Anodal Transcranial Direct Current Stimulation (tDCS) Over the Motor Cortex Increases Sympathetic Nerve Activity

Clancy, Jennifer A.; Johnson, Robyn; Raw, Rachael K.; Deuchars, Susan A.; Deuchars, Jim

doi:10.1016/j.brs.2013.08.005

Cited by 51 publications

(27 citation statements)

References 41 publications

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“…We noticed a trend towards a decrease in HR and BP. Interestingly, this is in contrast to studies that reported a trend towards increase in sympathetic predominance in healthy adults after anodal tDCS of the upper limb M1[6,7]. It is possible that the lower limb M1 could differentially affect autonomic flow due to variations in the termination of the corticospinal and corticobulbar pathways compared to the upper limb M1[14].…”

Section: Discussioncontrasting

confidence: 74%

“…However, safety reports on the effects of tDCS on cardiovascular autonomic function are limited and results are conflicting [5]. Some studies suggest that tDCS may shift autonomic function towards a more sympathetic tone[6, 7], while other studies reported no change in sympathovagal balance [8,9]. Most of the above studies have used spectral analyses of ECG to examine heart rate variability and blood pressure.…”

Section: Introductionmentioning

confidence: 99%

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Anodal tDCS of the lower limb M1 does not acutely affect clinical blood pressure and heart rate in healthy and post stroke individuals

Nguyen

Ugwu

Madhavan

2015

SOJN

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Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique increasingly investigated an adjunct modality to enhance the effects of motor therapy. Although the safety of tDCS in relation to cognition, sensation and perception has been well reviewed, there still exists limited information regarding its effects on blood pressure and heart rate. As tDCS is being largely used in conjunction with stroke rehabilitation, it is important that we understand the effects of tDCS on autonomic function in the stroke population. In this retrospective study, we examined the acute effects of tDCS of the lower limb motor cortex in healthy and post stroke individuals using clinical measurements of blood pressure and heart rate. Fifteen minutes of 1 mA anodal tDCS did not cause any clinically detectable changes in blood pressure or heart rate. This is the first study to report the cardiovascular autonomic effects of tDCS of the lower limb M1 in healthy and post stroke individuals. Further studies are needed to examine if these safety effects are preserved during repeated applications of tDCS.

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Section: Discussioncontrasting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Anodal tDCS of the lower limb M1 does not acutely affect clinical blood pressure and heart rate in healthy and post stroke individuals

Nguyen

Ugwu

Madhavan

2015

SOJN

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“…In addition, specific tests have been conducted for serum enolase, a protein associated with neuronal death, with no significant effect (35) and for evidence of structural brain damage (36). Studies have examined and found no significant abnormal changes in electroencephalographic activity (37) or in heart rate variability (38-40). The threshold for adverse effects was suggested in a safety study in rats (41), where the charge density necessary to induce brain damage in rats was found to be at least 100 times higher than the charge density used in tDCS trials.…”

Section: Safety and Adverse Effectsmentioning

confidence: 99%

“…The safety and efficacy of daily to twice-daily, domiciliary, 30-min, 1- to 3-mA tDCS sessions across nearly 3 years was reported in a patient with schizophrenia (44) . The longest acute treatment trials to date have delivered about 6 weeks of tDCS, with up to 30 sessions of tDCS (40, 45). These studies show no increased incidences of adverse events; though data is still limited.…”

Section: Safety and Adverse Effectsmentioning

confidence: 99%

Regulatory considerations for the clinical and research use of transcranial direct current stimulation (tDCS): Review and recommendations from an expert panel

Fregni

Nitsche

Loo

et al. 2014

Clinical Research and Regulatory Affairs

229

161

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The field of transcranial electrical stimulation (tES) has experienced significant growth in the past 15 years. One of the tES techniques leading this increased interest is transcranial direct current stimulation (tDCS). Significant research efforts have been devoted to determining the clinical potential of tDCS in humans. Despite the promising results obtained with tDCS in basic and clinical neuroscience, further progress has been impeded by a lack of clarity on international regulatory pathways. We therefore convened a group of research and clinician experts on tDCS to review the research and clinical use of tDCS. In this report, we review the regulatory status of tDCS, and we summarize the results according to research, off-label and compassionate use of tDCS in the following countries: Australia, Brazil, France, Germany, India, Iran, Italy, Portugal, South Korea, Taiwan and United States. Research use, off label treatment and compassionate use of tDCS are employed in most of the countries reviewed in this study. It is critical that a global or local effort is organized to pursue definite evidence to either approve and regulate or restrict the use of tDCS in clinical practice on the basis of adequate randomized controlled treatment trials.

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“…Stimulation of the motor cortex however has been shown to result in increased sympathetic activity [15, 16]. It is also possible to harness the cortical contribution to sympatho-vagal balance, such as via anodal transcranial stimulation, which has been suggested to increase sympathetic nerve activity, likely via inhibition of the medial prefrontal cortex and/or stimulation of the motor cortex [17]. …”

Section: Anatomic Considerationsmentioning

confidence: 99%

Innervation of the heart: An invisible grid within a black box

Kapa

DeSimone

Asirvatham

2016

Trends in Cardiovascular Medicine

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Autonomic control of cardiovascular function is mediated by a complex interplay between central, peripheral, and innate cardiac components. This interplay is what mediates the normal cardiovascular response to physiologic and pathologic stressors, including blood pressure, cardiac contractile function, and arrhythmias. However, in order to understand how modern therapies directly affecting autonomic function may be harnessed to treat various cardiovascular disease states requires an intimate understanding of anatomic and physiologic features of the innervation of the heart. Thus, in this review, we focus on defining features of the central, peripheral, and cardiac components of cardiac innervation, how each component may contribute to dysregulation of normal cardiac function in various disease states and how modulation of these components may offer therapeutic options for these diseases.

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Anodal Transcranial Direct Current Stimulation (tDCS) Over the Motor Cortex Increases Sympathetic Nerve Activity

Cited by 51 publications

References 41 publications

Anodal tDCS of the lower limb M1 does not acutely affect clinical blood pressure and heart rate in healthy and post stroke individuals

Anodal tDCS of the lower limb M1 does not acutely affect clinical blood pressure and heart rate in healthy and post stroke individuals

Regulatory considerations for the clinical and research use of transcranial direct current stimulation (tDCS): Review and recommendations from an expert panel

Innervation of the heart: An invisible grid within a black box

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