direct current stimulation is a noninvasive technique that has been experimentally tested for a number of psychiatric and neurological conditions. Preliminary observations suggest that this approach can indeed influence a number of cellular and molecular pathways that may be disease relevant. However, the mechanisms of action underlying its beneficial effects are largely unknown and need to be better understood to allow this therapy to be used optimally. In this review, we summarize the physiological responses observed in vitro and in vivo, with a particular emphasis on cellular and molecular cascades associated with inflammation, angiogenesis, neurogenesis, and neuroplasticity recruited by direct current stimulation, a topic that has been largely neglected in the literature. A better understanding of the neural responses to transcranial direct current stimulation is critical if this therapy is to be used in large-scale clinical trials with a view of being routinely offered to patients suffering from various conditions affecting the central nervous system. PMID:25522391

  17. Repeated transcranial direct current stimulation prevents abnormal behaviors associated with abstinence from chronic nicotine consumption.

    PubMed

    Pedron, Solène; Monnin, Julie; Haffen, Emmanuel; Sechter, Daniel; Van Waes, Vincent

    2014-03-01

    Successful available treatments to quit smoking remain scarce. Recently, the potential of transcranial direct current stimulation (tDCS) as a tool to reduce craving for nicotine has gained interest. However, there is no documented animal model to assess the neurobiological mechanisms of tDCS on addiction-related behaviors. To address this topic, we have developed a model of repeated tDCS in mice and used it to validate its effectiveness in relieving nicotine addiction. Anodal repeated tDCS was applied over the frontal cortex of Swiss female mice. The stimulation electrode (anode) was fixed directly onto the cranium, and the reference electrode was placed onto the ventral thorax. A 2 × 20 min/day stimulation paradigm for five consecutive days was used (0.2 mA). In the first study, we screened for behaviors altered by the stimulation. Second, we tested whether tDCS could alleviate abnormal behaviors associated with abstinence from nicotine consumption. In naive animals, repeated tDCS had antidepressant-like properties 3 weeks after the last stimulation, improved working memory, and decreased conditioned place preference for nicotine without affecting locomotor activity and anxiety-related behavior. Importantly, abnormal behaviors associated with chronic nicotine exposure (ie, depression-like behavior, increase in nicotine-induced place preference) were normalized by repeated tDCS. Our data show for the first time in an animal model that repeated tDCS is a promising, non-expensive clinical tool that could be used to reduce smoking craving and facilitate smoking cessation. Our animal model will be useful to investigate the mechanisms underlying the effects of tDCS on addiction and other psychiatric disorders. PMID:24154668

  18. Subcortical Structures in Humans Can Be Facilitated by Transcranial Direct Current Stimulation

    PubMed Central

    Nonnekes, Jorik; Arrogi, Anass; Munneke, Moniek A. M.; van Asseldonk, Edwin H. F.; Oude Nijhuis, Lars B.; Geurts, Alexander C.; Weerdesteyn, Vivian

    2014-01-01

    Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that alters cortical excitability. Interestingly, in recent animal studies facilitatory effects of tDCS have also been observed on subcortical structures. Here, we sought to provide evidence for the potential of tDCS to facilitate subcortical structures in humans as well. Subjects received anodal-tDCS and sham-tDCS on two separate testing days in a counterbalanced order. After stimulation, we assessed the effect of tDCS on two responses that arise from subcortical structures; (1) wrist and ankle responses to an imperative stimulus combined with a startling acoustic stimulus (SAS), and (2) automatic postural responses to external balance perturbations with and without a concurrent SAS. During all tasks, response onsets were significantly faster following anodal-tDCS compared to sham-tDCS, both in trials with and without a SAS. The effect of tDCS was similar for the dominant and non-dominant leg. The SAS accelerated the onsets of ankle and wrist movements and the responses to backward, but not forward perturbations. The faster onsets of SAS-induced wrist and ankle movements and automatic postural responses following stimulation provide strong evidence that, in humans, subcortical structures - in particular the reticular formation - can be facilitated by tDCS. This effect may be explained by two mechanisms that are not mutually exclusive. First, subcortical facilitation may have resulted from enhanced cortico-reticular drive. Second, the applied current may have directly stimulated the reticular formation. Strengthening reticulospinal output by tDCS may be of interest to neurorehabilitation, as there is evidence for reticulospinal compensation after corticospinal lesions. PMID:25233458

