ダシルバAFはこのレビューを完了するにはCTSAハイテク資金助成金、ミシガン大学から資金援助を受けた。ヴォルツMSは、財団シャリテからの助成金の奨学金によって運営されている。

<ol>
	<li>Fregni, F., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Technology+insight:+noninvasive+brain+stimulation+in+neurology-perspectives+on+the+therapeutic+potential+of+rTMS+and+tDCS.">Technology insight: noninvasive brain stimulation in neurology-perspectives on the therapeutic potential of rTMS and tDCS.</a> Nat Clin Pract Neurol. 3 (7), 383-383 (2007).</li><li>Wagner, T., Valero-Cabre, A., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Noninvasive+human+brain+stimulation.">Noninvasive human brain stimulation.</a> Annu Rev Biomed Eng. 9, 527-527 (2007).</li><li>Fregni, F., Freedman, S., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recent+advances+in+the+treatment+of+chronic+pain+with+non-invasive+brain+stimulation+techniques.">Recent advances in the treatment of chronic pain with non-invasive brain stimulation techniques.</a> Lancet Neurol. 6 (2), 188-188 (2007).</li><li>Lefaucheur, J. P., Antal, A., Ahdab, R., Ciampi de Andra, D., Fregni, F., Khedr, E. M., Nitsche, M., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+use+of+repetitive+transcranial+magnetic+stimulation+(rTMS)+and+transcranial+direct+current+stimulation+(tDCS)+to+relieve+pain.">The use of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) to relieve pain.</a> Brain Stimul. 1 (4), 337-337 (2008).</li><li>Antal, A., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+magnetic+and+direct+current+stimulation+in+the+therapy+of+pain.">Transcranial magnetic and direct current stimulation in the therapy of pain.</a> Schmerz Apr. 24 (2), 161-161 (2010).</li><li>Nitsche, M. A., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Excitability+changes+induced+in+the+human+motor+cortex+by+weak+transcranial+direct+current+stimulation.">Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation.</a> J Physiol. 527 (Pt 3), 633-633 (2000).</li><li>Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+direct+current+stimulation:+state+of+the+art.">Transcranial direct current stimulation: state of the art.</a> Brain Stimul. 11, 642-642 (2008).</li><li>Merrill, D. R., Bikson, M., Jefferys, J. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrical+stimulation+of+excitable+tissue:+design+of+efficacious+and+safe+protocols.">Electrical stimulation of excitable tissue: design of efficacious and safe protocols.</a> J Neurosci Methods. 141 (2), 171-171 (2005).</li><li>Boggio, P. S., Khoury, L. P., Martins, D. C., Martins, O. E., de Macedo, E. C., Fregni, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Temporal+cortex+direct+current+stimulation+enhances+performance+on+a+visual+recognition+memory+task+in+Alzheimer+disease.">Temporal cortex direct current stimulation enhances performance on a visual recognition memory task in Alzheimer disease.</a> J Neurol Neurosurg Psychiatry. 80 (4), 444-444 (2009).</li><li>Fregni, F., Boggio, P. S., Nitsche, M., Bermpohl, F., Antal, A., Feredoes, E., Marcolin, M. A., Rigonatti, S. P., Silva, M. T., Paulus, W., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anodal+transcranial+direct+current+stimulation+of+prefrontal+cortex+enhances+working+memory.">Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory.</a> Exp Brain Res. 166 (1), 23-23 (2005).</li><li>Dundas, J. E., Thickbroom, G. W., Mastaglia, F. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Perception+of+comfort+during+transcranial+DC+stimulation:+effect+of+NaCl+solution+concentration+applied+to+sponge+electrodes.">Perception of comfort during transcranial DC stimulation: effect of NaCl solution concentration applied to sponge electrodes.</a> Clin Neurophysiol. 118 (5), 1166-1166 (2007).</li><li>Minhas, P., Datta, A., Bikson, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cutaneous+perception+during+tDCS:+Role+of+electrode+shape+and+sponge+salinity.">Cutaneous perception during tDCS: Role of electrode shape and sponge salinity.</a> Clin Neurophysiol. 11, (2010).</li><li>Antal, A., Terney, D., Poreisz, C., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Towards+unravelling+task-related+modulations+of+neuroplastic+changes+induced+in+the+human+motor+cortex.">Towards unravelling task-related modulations of neuroplastic changes induced in the human motor cortex.</a> Eur J Neurosci. 26 (9), 2687-2687 (2007).