Hadar R, Winter R, Callesen HE, Wieske F, Habelt B, Khadka N, Felgel-Farnholz V, Barroeta-Hlusicka E, Reis J, Tatarau CA, Funke K, Fritsch B, Bernhardt N, Bikson M, Nitsche MA, Winter C. 2018. Prevention of schizophrenia deficits via non-invasive adolescent frontal cortex stimulation in rats. Nature Molecular Psychiatry. 2019. https://doi.org/10.1038/s41380-019-0356-x. PDF

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Abstract

Schizophrenia is a severe neurodevelopmental psychiatric affliction manifested behaviorally at late adolescence/early adulthood. Current treatments comprise antipsychotics which act solely symptomatic, are limited in their effectiveness and often associated with side-effects. We here report that application of non-invasive transcranial direct current stimulation (tDCS) during adolescence, prior to schizophrenia-relevant behavioral manifestation, prevents the development of positive symptoms and related neurobiological alterations in the maternal immune stimulation (MIS) model of schizophrenia.

Title: Neurocognitive mechanisms of DLPFC tDCS in major depressive disorder

Speaker: Dr. Maria Ironside, Post Doctoral Research Fellow, Center for Depression, Anxiety and Stress Research, McLean Hospital – Harvard Medical School

When: Friday Feb. 1 2019 at 1 pm

Where: CCNY Center for Discovery and Innovation, 4th floor seminar room (CDI 4.352)

Contact: Greg Kronberg (gregkronberg@gmail.com, 212-650-8876) for access to CDI building

Abstract:

The difficulty in treating mood and anxiety disorders has sparked clinical interest in novel treatments, such as transcranial direct current stimulation (tDCS) of the dorsolateral prefrontal cortex (DLPFC). However, underlying mechanisms of action are unclear. It is established that people with mood and anxiety disorders have negative cognitive biases, such as increased vigilance to threat. Psychiatric treatments have acute effects on these cognitive biases which predict later therapeutic action. Such effects are proposed as cognitive biomarkers of response.

A healthy volunteer investigation revealed an anxiolytic like effect (reduced threat vigilance) of a single session of tDCS on a behavioural test of proven clinical relevance (Ironside et al., 2016, Biological Psychiatry). Complementing these data, we used functional imaging to reveal that, in a sample of trait anxious females, tDCS of the DLPFC increased activation in an attentional control network and reduced amygdala response to fearful face distractors (Ironside et al., 2018, JAMA Psychiatry). This provides causal evidence that modulating activity in the DLPFC inhibits amygdala response to threat, providing a potential neural mechanism for the previous reduction in vigilance to threat. Collectively, these results propose an emerging neurocognitive model for the mechanisms of action of tDCS. We also examined pairing tDCS with attentional bias modification training and found no effect of stimulation.

Together, findings point to an anxiolytic-like effect of DLPFC tDCS on cognitive and neural biomarkers relevant to mood and anxiety disorders, indicating potential cognitive and underlying neural mechanisms that may mediate the reported clinical efficacy of DLPFC tDCS. This has implications as the identification of treatment response markers could aid patient selection for future trials and ultimately treatment selection for patients.

Adair, Devin, Dennis Q. Truong, Libby Ho, Bashar W. Badran, Helen Borges, and Marom Bikson. 2019. Abstract #124: How to modulate cognition with cranial nerve stimulation? Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e42-3, https://doi.org/10.1016/j.brs.2018.12.131.

Bikson, M. 2019. Downloading personalized brain stimulation. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 424, https://doi.org/10.1016/j.brs.2018.12.375.

Chhatbar, Pratik Y., Steven A. Kautz, Istvan Takacs, Nathan C. Rowland, Gonzalo J. Revuelta, Mark S. George, Marom Bikson, and Wuwei Feng. 2019. Abstract #22: First report of recording transcranial direct current stimulation-generated electric fields in subthalamic nuclei using directional leads. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e8, https://doi.org/10.1016/j.brs.2018.12.029.

DaFonseca, Estevão, Alexandre F. DaSilva, Marom Bikson, Dennis Troung, and Marcos F. DosSantos. 2019. Proceedings #21: Specific patterns of current flow generated by different tDCS montages in the midbrain and in the trigeminal brainstem sensory nuclear complex. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e84-6, https://doi.org/10.1016/j.brs.2018.12.190.

Datta, Abhishek, Yu Huang, Chris Thomas, Marom Bikson, and Ahmed Duke Shereen. 2019. Proceedings #12: Influence of incorporating electrode information from MR images: Towards building more realistic forward models. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e72-4, https://doi.org/10.1016/j.brs.2018.12.181.

Esmaeilpour, Z., M. Jackson, G. Kronberg, T. Zhang, R. Esteller, B. Hershey, and M. Bikson. 2019. Effect of kHz electrical stimulation on hippocampal brain slice excitability and network dynamics. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 586, https://doi.org/10.1016/j.brs.2018.12.948.