  19. Positron emission tomography during transcranial magnetic stimulation does not require mu-metal shielding.

    PubMed

    Lee, Jae Sung; Narayana, Shalini; Lancaster, Jack; Jerabek, Paul; Lee, Dong Soo; Fox, Peter

    2003-08-01

    Recording brain activity using positron emission tomography (PET) during the stimulation of different parts of the brain by transcranial magnetic stimulation (TMS) permits the mapping of neural connections in the living human brain. However, controversy remains regarding the need for micro-metal shielding of the PET scanner during magnetic stimulation. The aim of this study was to test the effects of magnetic fields generated by TMS on PET data acquisition. With TMS-on and -off in the PET field of view, transmission scans with a (68)Ge/(68)Ga pin source and emission scans with an uniform phantom filled with water and (18)F were acquired. The frequency and intensity of stimulation were set at 3-5 Hz and 70-80% of the maximum output of the stimulator, respectively. The TMS coil was placed at several locations inside the PET gantry, and the main field direction of the TMS coil was varied between parallel and perpendicular orientation to the scanner's axis. Qualitative and quantitative evaluation of the sinograms of transmission PET scans and reconstructed emission images indicated no measurable differences between TMS-on and -off and post-TMS conditions for any position or orientation. The long distance between the TMS coil and the detector block in the PET scanner, as well as the rapid reduction of the magnetic field with distance (3% of maximum field at 10 cm, in air), could explain the lack of TMS interference. The brief duration (approximately 250 micros) of the TMS pulses relative to the total PET acquisition time would also explain the lack of TMS effects. The lack of TMS effects on the PET scanner, as well as PET imaging without any shielding, has been reported by other laboratories. PMID:12948735

  20. Change in Mean Frequency of Resting-State Electroencephalography after Transcranial Direct Current Stimulation.

    PubMed

    Boonstra, Tjeerd W; Nikolin, Stevan; Meisener, Ann-Christin; Martin, Donel M; Loo, Colleen K

    2016-01-01

    Transcranial direct current stimulation (tDCS) is proposed as a tool to investigate cognitive functioning in healthy people and as a treatment for various neuropathological disorders. However, the underlying cortical mechanisms remain poorly understood. We aim to investigate whether resting-state electroencephalography (EEG) can be used to monitor the effects of tDCS on cortical activity. To this end we tested whether the spectral content of ongoing EEG activity is significantly different after a single session of active tDCS compared to sham stimulation. Twenty participants were tested in a sham-controlled, randomized, crossover design. Resting-state EEG was acquired before, during and after active tDCS to the left dorsolateral prefrontal cortex (15 min of 2 mA tDCS) and sham stimulation. Electrodes with a diameter of 3.14 cm(2) were used for EEG and tDCS. Partial least squares (PLS) analysis was used to examine differences in power spectral density (PSD) and the EEG mean frequency to quantify the slowing of EEG activity after stimulation. PLS revealed a significant increase in spectral power at frequencies below 15 Hz and a decrease at frequencies above 15 Hz after active tDCS (P = 0.001). The EEG mean frequency was significantly reduced after both active tDCS (P < 0.0005) and sham tDCS (P = 0.001), though the decrease in mean frequency was smaller after sham tDCS than after active tDCS (P = 0.073). Anodal tDCS of the left DLPFC using a high current density bi-frontal electrode montage resulted in general slowing of resting-state EEG. The similar findings observed following sham stimulation question whether the standard sham protocol is an appropriate control condition for tDCS. PMID:27375462