</li><li>Datta, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Gyri-precise+head+model+of+transcranial+direct+current+stimulation:+improved+spatial+focality+using+a+ring+electrode+versus+conventional+rectangular+pad.">Gyri-precise head model of transcranial direct current stimulation: improved spatial focality using a ring electrode versus conventional rectangular pad.</a> Brain Stimul. 2 (4), 201-201 (2009).</li><li>Minhas, P., Bansal, V., Patel, J., Ho, J. S., Diaz, J., Datta, A., Bikson, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrodes+for+high-definition+transcutaneous+DC+stimulation+for+applications+in+drug+delivery+and+electrotherapy,+including+tDCS.">Electrodes for high-definition transcutaneous DC stimulation for applications in drug delivery and electrotherapy, including tDCS.</a> J Neurosci Methods. 190 (2), (2010).</li><li>Brunoni, A. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+Systematic+Review+on+Reporting+and+Assessment+of+Adverse+Effects+associated+with+Transcranial+Direct+Current+Stimulation.">A Systematic Review on Reporting and Assessment of Adverse Effects associated with Transcranial Direct Current Stimulation.</a> Int J Neuropsychopharmacol. , (2011).</li><li>Wagner, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+direct+current+stimulation:+a+computer-based+human+model+study.">Transcranial direct current stimulation: a computer-based human model study.</a> Neuroimage. 35 (3), 1113-1113 (2007).</li><li>Nitsche, M. A., Doemkes, S., Karaköse, T., Antal, A., Liebetanz, D., Lang, N., Tergau, F., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Shaping+the+effects+of+transcranial+direct+current+stimulation+of+the+human+motor+cortex.">Shaping the effects of transcranial direct current stimulation of the human motor cortex.</a> J Neurophysiol. 97 (4), 3109-3109 (2007).</li><li>Wagner, T., Fregni, F., Fecteau, S., Grodzinsky, A., Zahn, M., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+direct+current+stimulation:+a+computer-based+human+model+study.">Transcranial direct current stimulation: a computer-based human model study.</a> Neuroimage. 35 (3), 1113-1113 (2007).</li><li>Boggio, P. S., Rigonatti, S. P., Ribeiro, R. B., Myczkowski, M. L., Nitsche, M. A., Pascual-Leone, A., Fregni, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+randomized,+double-blind+clinical+trial+on+the+efficacy+of+cortical+direct+current+stimulation+for+the+treatment+of+major+depression.">A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression.</a> Int J Neuropsychopharmacol. 11 (2), 249-249 (2008).</li><li>Williams, J. A., Pascual-Leone, A., Fregni, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interhemispheric+modulation+induced+by+cortical+stimulation+and+motor+training.">Interhemispheric modulation induced by cortical stimulation and motor training.</a> Phys Ther. 90 (3), 398-398 (2010).</li><li>Lang, N., Nitsche, M. A., Rothwel, J. C., Williams, J. A., Lemon, R. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+transcranial+direct+current+stimulation+over+the+human+motor+cortex+on+corticospinal+and+transcallosal+excitability.">Effects of transcranial direct current stimulation over the human motor cortex on corticospinal and transcallosal excitability.</a> Exp Brain Res. 156 (4), 439-439 (2004).</li><li>Bikson, M., Datta, A., Rahman, A., Scaturro, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Electrode+montages+for+tDCS+and+weak+transcranial+electrical+stimulation:+role+of+"return"+electrode's+position+and+size.">Electrode montages for tDCS and weak transcranial electrical stimulation: role of "return" electrode's position and size.</a> Clin Neurophysiol. 121 (12), (1976).</li><li>Bikson, M., Fregni, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+direct+current+stimulation+in+patients+with+skull+defects+and+skull+plates:+high-resolution+computational+FEM+study+of+factors+altering+cortical+current+flow.">Transcranial direct current stimulation in patients with skull defects and skull plates: high-resolution computational FEM study of factors altering cortical current flow.</a> Neuroimage. 52 (4), 1268-1268 (2010).</li><li>Datta, A., Baker, J. M., Bikson, M., Fridriksson, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Individualized+model+predicts+brain+current+flow+during+transcranial+direct-current+stimulation+treatment+in+responsive+stroke+patient.">Individualized model predicts brain current flow during transcranial direct-current stimulation treatment in responsive stroke patient.</a> Brain Stimulation. , (2011).