Journal articles: 'TDCS/TMS'

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Hummel, F., and L. G. Cohen. "W15.1 TMS and tDCS." Clinical Neurophysiology 122 (June 2011): S49. http://dx.doi.org/10.1016/s1388-2457(11)60165-x.

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Begemann, Marieke J., Bodyl A. Brand, Branislava Ćurčić-Blake, André Aleman, and Iris E. Sommer. "Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis." Psychological Medicine 50, no. 15 (October 19, 2020): 2465–86. http://dx.doi.org/10.1017/s0033291720003670.

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AbstractBackgroundCognition is commonly affected in brain disorders. Non-invasive brain stimulation (NIBS) may have procognitive effects, with high tolerability. This meta-analysis evaluates the efficacy of transcranial magnetic stimulation (TMS) and transcranial Direct Current Stimulation (tDCS) in improving cognition, in schizophrenia, depression, dementia, Parkinson's disease, stroke, traumatic brain injury, and multiple sclerosis.MethodsA PRISMA systematic search was conducted for randomized controlled trials. Hedges' g was used to quantify effect sizes (ES) for changes in cognition after TMS/tDCS v. sham. As different cognitive functions may have unequal susceptibility to TMS/tDCS, we separately evaluated the effects on: attention/vigilance, working memory, executive functioning, processing speed, verbal fluency, verbal learning, and social cognition.ResultsWe included 82 studies (n = 2784). For working memory, both TMS (ES = 0.17, p = 0.015) and tDCS (ES = 0.17, p = 0.021) showed small but significant effects. Age positively moderated the effect of TMS. TDCS was superior to sham for attention/vigilance (ES = 0.20, p = 0.020). These significant effects did not differ across the type of brain disorder. Results were not significant for the other five cognitive domains.ConclusionsOur results revealed that both TMS and tDCS elicit a small trans-diagnostic effect on working memory, tDCS also improved attention/vigilance across diagnoses. Effects on the other domains were not significant. Observed ES were small, yet even slight cognitive improvements may facilitate daily functioning. While NIBS can be a well-tolerated treatment, its effects appear domain specific and should be applied only for realistic indications (i.e. to induce a small improvement in working memory or attention).

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Nissim, Nicole R., Paul J. Moberg, and Roy H. Hamilton. "Efficacy of Noninvasive Brain Stimulation (tDCS or TMS) Paired with Language Therapy in the Treatment of Primary Progressive Aphasia: An Exploratory Meta-Analysis." Brain Sciences 10, no. 9 (August 28, 2020): 597. http://dx.doi.org/10.3390/brainsci10090597.

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Noninvasive brain stimulation techniques, such as transcranial direct current stimulation (tDCS) and transcranial magnetic stimulation (TMS), paired with behavioral language therapy, have demonstrated the capacity to enhance language abilities in primary progressive aphasia (PPA), a debilitating degenerative neurological syndrome that leads to declines in communication abilities. The aim of this meta-analysis is to systematically evaluate the efficacy of tDCS and TMS in improving language outcomes in PPA, explore the magnitude of effects between stimulation modalities, and examine potential moderators that may influence treatment effects. Standard mean differences for change in performance from baseline to post-stimulation on language-related tasks were evaluated. Six tDCS studies and two repetitive TMS studies met inclusion criteria and provided 22 effects in the analysis. Random effect models revealed a significant, heterogeneous, and moderate effect size for tDCS and TMS in the enhancement of language outcomes. Findings demonstrate that naming ability significantly improves due to brain stimulation, an effect found to be largely driven by tDCS. Future randomized controlled trials are needed to determine long-term effectiveness of noninvasive brain stimulation techniques on language abilities, further delineate the efficacy of tDCS and TMS, and identify optimal parameters to enable the greatest gains for persons with PPA.

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Dell’Osso, Bernardo, and A. Carlo Altamura. "Transcranial Brain Stimulation Techniques For Major Depression: Should We Extend TMS Lessons to tDCS?" Clinical Practice & Epidemiology in Mental Health 10, no. 1 (October 3, 2014): 92–93. http://dx.doi.org/10.2174/1745017901410010092.

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Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive brain stimulation techniques that, by means of magnetic fields and low intensity electrical current, respectively, aim to interefere with and modulate cortical excitability, at the level of dorsolateral prefrontal cortex, in patients with major depression and poor response to standard antidepressants. While the clinical efficacy of TMS in major depression has been extensively investigated over the last 10 years, tDCS has attracted research interest only in the last years, with fewer randomized clinical trials (RCTs) in the field. Nevertheless, in spite of the different rationale and mechanism of action of the two techniques, tDCS recent acquisitions, in relation to the treatment of major depression, seem to parallel those previously obtained with TMS, in terms of treatment duration to achieve optimal benefit and patient's history of drug-resistance. After briefly introducing the two techniques, the article examines possible common pathways of clinical use for TMS and tDCS, emerging from recent RCTs and likely orienting future investigation with non invasive brain stimulation for the treatment of major depression.

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McCambridge, Alana B., James W. Stinear, and Winston D. Byblow. "A dissociation between propriospinal facilitation and inhibition after bilateral transcranial direct current stimulation." Journal of Neurophysiology 111, no. 11 (June 1, 2014): 2187–95. http://dx.doi.org/10.1152/jn.00879.2013.

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Propriospinal premotoneurons (PN) are essential for accurate control of the upper limb. They receive bilateral input from premotor (PM) and primary motor (M1) cortices. In humans, excitability of PNs can be estimated from motor-evoked potentials (MEPs) by pairing a descending volley using transcranial magnetic stimulation (TMS) to summate with an ascending volley from peripheral nerve stimulation at the C3–C4 level of the spinal cord. Transcranial direct current stimulation (tDCS) alters excitability of cortical and subcortical areas. A recent study demonstrated that cathodal tDCS can suppress facilitatory (FAC) and inhibitory (INH) components of PN excitability, presumably via effects on corticoreticulospinal neurons (Bradnam LV, Stinear CM, Lewis GN, Byblow WD. J Neurophysiol 103: 2382–2389, 2010). The present study investigated the effects of bilateral tDCS with healthy subjects. The cathode was placed over left dorsal PM or M1 and the anode over right M1 in separate sessions (PM-M1, M1-M1, or Sham). TMS of right M1 elicited MEPs in left biceps brachii across a range of TMS intensities chosen to examine PN-mediated FAC and INH. Conditioning was applied using median nerve stimulation with an interstimulus interval that coincided with TMS and peripheral volleys summating at the C3–C4 level. All participants showed FAC at TMS intensities near active motor threshold and INH at slightly higher intensities. After tDCS, FAC was reduced for M1-M1 compared with Sham but not after PM-M1 stimulation. Contrary to an earlier study with cathodal tDCS, INH was unchanged across all sessions. The difference between these and earlier findings may relate to dual- vs. single-hemisphere M1 stimulation. M1-M1 tDCS may be a useful adjuvant to techniques that aim to reduce upper limb impairment after stroke.

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Bradnam, Lynley V., Cathy M. Stinear, and Winston D. Byblow. "Cathodal transcranial direct current stimulation suppresses ipsilateral projections to presumed propriospinal neurons of the proximal upper limb." Journal of Neurophysiology 105, no. 5 (May 2011): 2582–89. http://dx.doi.org/10.1152/jn.01084.2010.