  1. Effects of anodal transcranial direct current stimulation on visually guided learning of grip force control.

    PubMed

    Minarik, Tamas; Sauseng, Paul; Dunne, Lewis; Berger, Barbara; Sterr, Annette

    2015-01-01

    Anodal transcranial Direct Current Stimulation (tDCS) has been shown to be an effective non-invasive brain stimulation method for improving cognitive and motor functioning in patients with neurological deficits. tDCS over motor cortex (M1), for instance, facilitates motor learning in stroke patients. However, the literature on anodal tDCS effects on motor learning in healthy participants is inconclusive, and the effects of tDCS on visuo-motor integration are not well understood. In the present study we examined whether tDCS over the contralateral motor cortex enhances learning of grip-force output in a visually guided feedback task in young and neurologically healthy volunteers. Twenty minutes of 1 mA anodal tDCS were applied over the primary motor cortex (M1) contralateral to the dominant (right) hand, during the first half of a 40 min power-grip task. This task required the control of a visual signal by modulating the strength of the power-grip for six seconds per trial. Each participant completed a two-session sham-controlled crossover protocol. The stimulation conditions were counterbalanced across participants and the sessions were one week apart. Performance measures comprised time-on-target and target-deviation, and were calculated for the periods of stimulation (or sham) and during the afterphase respectively. Statistical analyses revealed significant performance improvements over the stimulation and the afterphase, but this learning effect was not modulated by tDCS condition. This suggests that the form of visuomotor learning taking place in the present task was not sensitive to neurostimulation. These null effects, together with similar reports for other types of motor tasks, lead to the proposition that tDCS facilitation of motor learning might be restricted to cases or situations where the motor system is challenged, such as motor deficits, advanced age, or very high task demand. PMID:25738809

  2. Change in Mean Frequency of Resting-State Electroencephalography after Transcranial Direct Current Stimulation

    PubMed Central

    Boonstra, Tjeerd W.; Nikolin, Stevan; Meisener, Ann-Christin; Martin, Donel M.; Loo, Colleen K.

    2016-01-01

    Transcranial direct current stimulation (tDCS) is proposed as a tool to investigate cognitive functioning in healthy people and as a treatment for various neuropathological disorders. However, the underlying cortical mechanisms remain poorly understood. We aim to investigate whether resting-state electroencephalography (EEG) can be used to monitor the effects of tDCS on cortical activity. To this end we tested whether the spectral content of ongoing EEG activity is significantly different after a single session of active tDCS compared to sham stimulation. Twenty participants were tested in a sham-controlled, randomized, crossover design. Resting-state EEG was acquired before, during and after active tDCS to the left dorsolateral prefrontal cortex (15 min of 2 mA tDCS) and sham stimulation. Electrodes with a diameter of 3.14 cm2 were used for EEG and tDCS. Partial least squares (PLS) analysis was used to examine differences in power spectral density (PSD) and the EEG mean frequency to quantify the slowing of EEG activity after stimulation. PLS revealed a significant increase in spectral power at frequencies below 15 Hz and a decrease at frequencies above 15 Hz after active tDCS (P = 0.001). The EEG mean frequency was significantly reduced after both active tDCS (P < 0.0005) and sham tDCS (P = 0.001), though the decrease in mean frequency was smaller after sham tDCS than after active tDCS (P = 0.073). Anodal tDCS of the left DLPFC using a high current density bi-frontal electrode montage resulted in general slowing of resting-state EEG. The similar findings observed following sham stimulation question whether the standard sham protocol is an appropriate control condition for tDCS. PMID:27375462

