经颅直流电刺激在注意缺陷多动障碍治疗中的应用

经颅直流电刺激(tDCS)治疗注意缺陷多动障碍(ADHD)主要是选取患者的背外侧前额叶(DLPFC)作为刺激区域, 通过调节其皮层兴奋性, 从而缓解其ADHD的症状和改善其受损的认知功能。针对tDCS在ADHD治疗研究中的问题, 未来可从有效性、确定最佳刺激参数、个体差异、不同亚型及与其他疗法联合使用等五个方面来进一步研究。     

经颅直流电刺激在抑郁症治疗中的应用

已有的神经影像学研究成果揭示, 抑郁症发作的重要原因之一是大脑前额叶皮层结构和功能受损。经颅直流电刺激(tDCS)作为一种无创脑刺激, 选取前额叶皮层作为刺激区域, 通过调节皮层兴奋性来治疗抑郁症, 能够有效缓解抑郁症状和改善受损的认知功能, 疗效明显且持久稳定。针对tDCS在抑郁症治疗研究中的问题, 未来可从有效性、个体差异以及预防干预等六个方面进一步研究, 以期tDCS作为一种具有潜力的治疗手段, 在临床上有更为广泛地应用。     

经颅直流电刺激对健康人群反应抑制的影响

反应抑制是指抑制不恰当的或不符合当前需要的行为的能力, 研究表明反应抑制主要与额下回、背外侧前额叶和前辅助运动区的功能有关。经颅直流电刺激(tDCS)是一种非侵入式脑刺激技术, 近年来对健康人群使用tDCS刺激相应脑区从而影响反应抑制功能的研究日益增多, 但主要研究结果不一致。阐明tDCS影响反应抑制具体的神经机制、减少tDCS研究的异质性、探索更有效的tDCS刺激方式和确定tDCS效果的年龄依赖性差异已成为目前亟待解决的问题。     

额叶区域的经颅直流电刺激对抑制控制的影响

抑制控制是执行功能的重要组成部分之一, 研究表明抑制控制与额叶区域的活动有关。经颅直流电刺激(Transcranial Direct Current Stimulation, tDCS)是一种非侵入性的脑刺激技术, 可以调节脑区的激活程度。研究表明tDCS刺激额叶的部分区域可以有效干预参与者的抑制控制水平, 而这一干预作用会受到刺激位置、刺激类型以及实验任务等条件变化的影响。目前tDCS已应用于不同人群的抑制控制研究, 并能与其他研究技术较好的结合。     

右腹外侧前额叶对高抑郁水平成年人社会情绪调节的作用：一项tDCS研究

已有的经颅直流电刺激(transcranial direct current stimulation, tDCS)研究证明, 右腹外侧前额叶(right ventrolateral prefrontal cortex, RVLPFC)是社会情绪调节的重要脑区, 激活RVLPFC可显著降低人们对社会性负性情绪体验的强度。社会功能受损是抑郁症患者或抑郁倾向人群的重要特征之一。该群体对社会排斥的敏感性高, 且对负性社会情绪体验的情绪调节能力降低。在本研究中, 我们采用外显的情绪调节任务, 研究了高、低抑郁水平的两组成年人被试在RVLPFC接受阳性tDCS后其情绪调节能力的改变。结果表明, 虽然采用tDCS激活RVLPFC可帮助被试通过情绪调节(认知重评)减弱负性情绪体验, 但高抑郁水平被试的负性情绪强度下降程度明显小于低抑郁水平被试。另外本文还发现, 与源于个人的负性情绪相比, tDCS效应对源于社会的负性情绪(即社会排斥)更强。本研究是采用电或磁刺激提高抑郁人群社会情绪调节能力的首次尝试。实验结果表明, 高抑郁水平成年人的RVLPFC仅通过单次、短时间(34 min)的tDCS激活, 其情绪调节能力并未得到显著提升。这提示对抑郁倾向群体或抑郁症患者的干预或治疗需要多次施加tDCS。     

工作记忆刷新及其训练效应——经颅直流电刺激的作用

工作记忆刷新是执行功能的重要成分之一。以往研究结合n-back任务和经颅直流电刺激（transcranial direct current stimulation ,tDCS）技术探究刷新能力，发现tDCS技术能够一定程度上增强刷新训练效果并引起大脑神经元相关活动的变化，其增强效果能够维持一定的时间，且能够迁移到其他认知任务之中。但tDCS的干预效果在各项研究中存在一定的差异性。其作用效果会受到训练任务与训练方式、电流强度、电极布局和训练时间间隔等因素的影响。未来研究可以探索tDCS结合刷新训练的最佳刺激参数，以获得最优化的干预效果。     

