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1. Training in the practice of noninvasive brain stimulation: Recommendations from an IFCN committee

Author

Fried, PJ, Santarnecchi, E, Antal, A, Bartres-Faz, D, Bestmann, S, Carpenter, LL, Celnik, P, Edwards, D, Farzan, F, Fecteau, S, George, MS, He, B, Kim, YH, Leocani, L, Lisanby, SH, Loo, C, Luber, B, Nitsche, MA, Paulus, W, Rossi, S, Rossini, PM, Rothwell, J, Sack, AT, Thut, G, Ugawa, Y, Ziemann, U, Hallett, M, Pascual-Leone, A, Fried, PJ, Santarnecchi, E, Antal, A, Bartres-Faz, D, Bestmann, S, Carpenter, LL, Celnik, P, Edwards, D, Farzan, F, Fecteau, S, George, MS, He, B, Kim, YH, Leocani, L, Lisanby, SH, Loo, C, Luber, B, Nitsche, MA, Paulus, W, Rossi, S, Rossini, PM, Rothwell, J, Sack, AT, Thut, G, Ugawa, Y, Ziemann, U, Hallett, M, and Pascual-Leone, A

Abstract

As the field of noninvasive brain stimulation (NIBS) expands, there is a growing need for comprehensive guidelines on training practitioners in the safe and effective administration of NIBS techniques in their various research and clinical applications. This article provides recommendations on the structure and content of this training. Three different types of practitioners are considered (Technicians, Clinicians, and Scientists), to attempt to cover the range of education and responsibilities of practitioners in NIBS from the laboratory to the clinic. Basic or core competencies and more advanced knowledge and skills are discussed, and recommendations offered regarding didactic and practical curricular components. We encourage individual licensing and governing bodies to implement these guidelines.

Published
2021

2. Multimodal association of tDCS with electroencephalography

Author

Brunoni, AR, Nitsche, MA, Loo, CK, Bolognini, N, Diana, L, Bolognini N., Diana L., Brunoni, AR, Nitsche, MA, Loo, CK, Bolognini, N, Diana, L, Bolognini N., and Diana L.

Abstract

In the field of neuromodulation, we have observed an increase in the popularity of approaches that combine transcranial electrical stimulation (tES) with additional methods to establish, in vivo, the neurophysiological consequences of a given experimental or therapeutic manipulation. Research in the development of multimodal approaches has provided new methods that can be combined with tES to study brain functions. This chapter aims to introduce the reader to some basic principles of this multimodal approach. We begin with a brief definition of multimodal association and a description of its advantages. Afterwards, we provide a more specific description of how we can combine tES with electroencephalography (EEG). We show that EEG is a feasible and reliable way to track electrophysiological changes induced by tES, deepening our understanding of the mechanisms of action of this tool and revealing the key role of several stimulation features. In neuropsychiatric diseases, a combined tES-EEG approach may allow the prediction of clinical responses to tES, the discrimination of responders from non-responders, allowing improvements in the efficacy of tES and the tracking of tES-induced neuroplastic changes associated with recovery.

Published
2021

5. Consensus Paper: Experimental Neurostimulation of the Cerebellum

Author

Miterko, LN, Baker, KB, Beckinghausen, J, Bradnam, LV, Cheng, MY, Cooperrider, J, DeLong, MR, Gornati, SV, Hallett, M, Heck, DH, Hoebeek, FE, Kouzani, Abbas, Kuo, SH, Louis, ED, Machado, A, Manto, M, McCambridge, AB, Nitsche, MA, Taib, NOB, Popa, T, Tanaka, M, Timmann, D, Steinberg, GK, Wang, EH, Wichmann, T, Xie, T, Sillitoe, RV, Miterko, LN, Baker, KB, Beckinghausen, J, Bradnam, LV, Cheng, MY, Cooperrider, J, DeLong, MR, Gornati, SV, Hallett, M, Heck, DH, Hoebeek, FE, Kouzani, Abbas, Kuo, SH, Louis, ED, Machado, A, Manto, M, McCambridge, AB, Nitsche, MA, Taib, NOB, Popa, T, Tanaka, M, Timmann, D, Steinberg, GK, Wang, EH, Wichmann, T, Xie, T, and Sillitoe, RV