  3. Excitability of the motor system: A transcranial magnetic stimulation study on singing and speaking.

    PubMed

    Royal, Isabelle; Lidji, Pascale; Théoret, Hugo; Russo, Frank A; Peretz, Isabelle

    2015-08-01

    The perception of movements is associated with increased activity in the human motor cortex, which in turn may underlie our ability to understand actions, as it may be implicated in the recognition, understanding and imitation of actions. Here, we investigated the involvement and lateralization of the primary motor cortex (M1) in the perception of singing and speech. Transcranial magnetic stimulation (TMS) was applied independently for both hemispheres over the mouth representation of the motor cortex in healthy participants while they watched 4-s audiovisual excerpts of singers producing a 2-note ascending interval (singing condition) or 4-s audiovisual excerpts of a person explaining a proverb (speech condition). Subjects were instructed to determine whether a sung interval/written proverb, matched a written interval/proverb. During both tasks, motor evoked potentials (MEPs) were recorded from the contralateral mouth muscle (orbicularis oris) of the stimulated motor cortex compared to a control task. Moreover, to investigate the time course of motor activation, TMS pulses were randomly delivered at 7 different time points (ranging from 500 to 3500 ms after stimulus onset). Results show that stimulation of the right hemisphere had a similar effect on the MEPs for both the singing and speech perception tasks, whereas stimulation of the left hemisphere significantly differed in the speech perception task compared to the singing perception task. Furthermore, analysis of the MEPs in the singing task revealed that they decreased for small musical intervals, but increased for large musical intervals, regardless of which hemisphere was stimulated. Overall, these results suggest a dissociation between the lateralization of M1 activity for speech perception and for singing perception, and that in the latter case its activity can be modulated by musical parameters such as the size of a musical interval. PMID:26116909

  4. How does transcranial magnetic stimulation modify neuronal activity in the brain? - Implications for studies of cognition

    PubMed Central

    Siebner, Hartwig R.; Hartwigsen, Gesa; Kassuba, Tanja; Rothwell, John

    2010-01-01

    Transcranial magnetic stimulation (TMS) uses a magnetic field to “carry” a short lasting electrical current pulse into the brain where it stimulates neurones, particularly in superficial regions of cerebral cortex. TMS can interfere with cognitive functions in two ways. A high intensity TMS pulse causes a synchronised high frequency burst of discharge in a relatively large population of neurones that is terminated by a long lasting GABAergic inhibition. The combination of artificial synchronisation of activity followed by depression effectively disrupts perceptual, motor and cognitive processes in the human brain. This transient neurodisruption has been termed a “virtual lesion”. Smaller intensities of stimulation produce less activity; in such cases, cognitive operations can probably continue but are disrupted because of the added noisy input from the TNS pulse. It is usually argued that if a TMS pulse affects performance, then the area stimulated must provide an essential contribution to behaviour being studied. However, there is one exception to this: the pulse could be applied to an area that is not involved in the task but which has projections to the critical site. Activation of outputs from the site of stimulation could potentially disrupt processing at the distant site, interfering with behaviour without having any involvement in the task. A final important feature of the response to TMS is “context dependency”, which indicates that the response depends on how excitable the cortex is at the time the stimulus is applied: if many neurones are close to firing threshold then the more of them are recruited by the pulse than at rest. Many studies have noted this context-dependent modulation. However, it is often assumed that the excitability of an area has a simple relationship to activity in that area. We argue that this is not necessarily the case. Awareness of the problem may help resolve some apparent anomalies in the literature. PMID:19371866

  5. Influence of Transcranial Direct Current Stimulation to the Cerebellum on Standing Posture Control

    PubMed Central

    Inukai, Yasuto; Saito, Kei; Sasaki, Ryoki; Kotan, Shinichi; Nakagawa, Masaki; Onishi, Hideaki

    2016-01-01

    Damage to the vestibular cerebellum results in dysfunctional standing posture control. Patients with cerebellum dysfunction have a larger sway in the center of gravity while standing compared with healthy subjects. Transcranial direct current stimulation (tDCS) is a noninvasive technique for selectively exciting or inhibiting specific neural structures with potential applications in functional assessment and treatment of neural disorders. However, the specific stimulation parameters for influencing postural control have not been assessed. In this study, we investigated the influence of tDCS when applied over the cerebellum on standing posture control. Sixteen healthy subjects received tDCS (20 min, 2 mA) over the scalp 2 cm below the inion. In Experiment 1, all 16 subjects received tDCS under three stimulus conditions, Sham, Cathodal, and Anodal, in a random order with the second electrode placed on the forehead. In Experiment 2, five subjects received cathodal stimulation only with the second electrode placed over the right buccinator muscle. Center of gravity sway was measured twice for 60 s before and after tDCS in a standing posture with eyes open and legs closed, and average total locus length, locus length per second, rectangular area, and enveloped area were calculated. In Experiment 1, total locus length and locus length per second decreased significantly after cathodal stimulation but not after anodal or sham stimulation, while no tDCS condition influenced rectangular or enveloped areas. In Experiment 2, cathodal tDCS again significantly reduced total locus length and locus length per second but not rectangular and enveloped areas. The effects of tDCS on postural control are polarity-dependent, likely reflecting the selective excitation or inhibition of cerebellar Purkinje cells. Cathodal tDCS to the cerebellum of healthy subjects can alter body sway (velocity). PMID:27458358

