Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation

Bersani, Francesco Saverio; Minichino, Amedeo; Bernabei, Laura; Spagnoli, Francesco; Corrado, Alessandra; Vergnani, Lucilla; Mannarelli, Daniela; Pauletti, Caterina; Fattapposta, Francesco; Biondi, Massimo; Chiaie, Roberto Delle

doi:10.1016/j.jad.2016.11.037

Cited by 39 publications

(41 citation statements)

References 59 publications

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“…Although different studies showed a positive effect of tDCS on cognitive functions (without cognitive training) i.e. attention and working memory [33,47,48], executive functions [49], a recent meta-analysis reported no cognitive benefits but rather a reduced practice effect for processing speed tasks [37]. The choice of a high sensitivity test for cognitive assessment and the combined tDCS-sertraline treatment could explain our results; however, further studies are needed to address this issue.…”

Section: Discussionmentioning

confidence: 58%

Transcranial direct current stimulation: A novel approach in the treatment of vascular depression

et al. 2020

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Background: Despite the impact of depression in terms of personal suffering and socioeconomic burden, most currently available treatment options are often ineffective. A particularly difficult-to-treat depressive disorder characteristic of the elderly is vascular depression, a late-life depressive syndrome related to a variety of potential vascular mechanisms. Transcranial Direct Current Stimulation (tDCS), a non-invasive and effective somatic approach to depression, also showed positive effects on cognitive deficits. Aim: We performed a double-blind randomized study to investigate the efficacy of tDCS as augmentation strategy to sertraline in the treatment of vascular depression, hypothesizing a positive effect in both depressive symptoms and cognitive functions. Methods: We enrolled 93 inpatients over 60 years of age with a diagnosis of vascular depression. Depressive symptoms were weekly assessed (T0, T1, T2) with the 21-items Hamilton depression rating scale (HDRS). Cognitive functioning was evaluated with the Milan Overall Dementia Assessment (MODA) at baseline and after the treatment protocol. All patients were randomly assigned into three groups, Group I: one tDCS stimulation per day, Group II: two tDCS stimulations per day, Sham group: one sham tDCS stimulation per day. Stimulation was performed for 10 consecutive working days. Results: A significant interaction time*treatment was observed on HDRS scores (F ¼ 14, p < 0.001). All groups improved at T1 but whereas Group II significantly differed from the Sham group (p < 0.001) we observed no difference between Sham and Group I. At T2 all groups improved but Group II showed the greater improvement (vs. Sham p < 0.001; vs. Group I p < 0.001) and the Sham group the smallest (vs. Group I p ¼ 0.005). A significant interaction time*treatment was also observed on MODA scores (F ¼ 3.31, p ¼ 0.04). Only subjects treated with tDCS improved at T2 (Group I: p < 0.001; Group II: p ¼ 0.007). However, no difference between Group I and II was shown. Conclusion: tDCS as augmentation treatment of an adequate pharmacotherapy is a potential strategy in the management of vascular depression, a disease known to be often unresponsive to antidepressants only. Non-invasiveness, the absence of severe side effects and the possibility of administering it to outpatients at an affordable price make tDCS an important tool in clinical practice.

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Section: Discussionmentioning

confidence: 58%

Transcranial direct current stimulation: A novel approach in the treatment of vascular depression

et al. 2020

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“…In particular, it has been shown that several neuropsychiatric disorders, such as bipolar disorder [23] or schizophrenia [24], are associated with dysfunction of cerebellocerebral networks, which can be normalized by cerebellar stimulation through modulation of the cerebellar brain inhibition (CBI) or surround-motor inhibition (SMI) [23,24]. The clinical implications extend, therefore, towards neuropsychiatric disorders, filling a gap between conventional neurology and conventional psychiatry.…”

Section: Introductionmentioning

confidence: 99%

Consensus Paper: Cerebellum and Emotion

et al. 2016

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The field of non-invasive stimulation of the cerebellum is quickly expanding. The anatomical structure of the cerebellum with a high density of neurons in the superficial layer, its electrical properties, and its participation in numerous closed-loop circuits involved in motor, cognitive, and affective operations both in children and in adults make of the cerebellum a target with very high potential for neuromodulation of both cerebellar and extra-cerebellar disorders, in neurology, psychiatry, and neurosurgery. A common research effort is required to extract the optimal parameters of stimulation and to identify how non-invasive stimulation of the cerebellum modifies cerebellar plasticity and functional connectivity in remote cortical and subcortical areas. A patient stratification should be considered.

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“…For studies in affective disorders, 3 studies pertained to major depressive disorder (MDD) and 2 to euthymic bipolar disorder [ 29 - 33 ]. In all the 5 studies, anodal tDCS was applied over the left DLPFC, and in the 2 studies in euthymic bipolar patients, cathodal tDCS was additionally applied on the right cerebellar cortex.…”

Section: Resultsmentioning

confidence: 99%

“…These studies demonstrated the feasibility of EEG-based classification that might help better select patients who would further benefit from tDCS treatment in both alleviating depressive symptoms and neurocognitive functioning. Bersani et al examined the effects of repeated prefrontal-excitatory and cerebellar-inhibitory tDCS on P300 novelty task in euthymic bipolar patients [ 32 , 33 ]. P3b reflects working memory update of change while subjects pay attention to stimulus, while P3a is elicited by unexpected stimulus and is thought to reflect automatic reorienting [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

Modulation of Electrophysiology by Transcranial Direct Current Stimulation in Psychiatric Disorders: A Systematic Review

Kim

Kwak

Lee

et al. 2018

Psychiatry Investig

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Objective Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique increasingly used to relieve symptoms of psychiatric disorders. Electrophysiologic markers, such as electroencephalography (EEG) and event-related potentials (ERP), have high temporal resolution sensitive to detect plastic changes of the brain associated with symptomatic improvement following tDCS application. Methods We performed systematic review to identify electrophysiological markers that reflect tDCS effects on plastic brain changes in psychiatric disorders. A total of 638 studies were identified by searching PubMed, Embase, psychINFPO. Of these, 21 full-text articles were assessed eligible and included in the review. Results Although the reviewed studies were heterogeneous in their choices of tDCS protocols, targeted electrophysiological markers, and disease entities, their results strongly support EEG/ERPs to sensitively reflect plastic brain changes and the associated symptomatic improvement following tDCS. Conclusion EEG/ERPs may serve a potent tool in revealing the mechanisms underlying psychiatric symptoms, as well as in localizing the brain area targeted for stimulation. Future studies in each disease entities employing consistent tDCS protocols and electrophysiological markers would be necessary in order to substantiate and further elaborate the findings of studies included in the present systematic review.

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Prefronto-cerebellar tDCS enhances neurocognition in euthymic bipolar patients. Findings from a placebo-controlled neuropsychological and psychophysiological investigation

Cited by 39 publications

References 59 publications

Transcranial direct current stimulation: A novel approach in the treatment of vascular depression

Transcranial direct current stimulation: A novel approach in the treatment of vascular depression

Consensus Paper: Cerebellum and Emotion

Modulation of Electrophysiology by Transcranial Direct Current Stimulation in Psychiatric Disorders: A Systematic Review

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