</li><li>Palm, U., Keeser, D., Schiller, C., Fintescu, Z., Nitsche, M., Reisinger, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Padberg+Skin+lesions+after+treatment+with+transcranial+direct+current+stimulation+(tDCS).">Padberg Skin lesions after treatment with transcranial direct current stimulation (tDCS).</a> Brain Stimul. 1 (4), 386-386 (2008).</li><li>Datta, A., Elwassif, M., Bikson, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Bio-heat+transfer+model+of+transcranial+DC+stimulation:+comparison+of+conventional+pad+versus+ring+electrode.">Bio-heat transfer model of transcranial DC stimulation: comparison of conventional pad versus ring electrode.</a> Conf Proc IEEE Eng Med Biol Soc. , 670-670 (2009).</li><li>Miranda, P. C., Faria, P., Hallett, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=What+does+the+ratio+of+injected+current+to+electrode+area+tell+us+about+current+density+in+the+brain+during+tDCS?.">What does the ratio of injected current to electrode area tell us about current density in the brain during tDCS?.</a> Clin Neurophysiol. 120 (6), 1183-1183 (2009).</li><li>Gandiga, P. C., Hummel, F. C., Cohen, L. G. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+DC+stimulation+(tDCS):+a+tool+for+double-blind+sham-controlled+clinical+studies+in+brain+stimulation.">Transcranial DC stimulation (tDCS): a tool for double-blind sham-controlled clinical studies in brain stimulation.</a> Clin Neurophysiol. 117 (4), 845-845 (2006).</li><li>Antal, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparatively+weak+after-effects+of+transcranial+alternating+current+stimulation+(tACS)+on+cortical+excitability+in+humans.">Comparatively weak after-effects of transcranial alternating current stimulation (tACS) on cortical excitability in humans.</a> Brain Stimul. 1 (2), 97-97 (2008).</li><li>Terney, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increasing+human+brain+excitability+by+transcranial+high-frequency+random+noise+stimulation.">Increasing human brain excitability by transcranial high-frequency random noise stimulation.</a> J Neurosci Methods. 28 (52), 14147-14147 (2008).</li><li>Fregni, F., Boggio, P. S., Mansur, C. G., Wagner, T., Ferreira, M. J., Lima, M. C., Rigonatti, S. P., Marcolin, M. A., Freedman, S. D., Nitsche, M. A., Pascual-Leone, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transcranial+direct+current+stimulation+of+the+unaffected+hemisphere+in+stroke+patients.">Transcranial direct current stimulation of the unaffected hemisphere in stroke patients.</a> Neuroreport. 16 (14), 1551-1551 (2005).</li><li>Antal, A., Terney, D., K hnl, S., Paulus, W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Anodal+transcranial+direct+current+stimulation+of+the+motor+cortex+ameliorates+chronic+pain+and+reduces+short+intracortical+inhibition.">Anodal transcranial direct current stimulation of the motor cortex ameliorates chronic pain and reduces short intracortical inhibition.</a> J Pain Symptom Manage. 39 (5), (2010).</li><li>Fregni, F., Gimenes, R., Valle, A. C., Ferreira, M. J., Rocha, R. R., Natalle, L., Bravo, R., Rigonatti, S. P., Freedman, S. D., Nitsche, M. A., Pascual-Leone, A., Boggio, P. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+randomized,+sham-controlled,+proof+of+principle+study+of+transcranial+direct+current+stimulation+for+the+treatment+of+pain+in+fibromyalgia.">A randomized, sham-controlled, proof of principle study of transcranial direct current stimulation for the treatment of pain in fibromyalgia.</a> Arthritis Rheum. 54 (12), (2006).</li><li>Boggio, P. S., Zaghi, S., Lopes, M., Fregni, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Modulatory+effects+of+anodal+transcranial+direct+current+stimulation+on+perception+and+pain+thresholds+in+healthy+volunteers.">Modulatory effects of anodal transcranial direct current stimulation on perception and pain thresholds in healthy volunteers.</a> Eur J Neurol. 15 (10), 1124-1124 (2008).</li><li>Fregni, F., Liguori, P., Fecteau, S., Nitsche, M. A., Pascual-Leone, A., Boggio, P. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cortical+stimulation+of+the+prefrontal+cortex+with+transcranial+direct+current+stimulation+reduces+cue-provoked+smoking+craving:+a+randomized,+sham-controlled+study.">Cortical stimulation of the prefrontal cortex with transcranial direct current stimulation reduces cue-provoked smoking craving: a randomized, sham-controlled study.</a> J Clin Psychiatry. 69 (1), 32-32 (2006).</li></ol>