Esmaeilpour, Zeinab, Ahmed Duke Shereen, Marom Bikson, and Hamed Ekhtiari. 2019. Abstract #147: MRI neuroimaging methods for tDCS: A methodological note on study design and parameter space. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e50, https://doi.org/10.1016/j.brs.2018.12.154.

Fallahrad, Mohamad, Louis Zannou, Niranjan Khadka, Steven A. Prescott, Stéphanie Ratté, Tianhe Zhang, Rosana Esteller, Brad Hershey, and Marom Bikson. 2019. Abstract #159: Hardware suitable for electrophysiology and stimulation in kHz range. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e54, https://doi.org/10.1016/j.brs.2018.12.166.

Favoretto, Diandra B., Eduardo Bergonzoni, Diego Nascimento, Brunna Rimoli, Tenysson Will-Lemos, Dennis Q. Truong, Renato Moraes, et al. 2019. Abstract #119: Polarity-dependent effects on postural control after high-definition transcranial direct current stimulation over the temporo-parietal junction. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e41, https://doi.org/10.1016/j.brs.2018.12.126.

Fonteneau, Clara, Marine Mondino, Martijn Arns, Chris Baeken, Marom Bikson, Andre R. Brunoni, Matthew J. Burke, et al. Sham tDCS: A hidden source of variability? reflections for further blinded, controlled trials. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation (2019/01), https://doi.org/10.1016/j.brs.2018.12.977.

Gebodh, Nigel, Zeinab Esmaeilpour, Devin Adair, Kenneth Chelette, Jacek Dmochowski, Lucas Parra, Adam J. Woods, Emily S. Kappenman, and Marom Bikson. 2019. Abstract #125: Failure of conventional signal processing techniques to remove “Physiological” artifacts from EEG during tDCS. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e43, https://doi.org/10.1016/j.brs.2018.12.132.

Gebodh, Nigel, Laura Vacchi, Devin Adair, Gozde Unal, Alexander Poltorak, Valeria Poltorak, and Marom Bikson. 2019. Proceedings #11: Replay of endogenous sleep rhythms to produce sleepiness. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e71-2, https://doi.org/10.1016/j.brs.2018.12.180.

Huang, Y., A. Datta, M. Bikson, and L. Parra. 2019. ROAST: A fully-automated, open-source, realistic vOlumetric-approach-based simulator for TES. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 391, https://doi.org/10.1016/j.brs.2018.12.253.

Huang, Y., and L. Parra. 2019. Deep brain areas can be reached by transcranial electric stimulation with multiple electrodes. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 390-1, https://doi.org/10.1016/j.brs.2018.12.252.

Huang, Yu, Chris Thomas, Abhishek Datta, and Lucas C. Parra. 2019. Proceedings #23: Inaccurate segmentation of lesioned brains can significantly affect targeted transcranial electrical stimulation on stroke patients. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e87-9, https://doi.org/10.1016/j.brs.2018.12.192.

Jiang, Jimmy, Dennis Q. Truong, and Marom Bikson. 2019. Abstract #115: What is theoretically more focal: HD-tDCS or TMS? Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e39-40, https://doi.org/10.1016/j.brs.2018.12.122.

Jiang, Jimmy, Dennis Q. Truong, Yu Huang, Lucas Parra, and Marom Bikson. 2019. Abstract #118: Transcranial electrical stimulation models using an emulated-CSF value approximate the meninges more accurately. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e40-1, https://doi.org/10.1016/j.brs.2018.12.125.

Khadka, N., A. Zannou, D. Truong, T. Zhang, R. Esteller, B. Hersey, and M. Bikson. 2019. Generation 2 kilohertz spinal cord stimulation (kHz-SCS) bioheat multi-physics model. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 566, https://doi.org/10.1016/j.brs.2018.12.876.

Khadka, Niranjan, Helen Borges, Trynia Kauffman, Alain Pascal, Bhaskar Paneri, Electra Nassis, Yungjae Shin, et al. 2019. Abstract #109: Tolerability of an adaptive-tDCS upto 4 mA using subject assessment and machine-learning to optimize dose. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e37-8, https://doi.org/10.1016/j.brs.2018.12.116.

Khadka, Niranjan, Helen Borges, Adantchede L. Zannou, Jongmin Jang, Byungjik Kim, Kiwon Lee, and Marom Bikson. 2019. Abstract #100: Dry tDCS: Tolerability of a novel multilayer hydrogel composite non-adhesive electrode for tDCS. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e35, https://doi.org/10.1016/j.brs.2018.12.107.

Kronberg, G., A. Rahman, M. Bikson, and L. Parra. 2019. A hebbian framework for predicting modulation of synaptic plasticity with tDCS. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 554, https://doi.org/10.1016/j.brs.2018.12.831.

Kronberg, Greg, Asif Rahman, Marom Bikson, and Lucas Parra. 2019. Abstract #122: A hebbian framework for predicting modulation of synaptic plasticity with tDCS. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e42, https://doi.org/10.1016/j.brs.2018.12.129.

