DaSilva AF recebeu apoio financeiro da concessão de financiamento CTSA high-tech, da Universidade de Michigan para completar esta revisão. Volz MS é financiado por uma bolsa de estudos bolsa da Stiftung Charité.

<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. 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Universidade da Cidade de Nova York detém patentes sobre estimulação cerebral, em que Marom Bikson é um inventor. Marom Bikson é um co-fundador da Soterix Medical Inc.

Etapas críticas: Aspectos a serem verificados antes do procedimento de partida: <ul><li> Primeiro de tudo, os pacientes devem ser rastreados para saber se há alguma contra-indicação para ETCC - estas contra-indicações podem ser de aplicação específica. Isto inclui questões como a presença de dor de cabeça severa ou freqüente, doença de pele crônica, ou reações adversas a um tratamento ETCC anterior. Se ele ou ela tem qualquer metal na cabeça ou teve uma lesão cerebral grave, as alterações anatômicas podem modificar o fluxo de corrente 23,24. História da gravidez, apreensão e história de um acidente vascular cerebral geralmente não são contra-indicações estrita - e, na verdade, podem ser critérios de inclusão, em alguns ensaios clínicos. </li><li> Verifique se há alguma lesão no couro cabeludo assuntos-adicionalmente deve ser especificamente entrevistados e inspecionados para a existência de doenças de pele. Se houver qualquer lesão, o procedimento ETCC devem ser evitados ou, se for o caso, assegurou que a estimulação não será realizado diretamente em cima ou do outro lado da lesão. Estimulação de um site diferente pode ser considerado. É relatado que repetiu ETCC diária provoca irritação na pele clinicamente significativo no âmbito do eletrodos em cerca de 7 pacientes. Há evidências de lesões induzidas ETCC de acordo com a integridade da pele. Por exemplo, tem sido mostrado vermelhidão extensos e marrom mudanças intracutânea crusty irregular com formas arredondadas devido ao TDC estímulo a uma intensidade de 2 mA por um período de duas semanas, incluindo cinco sessões por semana 25. Se ETCC é fortemente indicado ou tem que ser realizada, é possível tomar em consideração para estimular com menor intensidade, como 0,5-1,0 mA, mas não é garantido que isso vai impedir irritações de pele ou lesões. Assim, a condição da pele sob os eletrodos devem ser inspecionados antes e após ETCC 7. </li><li> Verifique os conectores dos cabos para a eletrólise. Use um outro par se evidente. É recomendável verificar os cabos, após cerca de dois meses de uso. </li></ul> Durante os dois ativos ou sham-ETCC sempre perguntar se sujeita ainda se sente confortável e é capaz de continuar procedimento. Possíveis modificações: <ul><li> Existem muitas variedades de posicionamento dos eletrodos 7 (Tabela 2). </li><li> Existem muitas variedades de tamanhos eletrodo 26 (Figura 7). Para uma determinada corrente aplicada, tamanho do eletrodo influencia a densidade de corrente 18 e influencia a focality do cérebro de modulação (Figura 8). Estudos clínicos sugerem que o tamanho menor do eletrodo de maior densidade da corrente 26, porém estudos de modelagem sugerem que a relação entre o tamanho do eletrodo e da zona de modulação do cérebro pode ser mais complexa 27. Além disso, os efeitos de pequenos eletrodos podem diferir qualitativamente devido ao desvio diferencial de corrente no couro cabeludo, e relativo maior efeito de borda para a área do eletrodo geral 7. Havia drasticamente níveis superiores de manobra para os tamanhos pequeno eletrodo informou que para os maiores esquemas de eletrodo 19. </li><li> High-Definition ETCC (HD-ETCC) é uma tecnologia que melhora focality espacial, mas exige hardware especial e controles processuais 15. </li><li> O eletrodo de montagem (posição do eletrodo e tamanho) junto com a corrente aplicada determinar a intensidade do campo gerado elétricas no cérebro que, por sua vez, determina a eficácia do ETCC. O uso de apenas densidade eletrodo de corrente, definida pela razão entre a força atual eo tamanho do eletrodo, foi proposto para normalizar os resultados clínicos -, mas estudos de modelagem sugerem que esta só pode aplicar mais de um alcance limitado e que, em geral eletrodo de design montage determina o resultado. Geralmente, o aumento da intensidade da corrente (ou densidade de corrente) para qualquer