  6. Influence of Transcranial Direct Current Stimulation to the Cerebellum on Standing Posture Control.

    PubMed

    Inukai, Yasuto; Saito, Kei; Sasaki, Ryoki; Kotan, Shinichi; Nakagawa, Masaki; Onishi, Hideaki

    2016-01-01

    Damage to the vestibular cerebellum results in dysfunctional standing posture control. Patients with cerebellum dysfunction have a larger sway in the center of gravity while standing compared with healthy subjects. Transcranial direct current stimulation (tDCS) is a noninvasive technique for selectively exciting or inhibiting specific neural structures with potential applications in functional assessment and treatment of neural disorders. However, the specific stimulation parameters for influencing postural control have not been assessed. In this study, we investigated the influence of tDCS when applied over the cerebellum on standing posture control. Sixteen healthy subjects received tDCS (20 min, 2 mA) over the scalp 2 cm below the inion. In Experiment 1, all 16 subjects received tDCS under three stimulus conditions, Sham, Cathodal, and Anodal, in a random order with the second electrode placed on the forehead. In Experiment 2, five subjects received cathodal stimulation only with the second electrode placed over the right buccinator muscle. Center of gravity sway was measured twice for 60 s before and after tDCS in a standing posture with eyes open and legs closed, and average total locus length, locus length per second, rectangular area, and enveloped area were calculated. In Experiment 1, total locus length and locus length per second decreased significantly after cathodal stimulation but not after anodal or sham stimulation, while no tDCS condition influenced rectangular or enveloped areas. In Experiment 2, cathodal tDCS again significantly reduced total locus length and locus length per second but not rectangular and enveloped areas. The effects of tDCS on postural control are polarity-dependent, likely reflecting the selective excitation or inhibition of cerebellar Purkinje cells. Cathodal tDCS to the cerebellum of healthy subjects can alter body sway (velocity). PMID:27458358

  7. Measurement of voluntary activation of fresh and fatigued human muscles using transcranial magnetic stimulation

    PubMed Central

    Todd, Gabrielle; Taylor, Janet L; Gandevia, S C

    2003-01-01

    Recently, transcranial magnetic stimulation of the motor cortex (TMS) revealed impaired voluntary activation of muscles during maximal efforts. Hence, we evaluated its use as a measure of voluntary activation over a range of contraction strengths in both fresh and fatigued muscles, and compared it with standard twitch interpolation using nerve stimulation. Subjects contracted the elbow flexors isometrically while force and EMG from biceps and triceps were recorded. In one study, eight subjects made submaximal and maximal test contractions with rests to minimise fatigue. In the second study, eight subjects made sustained maximal contractions to reduce force to 60 % of the initial value, followed by brief test contractions. Force responses were recorded following TMS or electrical stimulation of the biceps motor nerve. In other contractions, EMG responses to TMS (motor evoked potentials, MEPs) or to stimulation at the brachial plexus (maximal M waves, Mmax) were recorded. During contractions of 50 % maximum, TMS elicited large MEPs in biceps (> 90 % Mmax) which decreased in size (to ≈70 % Mmax) with maximal efforts. This suggests that faster firing rates made some motor units effectively refractory. With fatigue, MEPs were also smaller but remained > 70 % Mmax for contractions of 50–100 % maximum. For fresh and fatigued muscle, the superimposed twitch evoked by motor nerve and motor cortex stimulation decreased with increasing contraction strength. For nerve stimulation the relation was curvilinear, and for TMS it was linear for contractions of 50–100 % maximum (r2 = 1.00). Voluntary activation was derived using the expression: (1 – superimposed twitch/resting twitch) × 100. The resting twitch was measured directly for nerve stimulation and for TMS, it was estimated by extrapolation of the linear regression between the twitch and voluntary force. For cortical stimulation, this resulted in a highly linear relation between voluntary activation and force

  8. 40Hz-Transcranial alternating current stimulation (tACS) selectively modulates speech perception.