ニューヨーク市立大学では、マロムBiksonが発明されている、脳の刺激で特許を取得しています。マロムBiksonはSoterixメディカル株式会社の共同創立者です。

重要なステップ： 開始手続きの前にチェックする側面： <ul><li>まず第一に、患者は、TDCは任意の禁忌があるかどうかのスクリーニングを行うべきである - これらの禁忌は、アプリケーション固有のものである可能性があります。これは、重症または頻繁な頭痛、慢性皮膚疾患、または前回のTDCは治療の副作用の有無などの質問が含まれています。彼または彼女が頭の中であらゆる金属を持っているか、深刻な脳損傷を持っていた場合、解剖学的変化は23,24の電流の流れを変更することができます。脳卒中の発作、妊娠と歴史の歴史は、通常、厳格な禁忌ではない - と確かに、いくつかの臨床試験の組み入れ基準になるかもしれません。 </li><li>頭皮-さらに被写体上の任意の病変を確認するには、特にインタビューや皮膚疾患の有無を点検してください。どんな病変がある場合は、TDCはの手順は避けるか、あるいは、適切な場合には、刺激が直接病変を介して、または全体で実施されないことを確保すべきである。別のサイトの刺激が考えられる。それは、繰り返し毎日TDCは、一部の患者7の電極の下に臨床的に有意な皮膚刺激を引き起こすことが報告されている。皮膚の完全性に応じてTDCは誘導性病変の証拠がある。例えば、それは5つのセッションごとに25週を含めて2週間の期間のための広範な発赤と2 mAの強度におけるTDCの刺激に起因する不規則な円形の形状を持つ茶色の無愛想な皮の変化を示されている。 tDCSが強く示されているor実施する持っている場合は、そのようなミリアンペア0.5から1.0のような低強度で刺激するために考慮を考慮することは可能ですが、これは皮膚の炎症または病変を防止することは保証されません。従って、電極の下の皮膚の状態は、TDCは7の前と後に検査する必要があります。 </li><li>電気分解のためのケーブルのコネクタを確認します。明らか場合には、別のペアを使用してください。それは使用の約2ヶ月後にケーブルをチェックすることをお勧めします。 </li></ul>両方 - アクティブまたは偽- TDCは中に常に対象がまだ快適に感じていると手続きを続行できるかどうかを尋ねる。 実行可​​能な変更： <ul><li>電極の位置7（ 表2）の多くの品種があります。 </li><li>電極のサイズは26（ 図7）の多くの品種があります。所定の印加電流は、電極の大きさは電流密度18に影響し、脳の変調（ 図8）のfocalityに影響を与えます。臨床試験は、電極の大きさより大きな電流密度が26より小さいを示唆している、しかし、モデリングの研究は、脳の変調の電極の大きさと面積の関係は27より複雑である可能性を示唆している。さらに、小さな電極の効果は頭皮の電流の差動シャント、および全体的な電極面積7〜相対大きなエッジ効果による定性的に異なることがあります。大きな電極スキーム19より報告された小型の電極の大きさのためにシャントの優れたレベルが大幅にあった。 </li><li>高精細TDCは（HD - TDCは）空間focalityは向上しますが、特別なハードウェアおよび手続き上のコントロール15を必要とする技術です。 </li><li>印加電流とともに電極モンタージュ（電極の位置とサイズ）が順番に、TDCはの有効性を決定する、脳内に生成された電界強度を決定する。現在の強度と電極のサイズとの比率で定義されているだけで、電極の電流密度の使用は、臨床転帰を正規化するために提案されている - しかし、モデリングの研究は、これは限られた範囲で適用される可能性があり、その全体的な電極モンタージュの設計が結果を決める示唆している。一般的に、より強い効果のある特定のモンタージュ結果の現在の強さを（または電流密度）が増加。皮膚表面での電流密度は、脳19（ 図9）のそれよりはるかに高いことに注意することが重要です。 </li><li> &quot;リターン&quot;（&quot;基準&quot;）の位置は、電極脳を介して全体の電流の流れのパターンに影響を与える可能性があるため、さらにアクティブ電極22の下の脳の変調に影響を与える。したがって、 両電極の薬を考慮する必要があります。 </li><li>刺激の持続時間は、実験的アプローチの目的に依存します。刺激の持続時間の増加が発生し、後遺症3,4の長い期間に関連付けられています。しかし、少なくとも一つの研究では、より強度が必ずしもより堅牢な臨床転帰に変換していないことを示唆し、刺激の持続時間が増加された効果の方向の反転を報告した。公開されたパラメータ内のTDCは、増加する強さ（時間、duratiと望ましくない副作用の増加の可能性、安全性および忍容考えられているものの上に、または繰り返し率/番号）。 </li><li>電界の向き：電極の位置と極性によって定義される。陽極刺激は、通常、皮質興奮性2,3を増加させる一方、陰極刺激では一般的に、皮質の興奮性を減少させます。 </li><li>プラセボ：偽- TDCはの場合は上記と同じプロトコルが使用されている。しかし、現在は30秒間適用されます。これは、他の非侵襲的脳刺激法に比べてTDCはの利点の一つです。アクティブ- TDCは起因生じる感覚は、アプリケーションの初期の段階でのみ発生する傾向があるので、この偽の方法は、それが困難な患者がアクティブTDCはアプリケーションからプラセボを区別できるようになります。この最初のと簡単な刺激は、プラセボ群28信頼性の高い方法です。 </li><li>このようなTACS 29またはtRNS 30のような他の経頭蓋電気療法を使用するときのテクニックにも適用できることに注意してください。 </li></ul> 慢性的な痛みで、TDCはを使用するための理論的根拠： 複数の治療薬理学的治療法は、慢性疼痛患者のための唯一のささやかな救済を提供するという事実は、この衰弱性疾患の持続性の原因は、痛みに関連する神経回路網におけるプラスチックの変化の中で潜んでいるかもしれないという可能性を発生させます。興味深いことに、皮質活動の変調がTDCはで非侵襲的に達成することができる、などの皮質可塑性の変化による慢性疼痛の持続的な治療効果を生成するために報告されている、以前に説明した。 慢性的な痛みのTDCはの臨床効果： それは、運動皮質に適用されるTDCは、ローカルの皮質興奮性（ 図6）6 を変更することが示されている。より正確には、神経細胞の興奮性の増加に陽極刺激の結果、陰極刺激では逆の結果6を持っているのに対し。確かに、M1以上の陽極TDCはアプリケーションでは、偽のTDCはより視覚的アナログスケール（VAS）の痛みの定格のより大きな改善につながります。 M1刺激後の痛みに対するこの治療効果は、一時的なものの、三叉神経痛、脳卒中後疼痛症候群31、背中の痛み、線維筋痛症32のような神経障害性疼痛症候群の患者のいくつかのグループに再現された。興味深いことに、脊髄損傷による神経因性疼痛、、TDCはによる運動皮質の刺激で臨床試験は、痛みの改善と刺激の後二週間続いた累積鎮痛効果を示した。偽の刺激、そして同様にDLPFC 33の刺激と比較してM1の陽極TDCはのためのフォローアップの三週間後にまだ重要である線維筋痛症患者における鎮痛効果33の証拠もある。痛みの改善のためのDLFPC以上陽極TDCはの効果が広く検討されていないが、それはそれは健康な被験者34に疼痛閾値を調節するために使用することができることが示された。それにもかかわらず、この脳領域の刺激がアルツハイマー病9でメモリのタスクのパフォーマンスを向上させ、例えば大幅に35を手掛り引き起こした喫煙への渇望を減らし、作業メモリ10を高めるための信頼できる手法であるため、これが有用な戦略になるかもしれないことも考えられるには、慢性疼痛患者の痛みの処理に関連する情動 - 感情認知ネットワークを変調する。