resultado dado montagem em efeitos mais fortes. É importante notar que a densidade de corrente na superfície da pele é muito maior do que no cérebro 19 (Figura 9). </li><li> A posição do &quot;retorno&quot; (&quot;de referência&quot;) eletrodos podem influenciar o padrão de fluxo total de corrente através do cérebro e, portanto, até mesmo influenciar a modulação cérebro sob os eletrodos ativos 22. Assim, a poção de ambos os eletrodos devem ser considerados. </li><li> A duração do estímulo depende do objetivo da abordagem experimental. Um aumento de duração do estímulo é associado com a ocorrência e uma maior duração de efeitos posteriores 3,4. No entanto, pelo menos, um estudo relatou uma reversão dos efeitos sentidos quando a duração estímulo foi aumentada, sugerindo que a maior intensidade não se traduz necessariamente em um resultado mais robusto clínico. Embora ETCC dentro dos parâmetros publicados é considerada segura e bem tolerada, o potencial para efeitos colaterais indesejáveis ​​aumenta com a intensidade crescente (tempo, duratina, taxa de repetição ou / número). </li><li> Orientação do campo elétrico: definido pelas posições eletrodos e polaridade. Estimulação Cathodal tipicamente diminui a excitabilidade cortical, enquanto a estimulação anódica normalmente aumenta a excitabilidade cortical 2,3. </li><li> Placebo: Para sham-ETCC o mesmo protocolo acima é usado. No entanto, a corrente será aplicada por 30 segundos. Esta é uma das vantagens do ETCC em comparação com outros métodos não-invasivos de estimulação cerebral. Desde as sensações decorrentes resultou de ativo-ETCC tendem a ocorrer apenas em estágios iniciais de aplicação, este método farsa torna difícil para o paciente distinguir o placebo da aplicação ETCC ativa. Esta estimulação inicial e breve é um método fiável de placebo 28. </li><li> Note-se que a técnica também pode ser aplicada quando se utiliza outros terapias elétrica transcraniana como os TAC 29 ou TRNS 30. </li></ul> Justificativa para o uso ETCC na dor crônica: O fato de que várias modalidades terapêuticas farmacológicas fornecem somente o alívio modesto para pacientes com dor crônica levanta a possibilidade de que a causa para a persistência desta doença debilitante pode estar dentro de mudanças plásticas na dor relacionada com redes neurais. Curiosamente, a modulação da atividade cortical pode ser alcançado de forma não invasiva pela ETCC, como descrito anteriormente, o que foi relatado para produzir efeitos terapêuticos duradouros na dor crônica devido a mudanças na plasticidade cortical. Efeito clínico do ETCC em dor crônica: Tem sido demonstrado que a ETCC aplicada ao córtex motor muda a excitabilidade cortical locais (Figura 6) 6. Mais precisamente, os resultados estimulação anódica em um aumento da excitabilidade neuronal, enquanto a estimulação cathodal tem resultados opostos 6. De fato, a aplicação ETCC anódica mais M1 leva a uma maior melhora na escala visual analógica (VAS) classificações de dor do que ETCC farsa. Este efeito terapêutico sobre a dor após a estimulação M1, embora transitória, foi reproduzido em vários grupos de pacientes com síndromes de dor neuropática como neuralgia do trigêmeo, síndrome pós-AVC, dor 31, a dor nas costas e fibromialgia 32. Curiosamente, os ensaios clínicos de dor neuropática, devido a lesão da medula espinhal, a estimulação do córtex motor por ETCC mostrou melhora da dor e efeito analgésico cumulativo que durou duas semanas após a estimulação. Há também evidências de seu efeito analgésico em pacientes com fibromialgia 33 que ainda é significativa após três semanas de follow-up para a ETCC anódica do M1 em comparação com estimulação simulada, e assim como a estimulação dos 33 CPFDL. Embora os efeitos da ETCC anódica mais DLFPC para melhora da dor não foram exploradas exaustivamente, foi mostrado que pode ser usado para modular o limiar da dor em indivíduos saudáveis ​​34. No entanto, a estimulação desta área do cérebro é uma técnica confiável para melhorar a memória de trabalho 10, aumentando o desempenho em tarefas de memória na doença de Alzheimer 9 e reduzindo cue-provocou o desejo de fumar significativamente 35 por exemplo, por isso também é concebível que isso pode ser uma estratégia útil para modular afetivo-emocional redes cognitivas associadas ao processamento da dor em pacientes com dor crônica.