Louviot, Samuel, Jacek Dmochowski, Jacques Jonas, Louis Maillard, Sophie Colnat-Coulbois, Louise Tyvaert, and Laurent Koessler. 2019. Abstract #32: Medial and lateral temporal lobe neuromodulation in epilepsy: A simultaneous tdcs-seeg investigation. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e12, https://doi.org/10.1016/j.brs.2018.12.039.

Louviot, Samuel, Jacek Dmochowski, Jacques Jonas, Louis Maillard, Sophie Colnat-Coulbois, Louise Tyvaert, and Laurent koessler. 2019. Abstract #68: A human in-vivo evaluation of roast using simultaneous intracerebral electrical stimulations and scalp eeg. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e24, https://doi.org/10.1016/j.brs.2018.12.075.

Lucas Parra, Yu Huang. 2019. Abstract #38: Transcranial electric stimulation with multiple electrodes can reach deep brain areas. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e14, https://doi.org/10.1016/j.brs.2018.12.045.

Meiron, Oded, Rena Gale, Julia Namestnic, Odeya Bennet-Back, Jonathan David, Nigel Gebodh, Devin Adair, Zeinab Esmaeilpour, and Marom Bikson. 2019. Abstract #123: Attenuation of pathological EEG features in nonatal electroclinical syndromes: HD-tDCS in catastrophic epilepsies. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e42, https://doi.org/10.1016/j.brs.2018.12.130.

Mourdoukoutas, Antonios, Gozde Unal, John Martin, Mar Cortes, Jeremy Fidock, and Marom Bikson. 2019. Proceedings #14: Neuromodulation of spinal cord with tDCS extracephalic return electrode. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e75-6, https://doi.org/10.1016/j.brs.2018.12.183.

Quinn, Davin, Joel Upston, Thomas Jones, Jessica Richardson, Lindsay Worth, Violet Fratzke, Julia Stephen, et al. 2019. Abstract #1: Individualizing HD-tDCS with fMRI and E-field modeling: Pilot data from the NAVIGATE-TBI study. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e1, https://doi.org/10.1016/j.brs.2018.12.008.

Salvi, Carola, Ryan D. Conrardy, Marom Bikson, Mark Beeman, and Jordan Grafman. 2019. Abstract #142: Effects of high definition tDCS on problem solving networks. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e49, https://doi.org/10.1016/j.brs.2018.12.149.

Shaw, M., N. Pawlak, C. Choi, N. Khan, A. Datta, and M. Bikson. 2019. Transcranial direct current stimulation (tDCS) induces acute changes in brain metabolism. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 518, https://doi.org/10.1016/j.brs.2018.12.703.

Shereen, D., and L. Parra. 2019. Rapid measurement of electromagnetic fields induced from transcranial electric stimulation using magnetic resonance imaging. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): 584, https://doi.org/10.1016/j.brs.2018.12.938.

Shereen, Duke, and Lucas Parra. 2019. Abstract #98: Rapid field mapping using magnetic resonance imaging during transcranial direct current stimulation. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e34, https://doi.org/10.1016/j.brs.2018.12.105.

Tarbell, John, Marom Bikson, Limary M. Cancel, and Niranjan Khadka. 2019. Abstract #33: Direct current stimulation of endothelial monolayers induces an increase in transport by the electroosmotic effect. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e12, https://doi.org/10.1016/j.brs.2018.12.040.

Trapp, Nicholas T., Willa Xiong, Britt M. Gott, Gemma D. Espejo, Marom Bikson, and Charles R. Conway. 2019. Proceedings #51: 4 mA adaptive transcranial direct current stimulation for treatment-resistant depression: Early demonstration of feasibility with a 20-session course. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e124-5, https://doi.org/10.1016/j.brs.2018.12.220.

Truong, Dennis Q., Catherine Maglione, Yishai Valter, Louis Zannou, A. D. Shereen, Preston Williams, John H. Martin, and Marom Bikson. 2019. Abstract #29: Scaling spinal cord injury models for non-invasive stimulation. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e10-1, https://doi.org/10.1016/j.brs.2018.12.036.

Unal, Gozde, Bronte N. Ficek, Kimberly T. Webster, Syed Shahabuddin, Dennis Q. Truong, Marom Bikson, and Kyrana Tsapkini. 2019. Abstract #113: Individualized modeling for subjects with primary progressive aphasia. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e39, https://doi.org/10.1016/j.brs.2018.12.120.

Valero-Cabre, Antoni, Clara Sanches, Dennis Q. Truong, Marom Bikson, and Marc Teichmann. 2019. Abstract #2: Improvement of language function following prefrontal transcranial direct current brain stimulation in progressive supranuclear palsy. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e1-2, https://doi.org/10.1016/j.brs.2018.12.009.

Williams, Preston, John Brandenburg, Dennis Q. Truong, Alan C. Seifert, Adrish Sarkar, Junqian Xu, Marom Bikson, and John Martin. 2019. Abstract #136: Translational neuromodulation of motor-output using trans-spinal direct current stimulation (tsDCS) in a large animal model. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e46-7, https://doi.org/10.1016/j.brs.2018.12.143.

