Dr. Marom Bikson interviewed by Quartz.
Research article.
Testing the effectiveness of transcranial direct stimulation for the treatment of fatigue in multiple sclerosis.
Mult. Scler. J. 2017 Sep 22. doi: https://doi.org/10.1177/1352458517732842. Download PDF: Remotely…sham-controlled trial.
Leigh E Charvet, Bryan Dobbs, Michael T Shaw, Marom Bikson, Abhishek Datta and Lauren B Krupp.
Abstract:
Background: Fatigue is a common and debilitating feature of multiple sclerosis (MS) that remains without reliably effective treatment. Transcranial direct current stimulation (tDCS) is a promising option for fatigue reduction. We developed a telerehabilitation protocol that delivers tDCS to participants at home using specially designed equipment and real-time supervision (remotely supervised transcranial direct current stimulation (RS-tDCS)).
Objective: To evaluate whether tDCS can reduce fatigue in individuals with MS.
Methods: Dorsolateral prefrontal cortex left anodal tDCS was administered using a RS-tDCS protocol, paired with 20minutes of cognitive training. Here, two studies are considered. Study 1 delivered 10 openlabel tDCS treatments (1.5mA; n=15) compared to a cognitive training only condition (n=20). Study 2 was a randomized trial of active (2.0mA, n=15) or sham (n=12) delivered for 20 sessions. Fatigue was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS)—Fatigue Short Form.
Results and conclusion: In Study 1, there was modest fatigue reduction in the active group (−2.5±7.4 vs −0.2±5.3, p=0.30, Cohen’s d=−0.35). However, in Study 2 there was statistically significant reduction for the active group (−5.6±8.9 vs 0.9±1.9, p=0.02, Cohen’s d=−0.71). tDCS is a potential treatment for MS-related fatigue.
Event Time and Location: Wednesday, September 27, 2017, 3PM, Steinman Hall 402
George McConnell, PhD (Stevens Institute of Technology), Why Random Patterns of Deep Brain Stimulation Less Effectively Treat Parkinson’s Disease: Insights from In Vivo Studies
Abstract: Deep Brain Stimulation (DBS) of the subthalamic nucleus effectively treats several motor symptoms of Parkinson’s disease (PD), however, the mechanisms of action of DBS are unknown. Random temporal patterns of DBS are less effective than regular DBS, but the neural basis for this dependence on temporal pattern of stimulation is unclear. We quantified behavior and single-unit neuronal activity in parkinsonian rats to test the hypothesis that the ineffectiveness of irregular DBS is caused by a failure to mask low-frequency oscillatory activity. Irregular DBS relieved symptoms less effectively than regular DBS, even when delivered at a high average rate. The reduced effectiveness of random DBS paralleled a failure to suppress low-frequency oscillatory activity and suggest that long pauses during random DBS are responsible for the reduced effectiveness, because these pauses enable the propagation of low-frequency oscillatory activity. These results demonstrate a correlation between efficacy of DBS, temporal regularity of stimulus trains, and changes in neuronal oscillatory activity in the basal ganglia, highlighting the importance of considering temporal patterns – as opposed to simply the rate – of both stimulation and neuronal firing in studying the mechanisms of DBS for neurological disorders.
Prof. Marom Bikson interviewed for IBM thinkLeaders, May 4, 2017
Clinical Trial.
Comparison of the Long-Term Effect of Positioning the Cathode in tDCS in Tinnitus Patients.
Front. Aging Neurosci. 2017, July; 9(217) doi: 10.3389/fnagi.2017.00217 Download PDF: Comparing long-term effect
Sarah Rabau, Giriraj S. Shekhawat, Mohamed Aboseria, Daniel Griepp, Vincent Van Rompaey, Marom Bikson6 and Paul Van de Heyning.
Abstract:
Objective: Transcranial direct current stimulation (tDCS) is one of the methods described in the literature to decrease the perceived loudness and distress caused by tinnitus. However, the main effect is not clear and the number of responders to the treatment is variable. The objective of the present study was to investigate the effect of the placement of the cathode on the outcome measurements.
Methods: Patients considered for the trial were chronic non-pulsatile tinnitus patients with complaints for more than 3 months and a Tinnitus Functional Index (TFI) score that exceeded 25. The anode was placed on the right dorsolateral prefrontal cortex (DLPFC). In the first group—“bifrontal”—the cathode was placed on the left DLPFC, while in the second group—“shoulder”—the cathode was placed on the shoulder. Each patient received two sessions of tDCS weekly and eight sessions in total. Evaluations took place on the first visit for an ENT consultation, at the start of therapy, after eight sessions of tDCS and at the follow-up visit, which took place 84 days after the start of the therapy. Subjective outcome measures such as TFI, Visual Analog Scales (VAS) for loudness and percentage of consciousness of tinnitus were administered in every patient.