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This study investigated whether cathodal transcranial direct current stimulation (c-tDCS) of left primary motor cortex (M1) modulates excitability of ipsilateral propriospinal premotoneurons (PNs) in healthy humans. Transcranial magnetic stimulation (TMS) of the right motor cortex was used to obtain motor evoked potentials (MEPs) from the left biceps brachii (BB) while participants maintained contraction of the left BB. To examine presumed PN excitability, left BB MEPs were compared with those conditioned by median nerve stimulation (MNS) at the left elbow. Interstimulus intervals between TMS and MNS were set to produce summation at the C3–C4 level of the spinal cord. MNS facilitated BB MEPs elicited at TMS intensities near active motor threshold but inhibited BB MEPs at slightly higher intensities, indicative of putative PN modulation. c-tDCS suppressed the facilitatory and inhibitory effects of MNS. Sham tDCS did not alter either component. There was no effect of c-tDCS and sham tDCS on nonconditioned left BB MEPs or on the ipsilateral silent period of left BB. Right first dorsal interosseous MEPs were suppressed by c-tDCS. These results indicate that M1 c-tDCS can be used to modulate excitability of ipsilateral projections to presumed PNs controlling the proximal arm muscle BB. This technique may hold promise for promoting motor recovery of proximal upper limb function after stroke.

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Bradnam, Lynley V., Cathy M. Stinear, Gwyn N. Lewis, and Winston D. Byblow. "Task-Dependent Modulation of Inputs to Proximal Upper Limb Following Transcranial Direct Current Stimulation of Primary Motor Cortex." Journal of Neurophysiology 103, no. 5 (May 2010): 2382–89. http://dx.doi.org/10.1152/jn.01046.2009.

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Cathodal transcranial DC stimulation (c-tDCS) suppresses excitability of primary motor cortex (M1) controlling contralateral hand muscles. This study assessed whether c-tDCS would have similar effects on ipsi- and contralateral M1 projections to a proximal upper limb muscle. Transcranial magnetic stimulation (TMS) of left M1 was used to elicit motor evoked potentials (MEPs) in the left and right infraspinatus (INF) muscle immediately before and after c-tDCS of left M1, and at 20 and 40 min, post-c-tDCS. TMS was delivered as participants preactivated each INF in isolation (left, right) or both INF together (bilateral). After c-tDCS, ipsilateral MEPs in left INF and contralateral MEPs in right INF were suppressed in the left task but not in the bilateral or right tasks, indicative of task-dependent modulation. Ipsilateral silent period duration in the left INF was reduced after c-tDCS, indicative of altered transcallosal inhibition. These findings may have implications for the use of tDCS as an adjunct to therapy for the proximal upper limb after stroke.

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Kidgell, Dawson J., Robin M. Daly, Kayleigh Young, Jarrod Lum, Gregory Tooley, Shapour Jaberzadeh, Maryam Zoghi, and Alan J. Pearce. "Different Current Intensities of Anodal Transcranial Direct Current Stimulation Do Not Differentially Modulate Motor Cortex Plasticity." Neural Plasticity 2013 (2013): 1–9. http://dx.doi.org/10.1155/2013/603502.

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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.

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Dai, Wenjun, Yao Geng, Hao Liu, Chuan Guo, Wenxiang Chen, Jinhui Ma, Jinjin Chen, Yanbing Jia, Ying Shen, and Tong Wang. "Preconditioning with Cathodal High-Definition Transcranial Direct Current Stimulation Sensitizes the Primary Motor Cortex to Subsequent Intermittent Theta Burst Stimulation." Neural Plasticity 2021 (October 21, 2021): 1–8. http://dx.doi.org/10.1155/2021/8966584.

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Noninvasive brain stimulation techniques such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) can induce long-term potentiation-like facilitation, but whether the combination of TMS and tDCS has additive effects is unclear. To address this issue, in this randomized crossover study, we investigated the effect of preconditioning with cathodal high-definition (HD) tDCS on intermittent theta burst stimulation- (iTBS-) induced plasticity in the left motor cortex. A total of 24 healthy volunteers received preconditioning with cathodal HD-tDCS or sham intervention prior to iTBS in a random order with a washout period of 1 week. The amplitude of motor evoked potentials (MEPs) was measured at baseline and at several time points (5, 10, 15, and 30 min) after iTBS to determine the effects of the intervention on cortical plasticity. Preconditioning with cathodal HD-tDCS followed by iTBS showed a greater increase in MEP amplitude than sham cathodal HD-tDCS preconditioning and iTBS at each time postintervention point, with longer-lasting after-effects on cortical excitability. These results demonstrate that preintervention with cathodal HD-tDCS primes the motor cortex for long-term potentiation induced by iTBS and is a potential strategy for improving the clinical outcome to guide therapeutic decisions.

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Bergmann, Til Ole, Sergiu Groppa, Markus Seeger, Matthias Mölle, Lisa Marshall, and Hartwig Roman Siebner. "Acute Changes in Motor Cortical Excitability During Slow Oscillatory and Constant Anodal Transcranial Direct Current Stimulation." Journal of Neurophysiology 102, no. 4 (October 2009): 2303–11. http://dx.doi.org/10.1152/jn.00437.2009.

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Transcranial oscillatory current stimulation has recently emerged as a noninvasive technique that can interact with ongoing endogenous rhythms of the human brain. Yet, there is still little knowledge on how time-varied exogenous currents acutely modulate cortical excitability. In ten healthy individuals we used on-line single-pulse transcranial magnetic stimulation (TMS) to search for systematic shifts in corticospinal excitability during anodal sleeplike 0.8-Hz slow oscillatory transcranial direct current stimulation (so-tDCS). In separate sessions, we repeatedly applied 30-s trials (two blocks at 20 min) of either anodal so-tDCS or constant tDCS (c-tDCS) to the primary motor hand area during quiet wakefulness. Simultaneously and time-locked to different phase angles of the slow oscillation, motor-evoked potentials (MEPs) as an index of corticospinal excitability were obtained in the contralateral hand muscles 10, 20, and 30 s after the onset of tDCS. MEPs were also measured off-line before, between, and after both stimulation blocks to detect any lasting excitability shifts. Both tDCS modes increased MEP amplitudes during stimulation with an attenuation of the facilitatory effect toward the end of a 30-s tDCS trial. No phase-locking of corticospinal excitability to the exogenous oscillation was observed during so-tDCS. Off-line TMS revealed that both c-tDCS and so-tDCS resulted in a lasting excitability increase. The individual magnitude of MEP facilitation during the first tDCS trials predicted the lasting MEP facilitation found after tDCS. We conclude that sleep slow oscillation-like excitability changes cannot be actively imposed on the awake cortex with so-tDCS, but phase-independent on-line as well as off-line facilitation can reliably be induced.

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Biabani, Mana, Maryam Aminitehrani, Maryam Zoghi, Michael Farrell, Gary Egan, and Shapour Jaberzadeh. "The effects of transcranial direct current stimulation on short-interval intracortical inhibition and intracortical facilitation: a systematic review and meta-analysis." Reviews in the Neurosciences 29, no. 1 (December 20, 2017): 99–114. http://dx.doi.org/10.1515/revneuro-2017-0023.

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Abstract Transcranial direct current stimulation (tDCS) is increasingly being used to affect the neurological conditions with deficient intracortical synaptic activities (i.e. Parkinson’s disease and epilepsy). In addition, it is suggested that the lasting effects of tDCS on corticospinal excitability (CSE) have intracortical origin. This systematic review and meta-analysis aimed to examine whether tDCS has any effect on intracortical circuits. Eleven electronic databases were searched for the studies investigating intracortical changes induced by anodal (a) and cathodal (c) tDCS, in healthy individuals, using two paired-pulse transcranial magnetic stimulation (TMS) paradigms: short-interval intracortical inhibition (SICI) and intracortical facilitation (ICF). Additionally, motor-evoked potential (MEP) size alterations, assessed by single-pulse TMS, were extracted from these studies to investigate the probable intracortical origin of tDCS effects on CSE. The methodological quality of included studies was examined using Physiotherapy Evidence Database (PEDro) and Downs and Black’s (D&B) assessment tools. Thirteen research papers, including 24 experiments, were included in this study scoring good and medium quality in PEDro and D&B scales, respectively. Immediately following anodal tDCS (a-tDCS) applications, we found significant decreases in SICI, but increases in ICF and MEP size. However, ICF and MEP size significantly decreased, and SICI increased immediately following cathodal tDCS (c-tDCS). The results of this systematic review and meta-analysis reveal that a-tDCS changes intracortical activities (SICI and ICF) toward facilitation, whereas c-tDCS alters them toward inhibition. It can also be concluded that increases and decreases in CSE after tDCS application are associated with corresponding changes in intracortical activities. The results suggest that tDCS can be clinically useful to modulate intracortical circuits.