Zannou, Adantchede L., Niranjan Khadka, Mohamad FallahRad, Dennis Truong, and Marom Bikson. 2019. Abstract #30: Tissue temperature increases by HF10 senza spinal cord stimulation system: Phantom and bioheat model. Brain Stimulation: Basic, Translational, and Clinical Research in Neuromodulation 12 (2) (03/01; 2019/01): e11, https://doi.org/10.1016/j.brs.2018.12.037.

Fonteneau C, Mondino M, Arns M, Baeken C, Bikson M, Brunoni AR, Burke MJ, Neuvonen T, Padberg F, Pascual-Leone A, Poulet E, Ruffini G, Santarnecchi E, Sauvaget A, Schellhorn K, Suaud-Chagny M-F, Palm U, Brunelin J. Sham tDCS: a hidden source of variability? Reflections for further blinded, controlled trials. Brain Stimulation. https://doi.org/10.1016/j.brs.2018.12.977 (In Press). 2019

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Abstract
Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique increasingly used to modulate neural activity in the living brain. In order to establish the neurophysiological, cognitive or clinical effects of tDCS, most studies compare the effects of active tDCS to those observed with a sham tDCS intervention. In most cases, sham tDCS consists in delivering an active stimulation for a few seconds to mimic the sensations observed with active tDCS and keep participants blind to the intervention. However, to date, sham-controlled tDCS studies yield inconsistent results, which might arise in part from sham inconsistencies. Indeed, a multiplicity of sham stimulation protocols is being used in the tDCS research field and might have different biological effects beyond the intended transient sensations. Here, we seek to enlighten the scientific community to this possible confounding factor in order to increase reproducibility of neurophysiological, cognitive and clinical tDCS studies.

da S. Machado D. G., Unal G., Andrade S. M., Moreira A., Altimari L. R., Brunoni A. R., Perrey S., Mauger A. R., Bikson M., Okano, A. H. (2018). Effect of transcranial direct current stimulation on exercise performance: A systematic review and meta-analysis. Brain Stimulation. 12(3), 593–605. https://doi.org/10.1016/j.brs.2018.12.227 PDF

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Abstract: Transcranial direct current stimulation (tDCS) has been used to improve exercise performance, though the protocols used, and results found are mixed. We aimed to analyze the effect of tDCS on improving exercise performance. A systematic search was performed on the following databases, until December 2017: PubMed/MEDLINE, Embase, Web of Science, SCOPUS, and SportDiscus. Full-text articles that used tDCS for exercise performance improvement in adults were included. We compared the effect of anodal (anode near nominal target) and cathodal (cathode near nominal target) tDCS to a sham/control condition on the outcome measure (performance in isometric, isokinetic or dynamic strength exercise and whole-body exercise). 22 studies (393 participants) were included in the qualitative synthesis and 11 studies (236 participants) in the meta-analysis. The primary motor cortex (M1) was the main nominal tDCS target (n = 16; 72.5%). A significant effect favoring anodal tDCS (a-tDCS) applied before exercise over M1 was found on cycling time to exhaustion (mean difference = 93.41 s; 95%CI = 27.39 s–159.43 s) but this result was strongly influenced by one study (weight = 84%), no effect was found for cathodal tDCS (c-tDCS). No significant effect was found for a-tDCS applied on M1 before or during exercise on isometric muscle strength of the upper or lower limbs. Studies regarding a-tDCS over M1 on isokinetic muscle strength presented mixed results. Individual results of studies using a-tDCS applied over the prefrontal and motor cortices either before or during dynamic muscle strength testing showed positive results, but performing meta-analysis was not possible. For the protocols tested, a-tDCS but not c-tDCS vs. sham over M1 improved exercise performance in cycling only. However, this result was driven by a single study, which when removed was no longer significant. Further well-controlled studies with larger sample sizes and broader exploration of the tDCS montages and doses are warranted.

Dobbs B., Pawlak N., Biagioni M., Agarwal S., Shaw M., Pilloni G., Bikson M., Datta A., Charvet L. (2018). Generalizing remotely supervised transcranial direct current stimulation (tDCS): feasibility and benefit in Parkinson’s disease. Journal of NeuroEngineering and Rehabilitation, 15(1). https://doi.org/10.1186/s12984-018-0457-9

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Abstract: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that has been shown to improve common symptoms of neurological disorders like depressed mood, fatigue, motor deficits and cognitive dysfunction. tDCS requires daily treatment sessions in order to be effective. We developed a remotely supervised tDCS (RS-tDCS) protocol for participants with multiple sclerosis (MS) to increase accessibility of tDCS, reducing clinician, patient, and caregiver burden. The goal of this protocol is to facilitate home use for larger trials with extended treatment periods. In this study we determine the generalizability of RS-tDCS paired with cognitive training (CT) by testing its feasibility in participants with Parkinson’s disease (PD). Following the methods in our MS protocol development, we enrolled sixteen participants (n = 12 male, n = 4 female; mean age 66 years) with PD to complete ten open-label sessions of RS-tDCS paired with CT (2.0 mA × 20 min) at home under the remote supervision of a trained study technician. Tolerability data were collected before, during, and after each individual session. Baseline and follow-up measures included symptom inventories (fatigue and sleep) and cognitive assessments. RS-tDCS was feasible and tolerable for patients with PD, with at-home access leading to high protocol compliance. Side effects were mostly limited to mild sensations of transient itching and burning under the electrode sites. Similar to prior finding sin MS, we found preliminary efficacy for improvement of fatigue and cognitive processing speed in PD. RS-tDCS paired with CT is feasible for participants with PD to receive at home treatment. Signals of benefit for reduced fatigue and improved cognitive processing speed are consistent across the PD and MS samples. RS-tDCS can be generalized to provide tDCS to a range of patients with neurologic disorders for at-home rehabilitation.

