Using Transcranial Direct-Current Stimulation to Treat Stroke Patients With Aphasia

Baker, Julie M.; Rorden, Chris; Fridriksson, Julius

doi:10.1161/strokeaha.109.576785

Cited by 474 publications

(510 citation statements)

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“…More recently weak alternating currents (tACS) have also been used in an effort to entrain or modulate brain activity (Herrmann et al, 2013;Reato et al, 2013;Ali et al, 2013;Alekseichuk et al, 2016;Lustenberger et al, 2016). Because of their simplicity, flexibility and safety profile, these techniques have been investigated in over 70 neuropsychiatric conditions, including major depression , epilepsy (Fregni et al, 2006d;Auvichayapat et al, 2013), tinnitus (Frank et al, 2012), Parkinson's disease (Fregni et al, 2006b), pain control (Fregni et al, 2006a(Fregni et al, , 2006c, and stroke rehabilitation (Schlaug et al, 2008;Baker et al, 2010) among others. In healthy subjects tDCS may benefit declarative memory (Marshall et al, 2004), working memory (Fregni et al, 2005), motor learning (Reis and Fritsch, 2011), verbal fluency (Pereira et al, 2013), and planning ability (Dockery et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation

et al. 2017

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Transcranial electric stimulation aims to stimulate the brain by applying weak electrical currents at the scalp. However, the magnitude and spatial distribution of electric fields in the human brain are unknown. We measured electric potentials intracranially in ten epilepsy patients and estimated electric fields across the entire brain by leveraging calibrated current-flow models. When stimulating at 2 mA, cortical electric fields reach 0.8 V/m, the lower limit of effectiveness in animal studies. When individual whole-head anatomy is considered, the predicted electric field magnitudes correlate with the recorded values in cortical (r = 0.86) and depth (r = 0.88) electrodes. Accurate models require adjustment of tissue conductivity values reported in the literature, but accuracy is not improved when incorporating white matter anisotropy or different skull compartments. This is the first study to validate and calibrate current-flow models with in vivo intracranial recordings in humans, providing a solid foundation to target stimulation and interpret clinical trials.

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Section: Introductionmentioning

confidence: 99%

Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation

et al. 2017

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“…Although the mechanism of tDCS remains an area of active research, there is evidence to suggest that in the cortex tDCS modulates synaptic strength and likely stimulates pyramidal neurons and interneurons (Nitsche et al, 2005;Stagg and Nitsche, 2011). As a therapy, tDCS has shown some success in treating major depression (Fregni et al, 2006a,b;Brunoni et al, 2011), memory deficits in Parkinson's disease (Boggio et al, 2006), memory deficits in Alzheimer's disease (Boggio et al, 2009(Boggio et al, , 2012, aphasia (Baker et al, 2010;Kang et al, 2011;You et al, 2011), and as a recovery aid for stroke patients (Fregni et al, 2005b;Miniussi et al, 2008;Jo et al, 2009;Kang et al, 2009;Bolognini et al, 2011;Bueno et al, 2011). Despite these findings, less research has been done investigating the effects of tDCS on WM.…”

Section: Introductionmentioning

confidence: 99%

Parietal Contributions to Visual Working Memory Depend on Task Difficulty

Jones¹,

Crane²,

Feenstra³

et al. 2012

PsycEXTRA Dataset

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The nature of parietal contributions to working memory (WM) remain poorly understood but of considerable interest. We previously reported that posterior parietal damage selectively impaired WM probed by recognition (Berryhill and Olson, 2008a). Recent studies provided support using a neuromodulatory technique, transcranial direct current stimulation (tDCS) applied to the right parietal cortex (P4). These studies confirmed parietal involvement in WM because parietal tDCS altered WM performance: anodal current tDCS improved performance in a change detection task, and cathodal current tDCS impaired performance on a sequential presentation task. Here, we tested whether these complementary results were due to different degrees of parietal involvement as a function of WM task demands, WM task difficulty, and/or participants' WM capacity. In Experiment 1, we applied cathodal and anodal tDCS to the right parietal cortex and tested participants on both previously used WM tasks. We observed an interaction between tDCS (anodal, cathodal), WM task difficulty, and participants' WM capacity. When the WM task was difficult, parietal stimulation (anodal or cathodal) improved WM performance selectively in participants with high WM capacity. In the low WM capacity group, parietal stimulation (anodal or cathodal) impaired WM performance. These nearly equal and opposite effects were only observed when the WM task was challenging, as in the change detection task. Experiment 2 probed the interplay of WM task difficulty and WM capacity in a parametric manner by varying set size in the WM change detection task. Here, the effect of parietal stimulation (anodal or cathodal) on the high WM capacity group followed a linear function as WM task difficulty increased with set size. The low WM capacity participants were largely unaffected by tDCS. These findings provide evidence that parietal involvement in WM performance depends on both WM capacity and WM task demands. We discuss these findings in terms of alternative WM strategies employed by low and high WM capacity individuals. We speculate that low WM capacity individuals do not recruit the posterior parietal lobe for WM tasks as efficiently as high WM capacity individuals. Consequently, tDCS provides greater benefit to individuals with high WM capacity.