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Iannone, Aline, Antonio Pedro de Mello Cruz, Joaquim Pereira Brasil-Neto, and Raphael Boechat-Barros. "Transcranial magnetic stimulation and transcranial direct current stimulation appear to be safe neuromodulatory techniques useful in the treatment of anxiety disorders and other neuropsychiatric disorders." Arquivos de Neuro-Psiquiatria 74, no. 10 (October 2016): 829–35. http://dx.doi.org/10.1590/0004-282x20160115.

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ABSTRACT Transcranial magnetic stimulation (TMS) has recently been investigated as a possible adjuvant treatment for many neuropsychiatric disorders, and has already been approved for the treatment of drug-resistant depression in the United States and in Brazil, among other countries. Although its use in other neuropsychiatric disorders is still largely experimental, many physicians have been using it as an off-label add-on therapy for various disorders. More recently, another technique, transcranial direct current stimulation (tDCS), has also become available as a much cheaper and portable alternative to TMS, although its mechanisms of action are different from those of TMS. The use of off-label therapeutic TMS or tDCS tends to occur in the setting of diseases that are notoriously resistant to other treatment modalities. Here we discuss the case of anxiety disorders, namely panic and post-traumatic stress disorders, highlighting the uncertainties and potential problems and benefits of the clinical use of these neuromodulatory techniques at the current stage of knowledge.

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Tscherpel, Caroline, and Christian Grefkes. "Funktionserholung nach Schlaganfall und die therapeutische Rolle der nicht-invasiven Hirnstimulation." Klinische Neurophysiologie 51, no. 04 (October 29, 2020): 214–23. http://dx.doi.org/10.1055/a-1272-9435.

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ZusammenfassungIm Bereich der non-invasiven Hirnstimulation stellen die transkranielle Magnetstimulation (engl. transcranial magnetic stimulation, TMS) sowie die transkranielle Gleichstromstimulation (engl. transcranial direct current stimulation, tDCS) bis heute die wichtigsten Techniken zur Modulation kortikaler Erregbarkeit dar. Beide Verfahren induzieren Nacheffekte, welche die Zeit der reinen Stimulation überdauern, und ebnen damit den Weg für ihren therapeutischen Einsatz beim Schlaganfall. In diesem Übersichtsartikel diskutieren wir die aktuelle Datenlage TMS- und tDCS-vermittelter Therapien für die häufigsten schlaganfallbedingten Defizite wie Hemiparese, Aphasie und Neglect. Darüber hinaus adressieren wir mögliche Einschränkungen der gegenwärtigen Ansätze und zeigen Ansatzpunkte auf, um Neuromodulation nach Schlaganfall effektiver zu gestalten und damit das Outcome der Patienten zu verbessern.

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Brunoni, André Russowsky, Chei Tung Teng, Claudio Correa, Marta Imamura, Joaquim P. Brasil-Neto, Raphael Boechat, Moacyr Rosa, et al. "Neuromodulation approaches for the treatment of major depression: challenges and recommendations from a working group meeting." Arquivos de Neuro-Psiquiatria 68, no. 3 (June 2010): 433–51. http://dx.doi.org/10.1590/s0004-282x2010000300021.

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The use of neuromodulation as a treatment for major depressive disorder (MDD) has recently attracted renewed interest due to development of other non-pharmacological therapies besides electroconvulsive therapy (ECT) such as transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), deep brain stimulation (DBS), and vagus nerve stimulation (VNS). METHOD: We convened a working group of researchers to discuss the updates and key challenges of neuromodulation use for the treatment of MDD. RESULTS: The state-of-art of neuromodulation techniques was reviewed and discussed in four sections: [1] epidemiology and pathophysiology of MDD; [2] a comprehensive overview of the neuromodulation techniques; [3] using neuromodulation techniques in MDD associated with non-psychiatric conditions; [4] the main challenges of neuromodulation research and alternatives to overcome them. DISCUSSION: ECT is the first-line treatment for severe depression. TMS and tDCS are strategies with a relative benign profile of side effects; however, while TMS effects are comparable to antidepressant drugs for treating MDD; further research is needed to establish the role of tDCS. DBS and VNS are invasive strategies with a possible role in treatment-resistant depression. In summary, MDD is a chronic and incapacitating condition with a high prevalence; therefore clinicians should consider all the treatment options including invasive and non-invasive neuromodulation approaches.

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Galea, Joseph M., and Pablo Celnik. "Brain Polarization Enhances the Formation and Retention of Motor Memories." Journal of Neurophysiology 102, no. 1 (July 2009): 294–301. http://dx.doi.org/10.1152/jn.00184.2009.

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One of the first steps in the acquisition of a new motor skill is the formation of motor memories. Here we tested the capacity of transcranial DC stimulation (tDCS) applied over the motor cortex during motor practice to increase motor memory formation and retention. Nine healthy individuals underwent a crossover transcranial magnetic stimulation (TMS) study designed to test motor memory formation resulting from training. Anodal tDCS elicited an increase in the magnitude and duration of motor memories in a polarity-specific manner, as reflected by changes in the kinematic characteristics of TMS-evoked movements after anodal, but not cathodal or sham stimulation. This effect was present only when training and stimulation were associated and mediated by a differential modulation of corticomotor excitability of the involved muscles. These results indicate that anodal brain polarization can enhance the initial formation and retention of a new motor memory resulting from training. These processes may be the underlying mechanisms by which tDCS enhances motor learning.

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Gunduz, Muhammed Enes, Kevin Pacheco-Barrios, Camila Bonin Pinto, Dante Duarte, Faddi Ghassan Saleh Vélez, Anna Carolyna Lepesteur Gianlorenco, Paulo Eduardo Portes Teixeira, et al. "Effects of Combined and Alone Transcranial Motor Cortex Stimulation and Mirror Therapy in Phantom Limb Pain: A Randomized Factorial Trial." Neurorehabilitation and Neural Repair 35, no. 8 (June 1, 2021): 704–16. http://dx.doi.org/10.1177/15459683211017509.

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Phantom limb pain (PLP) is a frequent complication in amputees, which is often refractory to treatments. We aim to assess in a factorial trial the effects of transcranial direct current stimulation (tDCS) and mirror therapy (MT) in patients with traumatic lower limb amputation; and whether the motor cortex plasticity changes drive these results. In this large randomized, blinded, 2-site, sham-controlled, 2 × 2 factorial trial, 112 participants with traumatic lower limb amputation were randomized into treatment groups. The interventions were active or covered MT for 4 weeks (20 sessions, 15 minutes each) combined with 2 weeks of either active or sham tDCS (10 sessions, 20 minutes each) applied to the contralateral primary motor cortex. The primary outcome was PLP changes on the visual analogue scale at the end of interventions (4 weeks). Motor cortex excitability and cortical mapping were assessed by transcranial magnetic stimulation (TMS). We found no interaction between tDCS and MT groups ( F = 1.90, P = .13). In the adjusted models, there was a main effect of active tDCS compared to sham tDCS (beta coefficient = −0.99, P = .04) on phantom pain. The overall effect size was 1.19 (95% confidence interval: 0.90, 1.47). No changes in depression and anxiety were found. TDCS intervention was associated with increased intracortical inhibition (coefficient = 0.96, P = .02) and facilitation (coefficient = 2.03, P = .03) as well as a posterolateral shift of the center of gravity in the affected hemisphere. MT induced no motor cortex plasticity changes assessed by TMS. These findings indicate that transcranial motor cortex stimulation might be an affordable and beneficial PLP treatment modality.