electrode positioning and montage in transcranial direct current stimulation

経頭蓋直流電流刺激（TDCは）このメソッドは、皮質興奮性2を変更するには、非侵襲的で安全な代替手段を提供しているので集中的に過去10年間に研究されているテクニックです。 TDCはいずれかのセッションの効果は数分間続くこと、そしてその効果は刺激の極性に依存し、その陰極刺激では皮質の興奮性の低下を誘導するような、と陽極刺激での期間を超えて続くことがある皮質の興奮性の増加を誘発する刺激6。これらの効果は、精神神経疾患の様々なも臨床的に認知神経科学の探求とされている-複数の連続したセッション4上で適用される場合は特に。神経科学と臨床医の注目を集めている分野の一つは、痛みに関連した神経回路網の変調3,5のためのTDCはの使用です。痛みの研究の2つの主要な皮質領域の変調が検討されている：一次運動野と背外側前頭前皮質7。電極モンタージュの重要な役割のために、この記事では、我々は痛みでTDCは臨床試験のための電極配置のための別の選択肢を示し、刺激の各方法の長所と短所を議論している。

Watch this Scientific Journal Video about Electrode Positioning and Montage in Transcranial Direct Current Stimulation at JoVE.com

Electrode Positioning and Montage in Transcranial Direct Current Stimulation

経頭蓋直流電流刺激（TDCは）皮質の興奮性を調節するために確立された技術です。<sup&gt; 1,2</sup&gt;。それは皮質可塑性、容易な操作、および安全なプロファイルへの影響に起因する神経科学の調査ツールとして使用されています。 TDCはは有望な結果を示していることを一つの領域は、痛みの緩和です。<sup&gt; 3月5日</sup&gt;。

経頭蓋直流電流刺激で電極の位置とモンタージュ

Transcranial direct current stimulation (tDCS) is a technique that has been intensively investigated in the past decade as this method offers a ...

electrode-positioning-montage-transcranial-direct-current

Research

JoVE Journal

Neuroscience

262.1K ビュー.  University of Michigan. 経頭蓋直流電流刺激（TDCは）皮質の興奮性を調節するために確立された技術です。 1,2。それは皮質可塑性、容易な操作、および安全なプロファイルへの影響に起因する神経科学の調査ツールとして使用されています。 TDCはは有望な結果を示していることを一つの領域は、痛みの緩和です。 3月5日。

ビデオ: Electrode Positioning and Montage in Transcranial Direct Current Stimulation

Combining Transcranial Magnetic Stimulation and fMRI to Examine the Default Mode Network

The default mode network is a group of brain regions that are active when an individual is not focused on the outside world and the brain is at "wakeful rest."1,2,3 It is thought the default mode network corresponds to self-referential or "internal mentation".2,3
It has been hypothesized that, in humans, activity within the default mode network is correlated with certain pathologies (for instance, hyper-activation has been linked to schizophrenia 4,5,6 and autism spectrum disorders 7 whilst hypo-activation of the network has been linked to Alzheimer's and other neurodegenerative diseases 8). As such, noninvasive modulation of this network may represent a potential therapeutic intervention for a number of neurological and psychiatric pathologies linked to abnormal network activation. One possible tool to effect this modulation is Transcranial Magnetic Stimulation: a non-invasive neurostimulatory and neuromodulatory technique that can transiently or lastingly modulate cortical excitability (either increasing or decreasing it) via the application of localized magnetic field pulses.9
In order to explore the default mode network's propensity towards and tolerance of modulation, we will be combining TMS (to the left inferior parietal lobe) with functional magnetic resonance imaging (fMRI). Through this article, we will examine the protocol and considerations necessary to successfully combine these two neuroscientific tools.