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“…The usefulness of tDCS in chronic stroke was summarized by Stagg [32]. There are controversy results in the long term usefulness of speech therapy in fluent aphasia, but the non-invasive stimulation over the language area can improve [33][34][35][36] and tDCS [37,38]. There is a reversion of the imbalance of interhemispheric inhibition, speech induced activity shifts to the left side instead of both sides or right side and formation of a new language network which may responsible for the better outcome of aphasia several weeks after stimulation.…”

Section: Influence On Different Symptoms Of Stroke With Noninvasive Bmentioning

confidence: 99%

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

2014

Int J Neurorehabilitation Eng

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Two non-invasive brain stimulations have spread all over the world: repetitive trasncranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS). TMS is based on the current induction with a changing electromagnetic field in the nervous system [1] while tDCS changes the polarity of cell membranes [2]. General Aspects of TMS and tDCSTMS is widely used in research and daily medical practice. It was introduced as a diagnostic tool about thirty years ago to test functioning of motor pathways [3]. The motor evoked potential (MEP) and the measurement of the central motor conduction time (CMCT) has entered into daily practice. The other parameters of the electrophysiological examination assessed by TMS are mainly used in scientific work [4]. TMS aids the diagnosis of multiple sclerosis, furthermore the prognosis of stroke can be indicated by TMS [5]. Different paired pulse stimulations with TMS give a new insight into the function of the brain. In recent years, sophisticated brain plasticity can be detected by the measurement of intracortical excitability [6,7]. We learnt from these studies how different conditions can modify brain plasticity. It can be changed by different diseases, altered by drugs [8] and strongly influenced by non-invasive stimulations [2,9]. The single TMS and one session of repetitive stimulation have a short after-effect. However the effect of repeated stimulation for days exceeds the stimulation period and many times it lasts for months. This effect of rTMS has made it useful for therapy for the last 20 years. The low and high frequency stimulation, continuous theta burst stimulation (cTBS), intermittent theta burst stimulation (iTBS), anodal or cathodal stimulation are used for therapy. The intensity of rTMS was around the motor threshold and the duration of stimulation was 7-10 days. This paper reviews the most frequently studied symptoms of Parkinson's diseases and stroke although rTMS has been tried to treat all disorders of the central nervous system (CNS). Parkinson's Disease (PD)The first protocol was low frequency, low intensity monophasic stimulation for 7 days which improved the Parkinsonian symptoms and its results were maintained for several months after the stimulation [10,11]. The authors performed a "dose (intensity) response" curve with 1 Hz stimulation and they indicated that there is an optimal intensity using 1 Hz [12]. We learned from these studies that the therapeutic effect of rTMS develops after a delay in time of a few weeks. The improvement can be maintained for several months. The later studies confirmed these observations not only in PD but other diseases. Although, the high frequency stimulations over the primary motor cortex [13,14] had the same effect on the Parkinsonian scores but the after-effect lasted for a shorter time. iTBS over the dorsolateral prefrontal area improved the depression without effecting on bradykinesia [15]. The studies concentrated on varying the frequency which was applied but they did not try to find the optimal in...

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Using Transcranial Direct-Current Stimulation to Treat Stroke Patients With Aphasia

Cited by 474 publications

References 20 publications

Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation

Measurements and models of electric fields in the in vivo human brain during transcranial electric stimulation

Parietal Contributions to Visual Working Memory Depend on Task Difficulty

Non-Invasive Brain Stimulation and its Supposed Site of Action in the Rehabilitation of Parkinson’s Disease and Stroke

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