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Behrangrad, Shabnam, Maryam Zoghi, Dawson Kidgell, Farshad Mansouri, and Shapour Jaberzadeh. "The effects of concurrent bilateral anodal tDCS of primary motor cortex and cerebellum on corticospinal excitability: a randomized, double-blind sham-controlled study." Brain Structure and Function 227, no. 7 (August 19, 2022): 2395–408. http://dx.doi.org/10.1007/s00429-022-02533-7.

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AbstractTranscranial direct current stimulation (tDCS) applied to the primary motor cortex (M1), and cerebellum (CB) can change the level of M1 corticospinal excitability (CSE). A randomized double-blinded crossover, the sham-controlled study design was used to investigate the effects of concurrent bilateral anodal tDCS of M1 and CB (concurrent bilateral a-tDCSM1+CB) on the CSE. Twenty-one healthy participants were recruited in this study. Each participant received anodal-tDCS (a-tDCS) of 2 mA, 20 min in four pseudo-randomized, counterbalanced sessions, separated by at least 7 days (7.11 days ± 0.65). These sessions were bilateral M1 stimulation (bilateral a-tDCSM1), bilateral cerebellar stimulation (bilateral a-tDCSCB), concurrent bilateral a-tDCSM1+CB, and sham stimulation (bilateral a-tDCSSham). Transcranial magnetic stimulation (TMS) was delivered over the left M1, and motor evoked potentials (MEPs) of a contralateral hand muscle were recorded before and immediately after the intervention to measure CSE changes. Short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), and long interval intracortical inhibition (LICI) were assessed with paired-pulse TMS protocols. Anodal-tDCS significantly increased CSE after concurrent bilateral a-tDCSM1+CB and bilateral a-tDCSCB. Interestingly, CSE was decreased after bilateral a-tDCSM1. Respective alterations in SICI, LICI, and ICF were seen, including increased SICI and decreased ICF, which indicate the involvement of glutamatergic and GABAergic systems in these effects. These results confirm that the concurrent bilateral a-tDCSM1+CB have a facilitatory effect on CSE, whereas bilateral a-tDCSM1 exert some inhibitory effects. Moreover, the effects of the 2 mA, 20 min a-tDCS on the CB were consistent with its effects on the M1.

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Keerthy, B. N., Sai Sreevalli Sarma Sreepada, Shalini S. Naik, Anushree Bose, Raju Hanumegowda, Urvakhsh Meherwan Mehta, Ganesan Venkatasubramanian, Jagadisha Thirthalli, Talakad N. Sathyaprabha, and Kaviraja Udupa. "Effects of a single session of cathodal transcranial direct current stimulation primed intermittent theta-burst stimulation on heart rate variability and cortical excitability measures." Indian Journal of Physiology and Pharmacology 65 (December 8, 2021): 162–66. http://dx.doi.org/10.25259/ijpp_339_2020.

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Objectives: Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have been used as neuromodulators in neuropsychiatric conditions. This study is aimed to find the effects of a single session of priming cathodal tDCS with intermittent theta-burst stimulation (iTBS) over left dorsolateral prefrontal cortex on heart rate variability (HRV) and cortical excitability parameters before and after perturbation. Materials and Methods: The neuromodulatory techniques used in the study were Cathodal tDCS for 20 min followed by iTBS for 3 min on the left dorsolateral prefrontal cortex (DLPFC). HRV variables and TMS parameters were recorded before and after this intervention of combined neuromodulation in 31 healthy volunteers (20 males and 11 females; age range of 19–35 years with Mean ± SD = 24.2 ± 4.7 years). Results: The results showed an overall increase in cortical excitability and parasympathetic dominance in healthy volunteers. Other measures of cortical excitability and HRV did not change significantly following single session of combined neuromodulation. Conclusion: This study showed that there is an overall increase in cortical excitability and parasympathetic dominance in the cohort of healthy volunteers following a combination of neuromodulation involving cathodal tDCS followed by iTBS over left DLPFC. Future studies exploring the effects of other possible combinations with sham stimulation could be carried out to explore the utility of dual stimulation as add-on therapy in disorders.

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Caulfield, Kevin. "Toward prospective electric field dosing in TMS and tDCS." Brain Stimulation 14, no. 6 (November 2021): 1739. http://dx.doi.org/10.1016/j.brs.2021.10.502.

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Bailey, Neil W., Richard H. Thomson, Kate E. Hoy, Julio C. Hernandez-Pavon, and Paul B. Fitzgerald. "TDCS increases cortical excitability: Direct evidence from TMS-EEG." Cortex 74 (January 2016): 320–22. http://dx.doi.org/10.1016/j.cortex.2014.10.022.

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Mikkonen, M., and I. Laakso. "Inter-postural changes in TDCS and TMS electric fields." Brain Stimulation 12, no. 2 (March 2019): 497–98. http://dx.doi.org/10.1016/j.brs.2018.12.628.

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Romero Lauro, Leonor J., Mario Rosanova, Giulia Mattavelli, Silvia Convento, Alberto Pisoni, Alexander Opitz, Nadia Bolognini, and Giuseppe Vallar. "TDCS increases cortical excitability: Direct evidence from TMS–EEG." Cortex 58 (September 2014): 99–111. http://dx.doi.org/10.1016/j.cortex.2014.05.003.

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Kesikburun, Serdar. "Non-invasive brain stimulation in rehabilitation." Turkish Journal of Physical Medicine and Rehabilitation 68, no. 1 (March 1, 2022): 1–8. http://dx.doi.org/10.5606/tftrd.2022.10608.

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Non-invasive brain stimulation (NIBS) has been seen more common in rehabilitation settings. It can be used for the treatment of stroke, spinal cord injury, traumatic brain injury and multiple sclerosis, as well as for some diagnostic neurophysiological measurements. Two major modalities of NIBS are transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS). As an add-on therapy to conventional rehabilitative treatments, the main goal of NIBS is to create neuromodulation by inhibiting or activating neural activity in the targeted cortical region. Indications for therapeutic NIBS in neurorehabilitation are motor recovery, aphasia, neglect, dysphagia, cognitive disorders, spasticity, and central pain. The NIBS can be regarded a safe technique with appropriate patient selection and defined treatment parameters. This review provides an overview on NIBS modalities, specifically TMS and tDCS, the working mechanisms, the stimulation techniques, areas of use, neuronavigation systems and safety considerations.

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Knodel, N., S. Pillen, D. Hermle, M. Hanke, U. Ziemann, and T. O. Bergmann. "P18 TDCS intensity-dependent online modulation of motor cortex excitability: a combined TDCS-TMS study." Clinical Neurophysiology 130, no. 8 (August 2019): e154-e155. http://dx.doi.org/10.1016/j.clinph.2019.04.672.

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Pillen, S., N. Knodel, D. Hermle, M. Hanke, U. Ziemann, and T. Bergmann. "P144 TDCS intensity-dependent online modulation of motor cortex excitability: A combined TDCS-TMS study." Clinical Neurophysiology 131, no. 4 (April 2020): e94-e95. http://dx.doi.org/10.1016/j.clinph.2019.12.255.

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Zaninotto, Ana Luiza, Mirret M. El-Hagrassy, Jordan R. Green, Maíra Babo, Vanessa Maria Paglioni, Glaucia Guerra Benute, and Wellingson Silva Paiva. "Transcranial direct current stimulation (tDCS) effects on traumatic brain injury (TBI) recovery: A systematic review." Dementia & Neuropsychologia 13, no. 2 (June 2019): 172–79. http://dx.doi.org/10.1590/1980-57642018dn13-020005.