electrode positioning and montage in transcranial direct current stimulation

Estimulação transcraniana por corrente (ETCC) é uma técnica que tem sido intensamente investigada nos últimos dez anos como este método oferece uma alternativa não-invasiva e segura de alterar a excitabilidade cortical 2. Os efeitos de uma sessão de ETCC pode durar por vários minutos, e os seus efeitos dependem da polaridade do estímulo, como a estimulação cathodal induz uma diminuição da excitabilidade cortical, e estimulação anódica induz um aumento na excitabilidade cortical que pode durar além da duração do estímulo 6. Esses efeitos têm sido exploradas em neurociência cognitiva e também clinicamente em uma variedade de transtornos neuropsiquiátricos - especialmente quando aplicado ao longo de várias sessões consecutivas 4. Uma área que vem atraindo a atenção dos neurocientistas e médicos é o uso da ETCC para a modulação da dor relacionados com redes neurais 3,5. Modulação dos dois principais áreas corticais na investigação da dor tem sido explorada: córtex motor primário e córtex pré-frontal dorsolateral 7. Devido ao papel crítico do eletrodo de montagem, neste artigo, vamos mostrar diferentes alternativas para a colocação do eletrodo para ensaios clínicos em ETCC dor; discutir vantagens e desvantagens de cada método de estimulação.

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

Estimulação transcraniana por corrente (ETCC) é uma técnica estabelecida para modular a excitabilidade cortical<sup&gt; 1,2</sup&gt;. Ela tem sido usada como uma ferramenta de investigação em neurociência, devido aos seus efeitos sobre a plasticidade cortical, de fácil operação e perfil de segurança. Uma área que ETCC vem mostrando resultados animadores é alívio da dor<sup&gt; 05/03</sup&gt;.

Posicionamento do eletrodo e Montage na estimulação transcraniana por corrente

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

261.6K visualizações.  University of Michigan. Estimulação transcraniana por corrente (ETCC) é uma técnica estabelecida para modular a excitabilidade cortical 1,2. Ela tem sido usada como uma ferramenta de investigação em neurociência, devido aos seus efeitos sobre a plasticidade cortical, de fácil operação e perfil de segurança. Uma área que ETCC vem mostrando resultados animadores é alívio da dor 05/03.

Vídeo: 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.

Combinando Estimulação Magnética Transcraniana e fMRI para o Exame da rede de modo padrão

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 ...

Neurociência

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.

A estimulação de corrente contínua e Multi-eletrodo de gravação matriz de perda de consciência em Ratos Cérebro Slice Preparação

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.

Efeitos da estimulação da corrente alternada transcraniana no córtex Motor primário por on-line abordagem combinada com estimulação magnética transcraniana

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.

Remotamente controlados direta Transcranial estimulação atual: Uma atualização para a segurança e tolerabilidade

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

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.

O uso combinado de terapia robótica e atual estimulação transcraniana direto para o membro superior

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.

Transcraniana por corrente contínua estimulação (tDCS) em ratos

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.

Determinação de localização de estimulação usando um digitalizador 3D com estimulação transcraniana de alta definição da corrente direta

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.

