Name: non-invasive electrical brain stimulation montages for modulation of human motor function
Uploaded: 2016-02-04T13:00:00
Description: Watch this Scientific Journal Video about Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function at JoVE.com

MC and JR are supported by the German Research Foundation (DFG RE 2740/3-1).

Ethics statement: Human studies require written informed consent of participants before study entry. Obtain approval by the relevant ethics committee before recruitment of participants. Make sure studies are in accordance with the Declaration of Helsinki. The representative findings reported here (Figure 4) are based on a study performed in accordance with the Declaration of Helsinki amended by the 59th WMA General Assembly, Seoul, October 2008 and approved by the local Ethics Committee of the Uni...

This protocol describes typical materials and procedural steps for modulation of hand motor function and skill learning using NEBS, specifically unilateral and bilateral M1 stimulation for anodal tDCS, and unilateral tRNS. Before choosing a particular NEBS protocol for a human motor system study, e.g., in the context of motor learning, methodological aspects (safety, tolerability, blinding) as well as conceptual aspects (montage or current type specific effects on a particular brain region) need to be taken into...

Non-invasive electrical brain stimulation (NEBS), the administration of electrical currents to the brain through the intact skull, can modify brain function and behavior1-3. To optimize the therapeutic potential of NEBS strategies understanding the underlying mechanisms leading to neurophysiological and behavioral effects is still needed. Standardization of application across different laboratories and full transparency of stimulation procedures provides the basis for comparability of data which supports reliable interpretation of results and evaluation of the proposed mechanisms of action. Transcranial direct current stimulation (tDCS) or transcranial alternating current stimulation (tACS) differ by parameters of the applied electrical current: tDCS consists of an unidirectional constant current flow between two electrodes (anode and cathode)2-6 while tACS uses an alternating current applied at a specific frequency7. Transcranial random noise stimulation (tRNS) is a special form of tACS that uses an alternating current applied at random frequencies (e.g., 100-640 Hz) resulting in quickly varying stimulation intensities and removing polarity-related effects4,6,7. Polarity is only of relevance if the stimulation setting includes a stimulation offset, e.g., noise spectrum randomly changing around a +1 mA baseline intensity (usually not used). For the purpose of this article, we will focus on work using tDCS and tRNS effects on the motor system, closely following a recent publication from our lab6.
The underlying mechanisms of action of tRNS are even less understood than of tDCS but likely different from the latter. Theoretically, in the conceptual framework of stochastic resonance tRNS introduces stimulation-induced noise to a neuronal system which may provide a signal processing benefit by altering the signal-to-noise ratio4,8,9. TRNS may predominantly amplify weaker signals and could thus optimize task-specific brain activity (endogenous noise9). Anodal tDCS increases cortical excitability indicated by alteration of the spontaneous neuronal firing rate10 or increased motor evoked potential (MEP) amplitudes2 with the effects outlasting the stimulation duration for minutes to hours. Long-lasting increases in synaptic efficacy known as long-term potentiation are thought to contribute to learning and memory. Indeed, anodal tDCS enhances synaptic efficacy of motor cortical synapses repeatedly activated by a weak synaptic input11. In accordance, improved motor function/skill acquisition is often revealed only if stimulation is co-applied with motor training11-13, also suggesting synaptic co-activation as a prerequisite of this activity-dependent process. Nevertheless, causality between increases in cortical excitability (increase in firing rate or MEP amplitude) on one hand and improved synaptic efficacy (LTP or behavioral function such as motor learning) on the other hand has not been demonstrated.
NEBS applied to the primary motor cortex (M1) has attracted increasing interest as safe and effective method to modulate human motor function1. Neurophysiological effects and behavioral outcome may depend on the stimulation strategy (e.g., tDCS polarity or tRNS), electrode size and montage4-6,14,15. Aside from subject-inherent anatomical and physiological factors the electrode montage significantly influences electric field distribution and may result in different patterns of current spreading within the cortex16-18. In addition to the intensity of the applied current the size of the electrodes determines the current density delivered3. Common electrode montages in human motor system studies include (Figure 1): 1) anodal tDCS as unilateral M1 stimulation with the anode positioned on the M1 of interest and the cathode positioned on the contralateral forehead; the basic idea of this approach is upregulation of excitability in the M1 of interest6,13,19-22; 2) anodal tDCS as bilateral M1 stimulation (also referred to as &#34;bihemispheric&#34; or &#34;dual&#34; stimulation) with the anode positioned on the M1 of interest and the cathode positioned on the contralateral M15,6,14,23,24; the basic idea of this approach is maximizing stimulation benefits by upregulation of excitability in the M1 of interest while downregulating excitability in the opposite M1 (i.e., modulation of interhemispheric inhibition between the two M1s); 3) For tRNS, only the above mentioned unilateral M1 stimulation montage has been investigated4,6; with this montage excitability enhancing effects of tRNS have been found for the frequency spectrum of 100-640 Hz4. The choice of brain stimulation strategy and electrode montage represents a critical step for an efficient and reliable use of NEBS in clinical or research settings. Here these three NEBS procedures are described in detail as used in human motor system studies and methodological and conceptual aspects are discussed. Materials for unilateral or bilateral tDCS and unilateral tRNS are the same (Figure 2).
<img alt="Figure 1" src="/files/ftp_upload/53367/53367fig1.jpg" /> 
Figure 1.&#160;Electrode montages and current direction for distinct NEBS strategies.&#160;(A) For unilateral anodal transcranial direct current stimulation (tDCS), the anode is centered over the primary motor cortex of interest and the cathode positioned over the contralateral supra-orbital area. (B) For bilateral motor cortex stimulation, anode and cathode are located each over one motor cortex. The position of the anode determines the motor cortex of interest for anodal tDCS. (C) For unilateral transcranial random noise stimulation (tRNS), one electrode is located over the motor cortex and the other electrode over the contralateral supra-orbital area. The current flow between electrodes is indicated by the black arrow. Anode (+, red), cathode (-, blue), Alternating current (+/-, green). <a href="https://www.jove.com/files/ftp_upload/53367/53367fig1large.jpg" target="_blank">Please click here to view a larger version of this figure.</a>