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ABSTRACT. Traumatic brain injury (TBI) is a major cause of chronic disability. Less than a quarter of moderate and severe TBI patients improved in their cognition within 5 years. Non-invasive brain stimulation, including transcranial direct current stimulation (tDCS), may help neurorehabilitation by boosting adaptive neuroplasticity and reducing pathological sequelae following TBI. Methods: we searched MEDLINE/PubMed and Web of Science databases. We used Jadad scale to assess methodological assumptions. Results: the 14 papers included reported different study designs; 2 studies were open-label, 9 were crossover randomized clinical trials (RCTs), and 3 were parallel group RCTs. Most studies used anodal tDCS of the left dorsolateral prefrontal cortex, but montages and stimulation parameters varied. Multiple studies showed improved coma recovery scales in disorders of consciousness, and improved cognition on neuropsychological assessments. Some studies showed changes in neurophysiologic measures (electroencephalography (EEG) and transcranial magnetic stimulation (TMS), correlating with clinical findings. The main methodological biases were lack of blinding and randomization reports. Conclusion: tDCS is a safe, non-invasive neuromodulatory technique that can be given as monotherapy but may be best combined with other therapeutic strategies (such as cognitive rehabilitation and physical therapy) to further improve clinical cognitive and motor outcomes. EEG and TMS may help guide research due to their roles as biomarkers for neuroplasticity.

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Ferrucci, Roberta, Tommaso Bocci, Francesca Cortese, Fabiana Ruggiero, and Alberto Priori. "Noninvasive Cerebellar Stimulation as a Complement Tool to Pharmacotherapy." Current Neuropharmacology 17, no. 1 (December 5, 2018): 14–20. http://dx.doi.org/10.2174/1570159x15666171114142422.

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Background: Cerebellar ataxias represent a wide and heterogeneous group of diseases characterized by balance and coordination disturbance, dysarthria, dyssynergia and adyadococinesia, caused by a dysfunction in the cerebellum. In recent years there has been growing interest in discovering therapeutical strategy for specific forms of cerebellar ataxia. Together with pharmacological studies, there has been growing interest in non-invasive cerebellar stimulation techniques to improve ataxia and limb coordination. Both transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are non-invasive techniques to modulate cerebro and cerebellar cortex excitability using magnetic or electric fields. </P><P> Methods: Here we aim to review the most relevant studies regarding the application of TMS and tDCS for the treatment of cerebellar ataxia. Conclusion: As pharmacological strategies were shown to be effective in specific forms of cerebellar ataxia and are not devoid of collateral effects, non-invasive stimulation may represent a promising strategy to improve residual cerebellar circuits functioning and a complement tool to pharmacotherapy.

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Nardone, Raffaele, Jürgen Bergmann, Monica Christova, Francesca Caleri, Frediano Tezzon, Gunther Ladurner, Eugen Trinka, and Stefan Golaszewski. "Effect of Transcranial Brain Stimulation for the Treatment of Alzheimer Disease: A Review." International Journal of Alzheimer's Disease 2012 (2012): 1–5. http://dx.doi.org/10.1155/2012/687909.

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Available pharmacological treatments for Alzheimer disease (AD) have limited effectiveness, are expensive, and sometimes induce side effects. Therefore, alternative or complementary adjuvant therapeutic strategies have gained increasing attention. The development of novel noninvasive methods of brain stimulation has increased the interest in neuromodulatory techniques as potential therapeutic tool for cognitive rehabilitation in AD. In particular, repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are noninvasive approaches that induce prolonged functional changes in the cerebral cortex. Several studies have begun to therapeutically use rTMS or tDCS to improve cognitive performances in patients with AD. However, most of them induced short-duration beneficial effects and were not adequately powered to establish evidence for therapeutic efficacy. Therefore, TMS and tDCS approaches, seeking to enhance cognitive function, have to be considered still very preliminary. In future studies, multiple rTMS or tDCS sessions might also interact, and metaplasticity effects could affect the outcome.

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Rapinesi, Chiara, Georgios D. Kotzalidis, Stefano Ferracuti, Gabriele Sani, Paolo Girardi, and Antonio Del Casale. "Brain Stimulation in Obsessive-Compulsive Disorder (OCD): A Systematic Review." Current Neuropharmacology 17, no. 8 (July 25, 2019): 787–807. http://dx.doi.org/10.2174/1570159x17666190409142555.

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Background: Obsessive-compulsive disorder (OCD) is a highly prevalent, severe, and chronic disease. There is a need for alternative strategies for treatment-resistant OCD. Objective: This review aims to assess the effect of brain stimulation techniques in OCD. Methods: We included papers published in peer-reviewed journals dealing with brain stimulation techniques in OCD. We conducted treatment-specific searches for OCD (Technique AND ((randomized OR randomised) AND control* AND trial) AND (magnetic AND stimulation OR (rTMS OR dTMS)) AND (obsess* OR compuls* OR OCD)) on six databases, i.e., PubMed, Cochrane, Scopus, CINAHL, PsycINFO, and Web of Science to identify randomised controlled trials and ClinicalTrials.gov for possible additional results. Results: Different add-on stimulation techniques could be effective for severely ill OCD patients unresponsive to drugs and/or behavioural therapy. Most evidence regarded deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS), while there is less evidence regarding transcranial direct current stimulation (tDCS), electroconvulsive therapy, and vagus nerve stimulation (for these last two there are no sham-controlled studies). Low-frequency TMS may be more effective over the supplementary motor area or the orbitofrontal cortex. DBS showed best results when targeting the crossroad between the nucleus accumbens and the ventral capsule or the subthalamic nucleus. Cathodal tDCS may be better than anodal in treating OCD. Limitations. We had to include methodologically inconsistent underpowered studies. Conclusion: Different brain stimulation techniques are promising as an add-on treatment of refractory OCD, although studies frequently reported inconsistent results. TMS, DBS, and tDCS could possibly find some use with adequate testing, but their standard methodology still needs to be established.

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Vanneste, Sven, Berthold Langguth, and Dirk De Ridder. "Do tDCS and TMS influence tinnitus transiently via a direct cortical and indirect somatosensory modulating effect? A combined TMS-tDCS and TENS study." Brain Stimulation 4, no. 4 (October 2011): 242–52. http://dx.doi.org/10.1016/j.brs.2010.12.001.

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Winkelbeiner, Stephanie, Whitney Muscat, Andrea Joanlanne, Nikolaos Marousis, Maria Neumeier, Thomas Dierks, Erich Seifritz, Anil K. Malhotra, and Philipp Homan. "S43. ASSESSING THE VARIABILITY OF RESPONSE TO NON-INVASIVE BRAIN STIMULATION IN PSYCHOSIS." Schizophrenia Bulletin 46, Supplement_1 (April 2020): S48—S49. http://dx.doi.org/10.1093/schbul/sbaa031.109.

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Abstract Background Non-invasive brain stimulation has been introduced as add-on treatment for psychotic symptoms, not least because transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have a low risk profile. Yet, the initial excitement is wearing off and there is a lack of consistent evidence from randomized controlled trials (RCT) for the efficacy of brain stimulation. It is often claimed that this is because patients respond very differently to brain stimulation, with some benefiting much more than others. However, is there really strong evidence from RCTs that patients do respond differently? This question can be assessed by comparing the overall variability under active stimulation with the variability under sham stimulation across studies. Methods We included all double-blinded, sham-controlled RCTs and crossover studies of adults with a diagnosis of a schizophrenia spectrum disorder that used TMS or tDCS for the treatment of psychotic symptoms. We extracted a measure of variability (standard deviation, standard error, or confidence interval) of the primary outcome for active and sham stimulation, computed variance-weighted variability ratios for each study, and entered them into a random-effects model. In the case of individual differences in response to TMS or tDCS, we expected that the overall variability under active stimulation would be increased compared to sham stimulation (as evidenced by an overall variability ratio significantly larger than 1). Results A total of 39 RCTs and crossover trials with 1 352 patients were included. We found that the variability under active stimulation was not significantly larger than under sham stimulation (variability ratio = 1.07; 95% CI: 0.99, 1.16; P = 0.098). Discussion These results do not provide strong evidence for the presence of individual differences in response to non-invasive brain stimulation in patients with schizophrenia spectrum disorders. The search for subgroups and prognostic biomarkers may require more complex study designs including N-of-1 trials.

