Transcranial Direct Current Stimulation above the Medial Prefrontal Cortex Facilitates Decision-Making following Periods of Low Outcome Controllability

Csifcsák, Gábor; Bjørkøy, Jorunn; Kuyateh, Sarjo; Reithe, Haakon; Mittner, Matthias

doi:10.1523/eneuro.0041-21.2021

Cited by 4 publications

(8 citation statements)

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“…The important role of ACC in HIV brain disease is supported by neurobehavioral and brain imaging studies in HIV: first, ACC injury in PWH has been detected using various brain imaging techniques, including structural MRI [ 17 ], task-based functional MRI (fMRI) [ 18 ], task-free fMRI [ 19 ] and perfusion MRI [ 20 ], proton magnetic resonance spectroscopy (MRS) [ 3 , 21 – 23 ], and positron emission tomography (PET) [ 20 , 24 ]; second, the high prevalence of executive deficits [ 25 ] and apathy [ 26 ]—both are known to involve the ACC [ 27 – 29 ]—provides additional evidence supporting the prevalence and importance of ACC injury in PWH. Furthermore, using invasive and non-invasive brain stimulation techniques (including deep brain stimulation, repetitive transcranial magnetic stimulation (rTMS), and tDCS), previous studies provided evidence suggesting that dACC stimulation might be effective in modulating brain/cognitive function [ 30 – 33 ] and emotional processes [ 34 ], as well as in treating disorders like obsessive compulsive disorder [ 35 , 36 ]. Highly relevant to the present study, two previous studies found that one session of anodal tDCS stimulation (1.5–2 mA, 15–20 minutes) targeting the dACC was sufficient to induce detectable changes at a behavioral (“more efficient adjustments in decision‐making strategies” [ 33 ]) or neural level (neuronal signal related to “improved efficiency of neural resources for inhibitory control and error processing” [ 32 ]), providing further support for the present study.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, using invasive and non-invasive brain stimulation techniques (including deep brain stimulation, repetitive transcranial magnetic stimulation (rTMS), and tDCS), previous studies provided evidence suggesting that dACC stimulation might be effective in modulating brain/cognitive function [ 30 – 33 ] and emotional processes [ 34 ], as well as in treating disorders like obsessive compulsive disorder [ 35 , 36 ]. Highly relevant to the present study, two previous studies found that one session of anodal tDCS stimulation (1.5–2 mA, 15–20 minutes) targeting the dACC was sufficient to induce detectable changes at a behavioral (“more efficient adjustments in decision‐making strategies” [ 33 ]) or neural level (neuronal signal related to “improved efficiency of neural resources for inhibitory control and error processing” [ 32 ]), providing further support for the present study. The posterior cingulate cortex (PCC) was selected as the secondary target region, as the PCC is a central hub of the default mode network (DMN) and both PCC and DMN have been frequently implicated in various neurodegenerative diseases [ 37 , 38 ], including HAND [ 19 , 39 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

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Cingulate transcranial direct current stimulation in adults with HIV