Results: There was no difference in the results for tinnitus loudness and the distress experienced between the placement of the cathode on the left DLPFC or on the shoulder. In addition, no statistically significant overall effect was found between the four test points. However, up to 39.1% of the patients experienced a decrease in loudness, measured by the VAS for loudness. Moreover, 72% of those in the bifrontal group, but only 46.2% of those in the shoulder group reported some improvement in distress.
Conclusion: While some improvement was noted, this was not statistically significant. Both electrode placements stimulated the right side of the hippocampus, which could be responsible for the effect found in both groups. Further research should rule out the placebo effect and investigate alternative electrode positions.
Ezquerro F, Moffa AH, Bikson M, Khadka N, Aparicio LVM, Sampaio BD Jr, Fregni F, Bensenor I, Lotufo P, Pereira AC, Brunoni AR
Download: PDF Published in Neuromodulation DOI
Abstract
Objective: To evaluate whether and to which extent skin redness (erythema) affects investigator blinding in transcranial direct current stimulation (tDCS) trials.
Material and Methods:Twenty-six volunteers received sham and active tDCS, which was applied with saline-soaked sponges of different thicknesses. High-resolution skin images, taken before and 5, 15, and 30 min after stimulation, were randomized and presented to experienced raters who evaluated erythema intensity and judged on the likelihood of stimulation condition (sham vs. active). In addition, semi-automated image processing generated probability heatmaps and surface area coverage of erythema. Adverse events were also collected.
Results: Erythema was present, but less intense in sham compared to active groups. Erythema intensity was inversely and directly associated to correct sham and active stimulation group allocation, respectively. Our image analyses found that erythema also occurs after sham and its distribution is homogenous below electrodes. Tingling frequency was higher using thin compared to thick sponges, whereas erythema was more intense under thick sponges.
Conclusions:Optimal investigator blinding is achieved when erythema after tDCS is mild. Erythema distribution under the electrode is patchy, occurs after sham tDCS and varies according to sponge thickness. We discuss methods to address skin erythema-related tDCS unblinding.
Congratulations to Belen, Asif, and Natalie
Neuromodulation of Axon Terminals
Cerebral Cortex, 2017; 1–9 doi: 10.1093/cercor/bhx158 Download PDF:NeuromodulationofAxons
Darpan Chakraborty, Dennis Q. Truong, Marom Bikson and Hanoch Kaphzan
Abstract: Understanding which cellular compartments are influenced during neuromodulation underpins any rational effort to explain and optimize outcomes. Axon terminals have long been speculated to be sensitive to polarization, but experimentally informed models for CNS stimulation are lacking. We conducted simultaneous intracellular recording from the neuron soma and axon terminal (blebs) during extracellular stimulation with weak sustained (DC) uniform electric fields in mouse cortical slices. Use of weak direct current stimulation (DCS) allowed isolation and quantification of changes in axon terminal biophysics, relevant to both suprathreshold (e.g., deep brain stimulation, spinal cord stimulation, and transcranial magnetic stimulation) and subthreshold (e.g., transcranial DCS and transcranial alternating current stimulation) neuromodulation approaches. Axon terminals polarized with sensitivity (mV of membrane polarization per V/ m electric field) 4 times than somas. Even weak polarization (<2 mV) of axon terminals significantly changes action potential dynamics (including amplitude, duration, conduction velocity) in response to an intracellular pulse. Regarding a cellular theory of neuromodulation, we explain how suprathreshold CNS stimulation activates the action potential at terminals while subthreshold approaches modulate synaptic efficacy through axon terminal polarization. We demonstrate that by virtue of axon polarization and resulting changes in action potential dynamics, neuromodulation can influence analog– digital information processing.
Friday 6/23 at 3 pm in CDI 3rd floor conference room (3.352)
Laurent Koessler from CNRS and Lorraine University will be speaking
Title: Brain source detection and localization using multi-scale EEG recording.
Abstract: In drug-resistant epilepsy surgery investigations, epileptogenic zone and brain functional areas localization are required. This localization relies on scalp and intracerebral EEG recordings. In Nancy (France) I developed a program concerning simultaneous scalp and intracerebral EEG recordings. Using this methodological approach, 1) in vivo human brain tissue conductivities can be estimated, 2) relationship from brain sources to scalp EEG correlates can be studied and 3) non invasive electrical source localization can be validated.