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Giuffre, Adrianna, Ephrem Zewdie, James Wrightson, Helen Carlson, Hsing-Ching Kuo, Ali Babwani, and Adam Kirton. "Effects of tDCS and HD-tDCS Enhanced Motor Learning on Robotic TMS Motor Maps in Children." Brain Stimulation 14, no. 6 (November 2021): 1635–36. http://dx.doi.org/10.1016/j.brs.2021.10.153.

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Ghosh, Soumya, David Hathorn, Jennifer Eisenhauer, Jesse Dixon, and Ian D. Cooper. "Anodal Transcranial Direct Current Stimulation over the Vertex Enhances Leg Motor Cortex Excitability Bilaterally." Brain Sciences 9, no. 5 (April 29, 2019): 98. http://dx.doi.org/10.3390/brainsci9050098.

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In many studies, anodal transcranial Direct Current Stimulation (tDCS) is applied near the vertex to simultaneously facilitate leg motor cortex (M1) of both hemispheres and enhance recovery of gait and balance in neurological disorders. However, its effect on the excitability of leg M1 in either hemisphere is not well known. In this double-blind sham-controlled study, corticospinal excitability changes induced in leg M1 of both hemispheres by anodal (2 mA for 20 minutes) or sham tDCS (for 20 min) over the vertex were evaluated. Peak amplitudes of Transcranial Magnetic Stimulation (TMS) induced motor evoked potentials (MEPs) were measured over the contralateral Tibialis Anterior (TA) muscle before and up to 40 min after tDCS in 11 normal participants. Analysis of data from all participants found significant overall increase in the excitability of leg M1 after tDCS. However, in individual subjects there was variability in observed effects. In 4 participants, 20 min of tDCS increased mean MEPs of TAs on both sides; in 4 participants there was increased mean MEP only on one side and in 3 subjects there was no change. It’s not known if the benefits of tDCS in improving gait and balance are dependent on excitability changes induced in one or both leg M1; such information may be useful to predict treatment outcomes.

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Bolognini, Nadia, Luca Zigiotto, Maíra Izzadora Souza Carneiro, and Giuseppe Vallar. "“How Did I Make It?”: Uncertainty about Own Motor Performance after Inhibition of the Premotor Cortex." Journal of Cognitive Neuroscience 28, no. 7 (July 2016): 1052–61. http://dx.doi.org/10.1162/jocn_a_00950.

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Optimal motor performance requires the monitoring of sensorimotor input to ensure that the motor output matches current intentions. The brain is thought to be equipped with a “comparator” system, which monitors and detects the congruence between intended and actual movement; results of such a comparison can reach awareness. This study explored in healthy participants whether the cathodal transcranial direct current stimulation (tDCS) of the right premotor cortex (PM) and right posterior parietal cortex (PPC) can disrupt performance monitoring in a skilled motor task. Before and after tDCS, participants underwent a two-digit sequence motor task; in post-tDCS session, single-pulse TMS (sTMS) was applied to the right motor cortex, contralateral to the performing hand, with the aim of interfering with motor execution. Then, participants rated on a five-item questionnaire their performance at the motor task. Cathodal tDCS of PM (but not sham or PPC tDCS) impaired the participants' ability to evaluate their motor performance reliably, making them unconfident about their judgments. Congruently with the worsened motor performance induced by sTMS, participants reported to have committed more errors after sham and PPC tDCS; such a correlation was not significant after PM tDCS. In line with current computational and neuropsychological models of motor control and awareness, the present results show that a mechanism in the PM monitors and compares intended versus actual movements, evaluating their congruence. Cathodal tDCS of the PM impairs the activity of such a “comparator,” disrupting self-confidence about own motor performance.

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Godeiro, Clecio, Carina França, Rafael Bernhart Carra, Felipe Saba, Roberta Saba, Débora Maia, Pedro Brandão, et al. "Use of non-invasive stimulation in movement disorders: a critical review." Arquivos de Neuro-Psiquiatria 79, no. 7 (July 2021): 630–46. http://dx.doi.org/10.1590/0004-282x-anp-2020-0381.

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Abstract Background: Noninvasive stimulation has been widely used in the past 30 years to study and treat a large number of neurological diseases, including movement disorders. Objective: In this critical review, we illustrate the rationale for use of these techniques in movement disorders and summarize the best medical evidence based on the main clinical trials performed to date. Methods: A nationally representative group of experts performed a comprehensive review of the literature in order to analyze the key clinical decision-making factors driving transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) in movement disorders. Classes of evidence and recommendations were described for each disease. Results: Despite unavoidable heterogeneities and low effect size, TMS is likely to be effective for treating motor symptoms and depression in Parkinson’s disease (PD). The efficacy in other movement disorders is unclear. TMS is possibly effective for focal hand dystonia, essential tremor and cerebellar ataxia. Additionally, it is likely to be ineffective in reducing tics in Tourette syndrome. Lastly, tDCS is likely to be effective in improving gait in PD. Conclusions: There is encouraging evidence for the use of noninvasive stimulation on a subset of symptoms in selected movement disorders, although the means to optimize protocols for improving positive outcomes in routine clinical practice remain undetermined. Similarly, the best stimulation paradigms and responder profile need to be investigated in large clinical trials with established therapeutic and assessment paradigms that could also allow genuine long-term benefits to be determined.

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Christova, M., D. Rafolt, S. Golaszewski, and E. Gallasch. "P 157. Anodal tDCS during skill learning preconditioned by cathodal tDCS improves motor memory – A TMS study." Clinical Neurophysiology 124, no. 10 (October 2013): e139. http://dx.doi.org/10.1016/j.clinph.2013.04.234.

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Cichon, Natalia, Lidia Wlodarczyk, Joanna Saluk-Bijak, Michal Bijak, Justyna Redlicka, Leslaw Gorniak, and Elzbieta Miller. "Novel Advances to Post-Stroke Aphasia Pharmacology and Rehabilitation." Journal of Clinical Medicine 10, no. 17 (August 24, 2021): 3778. http://dx.doi.org/10.3390/jcm10173778.

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Aphasia is one of the most common clinical features of functional impairment after a stroke. Approximately 21–40% of stroke patients sustain permanent aphasia, which progressively worsens one’s quality of life and rehabilitation outcomes. Post-stroke aphasia treatment strategies include speech language therapies, cognitive neurorehabilitation, telerehabilitation, computer-based management, experimental pharmacotherapy, and physical medicine. This review focuses on current evidence of the effectiveness of impairment-based aphasia therapies and communication-based therapies (as well as the timing and optimal treatment intensities for these interventions). Moreover, we present specific interventions, such as constraint-induced aphasia therapy (CIAT) and melodic intonation therapy (MIT). Accumulated data suggest that using transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) is safe and can be used to modulate cortical excitability. Therefore, we review clinical studies that present TMS and tDCS as (possible) promising therapies in speech and language recovery, stimulating neuroplasticity. Several drugs have been used in aphasia pharmacotherapy, but evidence from clinical studies suggest that only nootropic agents, donepezil and memantine, may improve the prognosis of aphasia. This article is an overview on the current state of knowledge related to post-stroke aphasia pharmacology, rehabilitation, and future trends.

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Cabibel, Vincent, Makii Muthalib, Jérôme Froger, and Stéphane Perrey. "Comparison of repeated transcranial stimulation and transcranial direct-current stimulation on primary motor cortex excitability and inhibition: A pilot study." Movement & Sport Sciences - Science & Motricité, no. 100 (2018): 59–67. http://dx.doi.org/10.1051/sm/2018001.

