Remotely Supervised Transcranial Direct Current Stimulation Increases the Benefit of At-Home Cognitive Training in Multiple Sclerosis

Neuromodulation. 2017 Feb 22. doi: 10.1111/ner.12583. [Epub ahead of print]
PMID: 28225155

Leigh Charvet, PhD; Michael Shaw, BS; Bryan Dobbs, MS; Ariana Frontario, BS; Kathleen Sherman, MS; Marom Bikson, PhD; Abhishek Datta, PhD; Lauren Krupp, MD; Esmail Zeinapour, MS; Margaret Kasschau, BS

Full paper PDF: 10.1111@ner.12583

Objective: To explore the efficacy of remotely-supervised transcranial direct current stimulation (RS-tDCS) paired with cognitive training (CT) exercise in participants with multiple sclerosis (MS). Methods: In a feasibility study of RS-tDCS in MS, participants completed ten sessions of tDCS paired with CT (1.5 mA 3 20 min, dorsolateral prefrontal cortex montage). RS-tDCS participants were compared to a control group of adults with MS who underwent ten 20-min CT sessions through the same remotely supervised procedures. Cognitive outcomes were tested by composite scores measuring change in performance on standard tests (Brief International Cognitive Assessment in MS or BICAMS), basic attention (ANT-I Orienting and Attention Networks, Cogstate Detection), complex attention (ANT-I Executive Network, Cogstate Identification and One-Back), and intra-individual response variability (ANT-I and Cogstate identification; sensitive markers of disease status). Results: After ten sessions, the tDCS group (n 5 25) compared to the CT only group (n 5 20) had significantly greater improvement in complex attention (p 5 0.01) and response variability (p 5 0.01) composites. The groups did not differ in measures of basic attention (p 5 0.95) or standard cognitive measures (p 5 0.99). Conclusions: These initial findings indicate benefit for RS-tDCS paired with CT in MS. Exploratory analyses indicate that the earliest tDCS cognitive benefit is seen in complex attention and response variability. Telerehabilitation using RS-tDCS combined with CT may lead to improved outcomes in MS.

Higher-order power harmonics of pulsed electrical stimulation modulates corticospinal contribution of peripheral nerve stimulation.
Chen CF, Bikson M, Chou LW, Shan C, Khadka N, Chen WS, Fregni F.
Nature Sci Rep. 2017 Mar 3;7:43619. doi: 10.1038/srep43619.
PMID: 28256638  Download Full Paper: srep43619

Abstract: It is well established that electrical-stimulation frequency is crucial to determining the scale of induced neuromodulation, particularly when attempting to modulate corticospinal excitability. However, the modulatory effects of stimulation frequency are not only determined by its absolute value but also by other parameters such as power at harmonics. The stimulus pulse shape further influences parameters such as excitation threshold and fiber selectivity. The explicit role of the power in these harmonics in determining the outcome of stimulation has not previously been analyzed. In this study, we adopted an animal model of peripheral electrical stimulation that includes an amplitude-adapted pulse train which induces force enhancements with a corticospinal contribution. We report that the electrical-stimulation-induced force enhancements were correlated with the amplitude of stimulation power harmonics during the amplitude-adapted pulse train. This is a pilot, but important first demonstration that power at high order harmonics in the frequency spectrum of electrical stimulation pulses may contribute to neuromodulation, thus warrant explicit attention in therapy design and analysis.

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 Scientists, entrepreneurs in Chicago area tackle ‘brain hacking’

March 3, 2017, by Ted Gregory

Link to article

Selection: “Marom Bikson is optimistic and pragmatic. A biomedical engineering professor and co-director of Neural Engineering at the City College of New York, Bikson said it is clear that tDCS can change the brain. Many prospective users are unwilling to wait for lengthy human trials and related research before trying the technology.

“Among scientists who are incredulous or skeptical, the concern is often that we’re moving too fast,” Bikson said. But people who are suffering from depression, chronic pain and cognitive decline “have a different time scale,” he said. “They don’t have 10 years, and I don’t blame them for looking for alternatives.”

 

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