Marom Bikson featured in Daily Beast article on brain stimulation “Flow Neuroscience Advertises Pumping Electricity Into Your Own Brain at Home. Should You Do It?”  Dec 2, 2018

Article is here

Lee S. H., Im J. J., Oh J. K., Choi E. K., Yoon S., Bikson M., Song I.-U., Jeong H., Chung Y-A. (2018). Transcranial direct current stimulation for online gamers: A prospective single-arm feasibility study. Journal of Behavioral Addictions, 1–5. Akademiai Kiado Zrt. Retrieved from http://dx.doi.org/10.1556/2006.7.2018.107

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Abstract: Excessive use of online games can have negative influences on mental health and daily functioning. Although the effects of transcranial direct current stimulation (tDCS) have been investigated for the treatment of addiction, it has not been evaluated for excessive online game use. This study aimed to investigate the feasibility and tolerability of tDCS over the dorsolateral prefrontal cortex (DLPFC) in online gamers. A total of 15 online gamers received 12 active tDCS sessions over the DLPFC (anodal left/cathodal right, 2 mA for 30 min, 3 times per week for 4 weeks). Before and after tDCS sessions, all participants underwent 18F-fluoro-2-deoxyglucose positron emission tomography scans and completed the Internet Addiction Test (IAT), Brief Self Control Scale (BSCS), and Beck Depression Inventory-II (BDI-II). After tDCS sessions, weekly hours spent on games (p = .02) and scores of IAT (p < .001) and BDI-II (p = .01) were decreased, whereas BSCS score was increased (p = .01). Increases in self-control were associated with decreases in both addiction severity (p = .002) and time spent on games (p = .02). Moreover, abnormal right-greater-than-left asymmetry of regional cerebral glucose metabolism in the DLPFC was partially alleviated (p = .04). Our preliminary results suggest that tDCS may be useful for reducing online game use by improving interhemispheric balance of glucose metabolism in the DLPFC and enhancing self-control. Larger sham-controlled studies with longer follow-up period are warranted to validate the efficacy of tDCS in gamers.

Gebodh, N., Esmaeilpour, Z., Adair, D., Chelette, K., Dmochowski, J., Woods, A. J., Kappenman, E. S., Parra L. C., Bikson M. (2019). Inherent physiological artifacts in EEG during tDCS. NeuroImage, 185, 408–424. Elsevier BV.

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Abstract

Online imaging and neuromodulation is invalid if stimulation distorts measurements beyond the point of accurate measurement. In theory, combining transcranial Direct Current Stimulation (tDCS) with electroencephalography (EEG) is compelling, as both use non-invasive electrodes and image-guided dose can be informed by the reciprocity principle. To distinguish real changes in EEG from stimulation artifacts, prior studies applied conventional signal processing techniques (e.g. high-pass filtering, ICA). Here, we address the assumptions underlying the suitability of these approaches. We distinguish physiological artifacts – defined as artifacts resulting from interactions between the stimulation induced voltage and the body and so inherent regardless of tDCS or EEG hardware performance – from methodology-related artifacts – arising from non-ideal experimental conditions or non-ideal stimulation and recording equipment performance. Critically, we identify inherent physiological artifacts which are present in all online EEG-tDCS: 1) cardiac distortion and 2) ocular motor distortion. In conjunction, non-inherent physiological artifacts which can be minimized in most experimental conditions include: 1) motion and 2) myogenic distortion. Artifact dynamics were analyzed for varying stimulation parameters (montage, polarity, current) and stimulation hardware. Together with concurrent physiological monitoring (ECG, respiration, ocular, EMG, head motion), and current flow modeling, each physiological artifact was explained by biological source-specific body impedance changes, leading to incremental changes in scalp DC voltage that are significantly larger than real neural signals. Because these artifacts modulate the DC voltage and scale with applied current, they are dose specific such that their contamination cannot be accounted for by conventional experimental controls (e.g. differing stimulation montage or current as a control). Moreover, because the EEG artifacts introduced by physiologic processes during tDCS are high dimensional (as indicated by Generalized Singular Value Decomposition- GSVD), non-stationary, and overlap highly with neurogenic frequencies, these artifacts cannot be easily removed with conventional signal processing techniques. Spatial filtering techniques (GSVD) suggest that the removal of physiological artifacts would significantly degrade signal integrity. Physiological artifacts, as defined here, would emerge only during tDCS, thus processing techniques typically applied to EEG in the absence of tDCS would not be suitable for artifact removal during tDCS. All concurrent EEG-tDCS must account for physiological artifacts that are a) present regardless of equipment used, and b) broadband and confound a broad range of experiments (e.g. oscillatory activity and event related potentials). Removal of these artifacts requires the recognition of their non-stationary, physiology-specific dynamics, and individualized nature. We present a broad taxonomy of artifacts (non/stimulation related), and suggest possible approaches and challenges to denoising online EEG-tDCS stimulation artifacts.