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Repeated transcranial magnetic stimulation (rTMS) is a well-known clinical neuromodulation technique, but transcranial direct-current stimulation (tDCS) is rapidly growing interest for neurorehabilitation applications. Both methods (contralesional hemisphere inhibitory low-frequency: LF-rTMS or lesional hemisphere excitatory anodal: a-tDCS) have been employed to modify the interhemispheric imbalance following stroke. The aim of this pilot study was to compare aHD-tDCS (anodal high-definition tDCS) of the left M1 (2 mA, 20 min) and LF-rTMS of the right M1 (1 Hz, 20 min) to enhance excitability and reduce inhibition of the left primary motor cortex (M1) in five healthy subjects. Single-pulse TMS was used to elicit resting and active (low level muscle contraction, 5% of maximal electromyographic signal) motor-evoked potentials (MEPs) and cortical silent periods (CSPs) from the right and left extensor carpi radialis muscles at Baseline, immediately and 20 min (Post-Stim-20) after the end of each stimulation protocol. LF-rTMS or aHD-tDCS significantly increased right M1 resting and active MEP amplitude at Post-Stim-20 without any CSP modulation and with no difference between methods. In conclusion, this pilot study reported unexpected M1 excitability changes, which most likely stems from variability, which is a major concern in the field to consider.

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Madhavan, Sangeetha, James W. Stinear, and Neeta Kanekar. "Effects of a Single Session of High Intensity Interval Treadmill Training on Corticomotor Excitability following Stroke: Implications for Therapy." Neural Plasticity 2016 (2016): 1–8. http://dx.doi.org/10.1155/2016/1686414.

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Objective. High intensity interval treadmill training (HIITT) has been gaining popularity for gait rehabilitation after stroke. In this study, we examined the changes in excitability of the lower limb motor cortical representation (M1) in chronic stroke survivors following a single session of HIITT. We also determined whether exercise-induced changes in excitability could be modulated by transcranial direct current stimulation (tDCS) enhanced with a paretic ankle skill acquisition task.Methods. Eleven individuals with chronic stroke participated in two 40-minute treadmill-training sessions: HIITT alone and HITT preceded by anodal tDCS enhanced with a skill acquisition task (e-tDCS+HIITT). Transcranial magnetic stimulation (TMS) was used to assess corticomotor excitability of paretic and nonparetic tibialis anterior (TA) muscles.Results. HIIT alone reduced paretic TA M1 excitability in 7 of 11 participants by ≥ 10%. e-tDCS+HIITT increased paretic TA M1 excitability and decreased nonparetic TA M1 excitability.Conclusions. HIITT suppresses corticomotor excitability in some people with chronic stroke. When HIITT is preceded by tDCS in combination with a skill acquisition task, the asymmetry of between-hemisphere corticomotor excitability is reduced.Significance. This study provides preliminary data indicating that the cardiovascular benefits of HIITT may be achieved without suppressing motor excitability in some stroke survivors.

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Rahman, Simin, Ummutal Siddique, Ashlyn Frazer, Alan Pearce, and Dawson Kidgell. "tDCS Anodal tDCS increases bilateral corticospinal excitability irrespective of hemispheric dominance." Journal of Science and Medicine 2, no. 2 (June 3, 2020): 1–17. http://dx.doi.org/10.37714/josam.v2i2.40.

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Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that utilizes weak direct currents to induce polarity-dependent modulation of corticospinal excitability. Although tDCS exerts a modulatory effect over the stimulation region, several studies have also demonstrated that distal areas of the brain connected to the region of stimulation may also be affected, as well as the contralateral hemisphere. Objective: We examined the effect of a single session of anodal tDCS on corticospinal excitability and inhibition of both the stimulated and non-stimulated hemisphere and examined the influence of these responses by the brain-derived neurotrophic factor (BDNF) polymorphism. Methods: In a randomized cross-over design, changes in corticospinal excitability and inhibition of the stimulated and non-stimulated hemispheres were analysed in 13 participants in both the dominant and non-dominant primary motor cortex (M1). Participants were exposed to 20 min of anodal and sham tDCS and also undertook a blood sample for BDNF genotyping. Results: TMS revealed a bilateral increase in corticospinal excitability irrespective of which hemisphere (dominant vs non-dominant) was stimulated (all P < 0.05). Furthermore, the induction of corticospinal excitability was influenced by the BDNF polymorphism. Conclusion: This finding shows that anodal tDCS induces bilateral effects in corticospinal excitability irrespective of hemispheric dominance. This finding provides scientists and medical practitioners with a greater understanding as to how this technique may be used as a therapeutic tool for clinical populations.

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Lauro, L. J. Romero, A. Pisoni, M. Rosanova, G. Mattavelli, N. Bolognini, and G. Vallar. "P230 Localizing the effects of anodal tDCS: A TMS-EEG study." Clinical Neurophysiology 128, no. 3 (March 2017): e127-e128. http://dx.doi.org/10.1016/j.clinph.2016.10.347.

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Bocci, T., M. Caleo, L. Briscese, S. Tognazzi, E. S. Perego, L. Maffei, S. Rossi, A. Priori, and F. Sartucci. "Homeostatic plasticity and human primary visual cortex: A tDCS/TMS study." International Journal of Psychophysiology 85, no. 3 (September 2012): 379–80. http://dx.doi.org/10.1016/j.ijpsycho.2012.07.046.

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Jiang, Jimmy, Dennis Q. Truong, and Marom Bikson. "Abstract #115: What is Theoretically More Focal: HD-tDCS or TMS?" Brain Stimulation 12, no. 2 (March 2019): e39-e40. http://dx.doi.org/10.1016/j.brs.2018.12.122.

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Convento, Silvia, Giuseppe Vallar, Chiara Galantini, and Nadia Bolognini. "Neuromodulation of Early Multisensory Interactions in the Visual Cortex." Journal of Cognitive Neuroscience 25, no. 5 (May 2013): 685–96. http://dx.doi.org/10.1162/jocn_a_00347.

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Merging information derived from different sensory channels allows the brain to amplify minimal signals to reduce their ambiguity, thereby improving the ability of orienting to, detecting, and identifying environmental events. Although multisensory interactions have been mostly ascribed to the activity of higher-order heteromodal areas, multisensory convergence may arise even in primary sensory-specific areas located very early along the cortical processing stream. In three experiments, we investigated early multisensory interactions in lower-level visual areas, by using a novel approach, based on the coupling of behavioral stimulation with two noninvasive brain stimulation techniques, namely, TMS and transcranial direct current stimulation (tDCS). First, we showed that redundant multisensory stimuli can increase visual cortical excitability, as measured by means of phosphene induction by occipital TMS; such physiological enhancement is followed by a behavioral facilitation through the amplification of signal intensity in sensory-specific visual areas. The more sensory inputs are combined (i.e., trimodal vs. bimodal stimuli), the greater are the benefits on phosphene perception. Second, neuroelectrical activity changes induced by tDCS in the temporal and in the parietal cortices, but not in the occipital cortex, can further boost the multisensory enhancement of visual cortical excitability, by increasing the auditory and tactile inputs from temporal and parietal regions, respectively, to lower-level visual areas.

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Cabibel, Vincent, Makii Muthalib, Wei-Peng Teo, and Stephane Perrey. "High-definition transcranial direct-current stimulation of the right M1 further facilitates left M1 excitability during crossed facilitation." Journal of Neurophysiology 119, no. 4 (April 1, 2018): 1266–72. http://dx.doi.org/10.1152/jn.00861.2017.

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The crossed-facilitation (CF) effect refers to when motor-evoked potentials (MEPs) evoked in the relaxed muscles of one arm are facilitated by contraction of the opposite arm. The aim of this study was to determine whether high-definition transcranial direct-current stimulation (HD-tDCS) applied to the right primary motor cortex (M1) controlling the left contracting arm [50% maximum voluntary isometric contraction (MVIC)] would further facilitate CF toward the relaxed right arm. Seventeen healthy right-handed subjects participated in an anodal and cathodal or sham HD-tDCS session of the right M1 (2 mA for 20 min) separated by at least 48 h. Single-pulse transcranial magnetic stimulation (TMS) was used to elicit MEPs and cortical silent periods (CSPs) from the left M1 at baseline and 10 min into and after right M1 HD-tDCS. At baseline, compared with resting, CF (i.e., right arm resting, left arm 50% MVIC) increased left M1 MEP amplitudes (+97%) and decreased CSPs (−11%). The main novel finding was that right M1 HD-tDCS further increased left M1 excitability (+28.3%) and inhibition (+21%) from baseline levels during CF of the left M1, with no difference between anodal and cathodal HD-tDCS sessions. No modulation of CSP or MEP was observed during sham HD-tDCS sessions. Our findings suggest that CF of the left M1 combined with right M1 anodal or cathodal HD-tDCS further facilitated interhemispheric interactions during CF from the right M1 (contracting left arm) toward the left M1 (relaxed right arm), with effects on both excitatory and inhibitory processing. NEW & NOTEWORTHY This study shows modulation of the nonstimulated left M1 by right M1 HD-tDCS combined with crossed facilitation, which was probably achieved through modulation of interhemispheric interactions.