Tomorrow June 21st at 2pm in CDI 3rd floor conference room (3.352)
Bashar Badran from the Medical Universty of South Carolina and University of New Mexico will be speaking
Title: Development, optimization, and neurophysiological effects of transcutaneous auricular vagus nerve stimulation (taVNS)
Abstract: taVNS is an emerging new form of neuromodulation involving transcutaneous electrical stimulation of the auricular branch of the vagus nerve. Still in its infancy and showing much clinical promise, the optimal human stimulation parameters and direct brain effects are undetermined. This lecture will present the findings of two important studies that aim to solve the taVNS problem of infinite parametric solutions. The first, a taVNS parametric study exploring 9 different combinations of pulse width and frequency and their activation of the vagal tone as measured by physiological recordings. The second is a novel multi-modal imaging study that establishes concurrent taVNS/fMRI and explores the direct brain effect of taVNS on the human brain’s BOLD response. These findings aim to establish an aim and direction of the optimal taVNS parameters to guide future trials.
Neuroimage. 2017 May 31;157:69-80. doi: 10.1016/j.neuroimage.2017.05.059.
Optimal use of EEG recordings to target active brain areas with transcranial electrical stimulation.
Dmochowski JP, Koessler L, Norcia AM, Bikson M, Parra LC.
Abstract: To demonstrate causal relationships between brain and behavior, investigators would like to guide brain stimulation using measurements of neural activity. Particularly promising in this context are electroencephalography (EEG) and transcranial electrical stimulation (TES), as they are linked by a reciprocity principle which, despite being known for decades, has not led to a formalism for relating EEG recordings to optimal stimulation parameters. Here we derive a closed-form expression for the TES configuration that optimally stimulates (i.e., targets) the sources of recorded EEG, without making assumptions about source location or distribution. We also derive a duality between TES targeting and EEG source localization, and demonstrate that in cases where source localization fails, so does the proposed targeting. Numerical simulations with multiple head models confirm these theoretical predictions and quantify the achieved stimulation in terms of focality and intensity. We show that constraining the stimulation currents automatically selects optimal montages that involve only a few (4-7) electrodes, with only incremental loss in performance when targeting focal activations. The proposed technique allows brain scientists and clinicians to rationally target the sources of observed EEG and thus overcomes a major obstacle to the realization of individualized or closed-loop brain stimulation.
“Noninvasive Neuromodulation Goes Deep” Jacek Dmochowski and Marom Bikson, Cell.http://dx.doi.org/10.1016/j.cell.2017.05.017
Modulating deep regions of the brain with noninvasive technology has challenged researchers for decades. In a new study, Grossman et al. leverage the emergence of a slowly oscillating ‘‘beat’’ from intersecting high-frequency electric fields to stimulate deep brain regions, opening a frontier in the biophysics and technology of brain stimulation. Download PDF: FullPaper
The Science of Consciousness June 5-10, 2017 La Jolla, California
‘The Science of Consciousness’ (‘TSC’) is an interdisciplinary conference on all aspects of the nature of conscious experience, awareness, feelings and existence. How does the brain produce consciousness? Is consciousness intrinsic to the universe, or an epiphenomenal illusion? How can consciousness causally affect brain processes? What are the best empirical theories? Do we have free will? How did life and consciousness originate and evolve? What are the origins of moral and aesthetic values? How can we improve mental, physical and cognitive function? Can consciousness persist after bodily death, e.g. through ‘uploading’ to machines, or via mental processes tied to the natural world?
For registration, hotel and other information see: http://www.consciousness.arizona.edu
Marom Bikson, CCNY/CUNY, ‘Non-Invasive Brain Stimulation Devices to Change Thought and Behavior’
June 6: PL4 2:00 to 4:10 pm Non-Invasive Brain Stimulation
Thursday, May 18, 2017, 12:20PM, NAC 6/113
Basilis Gidas (Brown University), Finding Genes and Towards a Mathematical Framework for Artificial Intelligence and Biological Systems
The first half of the lecture will be on a statistical model for finding genes in the human genome. The model contains two parts: (a) A finite network (graph) which represents the overall architecture of a gene. The vertices in the network represent DNA signals (small patterns) associated with a gene and which are recognized by proteins and enzymes involved in the transcription and translation of genes. The edges of the network correspond to interactions among these signals and represent statistical variability in the architecture across genes; (b) each signal and each part of a gene is a piece of DNA with a random length as well as a random variability of its nucleotide sequence. The second part of the model articulates these variabilities.