Silva-Filho, E., Okano, A. H., Morya, E., Albuquerque, J., Cacho, E., Unal, G., Bikson, M., et al. (2018). Neuromodulation treats Chikungunya arthralgia: a randomized controlled trial. Scientific Reports, 8(1). Springer Nature America, Inc.

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Download: PDF published in Scientific Reports – DOI

Abstract

The Chikungunya (CHIK) virus is epidemic in Brazil, with 170,000 cases in the first half of 2016. More than 60% of patients present relapsing and remitting chronic arthralgia with debilitating pain lasting years. There are no specific therapeutic agents to treat and rehabilitee infected persons with CHIK. Persistent pain can lead to incapacitation, requiring long-term pharmacological treatment. Advances in non-pharmacological treatments are necessary to promote pain relief without side effects and to restore functionality. Clinical trials indicate transcranial direct current stimulation (tDCS) can treat a broad range of chronic pain disorders, including diffuse neuromuscular pain and arthralgia. Here, we demonstrate that the tDCS across the primary motor cortex significantly reduces pain in the chronic phase of CHIK. High-resolution computational model was created to analyze the cortical electric field generated during tDCS and a diffuse and clustered brain current flow including M1 ipsilateral and contralateral, left DLPFC, nucleus accumbens, and cingulate was found. Our findings suggest tDCS could be an effective, inexpensive and deployable therapy to areas lacking resources with a significant number of patients with chronic CHIK persistent pain.

Zannou, A. L.*, Khadka, N.*, Truong, D. Q., Zhang, T., Esteller, R., Hershey, B., & Bikson, M. 2018. Temperature increases by kilohertz frequency spinal cord stimulation.

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Download: PDF published in Brain Stimulation – DOI

Abstract

Kilohertz frequency spinal cord stimulation (kHz-SCS) deposits significantly more power in tissue compared to SCS at conventional frequencies, reflecting increased duty cycle (pulse compression). We hypothesize kHz-SCS increases local tissue temperature by joule heat, which may influence the clinical outcomes. To establish the role of tissue heating in KHZ-SCS, a decisive first step is to characterize the range of temperature changes expected during conventional and KHZ-SCS protocols. Fiber optic probes quantified temperature increases around an experimental SCS lead in a bath phantom. These data were used to verify a SCS lead heat-transfer model based on joule heat. Temperature increases were then predicted in a seven-compartment (soft tissue, vertebral bone, fat, intervertebral disc, meninges, spinal cord with nerve roots) geometric human spinal cord model under varied parameterization. The experimentally constrained bio-heat model shows SCS waveform power (waveform RMS) determines tissue heating at the spinal cord and surrounding tissues. For example, we predict temperature increased at dorsal spinal cord of 0.18e1.72 ° C during 3.5 mA peak 10 KHz stimulation with a 40-10- 40 ms biphasic pulse pattern, 0.09e0.22 ° C during 3.5 mA 1 KHz 100-100-100 ms stimulation, and less than 0.05 ° C during 3.5 mA 50 Hz 200-100-200 ms stimulation. Notably, peak heating of the spinal cord and other tissues increases superlinearly with stimulation power and so are especially sensitive to in- cremental changes in SCS pulse amplitude or frequency (with associated pulse compression). Further supporting distinct SCS intervention strategies based on heating; the spatial profile of temperature changes is more uniform compared to electric fields, which suggests less sensitivity to lead position. Tissue heating may impact short and long-term outcomes of KHZ-SCS, and even as an adjunct mechanism, suggests distinct strategies for lead position and programming optimization.

Santos, T. E. . G., Favoretto, D. B., Toostani, I. G., Nascimento, D. C., Rimoli, B. P., Bergonzoni, E., et al. (2018). Manipulation of Human Verticality Using High. Frontiers in Neurology 64(2), p. 825.

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Download: PDF published in Frontiers in Neurology – DOI