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Chertkow, Howard. "111 - Surface neuromodulation (TMS and tDCS) for therapy of cognitive and psychiatric disorders." International Psychogeriatrics 32, S1 (October 2020): 25. http://dx.doi.org/10.1017/s1041610220001891.

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The field of neuromodulation has progressed significantly over the past two decades. It is evident that application of electrical (via tDCS, transcranial direct current stimulation) or magnetic (via rTMS, repetitive transcranial magnetic stimulation) brain stimulation over the skull surface can effect change in brain function, which appears sufficiently robust to have a therapeutic effect. Sometimes the neuromodulation is best coupled with other forms of training or rehabilitation for best efficacy. What are the most promising approaches? What conditions appear to benefit? What are the situations/diseases/ disease states where neuromodulation is sufficiently well-proven now (or may be so in the future) that clinicians should start to consider its use in their psychogeriatric practice? We will review studies showing that tDCS can have a therapeutic effect in dementia, stroke, depression, and a range of other psychiatric conditions. Recent work is showing that with tDCS one can achieve improvement in picture naming, executive function, and memory in Alzheimer Disease and Frontotemporal dementia (Howard Chertkow presentation, Baycrest Health Sciences, Toronto). In stroke rehabilitation, rTMS treatment has been shown to aid in motor and language recovery (Alex Thiel, McGill University). There is now sufficient evidence that tDCS and Magnetic Seizure therapy are beneficial in depression, that these can now become part of the therapeutic armamentarium in selected cases (Jeff Daskalakis, University of Toronto). A range of other neuropsychiatric conditions can also be considered for neuromodulation therapy with rTMS (Daniel Blumberger, University of Toronto, CAMH).By attending this symposium, a physician or health care professional will become familiar with the latest research into neuromodulation and its role in current therapy of neurological and psychiatric diseases.

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Antikacioglu, Levon, and Nevzat Tarhan. "A Speculation on the Mechanisms of ECT, TMS, tDCS and Similar Techniques." Journal of Neurobehavioral Sciences 3, no. 2 (2016): 69. http://dx.doi.org/10.5455/jnbs.1465994805.

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Mendonça, Lucia Iracema Zanotto de. "Transcranial brain stimulation (TMS and tDCS) for post-stroke aphasia rehabilitation: Controversies." Dementia & Neuropsychologia 8, no. 3 (September 2014): 207–15. http://dx.doi.org/10.1590/s1980-57642014dn83000003.

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Transcranial brain stimulation (TS) techniques have been investigated for use in the rehabilitation of post-stroke aphasia. According to previous reports, functional recovery by the left hemisphere improves recovery from aphasia, when compared with right hemisphere participation. TS has been applied to stimulate the activity of the left hemisphere or to inhibit homotopic areas in the right hemisphere. Various factors can interfere with the brain's response to TS, including the size and location of the lesion, the time elapsed since the causal event, and individual differences in the hemispheric language dominance pattern. The following questions are discussed in the present article: [a] Is inhibition of the right hemisphere truly beneficial?; [b] Is the transference of the language network to the left hemisphere truly desirable in all patients?; [c] Is the use of TS during the post-stroke subacute phase truly appropriate? Different patterns of neuroplasticity must occur in post-stroke aphasia.

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Alibazi, Razie J., Ashlyn K. Frazer, Jamie Tallent, Alan J. Pearce, Tibor Hortobágyi, and Dawson Kidgell. "A single session of submaximal grip strength training with or without high-definition anodal-TDCS produces no cross-education of maximal force." Brazilian Journal of Motor Behavior 15, no. 3 (September 1, 2021): 216–36. http://dx.doi.org/10.20338/bjmb.v15i3.223.

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BACKGROUND: Previous studies suggest that cross-education of strength may be modulated by increased corticospinal excitability of the ipsilateral primary motor cortex (M1) due to cross-activation. However, no study has examined the influence of bilateral TDCS of both M1 and how it affects corticospinal excitability, cross-activation and cross-education of muscle strength. METHOD: Twelve participants underwent three conditions in a randomized crossover design: (1) submaximal grip training and single-site unilateral-high definition-TDCS (2) submaximal grip training and bilateral anodal-high definition-TDCS, and (3) submaximal grip training and sham-high definition-TDCS. Submaximal gripping task involved a single-session of unilateral training which was squeezing the transducer at 70% of maximum voluntary isometric contraction (MVIC) grip force and performing four sets of 10 isometric contractions. Anodal-high definition-TDCS was applied for 15 min at 1.5 mA over right M1 or left and right M1s, and in a sham condition. Participants were pseudorandomized to receive either single-site or bilateral M1 stimulation with each session separated by one-week. Before and after each session, MVIC force of ipsilateral and contralateral gripping, ipsilateral stimulus-response curve, short-interval intracortical inhibition, cortical silent period, intracortical facilitation, long-interval intracortical inhibition, and cross-activation were measured. RESULTS: MVIC of the trained arm decreased by 43% (P=0.04) after training. We observed no changes in MVIC of the untrained hand and in any of the TMS measures (all P>0.05). CONCLUSION: A single session of submaximal grip training with or without anodal-high definition-TDCS produces no cross-education of maximal grip force nor does it affect the excitability of the ipsilateral M1.

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Jefferson, Samantha, Satish Mistry, Salil Singh, John Rothwell, and Shaheen Hamdy. "Characterizing the application of transcranial direct current stimulation in human pharyngeal motor cortex." American Journal of Physiology-Gastrointestinal and Liver Physiology 297, no. 6 (December 2009): G1035—G1040. http://dx.doi.org/10.1152/ajpgi.00294.2009.

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Transcranial direct current stimulation (tDCS) is a novel intervention that can modulate brain excitability in health and disease; however, little is known about its effects on bilaterally innervated systems such as pharyngeal motor cortex. Here, we assess the effects of differing doses of tDCS on the physiology of healthy human pharyngeal motor cortex as a prelude to designing a therapeutic intervention in dysphagic patients. Healthy subjects ( n = 17) underwent seven regimens of tDCS (anodal 10 min 1 mA, cathodal 10 min 1 mA, anodal 10 min 1.5 mA, cathodal 10 min 1.5 mA, anodal 20 min 1 mA, cathodal 20 min 1 mA, Sham) on separate days, in a double blind randomized order. Bihemispheric motor evoked potential (MEP) responses to single-pulse transcranial magnetic stimulation (TMS) as well as intracortical facilitation (ICF) and inhibition (ICI) were recorded using a swallowed pharyngeal catheter before and up to 60 min following the tDCS. Compared with sham, both 10 min 1.5 mA and 20 min 1 mA anodal stimulation induced increases in cortical excitability in the stimulated hemisphere (+44 ± 17% and +59 ± 16%, respectively; P < 0.005) whereas only 10 min 1.5 mA cathodal stimulation induced inhibition (−26 ± 4%, P = 0.02). There were neither contralateral hemisphere changes nor any evidence for ICI or ICF in driving the ipsilateral effects. In conclusion, anodal tDCS can alter pharyngeal motor cortex excitability in an intensity-dependent manner, with little evidence for transcallosal spread. Anodal stimulation may therefore provide a useful means of stimulating pharyngeal cortex and promoting recovery in dysphagic patients.

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Journal articles on the topic 'TDCS/TMS'

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