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			<td height="21" style="height:21px;width:301px;">Magnetic stimulator</td>
			<td style="width:271px;">Magstim</td>
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non-invasive electrical brain stimulation montages for modulation of human motor function

Non-invasive electrical brain stimulation (NEBS) is used to modulate brain function and behavior, both for research and clinical purposes. In particular, NEBS can be applied transcranially either as direct current stimulation (tDCS) or alternating current stimulation (tACS). These stimulation types exert time-, dose- and in the case of tDCS polarity-specific effects on motor function and skill learning in healthy subjects. Lately, tDCS has been used to augment the therapy of motor disabilities in patients with stroke or movement disorders. This article provides a step-by-step protocol for targeting the primary motor cortex with tDCS and transcranial random noise stimulation (tRNS), a specific form of tACS using an electrical current applied randomly within a pre-defined frequency range. The setup of two different stimulation montages is explained. In both montages the emitting electrode (the anode for tDCS) is placed on the primary motor cortex of interest. For unilateral motor cortex stimulation the receiving electrode is placed on the contralateral forehead while for bilateral motor cortex stimulation the receiving electrode is placed on the opposite primary motor cortex. The advantages and disadvantages of each montage for the modulation of cortical excitability and motor function including learning are discussed, as well as safety, tolerability and blinding aspects.

To investigate the effects of NEBS on the human motor system it is important to consider appropriate outcome measures. One advantage of the motor system is the accessibility of the cortical representations by electrophysiological tools. Motor evoked potentials are frequently used as an indicator of motor cortical excitability. After application of 9 or more minutes of anodal tDCS at a current density of 29 &#181;A/cm2, motor cortical excitability is increased for at least 30 mi...

Watch this Scientific Journal Video about Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function at JoVE.com

Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function (Video) | JoVE

Non-invasive electrical brain stimulation can modulate cortical function and behavior, both for research and clinical purposes. This protocol describes different brain stimulation approaches for modulation of the human motor system.

Non-Invasive Electrical Brain Stimulation Montages for Modulation of Human Motor Function

Non-invasive electrical brain stimulation (NEBS) is used to modulate brain function and behavior, both for research and clinical purposes. In particular, ...

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