    PubMed

    Rufener, Katharina S; Zaehle, Tino; Oechslin, Mathias S; Meyer, Martin

    2016-03-01

    The present study investigated the functional relevance of gamma oscillations for the processing of rapidly changing acoustic features in speech signals. For this purpose we analyzed repetition-induced perceptual learning effects in 18 healthy adult participants. The participants received either 6Hz or 40Hz tACS over the bilateral auditory cortex, while repeatedly performing a phoneme categorization task. In result, we found that 40Hz tACS led to a specific alteration in repetition-induced perceptual learning. While participants in the non-stimulated control group as well as those in the experimental group receiving 6Hz tACS considerably improved their perceptual performance, the application of 40Hz tACS selectively attenuated the repetition-induced improvement in phoneme categorization abilities. Our data provide causal evidence for a functional relevance of gamma oscillations during the perceptual learning of acoustic speech features. Moreover, we demonstrate that even less than twenty minutes of alternating current stimulation below the individual perceptual threshold is sufficient to affect speech perception. This finding is relevant in that this novel approach might have implications with respect to impaired speech processing in dyslexics and older adults. PMID:26779822

  9. Stimulus-response profile during single-pulse transcranial magnetic stimulation to the primary motor cortex.

    PubMed

    Hanakawa, Takashi; Mima, Tatsuya; Matsumoto, Riki; Abe, Mitsunari; Inouchi, Morito; Urayama, Shin-Ichi; Anami, Kimitaka; Honda, Manabu; Fukuyama, Hidenao

    2009-11-01

    We examined the stimulus-response profile during single-pulse transcranial magnetic stimulation (TMS) by measuring motor-evoked potentials (MEPs) with electromyographic monitoring and hemodynamic responses with functional magnetic resonance imaging (fMRI) at 3 Tesla. In 16 healthy subjects, single TMS pulses were irregularly delivered to the left primary motor cortex at a mean frequency of 0.15 Hz with a wide range of stimulus intensities. The measurement of MEP proved a typical relationship between stimulus intensity and MEP amplitude in the concurrent TMS-fMRI environment. In the population-level analysis of the suprathreshold stimulation conditions, significant increases in hemodynamic responses were detected in the motor/somatosensory network, reflecting both direct and remote effects of TMS, and also the auditory/cognitive areas, perhaps related to detection of clicks. The stimulus-response profile showed both linear and nonlinear components in the direct and remote motor/somatosensory network. A detailed analysis suggested that the nonlinear components of the motor/somatosensory network activity might be induced by nonlinear recruitment of neurons in addition to sensory afferents resulting from movement. These findings expand our basic knowledge of the quantitative relationship between TMS-induced neural activations and hemodynamic signals measured by neuroimaging techniques. PMID:19234068

  10. Opportunities for concurrent transcranial magnetic stimulation and electroencephalography to characterize cortical activity in stroke

    PubMed Central

    Sato, Sumire; Bergmann, Til Ole; Borich, Michael R.

    2015-01-01

    Stroke is the leading cause of disability in the United States. Despite the high incidence and mortality of stroke, sensitive and specific brain-based biomarkers predicting persisting disabilities are lacking. Both neuroimaging techniques like electroencephalography (EEG) and non-invasive brain stimulation (NIBS) techniques such as transcranial magnetic stimulation (TMS) have proven useful in predicting prognosis, recovery trajectories and response to rehabilitation in individuals with stroke. We propose, however, that additional synergetic effects can be achieved by simultaneously combining both approaches. Combined TMS-EEG is able to activate discrete cortical regions and directly assess local cortical reactivity and effective connectivity within the network independent of the integrity of descending fiber pathways and also outside the motor system. Studying cortical reactivity and connectivity in patients with stroke TMS-EEG may identify salient neural mechanisms underlying motor disabilities and lead to novel biomarkers of stroke pathophysiology which can then be used to assess, monitor, and refine rehabilitation approaches for individuals with significant disability to improve outcomes and quality of life after stroke. PMID:25999839