In this article, we examine the methodology and considerations relevant to the combination of TMS and fMRI to examine the effects of brain stimulation on the default network.

デフォルトモードのネットワークを検査する経頭蓋磁気刺激とfMRIを組み合わせ

The default mode network is a group of brain regions that are active when an individual is not focused on the outside world and the brain is at "wakeful ...

神経科学

Direct-current Stimulation and Multi-electrode Array Recording of Seizure-like Activity in Mice Brain Slice Preparation

Cathodal transcranial direct-current stimulation (tDCS) induces suppressive effects on drug-resistant seizures. To perform effective actions, the stimulation parameters (e.g., orientation, field strength, and stimulation duration) need to be examined in mice brain slice preparations. Testing and arranging the orientation of the electrode relative to the position of the mice brain slice are feasible. The present method preserves the thalamocingulate pathway to evaluate the effect of DCS on anterior cingulate cortex seizure-like activities. The results of the multichannel array recordings indicated that cathodal DCS significantly decreased the amplitude of the stimulation-evoked responses and duration of 4-aminopyridine and bicuculline-induced seizure-like activity. This study also found that cathodal DCS applications at 15 min caused long-term depression in the thalamocingulate pathway. The present study investigates the effects of DCS on thalamocingulate synaptic plasticity and acute seizure-like activities. The current procedure can test the optimal stimulation parameters including orientation, field strength, and stimulation duration in an in vitro mouse model. Also, the method can evaluate the effects of DCS on cortical seizure-like activities at both the cellular and network levels.

Studies have shown that cathodal transcranial direct-current stimulation can produce suppressive effects on drug-resistant seizures. In this study, an in vitro experimental setup was devised in which the direct-current stimulation and multielectrode array recording of seizure-like activity were evaluated in mice brain slice preparation. The direct-current stimulation parameters were evaluated.

マウス脳スライスの準備中に発作のような活動の直流刺激とマルチ電極アレイ録音

Cathodal transcranial direct-current stimulation (tDCS) induces suppressive effects on drug-resistant seizures. To perform effective actions, the ...

Effects of Transcranial Alternating Current Stimulation on the Primary Motor Cortex by Online Combined Approach with Transcranial Magnetic Stimulation

Transcranial Alternating Current Stimulation (tACS) is a neuromodulatory technique able to act through sinusoidal electrical waveforms in a specific frequency and in turn modulate ongoing cortical oscillatory activity. This neurotool allows the establishment of a causal link between endogenous oscillatory activity and behavior. Most of the tACS studies have shown online effects of tACS. However, little is known about the underlying action mechanisms of this technique because of the AC-induced artifacts on Electroencephalography (EEG) signals. Here we show a unique approach to investigate online physiological frequency-specific effects of tACS of the primary motor cortex (M1) by using single pulse Transcranial Magnetic Stimulation (TMS) to probe cortical excitability changes. In our setup, the TMS coil is placed over the tACS electrode while Motor Evoked Potentials (MEPs) are collected to test the effects of the ongoing M1-tACS. So far, this approach has mainly been used to study the visual and motor systems. However, the current tACS-TMS setup can pave the way for future investigations of cognitive functions. Therefore, we provide a step-by-step manual and video guidelines for the procedure.

Transcranial Alternating Current Stimulation (tACS) allows the modulation of cortical excitability in a frequency-specific fashion. Here we show a unique approach which combines online tACS with single pulse Transcranial Magnetic Stimulation (TMS) in order to "probe" cortical excitability by means of Motor Evoked Potentials.

経頭蓋交流電流刺激オンライン結合による一次運動野の経頭蓋磁気刺激の効果

Transcranial Alternating Current Stimulation (tACS) is a neuromodulatory technique able to act through sinusoidal electrical waveforms in a specific ...

Remotely Supervised Transcranial Direct Current Stimulation: An Update on Safety and Tolerability

The remotely supervised tDCS (RS-tDCS) protocol enables participation from home through guided and monitored self-administration of tDCS treatment while maintaining clinical standards. The current consensus regarding the efficacy of tDCS is that multiple treatment sessions are needed to observe targeted behavioral reductions in symptom burden. However, the requirement for patients to travel to clinic daily for stimulation sessions presents a major obstacle for potential participants, due to work or family obligations or limited ability to travel. This study presents a protocol that directly overcomes these obstacles by eliminating the need to travel to clinic for daily sessions.
This is an updated protocol for remotely supervised self-administration of tDCS for daily treatment sessions paired with a program of computer-based cognitive training for use in clinical trials. Participants only need to attend clinic twice, for a baseline and study-end visit. At baseline, participants are trained and provided with a study stimulation device, and a small laptop computer. Participants then complete the remainder of their stimulation sessions at home while they are monitored via videoconferencing software.
Participants complete computerized cognitive remediation during stimulation sessions, which may serve a therapeutic role or as a &#34;placeholder&#34; for other computer-based activity. Computers are enabled for real-time monitoring and remote control by study staff.
Outcome measures that assess feasibility and tolerance are administered remotely with the aid of visual analogue scales that are presented onscreen. Following completion of all RS-tDCS sessions, participants return to clinic for a study end visit in which all study equipment is returned.
Results support the safety, feasibility, and scalability of the RS-tDCS protocol for use in clinical trials. Across 46 patients, 748 RS-tDCS sessions have been completed. This protocol serves as a model for use in future clinical trials involving tDCS.