In Vivo Intracelular Gravação de Motoneurons vertebrais de rato identificados tipo durante estimulação de corrente direta trans-espinhal

Intracellular recording of spinal motoneurons in vivo provides a &#8220;gold standard&#8221; for determining the cells&#8217; electrophysiological ...

Simultaneous Application of Transcranial Direct Current Stimulation during Virtual Reality Exposure

Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation that changes the likelihood of neuronal firing through modulation of neural resting membranes. Compared to other techniques, tDCS is relatively safe, cost-effective, and can be administered while individuals are engaged in controlled, specific cognitive processes. This latter point is important as tDCS may predominantly affect intrinsically active neural regions. In an effort to test tDCS as a potential treatment for psychiatric illness, the protocol described here outlines a novel procedure that allows the simultaneous application of tDCS during exposure to trauma-related cues using virtual reality (tDCS+VR) for veterans with posttraumatic stress disorder (NCT03372460). In this double-blind protocol, participants are assigned to either receive 2 mA tDCS, or sham stimulation, for 25 minutes while passively watching three 8-minute standardized virtual reality drives through Iraq or Afghanistan, with virtual reality events increasing in intensity during each drive. Participants undergo six sessions of tDCS+VR over the course of 2-3 weeks, and psychophysiology (skin conductance reactivity) is measured throughout each session. This allows testing for within and between session changes in hyperarousal to virtual reality events and adjunctive effects of tDCS. Stimulation is delivered through a built-in rechargeable battery-driven tDCS device using a 1 (anode) x 1 (cathode) unilateral electrode set-up. Each electrode is placed in a 3 x 3 cm (current density 2.22 A/m2) reusable sponge pocket saturated with 0.9% normal saline. Sponges with electrodes are attached to the participant&#8217;s skull using a rubber headband with the electrodes placed such that they target regions within the ventromedial prefrontal cortex. The virtual reality headset is placed over the tDCS montage in such a way as to avoid electrode interference.

This manuscript outlines a novel protocol to allow the simultaneous application of transcranial direct current stimulation during exposure to warzone trauma-related cues using virtual reality for veterans with posttraumatic stress disorder.

Aplicação simultânea de estimulação de corrente direta transcraniana durante exposição à realidade virtual

Transcranial direct current stimulation (tDCS) is a form of non-invasive brain stimulation that changes the likelihood of neuronal firing through ...

Transcranial Direct Current Stimulation (tDCS) for Memory Enhancement

Memory enhancement is one of the great challenges in cognitive neuroscience and neurorehabilitation. Among various techniques used for memory enhancement, transcranial direct current stimulation (tDCS) is emerging as an especially promising tool for improvement of memory functions in a non-invasive manner. Here, we present a tDCS protocol that can be applied for memory enhancement in healthy-participant studies as well as in aging and dementia research. The protocol uses weak constant anodal current to stimulate cortical targets within cortico-hippocampal functional network engaged in memory processes. The target electrode is placed either on the posterior parietal cortex (PPC) or the dorsolateral prefrontal cortex (DLPFC), while the return electrode is placed extracranially (i.e., on the contralateral cheek). In addition, we outline a more advanced method of oscillatory tDCS, mimicking a natural brain rhythm to promote hippocampus-dependent memory functions, which can be applied in a personalized and non-personalized manner. We present illustrative results of associative and working memory improvement following single tDCS sessions (20 minutes) in which the described electrode montages were used with current intensities between 1.5 mA and 1.8 mA. Finally, we discuss crucial steps in the protocol and methodological decisions that must be made when designing a tDCS study on memory.

Transcranial Direct Current Stimulation tDCS for Memory Enhancement

A protocol for memory enhancement by using transcranial direct current stimulation (tDCS) targeting dorsolateral prefrontal and posterior parietal cortices, as core cortical nodes within hippocampo-cortical network, is presented. The protocol has been well evaluated in healthy-participant studies and is applicable to aging and dementia research as well.

Estimulação de corrente direta transcraniana (tDCS) para aprimoramento da memória

Memory enhancement is one of the great challenges in cognitive neuroscience and neurorehabilitation. Among various techniques used for memory enhancement, ...