  11. Visualizing Simulated Electrical Fields from Electroencephalography and Transcranial Electric Brain Stimulation: A Comparative Evaluation

    PubMed Central

    Eichelbaum, Sebastian; Dannhauer, Moritz; Hlawitschka, Mario; Brooks, Dana; Knösche, Thomas R.; Scheuermann, Gerik

    2014-01-01

    Electrical activity of neuronal populations is a crucial aspect of brain activity. This activity is not measured directly but recorded as electrical potential changes using head surface electrodes (electroencephalogram - EEG). Head surface electrodes can also be deployed to inject electrical currents in order to modulate brain activity (transcranial electric stimulation techniques) for therapeutic and neuroscientific purposes. In electroencephalography and noninvasive electric brain stimulation, electrical fields mediate between electrical signal sources and regions of interest (ROI). These fields can be very complicated in structure, and are influenced in a complex way by the conductivity profile of the human head. Visualization techniques play a central role to grasp the nature of those fields because such techniques allow for an effective conveyance of complex data and enable quick qualitative and quantitative assessments. The examination of volume conduction effects of particular head model parameterizations (e.g., skull thickness and layering), of brain anomalies (e.g., holes in the skull, tumors), location and extent of active brain areas (e.g., high concentrations of current densities) and around current injecting electrodes can be investigated using visualization. Here, we evaluate a number of widely used visualization techniques, based on either the potential distribution or on the current-flow. In particular, we focus on the extractability of quantitative and qualitative information from the obtained images, their effective integration of anatomical context information, and their interaction. We present illustrative examples from clinically and neuroscientifically relevant cases and discuss the pros and cons of the various visualization techniques. PMID:24821532

  12. Eyes wide shut: Transcranial alternating current stimulation drives alpha rhythm in a state dependent manner.

    PubMed

    Ruhnau, Philipp; Neuling, Toralf; Fuscá, Marco; Herrmann, Christoph S; Demarchi, Gianpaolo; Weisz, Nathan

    2016-01-01

    Transcranial alternating current stimulation (tACS) is used to modulate brain oscillations to measure changes in cognitive function. It is only since recently that brain activity in human subjects during tACS can be investigated. The present study aims to investigate the phase relationship between the external tACS signal and concurrent brain activity. Subjects were stimulated with tACS at individual alpha frequency during eyes open and eyes closed resting states. Electrodes were placed at Cz and Oz, which should affect parieto-occipital areas most strongly. Source space magnetoencephalography (MEG) data were used to estimate phase coherence between tACS and brain activity. Phase coherence was significantly increased in areas in the occipital pole in eyes open resting state only. The lag between tACS and brain responses showed considerable inter-individual variability. In conclusion, tACS at individual alpha frequency entrains brain activity in visual cortices. Interestingly, this effect is state dependent and is clearly observed with eyes open but only to a lesser extent with eyes closed. PMID:27252047

  13. Modulation of human auditory spatial scene analysis by transcranial direct current stimulation.

    PubMed

    Lewald, Jörg

    2016-04-01

    Localizing and selectively attending to the source of a sound of interest in a complex auditory environment is an important capacity of the human auditory system. The underlying neural mechanisms have, however, still not been clarified in detail. This issue was addressed by using bilateral bipolar-balanced transcranial direct current stimulation (tDCS) in combination with a task demanding free-field sound localization in the presence of multiple sound sources, thus providing a realistic simulation of the so-called "cocktail-party" situation. With left-anode/right-cathode, but not with right-anode/left-cathode, montage of bilateral electrodes, tDCS over superior temporal gyrus, including planum temporale and auditory cortices, was found to improve the accuracy of target localization in left hemispace. No effects were found for tDCS over inferior parietal lobule or with off-target active stimulation over somatosensory-motor cortex that was used to control for non-specific effects. Also, the absolute error in localization remained unaffected by tDCS, thus suggesting that general response precision was not modulated by brain polarization. This finding can be explained in the framework of a model assuming that brain polarization modulated the suppression of irrelevant sound sources, thus resulting in more effective spatial separation of the target from the interfering sound in the complex auditory scene. PMID:26825012