Abstract

Using conventional tDCS over the temporo-parietal junction (TPJ) we previously reported that it is possible to manipulate subjective visual vertical (SVV) and postural control. We also demonstrated that high-definition tDCS (HD-tDCS) can achieve substantially greater cortical stimulation focality than conventional tDCS. However, it is critical to establish dose-response effects using well-defined protocols with relevance to clinically meaningful applications. To conduct three pilot studies investigating polarity and intensity-dependent effects of HD-tDCS over the right TPJ on behavioral and physiological outcome measures in healthy subjects. We additionally aimed to establish the feasibility, safety, and tolerability of this stimulation protocol. We designed three separate randomized, double-blind, crossover phase I clinical trials in different cohorts of healthy adults using the same stimulation protocol. The primary outcome measure for trial 1 was SVV; trial 2, weight-bearing asymmetry (WBA); and trial 3, electroencephalography power spectral density (EEG-PSD). The HD-tDCS montage comprised a single central, and 3 surround electrodes (HD-tDCS3x1) over the right TPJ. For each study, we tested 3×2 min HD-tDCS3x1 at 1, 2 and 3 mA; with anode center, cathode center, or sham stimulation, in random order across days. We found significant SVV deviation relative to baseline, specific to the cathode center condition, with consistent direction and increasing with stimulation intensity. We further showed significant WBA with direction governed by stimulation polarity (cathode center, left asymmetry; anode center, right asymmetry). EEG-PSD in the gamma band was significantly increased at 3 mA under the cathode. The present series of studies provide converging evidence for focal neuromodulation that can modify physiology and have behavioral consequences with clinical potential.

Combined mnemonic strategy training and high-definition transcranial direct current stimulation for memory deficits in mild cognitive impairment

Download: PDF published in Alzheimer’s & Dementia: Translational Research & Clinical Interventions doi.org/10.1016/j.trci.2017.04.008

Benjamin M. Hampstead, Krishnankutty Sathian, Marom Bikson, Anthony Y. Stringer

ABSTRACT

Introduction: Memory deficits characterize Alzheimer’s dementia and the clinical precursor stage known as mild cognitive impairment. Nonpharmacologic interventions hold promise for enhancing functioning in these patients, potentially delaying functional impairment that denotes transition to dementia. Previous findings revealed that mnemonic strategy training (MST) enhances long-term retention of trained stimuli and is accompanied by increased blood oxygen level–dependent signal in the lateral frontal and parietal cortices as well as in the hippocampus. The present study was designed to enhance MST generalization, and the range of patients who benefit, via concurrent delivery of transcranial direct current stimulation (tDCS).

Methods: This protocol describes a prospective, randomized controlled, four-arm, double-blind study targeting memory deficits in those with mild cognitive impairment. Once randomized, participants complete five consecutive daily sessions in which they receive either active or sham high definition tDCS over the left lateral prefrontal cortex, a region known to be important for successful memory encoding and that has been engaged by MST. High definition tDCS (active or sham) will be combined with either MST or autobiographical memory recall (comparable to reminiscence therapy). Participants undergo memory testing using ecologically relevant measures and functional magnetic resonance imaging before and after these treatment sessions as well as at a 3-month follow-up. Primary outcome measures include face-name and object-location association tasks. Secondary outcome measures include self-report of memory abilities as well as a spatial navigation task (near transfer) and prose memory (medication instructions; far transfer). Changes in functional magnetic resonance imaging will be evaluated during both task performance and the resting-state using activation and connectivity analyses.

Discussion: The results will provide important information about the efficacy of cognitive and neuromodulatory techniques as well as the synergistic interaction between these promising approaches. Exploratory results will examine patient characteristics that affect treatment efficacy, thereby identifying those most appropriate for intervention.

Title: Safe Direct Current Neural Implant

Speaker: Gene Y. Fridman, PhD.  Associate Professor, Johns Hopkins University, Departments of Otolaryngology Head and Neck Surgery, Biomedical Engineering and Electrical Engineering

When: Friday Oct. 5 2018 at 2 pm

Where: CCNY Center for Discovery and Innovation, 4th floor seminar room ( CDI 4.352)

Details: Safe DC Neural Implant, Gene Y. Fridman

Contact: Greg Kronberg (gregkronberg@gmail.com, 212-650-8876) for access to CDI building

Abstract:

Safe Direct Current Stimulation (SDCS) technology holds the promise for the creation of a new class
of neural implants that could expand our ability to interact with the human nervous system.
Pacemakers, cochlear implants, and essentially all other chronically implanted neuroelectronic
prostheses rely on charge-balanced, biphasic pulses to excite neural or muscular activity without driving
electrochemical reactions that would otherwise liberate toxic substances at the metal electrode-saline
interface. While these devices are effective at stimulating the target neurons, inhibition of neural
activity and further expansion into alternate modes of neural control have been more challenging.
Many neurologic deficits, such as balance disorders, inability to control micturition, tinnitus, chronic
pain, psychiatric disorders, and epilepsy could benefit from a neural implant capable more extensive
control of neural activity. In contrast to the brief biphasic stimulus pulse used to evoke an action
potential in a target neuron, ionic direct current (iDC) delivered by an extracellular electrode has a
graded effect on its membrane potential. As the result, iDC is capable of increasing or decreasing the
probability of action potential generation. Excitation delivered this way results in an increase in neural
activity that maintains its natural stochastic firing properties. In addition to being able to increase,
decrease, or altogether block spiking behavior, this neuromodulation mechanism can control the speed
of action potential propagation, modulate sensitivity to synaptic input, and in principle alter synaptic
weights in a neural network by modulating spike timing dependent plasticity.
I will address our latest efforts toward developing the SDCS implant capable of delivering iDC to
neural targets and the application of this new technology for the treatment of chronic peripheral pain
and for the treatment of the vestibular balance disorders.