The above gene finding procedure is conceptually similar to what is believed to underlie speech recognition whereby recognition involves two types of information: The acoustic signal represented by a concatenation of phonemes, and global regularities articulated by grammars (or syntax). The underpinning process in visual recognition is undoubtedly similar. And so is – many practitioners believe – the functioning of biological processes whereby two principles are at work: physics (biochemistry) and evolution. Physics controls the biochemical interaction of macromolecules, but it is evolution that produced the perfect “code” or “syntactic language” for the collective behavior of genes (Gene Regulatory Networks), or the collective behavior of proteins in Signal Transduction Pathways in cell growth, cell division or immunology. While specific questions and application in speech, vision, and biology have seen impressive advances and have lead to a great deal of mathematical innovation (e.g. modern statistical learning), an underpinning mathematical framework is missing. Though we do not have the framework, we know quite a bit of some of the problems the framework needs to articulate and some of the properties it needs to have. Building on the gene finding process, the second part of the talk will aim at identifying some key sources that makes information processing in cognition and biology difficult, and hint towards a coherent hierarchical/grammatical framework.
The CCNY Neural Engineering group is excited for two important papers on the mechanisms of tDCS published in the same issue of Brain Stimulation journal.
Direct Current Stimulation Modulates LTP and LTD: Activity Dependence and Dendritic Effects.
Kronberg G, Bridi M, Abel T, Bikson M, Parra LC.
Brain Stimul. 2017 Jan – Feb;10(1):51-58. doi: 10.1016/j.brs.2016.10.001. Epub 2016 Oct 5. PMID: 28104085
Direct Current Stimulation Alters Neuronal Input/Output Function.
Lafon B, Rahman A, Bikson M, Parra LC.
Brain Stimul. 2017 Jan – Feb;10(1):36-45. doi: 10.1016/j.brs.2016.08.014. Epub 2016 Sep 1.PMID: 27717601
The SF Giants Are Zapping Their Brains With Electricity. Will It Help? MAY 8, 2017
“People like to say that electricity is the currency of the brain and that in many ways the brain is a circuit,” says Marom Bikson, a professor of biomedical engineering at City College of New York. “So when we apply electricity to the brain, we interact with that circuit, and we can change how that circuit works.”
Leite J, Goncalves Ó, Pereira P, Khadka N, Bikson M, Fregni F, Carvalho S
Download: PDF published in Neuroscience Research DOI
Abstract
This study examined the effects of bihemispheric and unihemispheric transcranial Direct Current Stimulation (tDCS) over the inferior frontal gyrus (IFG) on proactive control. Sixteen participants were randomized to receive (i) bihemispheric tDCS, with a 35 cm2 anodal electrode of the right IFG and a 35 cm2 cathode electrode of left IFG or (ii) unihemispheric tDCS, with a 35 cm2 anodal electrode of the right IFG and a 100 cm2 electrode of the left IFG or (iii) sham tDCS, while performing a prepotent inhibition task. There were significant speed-accuracy tradeoff effects in terms of switch costs: unihemispheric tDCS significantly decreased the accuracy when compared to bihemispheric, and sham tDCS, while increased response time when comparing to bihemispheric and sham tDCS. The computational model showed a symmetrical field intensity for the bihemispheric tDCS montage, and an asymmetrical for the unihemispheric tDCS montage. This study confirms that unihemispheric tDCS over the rIFG has a significant impact on response inhibition. The lack of results of bihemispheric tDCS brings two important findings for this study: (i) left IFG seems to be also critically associated with inhibitory response control, and (ii) these results highlight the importance of considering the dual effects of tDCS when choosing the electrode montage.
Jackson MP, Truong D, Brownlow ML, Wagner JA, McKinley RA, Bikson M, Jankord R. Safety parameter considerations of anodal transcranial Direct Current Stimulation in rats. Brain, Behavior, and Immunity 2017 pii: S0889-1591(17)30110-1. doi: 10.1016/j.bbi.2017.04.008 PDF
Nitsche M. Bikson M. Extending the parameter range for tDCS: Safety and tolerability of 4 mA stimulation. Brain Stimulation. Editorial, Volume 10, Issue 3, Pages 541–542, 2017 PDF
And don’t forget our seminal 2016 safety review here