  14. Eyes wide shut: Transcranial alternating current stimulation drives alpha rhythm in a state dependent manner

    PubMed Central

    Ruhnau, Philipp; Neuling, Toralf; Fuscá, Marco; Herrmann, Christoph S.; Demarchi, Gianpaolo; Weisz, Nathan

    2016-01-01

    Transcranial alternating current stimulation (tACS) is used to modulate brain oscillations to measure changes in cognitive function. It is only since recently that brain activity in human subjects during tACS can be investigated. The present study aims to investigate the phase relationship between the external tACS signal and concurrent brain activity. Subjects were stimulated with tACS at individual alpha frequency during eyes open and eyes closed resting states. Electrodes were placed at Cz and Oz, which should affect parieto-occipital areas most strongly. Source space magnetoencephalography (MEG) data were used to estimate phase coherence between tACS and brain activity. Phase coherence was significantly increased in areas in the occipital pole in eyes open resting state only. The lag between tACS and brain responses showed considerable inter-individual variability. In conclusion, tACS at individual alpha frequency entrains brain activity in visual cortices. Interestingly, this effect is state dependent and is clearly observed with eyes open but only to a lesser extent with eyes closed. PMID:27252047

  15. Transcranial direct current stimulation modulates ERP-indexed inhibitory control and reduces food consumption.

    PubMed

    Lapenta, Olivia Morgan; Sierve, Karina Di; de Macedo, Elizeu Coutinho; Fregni, Felipe; Boggio, Paulo Sérgio

    2014-12-01

    Food craving can be defined as the "urge to eat a specific food". Previous findings suggest impairment of inhibitory control, specifically a regulatory deficit in the lateral prefrontal circuitry that is associated with a compulsion for food. As demonstrated by three previous studies, bilateral transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC) (anode right/cathode left) reduces food craving and caloric intake. We designed the present study to evaluate the neural mechanisms that underlie these effects. We replicated the design of one of these previous studies but included electroencephalographic assessments to register evoked potentials in a Go/No-go task that contained pictures of food and furniture (a control visual stimulus). We collected data from nine women (mean age = 23.4 ± 2 years) in a crossover experiment. We observed that active DLPFC tDCS (anode right/cathode left), compared with sham stimulation, reduced the frontal N2 component and enhanced the P3a component of responses to No-go stimuli, regardless of the stimulus condition (food or furniture). Active tDCS was also associated with a reduction in caloric intake. We discuss our findings in the context of cortico-subcortical processing of craving and tDCS effects on inhibitory control neural circuitry. PMID:25128836

  16. Transcranial direct current stimulation over Broca's region improves phonemic and semantic fluency in healthy individuals.

    PubMed

    Cattaneo, Z; Pisoni, A; Papagno, C

    2011-06-01

    Previous studies have demonstrated that transcranial direct current stimulation (tDCS) can be proficiently used to modulate attentional and cognitive functions. For instance, in the language domain there is evidence that tDCS can fasten picture naming in both healthy individuals and aphasic patients, or improve grammar learning. In this study, we investigated whether tDCS can be used to increase healthy subjects' performance in phonemic and semantic fluency tasks, that are typically used in clinical assessment of language. Ten healthy individuals performed a semantic and a phonemic fluency task following anodal tDCS applied over Broca's region. Each participant underwent a real and a sham tDCS session. Participants were found to produce more words following real anodal tDCS both in the phonemic and in the semantic fluency. Control experiments ascertained that this finding did not depend upon unspecific effects of tDCS over levels of general arousal or attention or upon participants' expectations. These data confirm the efficacy of tDCS in transiently improving language functions by showing that anodal stimulation of Broca's region can enhanc