Published
2019

6. Heideggerovské konfrontace v paródické interpretační situaci

Author

Nitsche, Martin

Subjects
martin heidegger, ivan blecha, phenomenology, black notebooks, realistic phenomenology, topological phenomenology, Philosophy (General), B1-5802
Abstract

This review study considers Ivan Blecha’s book Bytí a svět. Heidegger v kontextu [Being and the World: Heidegger in Context] chiefly from the point of view of how to read Heidegger after the publication of the first volumes of the Black Notebooks in 2014 and the discussions that have followed in its wake. The peril of contemporary writing about Heidegger is understood by this study as a par-odic interpretive situation. Its basis is a loss of confidence in the governing principles of Heidegger’s seriously intended texts, which manifests itself in the fact that they have inadvertently become a parody of themselves. As a possible response to this situation, Blecha’s method of interpretative confrontations is highlighted. Blecha’s interpretation of Heidegger is subsequently characterized as moving towards a realistic and topological phenomenology.

Published
2022
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7. Regulatory considerations for the clinical and research use of transcranial direct current stimulation (tDCS): Review and recommendations from an expert panel

Author

Fregni F, Nitsche MA, Loo CK, Brunoni AR, MARANGOLO, Paola, Leite J., Fregni, F, Nitsche, Ma, Loo, Ck, Brunoni, Ar, Marangolo, Paola, and Leite, J.

Abstract

Background: Transcranial direct current stimulation has shown promising clinical results, leading to increased demand for an evidence-based review on its clinical effects. Objective: We convened a team of transcranial direct current stimulation experts to conduct a systematic review of clinical trials with more than 1 session of stimulation testing: pain, Parkinson’s disease motor function and cognition, stroke motor function and language, epilepsy, major depressive disorder, obsessive compulsive disorder, Tourette syndrome, schizophrenia, and drug addiction. Methods: Experts were asked to conduct this systematic review according to the search methodology from PRISMA guidelines. Recommendations on efficacy were categorized into Levels A (definitely effective), B (probably effective), C (possibly effective), or no recommendation. We assessed risk of bias for all included studies to confirm whether results were driven by potentially biased studies. Results: Although most of the clinical trials have been designed as proof-of-concept trials, some of the indications analyzed in this review can be considered as definitely effective (Level A), such as depression, and probably effective (Level B), such as neuropathic pain, fibromyalgia, migraine, post-operative patient-controlled analgesia and pain, Parkinson’s disease (motor and cognition), stroke (motor), epilepsy, schizophrenia, and alcohol addiction. Assessment of bias showed that most of the studies had low risk of biases, and sensitivity analysis for bias did not change these results. Effect sizes vary from 0.01 to 0.70 and were significant in about 8 conditions, with the largest effect size being in postoperative acute pain and smaller in stroke motor recovery (nonsignificant when combined with robotic therapy). Conclusion: All recommendations listed here are based on current published PubMed-indexed data. Despite high levels of evidence in some conditions, it must be underscored that effect sizes and duration of effects are often limited; thus, real clinical impact needs to be further determined with different study designs.

Published
2015

8. Response to letter to the editor: Safety of transcranial direct current stimulation: Evidence based update 2016

Author

Bikson, M, Grossman, P, Zannou, AL, Kronberg, G, Truong, D, Boggio, P, Brunoni, AR, Charvet, L, Fregni, F, Fritsch, B, Gillick, B, Hamilton, RH, Hampstead, BM, Kirton, A, Knotkova, H, Liebetanz, D, Liu, A, Loo, C, Nitsche, MA, Reis, J, Richardson, JD, Rotenberg, A, Turkeltaub, PE, Woods, AJ, Bikson, M, Grossman, P, Zannou, AL, Kronberg, G, Truong, D, Boggio, P, Brunoni, AR, Charvet, L, Fregni, F, Fritsch, B, Gillick, B, Hamilton, RH, Hampstead, BM, Kirton, A, Knotkova, H, Liebetanz, D, Liu, A, Loo, C, Nitsche, MA, Reis, J, Richardson, JD, Rotenberg, A, Turkeltaub, PE, and Woods, AJ

Published
2017

9. Preliminary evidence of 'other-race effect'-like behavior induced by cathodal-tDCS over the right occipital cortex, in the absence of overall effects on face/object processing

Author

Costantino, A, Titoni, M, Bossi, F, Premoli, I, Nitsche, M, Rivolta, D, Costantino, AI, Nitsche, MA, Rivolta, D., Costantino, A, Titoni, M, Bossi, F, Premoli, I, Nitsche, M, Rivolta, D, Costantino, AI, Nitsche, MA, and Rivolta, D.