This manuscript provides an updated remote supervision protocol that enables participation in transcranial direct current stimulation (tDCS) clinical trials while receiving treatment sessions from home. The protocol has been successfully piloted in both patients with multiple sclerosis and Parkinson&#39;s disease.

リモートでチャイルドの経頭蓋直通電流刺激: 安全性と忍容性に関する更新プログラム

The remotely supervised tDCS (RS-tDCS) protocol enables participation from home through guided and monitored self-administration of tDCS treatment while ...

Transcranial Electrical Brain Stimulation in Alert Rodents

Transcranial electrical brain stimulation can modulate cortical excitability and plasticity in humans and rodents. The most common form of stimulation in humans is transcranial direct current stimulation (tDCS). Less frequently, transcranial alternating current stimulation (tACS) or transcranial random noise stimulation (tRNS), a specific form of tACS using an electrical current applied randomly within a pre-defined frequency range, is used. The increase of noninvasive electrical brain stimulation research in humans, both for experimental and clinical purposes, has yielded an increased need for basic, mechanistic, safety studies in animals. This article describes a model for transcranial electrical brain stimulation (tES) through the intact skull targeting the motor system in alert rodents. The protocol provides step-by-step instructions for the surgical set-up of a permanent epicranial electrode socket combined with an implanted counter electrode on the chest. By placing a stimulation electrode into the epicranial socket, different electrical stimulation types, comparable to tDCS, tACS, and tRNS in humans, can be delivered. Moreover, the practical steps for tES in alert rodents are introduced. The applied current density, stimulation duration, and stimulation type may be chosen depending on the experimental needs. The caveats, advantages, and disadvantages of this set-up are discussed, as well as safety and tolerability aspects.

This protocol describes a surgical set-up for a permanent epicranial electrode socket and an implanted chest electrode in rodents. By placing a second electrode into the socket, different types of transcranial electrical brain stimulation can be delivered to the motor system in alert animals through the intact skull.

警告齧歯動物で経頭蓋脳の電気的刺激

Transcranial electrical brain stimulation can modulate cortical excitability and plasticity in humans and rodents. The most common form of stimulation in ...

Chronic Transcranial Electrical Stimulation and Intracortical Recording in Rats

Transcranial electrical stimulation (TES) is a powerful and relatively simple approach to diffusely influence brain activity either randomly or in a closed-loop event-triggered manner. Although many studies are focusing on the possible benefits and side-effects of TES in healthy and pathologic brains, there are still many fundamental open questions regarding the mechanism of action of the stimulation. Therefore, there is a clear need for a robust and reproducible method to test the acute and the chronic effects of TES in rodents. TES can be combined with regular behavioral, electrophysiological, and imaging techniques to investigate neuronal networks in vivo. The implantation of transcranial stimulation electrodes does not impose extra constraints on the experimental design while it offers a versatile, flexible tool to manipulate brain activity. Here we provide a detailed, step-by-step protocol to fabricate and implant transcranial stimulation electrodes to influence brain activity in a temporally constrained manner for months.

This detailed protocol describes transcranial stimulation electrode placement on the temporal bone in order to investigate the short- and long-term effects of transcranial electrical stimulation in freely moving rats.

慢性的な経頭蓋電気刺激およびラットの皮質内の記録

Transcranial electrical stimulation (TES) is a powerful and relatively simple approach to diffusely influence brain activity either randomly or in a ...

The Combined Use of Transcranial Direct Current Stimulation and Robotic Therapy for the Upper Limb

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of daily activities due to lower and upper limb impairments. Intensive physical and occupational therapy are still considered main treatments, but new adjunct therapies to standard rehabilitation that may optimize functional outcomes are being studied.
Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation technique that polarizes underlying brain regions through the application of weak direct currents through electrodes on the scalp, modulating cortical excitability. Increased interest in this technique can be attributed to its low cost, ease of use, and effects on human neural plasticity. Recent research has been performed to determine the clinical potential of tDCS in diverse conditions such as depression, Parkinson&#39;s disease, and motor rehabilitation after stroke. tDCS helps enhance brain plasticity and seems to be a promising technique in rehabilitation programs.
A number of robotic devices have been developed to assist in the rehabilitation of upper limb function after stroke. The rehabilitation of motor deficits is often a long process requiring multidisciplinary approaches for a patient to achieve maximum independence. These devices do not intend to replace manual rehabilitation therapy; instead, they were designed as an additional tool to rehabilitation programs, allowing immediate perception of results and tracking of improvements, thus helping patients to stay motivated.
Both tDSC and robot-assisted therapy are promising add-ons to stroke rehabilitation and target the modulation of brain plasticity, with several reports describing their use to be associated with conventional therapy and the improvement of therapeutic outcomes. However, more recently, some small clinical trials have been developed that describe the associated use of tDCS and robot-assisted therapy in stroke rehabilitation. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

The combined use of transcranial direct current stimulation and robotic therapy as an add-on for conventional rehabilitation therapy may result in improved therapeutic outcomes due to modulation of brain plasticity. In this article, we describe the combined methods used in our institute for improving motor performance after stroke.