Bio:

Dr. Gene Fridman is a Biomedical and Electrical engineer. He is an Associate Professor in the department of Otolaryngology Head and Neck Surgery in the School of Medicine and Biomedical and Electrical Engineering departments in the Whiting School of Engineering at Johns Hopkins University.  After receiving his Master of Science in Electrical Engineering from Purdue University in 1995, he worked in the aerospace and then in the biomedical industry as a software and systems engineer before deciding to engage in an academic career. He received his Ph.D. in Biomedical Engineering specializing in neural recording and stimulation and micro-electro-mechanical systems (MEMS) from UCLA in 2006. Since 2000 he has held an on-going consulting and collaborative relationship with biomedical engineering companies in research and design of neural stimulation and recording devices. He contributed to research and development of spinal cord, retinal, cortical, cochlear, and vestibular neural implants.

Prof. Marom Bikson features in “The Secret History of the Future” podcast by Slate and the Economist

Sept 12, 2018 – Episode 02: The Body Electric. Listen here

“Our mission is to reduce human suffering with technology. And we work work with all kinds of technology, including brain stimulation devices.”

Event Time and Location: Wednesday, September 12th @ 3PM in Steinman Hall Rm 402

Speaker: Jake Zabara (Inventor of Vagus Nerve Stimulation for Epilepsy and Depression)

Talk Title:  “From basic research to clinical therapy”

Current issue of Brain Stimulation (Volume 11, Issue 5) features our Dry tDCS modeling on the cover

Link: https://www.brainstimjrnl.com/issue/S1935-861X(18)X0005-9

PDF: Dry tDCS: Tolerability of a novel multilayer hydrogel composite non-adhesive electrode for transcranial direct current stimulation

Truong DQ, Bikson M. Physics of Transcranial Direct Current Stimulation Devices and Their History. J ECT. 2018;34(3):137-143.

Download: PDF published in The Journal of ECT – doi:10.1097/yct.0000000000000531

Abstract

Transcranial direct current stimulation (tDCS) devices apply direct current through electrodes on the scalp with the intention to modulate brain function for experimental or clinical purposes. All tDCS devices include a current controlled stimulator, electrodes that include a disposable electrolyte, and headgear to position the electrodes on the scalp. Transcranial direct current stimulation dose can be defined by the size and position of electrodes and the duration and intensity of current applied across electrodes. Electrode design and preparation are important for reproducibility and tolerability. High-definition tDCS uses smaller electrodes that can be arranged in arrays to optimize brain current flow. When intended to be used at home, tDCS devices require specific device design considerations. Computational models of current flow have been validated and support optimization and hypothesis testing. Consensus on the safety and tolerability of tDCS is protocol specific, but medical-grade tDCS devices minimize risk.

Khadka N, Borges H, Zannou AL, Jang J, Kim B, Lee K, Bikson M

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Download: PDF published in Brain Stimulation– DOI

Abstract

The adoption of transcranial Direct Current Stimulation (tDCS) is encouraged by portability and ease-of-use. However, the preparation of tDCS electrodes remains the most cumbersome and error-prone step. Here, we validate the performance of the first “dry” electrodes for tDCS. A “dry electrode” excludes 1) any saline or other electrolytes, that are prone to spread and leaving a residue; 2) any adhesive at the skin interface; or 3) any electrode preparation steps except the connection to the stimulator. The Multilayer Hydrogel Composite (MHC) dry-electrode design satisfied these criteria. Over an exposed scalp (supraorbital (SO) regions of forehead), we validated the performance of the first “dry” electrode for tDCS against the state-of-the-art conventional wet sponge-electrode to test the hypothesis that whether tDCS can be applied with a dry electrode with comparable tolerability as conventional “wet” techniques? MHC dry-electrode performance was verified using a skin-phantom, including mapping voltage at the phantom surface and mapping current inside the electrode using a novel biocompatible flexible printed circuit board current sensor matrix (fPCB-CSM). MHC dry-electrode performance was validated in a human trial including tolerability (VAS and adverse events), skin redness (erythema), and electrode current mapping with the fPCB-CSM. Experimental data from skin-phantom stimulation were compared against a finite element method (FEM) model. Under the tested conditions (1.5 mA and 2 mA tDCS for 20 min using MHC-dry and sponge-electrode), the tolerability was improved, and the erythema and adverse-events were comparable between the MHC dry-electrode and the state-of-the-art sponge electrodes. Dry (residue-free, non-spreading, non-adhesive, and no-preparation-needed) electrodes can be tolerated under the tested tDCS conditions, and possibly more broadly used in non-invasive electrical stimulation.

Transcutaneous auricular vagus nerve stimulation (taVNS) for improving oromotor function in newborns

Download: PDF published in Brain Stimulation – DOI

Bashar W. Badran, Dorothea D. Jenkins, William H. DeVries, Morgan Dancy, Philipp M. Summers, Georgia M. Mappin, Henry Bernstein, Marom Bikson, Patricia Coker-Bolt, Mark S. George