Abstract

Neuromodulation techniques such as tDCS have provided important insight into the neurophysiological mechanisms that mediate cognition. Albeit anodal tDCS (a-tDCS) often enhances cognitive skills, the role of cathodal tDCS (c-tDCS) in visual cognition is largely unexplored and inconclusive. Here, in a single-blind, sham-controlled study, we investigated the offline effects of 1.5 mA c-tDCS over the right occipital cortex of 86 participants on four tasks assessing perception and memory of both faces and objects. Results demonstrated that c-tDCS does not overall affect performance on the four tasks. However, post-hoc exploratory analysis on participants' race (Caucasian vs. non-Caucasians), showed a "face-specific" performance decrease (≈10%) in non-Caucasian participants only. This preliminary evidence suggests that c-tDCS can induce "other-race effect (ORE)-like" behavior in non-Caucasian participants that did not show any ORE before stimulation (and in case of sham stimulation). Our results add relevant information about the breadth of cognitive processes and visual stimuli that can be modulated by c-tDCS, about the design of effective neuromodulation protocols, and have important implications for the potential neurophysiological bases of ORE.

Published
2017

11. Primát vizuální zkušenosti při výkladu prostorové povahy zvuků v Husserlových přednáškách 'Ding und Raum'

Author

Nitsche, Martin

Subjects
edmund husserl, phenomenology of space, auditory perception, sonic localization, primacy of visuality, Philosophy (General), B1-5802
Abstract

The study critically analyzes Husserl’s interpretations of spatiality in his lectures from 1907, titled “Ding und Raum”. It seeks reasons why these lectures concentrate almost exclusively on visual perception and do not consider the constituting of space by means of auditory perception. He finds these reasons both in the ambivalent interpretation of location (i.e., the insufficiently considered relationship between localization and position) and in the not fully reflected upon conviction that sight is more important for a person in relation to the surrounding environment than is hearing. The study points out the possibility of applying Husserl’s formulated “method of layers” in the course of phenomenological research to sonic environments (assuming the rejection of the primacy of visuality in the interpretation of human experience).

Published
2022
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22. Regulatory Considerations for the Clinical and Research Use of Transcranial Direct Current Stimulation (tDCS): review and recommendations from an expert panel

Author

Fregni, F, Nitsche, M, Loo, C, Brunoni, A, Marangolo, P, Leite, J, Carvalho, S, Bolognini, N, Caumo, W, Paik, N, Simis, M, Ueda, K, Hamed, E, Luu, P, Tucker, D, Tyler, W, Brunelin, J, Datta, A, Juan, C, Venkatasubramaniam, G, Boggio, P, Bikson, M, Nitsche, MA, Brunoni, AR, Paik, NJ, Tucker, DM, Tyler, WJ, Juan, CH, Boggio, PS, Bikson, M., BOLOGNINI, NADIA, Fregni, F, Nitsche, M, Loo, C, Brunoni, A, Marangolo, P, Leite, J, Carvalho, S, Bolognini, N, Caumo, W, Paik, N, Simis, M, Ueda, K, Hamed, E, Luu, P, Tucker, D, Tyler, W, Brunelin, J, Datta, A, Juan, C, Venkatasubramaniam, G, Boggio, P, Bikson, M, Nitsche, MA, Brunoni, AR, Paik, NJ, Tucker, DM, Tyler, WJ, Juan, CH, Boggio, PS, Bikson, M., and BOLOGNINI, NADIA

Abstract

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. Therefore, a group of research and clinician experts on tDCS were convened to review the research and clinical use of tDCS. This report reviews the regulatory status of tDCS and summarizes 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 the US. 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.