上肢の経頭蓋直通電流刺激とロボット療法の併用

Neurologic disorders such as stroke and cerebral palsy are leading causes of long-term disability and can lead to severe incapacity and restriction of ...

Transcranial Direct Current Stimulation (tDCS) in Mice

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique proposed as an alternative or complementary treatment for several neuropsychiatric diseases. The biological effects of tDCS are not fully understood, which is in part explained due to the difficulty in obtaining human brain tissue. This protocol describes a tDCS mouse model that uses a chronically implanted electrode allowing the study of the long-lasting biological effects of tDCS. In this experimental model, tDCS changes the cortical gene expression and offers a prominent contribution to the understanding of the rationale for its therapeutic use.

Transcranial Direct Current Stimulation tDCS in Mice

Transcranial direct current stimulation (tDCS) is a therapeutic technique proposed to treat psychiatric diseases. An animal model is essential for understanding the specific biological alterations evoked by tDCS. This protocol describes a tDCS mouse model that uses a chronically implanted electrode.

マウスにおける経頭蓋直流電流刺激 (tDCS)

Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique proposed as an alternative or complementary treatment for ...

Stimulation Location Determination using a 3D Digitizer with High-Definition Transcranial Direct Current Stimulation

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, causal evidence of brain area activation leading to a behavior is often left missing. Transcranial direct current stimulation (tDCS), which can temporarily alter brain cortical excitability and activity, is a noninvasive neurophysiological tool used to study causal relationships in the human brain. High-definition transcranial direct current stimulation (HD-tDCS) is a noninvasive brain stimulation (NIBS) technique that produces a more focal current compared to conventional tDCS. Traditionally, the stimulation location has been roughly determined through the 10-20 EEG system, because determining precise stimulation points can be difficult. This protocol uses a 3D digitizer with HD-tDCS to increase accuracy in determination of stimulation points. The method is demonstrated using a 3D digitizer for more accurate localization of stimulation points in the right temporo-parietal junction (rTPJ).

Presented here is a protocol to achieve higher accuracy in determination of stimulation location combining a 3D digitizer with high-definition transcranial direct current stimulation.

高精細経頭蓋直流刺激を用いた3Dデジタイザーを用いた刺激位置決定

The abundance of neuroimaging data and rapid development of machine learning has made it possible to investigate brain activation patterns. However, ...

In Vivo Intracellular Recording of Type-Identified Rat Spinal Motoneurons During Trans-Spinal Direct Current Stimulation

Intracellular recording of spinal motoneurons in vivo provides a &#8220;gold standard&#8221; for determining the cells&#8217; electrophysiological characteristics in the intact spinal network and holds significant advantages relative to classical in vitro or extracellular recording techniques. An advantage of in vivo intracellular recordings is that this method can be performed on adult animals with a fully mature nervous system, and therefore many observed physiological mechanisms can be translated to practical applications. In this methodological paper, we describe this procedure combined with externally applied constant current stimulation, which mimics polarization processes occurring within spinal neuronal networks. Trans-spinal direct current stimulation (tsDCS) is an innovative method increasingly used as a neuromodulatory intervention in rehabilitation after various neurological injuries as well as in sports. The influence of tsDCS on the nervous system remains poorly understood and the physiological mechanisms behind its actions are largely unknown. The application of the tsDCS simultaneously with intracellular recordings enables us to directly observe changes of motoneuron membrane properties and characteristics of rhythmic firing in response to the polarization of the spinal neuronal network, which is crucial for the understanding of tsDCS actions. Moreover, when the presented protocol includes the identification of the motoneuron with respect to an innervated muscle and its function (flexor versus extensor) as well as the physiological type (fast versus slow) it provides an opportunity to selectively investigate the influence of tsDCS on identified components of spinal circuitry, which seem to be differently affected by polarization. The presented procedure focuses on surgical preparation for intracellular recordings and stimulation with an emphasis on the steps which are necessary to achieve preparation stability and reproducibility of results. The details of the methodology of the anodal or cathodal tsDCS application are discussed while paying attention to practical and safety issues.

This protocol describes in vivo intracellular recording of rat lumbar motoneurons with simultaneous trans-spinal direct current stimulation. The method enables us to measure membrane properties and to record rhythmic firing of motoneurons before, during and after anodal or cathodal polarization of the spinal cord.