Jiang

Dahmani²,

Bronshteyn³

et al. 2022

PLoS ONE

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Background Neuronal dysfunction plays an important role in the high prevalence of HIV-associated neurocognitive disorders (HAND) in people with HIV (PWH). Transcranial direct current stimulation (tDCS)—with its capability to improve neuronal function—may have the potential to serve as an alternative therapeutic approach for HAND. Brain imaging and neurobehavioral studies provide converging evidence that injury to the anterior cingulate cortex (ACC) is highly prevalent and contributes to HAND in PWH, suggesting that ACC may serve as a potential neuromodulation target for HAND. Here we conducted a randomized, double-blind, placebo-controlled, partial crossover pilot study to test the safety, tolerability, and potential efficacy of anodal tDCS over cingulate cortex in adults with HIV, with a focus on the dorsal ACC (dACC). Methods Eleven PWH (47–69 years old, 2 females, 100% African Americans, disease duration 16–36 years) participated in the study, which had two phases, Phase 1 and Phase 2. During Phase 1, participants were randomized to receive ten sessions of sham (n = 4) or cingulate tDCS (n = 7) over the course of 2–3 weeks. Treatment assignments were unknown to the participants and the technicians. Neuropsychology and MRI data were collected from four additional study visits to assess treatment effects, including one baseline visit (BL, prior to treatment) and three follow-up visits (FU1, FU2, and FU3, approximately 1 week, 3 weeks, and 3 months after treatment, respectively). Treatment assignment was unblinded after FU3. Participants in the sham group repeated the study with open-label cingulate tDCS during Phase 2. Statistical analysis was limited to data from Phase 1. Results Compared to sham tDCS, cingulate tDCS led to a decrease in Perseverative Errors in Wisconsin Card Sorting Test (WCST), but not Non-Perseverative Errors, as well as a decrease in the ratio score of Trail Making Test—Part B (TMT-B) to TMT—Part A (TMT-A). Seed-to-voxel analysis with resting state functional MRI data revealed an increase in functional connectivity between the bilateral dACC and a cluster in the right dorsal striatum after cingulate tDCS. There were no differences in self-reported discomfort ratings between sham and cingulate tDCS. Conclusions Cingulate tDCS is safe and well-tolerated in PWH, and may have the potential to improve cognitive performance and brain function. A future study with a larger sample is warranted.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cingulate transcranial direct current stimulation in adults with HIV

Jiang

Dahmani²,

Bronshteyn³

et al. 2022

PLoS ONE

View full text Add to dashboard Cite

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“…The rare outcome (20% of the trials) was the card’s feedback for the complementary action. In contrast with earlier studies ( 14 , 17 , 26 ), we decided to increase the contingency level in the controllable blocks to 80/20% (compared to the original 70/30%) in order to contrast the “control” vs. “no control” blocks even further. During the second block, rewards were delivered at random (response-feedback contingency was set to 50/50%).…”

Section: Methodsmentioning

confidence: 99%

“…Computational modeling of the cortical distribution of the tDCS-induced electric field on realistic head models ( 27 ) confirmed that this montage provides relatively focused stimulation of the mPFC/dACC ( 28 ). In addition, this montage was identical to the one used in a previous study that resulted in improved value-based choices following manipulations of reward/loss controllability for active vs. sham HD-tDCS ( 26 ). Active stimulation consisted of a 30-s ramp-up, 15 min stimulation, and 30-s ramp-down.…”

Section: Methodsmentioning

confidence: 99%

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Transcranial direct-current stimulation enhances Pavlovian tendencies during intermittent loss of control

et al. 2023

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IntroductionPavlovian bias is an innate motivational tendency to approach rewards and remain passive in the face of punishment. The relative reliance on Pavlovian valuation has been found to increase when the perceived control over environmental reinforcers is compromised, leading to behavior resembling learned helplessness (LH).MethodsSixty healthy young adults underwent a Go-NoGo reinforcement learning task and received anodal high-definition transcranial direct current stimulation (HD-tDCS) over the medial prefrontal/dorsal anterior cingulate cortex in our randomized, double-blind, sham- controlled study. Furthermore, we evaluated changes in cue-locked mid-frontal theta power derived from simultaneous electroencephalography (EEG). We hypothesized that active stimulation would reduce Pavlovian bias during manipulation of outcome controllability, and the effect would be accompanied by stronger mid-frontal theta activity, representing arbitration between choice strategies in favor of instrumental relative to Pavlovian valuation.ResultsWe found a progressive decrease in Pavlovian bias during and after loss of control over feedback. Active HD-tDCS counteracted this effect while not affecting the mid-frontal theta signal.DiscussionThe results were at odds with our hypotheses but also with previous findings reporting LH-like patterns during and after loss of control without brain stimulation. The discrepancy may be related to different protocols for the controllability manipulation. We argue that the subjective evaluation of task controllability is crucial in mediating the balance between Pavlovian and instrumental valuation during reinforcement learning and that the medial prefrontal/dorsal anterior cingulate cortex is a key region in this respect. These findings have implications for understanding the behavioral and neural underpinnings of LH in humans.

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