Published
2015

23. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee

Author

Rossini, Paolo Maria, Burke, D, Chen, R, Cohen, Lg, Daskalakis, Z, Di Iorio, R, Di Lazzaro, V, Ferreri, F, Fitzgerald, Pb, George, M, Hallett, M, Lefaucheur, Jp, Langguth, B, Matsumoto, H, Miniussi, C, Nitsche, Ma, Pascual Leone, A, Paulus, W, Rossi, S, Rothwell, Jc, Siebner, Hr, Ugawa, Y, Walsh, V, Ziemann, U., Rossini, Paolo Maria (ORCID:0000-0003-2665-534X), Rossini, Paolo Maria, Burke, D, Chen, R, Cohen, Lg, Daskalakis, Z, Di Iorio, R, Di Lazzaro, V, Ferreri, F, Fitzgerald, Pb, George, M, Hallett, M, Lefaucheur, Jp, Langguth, B, Matsumoto, H, Miniussi, C, Nitsche, Ma, Pascual Leone, A, Paulus, W, Rossi, S, Rothwell, Jc, Siebner, Hr, Ugawa, Y, Walsh, V, Ziemann, U., and Rossini, Paolo Maria (ORCID:0000-0003-2665-534X)

Abstract

These guidelines provide an up-date of previous IFCN report on "Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application" (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 "Report", was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain-behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.

Published
2015

24. Cathodal transcranial direct current stimulation induces regional, long-lasting, reversible reductions of cortical blood perfusion in rats

Author

Wachter, D, Wrede, A, Schulz-Schaeffer, WS, Taghizadeh-Waghefi, AT, Nitsche, MA, Rohde, V, and Liebetanz, D

Subjects
ddc: 610, sense organs, changes cortical blood flow, CBF, 610 Medical sciences, Medicine, Beeinflussung Blutfluss, skin and connective tissue diseases, tDCS
Abstract

Objective: Transcranial direct current stimulation (tDCS) induces polarity-specific changes of cerebral blood flow (CBF). To determine whether these changes are focally limited or if they incorporate large cortical regions with the potential for therapeutic applicability, we investigated the effects[for full text, please go to the a.m. URL], 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS)

Published
2012
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25. Clinical Research with Transcranial Direct Current Stimulation (tDCS): Challenges and Future Directions

Author

Brunoni, A, Nitsche, M, Bolognini, N, Bikson, M, Wagner, T, Merabet, L, Edwards, D, Valero Cabre, A, Rotenberg, A, Pascual Leone, A, Ferrucci, R, Priori, A, Boggio, P, Fregni, F, Brunoni, AR, Nitsche, MA, BOLOGNINI, NADIA, Edwards, DJ, Boggio, PS, Fregni, F., Brunoni, A, Nitsche, M, Bolognini, N, Bikson, M, Wagner, T, Merabet, L, Edwards, D, Valero Cabre, A, Rotenberg, A, Pascual Leone, A, Ferrucci, R, Priori, A, Boggio, P, Fregni, F, Brunoni, AR, Nitsche, MA, BOLOGNINI, NADIA, Edwards, DJ, Boggio, PS, and Fregni, F.

Abstract

Background: Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity, direct current to cortical areas facilitating or inhibiting spontaneous neuronal activity. In the past 10 years, tDCS physiologic mechanisms of action have been intensively investigated giving support for the investigation of its applications in clinical neuropsychiatry and rehabilitation. However, new methodologic, ethical, and regulatory issues emerge when translating the findings of preclinical and phase I studies into phase II and III clinical studies. The aim of this comprehensive review is to discuss the key challenges of this process and possible methods to address them. Methods: We convened a workgroup of researchers in the field to review, discuss, and provide updates and key challenges of tDCS use in clinical research. Main Findings/Discussion: We reviewed several basic and clinical studies in the field and identified potential limitations, taking into account the particularities of the technique. We review and discuss the findings into four topics: (1) mechanisms of action of tDCS, parameters of use and computer-based human brain modeling investigating electric current fields and magnitude induced by tDCS; (2) methodologic aspects related to the clinical research of tDCS as divided according to study phase (ie, preclinical, phase I, phase II, and phase III studies); (3) ethical and regulatory concerns; and (4) future directions regarding novel approaches, novel devices, and future studies involving tDCS. Finally, we propose some alternative methods to facilitate clinical research on tDCS. © 2012 Elsevier Inc. All rights reserved.

Published
2012

45. A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia.

Author

Fregni F, Gimenes R, Valle AC, Ferreira MJ, Rocha RR, Natalle L, Bravo R, Rigonatti SP, Freedman SD, Nitsche MA, Pascual-Leone A, and Boggio PS

Abstract

OBJECTIVE: Recent evidence suggests that fibromyalgia is a disorder characterized by dysfunctional brain activity. Because transcranial direct current stimulation (tDCS) can modulate brain activity noninvasively and can decrease pain in patients with refractory central pain, we hypothesized that tDCS treatment would result in pain relief in patients with fibromyalgia. METHODS: Thirty-two patients were randomized to receive sham stimulation or real tDCS with the anode centered over the primary motor cortex (M1) or the dorsolateral prefrontal cortex (DLPFC) (2 mA for 20 minutes on 5 consecutive days). A blinded evaluator rated the patient's pain, using the visual analog scale for pain, the clinician's global impression, the patient's global assessment, and the number of tender points. Other symptoms of fibromyalgia were evaluated using the Fibromyalgia Impact Questionnaire and the Short Form 36 Health Survey. Safety was assessed with a battery of neuropsychological tests. To assess potential confounders, we measured mood and anxiety changes throughout the trial. RESULTS: Anodal tDCS of the primary motor cortex induced significantly greater pain improvement compared with sham stimulation and stimulation of the DLPFC (P < 0.0001). Although this effect decreased after treatment ended, it was still significant after 3 weeks of followup (P = 0.004). A small positive impact on quality of life was observed among patients who received anodal M1 stimulation. This treatment was associated with a few mild adverse events, but the frequency of these events in the active-treatment groups was similar to that in the sham group. Cognitive changes were similar in all 3 treatment groups. CONCLUSION: Our findings provide initial evidence of a beneficial effect of tDCS in fibromyalgia, thus encouraging further trials. [ABSTRACT FROM AUTHOR]

Published
2006
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47. Beliefs von Geschichtslehrpersonen

Author

Nitsche, Martin

Subjects
Beliefs, Professionsforschung, bic Book Industry Communication::J Society & social sciences::JN Education::JNT Teaching skills & techniques
Abstract

As a history teacher it is important to acquire a meaningful understanding of what constitutes history, how historical knowledge is developed, and how historical learning and teaching of young people can succeed. Since these assumptions influence history teaching, it is necessary for teachers to reconsider their epistemological concepts and approaches while training to become a history teacher. The present study analyses the effects of teacher training on Swiss-German prospective history teachers’ epistemological beliefs, as well as on their assumptions about learning and teaching by applying quantitative methods of survey analysis. The results underline the importance of courses in history and history didactics for the formation of students’ concepts. The analysis does, however, also reveals that teacher training in German-speaking Switzerland may also lead to beliefs that are not necessarily defined as goals of higher education in history. Based on survey answers, a qualitative in-depth study with experienced teachers underlines the importance of beliefs for the design of history classes. Furthermore, the use of their assumptions for teaching is also influenced by the pedagogical content knowledge and other concepts (e.g. about learners) of the teachers. On the one hand, the results illustrate the effectiveness of future history teachers’ training courses, but on the other hand, they also underpin the need to discuss the design of higher education training for history teachers.

Published
2019
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48. Transcranial Direct Current Stimulation (tDCS) in Anxiety Disorders

Author

Mohammad Ali Salehinejad, Alessio Avenanti, Carmelo M. Vicario, Michael A. Nitsche, Dell'Osso B, Di Lorenzo G, and Vicario CM, Salehinejad MA, Avenanti A, Nitsche MA

Subjects
Panic disorder, Generalized anxiety disorder, Transcranial direct-current stimulation, business.industry, medicine.medical_treatment, Social anxiety, medicine.disease, tDCS, Anxiety disorder, Specific phobias, Brain stimulation, medicine, Anxiety, medicine.symptom, business, Social anxiety disorder, Agoraphobia, Neurostimulation, Neuroscience
Abstract

Transcranial direct current stimulation (tDCS) is a well-established noninvasive brain stimulation tool that allows to stimulate the cerebral cortex. In the current chapter, we examined all available research using this neurostimulation technique for the treatment of specific phobias, social anxiety disorder, panic disorder, agoraphobia, and generalized anxiety disorder. Overall, our work provides preliminary evidence that both excitatory stimulation of the left prefrontal cortex and inhibitory stimulation of the right prefrontal cortex can reduce symptom severity in anxiety disorders, although the low number of high-quality investigations in this field does not allow to make definite conclusions.

Published
2020

49. Acute aerobic exercise modulates cognition and cortical excitability in adults with attention-deficit hyperactivity disorder (ADHD) and healthy controls.

Author

Kuo HI, Nitsche MA, Wu YT, Chang JC, and Yang LK

Subjects
Humans, Male, Female, Adult, Young Adult, Evoked Potentials, Motor physiology, Cortical Excitability physiology, Electromyography, Attention Deficit Disorder with Hyperactivity physiopathology, Attention Deficit Disorder with Hyperactivity rehabilitation, Attention Deficit Disorder with Hyperactivity therapy, Exercise physiology, Cognition physiology, Transcranial Magnetic Stimulation
Abstract

Evidence suggests aerobic exercise has beneficial effects on cognitive performance in adults with attention-deficit hyperactivity disorder (ADHD). The underlying mechanisms might depend on mechanisms of exercise-mediated brain physiology. The study aims to investigate the effects of acute aerobic exercise on cortical excitability and cognitive performance, and the correlation between these phenomena in adults with ADHD. Twenty-six drug-naïve ADHD adults, and twenty-six age-, and gender-matched healthy controls were assessed with respect to cortical excitability and cognitive performance before and after acute aerobic exercise (a single session for 30 min) or a control intervention. The results show significantly enhanced intracortical facilitation (ICF) and decreased short intracortical inhibition (SICI) after aerobic exercise in healthy subjects. In contrast, SICI was significantly enhanced following acute aerobic exercise in ADHD. In ADHD, furthermore inhibitory control and motor learning were significantly improved after the acute aerobic exercise intervention. Alterations of SICI induced by aerobic exercise, and inhibitory control and motor learning improvement were significantly positively correlated in the ADHD group. Aerobic exercise had partially antagonistic effects in healthy controls, and ADHD patients. Furthermore, aerobic exercise-induced cognition-enhancing effects in ADHD depend on specific alterations of brain physiology, which differ from healthy humans., Competing Interests: Declaration of competing interest The authors declare no competing financial interests., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Published
2024
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50. A meta-analysis of the effects of transcranial direct current stimulation combined with cognitive training on working memory in healthy older adults.

Author

Lv Y, Wu S, Nitsche MA, Yue T, Zschorlich VR, and Qi F

Abstract

Background: Working memory (WM) loss, which can lead to a loss of independence, and declines in the quality of life of older adults, is becoming an increasingly prominent issue affecting the ageing population. Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, is emerging as a potential alternative to pharmacological treatments that shows promise for enhancing WM capacity and May enhance the effects of cognitive training (CT) interventions., Objective: The purpose of this meta-analysis was to explore how different tDCS protocols in combination with CT enhanced WM in healthy older adults., Methods: Randomized controlled trials (RCTs) exploring the effects of tDCS combined with CT on WM in healthy older adults were retrieved from the Web of Science, PubMed, Embase, Scopus and the Cochrane Library databases. The search time period ranged from database inception to January 15, 2024. Methodological quality of the trials was assessed using the risk-of-bias criteria for RCTs from the Cochrane Collaboration Network, and RevMan 5.3 (Cochrane, London, United Kingdom) was used for the meta-analysis of the final literature outcomes., Results: Six RCTs with a total of 323 participants were ultimately included. The results of the meta-analysis show that tDCS combined with CT statistically significantly improves WM performance compared to the control sham stimulation group in healthy older adults [standard mean difference (SMD) = 0.35, 95% CI: 0.11-0.59, I 2  = 0%, Z  = 0.004]. The first subgroup analysis indicated that, when the stimulus intensity was 2 mA, a statistically significant improvement in WM performance in healthy older adults was achieved (SMD = 0.39, 95% CI: 0.08-0.70, p  = 0.004]. The first subgroup analysis indicated that, when the stimulus intensity was 2 mA, a statistically significant improvement in WM performance in healthy older adults was achieved (SMD = 0.39, 95% CI: 0.08-0.70, I 2  = 6%, Z  = 2.46, p  = 0.01). The second subgroup analysis showed that long-term intervention (≥ 10 sessions) with tDCS combined with CT statistically significantly improved WM compared to the control group in healthy older adults (SMD = 0.72, 95% CI: 0.22-1.21, I 2  = 0%, Z  = 2.85, p  = 0.004)., Conclusion: tDCS combined with CT statistically significantly improves WM in healthy older adults. For the stimulus parameters, long-term interventions (≥ 10 sessions) with a stimulation intensity of 2 mA are the most effective., Competing Interests: MAN was in the Scientific Advisory Boards of Neuroelectrics, and Precisis. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Lv, Wu, Nitsche, Yue, Zschorlich and Qi.)

Published
2024
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