经颅电刺激与视功能调控

经颅电刺激(Transcranial Electrical Stimulation, TES)通过电极将特定模式的低强度电流作用于大脑头皮以调控皮层活动, 是一种非侵入、无创的神经刺激方法。根据刺激电流的模式的不同, TES分为经颅直流电刺激(tDCS), 经颅交流电刺激(tACS)和经颅随机电刺激(tRNS)。TES能对视功能诸如光幻视阈值、视野、对比敏感度、视知觉运动等进行一定程度上的调控, 并且能够与传统的视觉知觉学习训练相结合以调控视觉功能。对于不同的视觉功能, 不同的TES参数和模式的调控效果有所不同。     

腹内侧前额叶在内隐认知重评中的因果作用

情绪调节对维持个体心理健康、适应社会生活十分重要, 然而以往研究主要关注外显情绪调节, 目前我们对内隐情绪调节的认知神经机制的了解还非常有限。为揭示内隐情绪调节的核心脑区, 本研究使用句子整理任务启动内隐认知重评, 并采用经颅直流电刺激(transcranial direct current stimulation, tDCS)激活内侧前额叶特别是腹内侧前额叶(ventromedial prefrontal cortex, vmPFC), 考察该脑区在内隐情绪调节中的因果作用。结果表明, vmPFC被激活的被试组(实验组, n = 40)在内隐认知重评启动条件下比tDCS伪刺激组(对照组, n = 40), 在观看负性图片时报告了更少的负性情绪, 同时负性图片诱发的晚正成分(late positive potential, LPP)波幅更低(LPP是情绪体验强度的客观指标)。同时, 实验组比对照组在观看负性图片时表现出更低的枕区P1波幅(P1为早期视觉注意程度的客观指标)。以上结果说明, 激活以vmPFC为代表的内侧前额叶不但能增强内隐情绪调节的效果, 还能减少被试对负性刺激的早期注意分配。本研究是采用tDCS技术考察启动引起的内隐情绪调节的首次尝试, 研究结果不但表明了以vmPFC为代表的内侧前额叶在内隐认知重评中的关键作用, 还为临床应用研究指出了增强内隐情绪调节能力的神经调控潜在靶点。     

前额叶的无创神经干预对饮食控制的影响:基于rTMS和tDCS研究的综述

饮食控制缺陷可导致超重、肥胖和饮食失调。已有研究表明,肥胖和饮食失调者在前额叶认知控制神经环路上存在缺陷。无创神经干预-经颅直流电刺激(t DCS)和重复经颅磁刺激(r TMS)-通过调节前额叶皮层兴奋性来提高饮食控制能力,改善饮食失调症状。未来的研究应考虑不同刺激参数和刺激位点下的干预效应,融合其他神经生理技术考察无创神经干预改善饮食控制的作用机制,考虑个体差异性并结合客观的行为范式进行探究。     

第三方惩罚的神经机制：来自经颅直流电刺激的证据

第三方惩罚既是社会规范在群体得以维系的基石, 也是个体维护社会规范的体现。当前关注社会规范的神经研究大多基于第二方惩罚的独裁者或最后通牒实验框架, 缺乏对第三方维护社会规范过程中相关脑区活动的探索, 对这一过程的内在神经机制也不清楚。本文基于第三方惩罚的独裁者博弈框架, 对右侧背外侧前额叶区域(DLPFC)进行不同极性的经颅直流电刺激(tDCS), 同时依据第三方是否需要为其惩罚付出成本设计了零成本和有成本两个实验任务。结果发现, 第三方在零成本任务的情绪反应和惩罚显著受到tDCS设置的影响, 且阴极刺激显著提升了第三方的惩罚值, 这表明情绪机制对第三方惩罚有着重要影响。另外, 第三方在零成本和有成本任务中的惩罚差异在不同tDCS设置之间也存在显著差异, 这与第三方惩罚还受到自利机制影响的观点相符。本文率先为右侧DLPFC活动影响第三方惩罚提供了神经层面的证据, 且支持了第三方对社会规范的遵从与其负性情绪反应和自利加工密切相关的机制解释。     

The effects of transcranial direct current stimulation (tDCS) on multitasking performance and oculometrics

Multitasking is the ability to perform more than one task simultaneously. The need to multitask is common in many industries especially within the military with tasks such as air traffic controllers, cyber defense operators and image analysts. However, as the time on task increases, information throughput can become overwhelming resulting in a performance decrement. Through task prioritizing, the operator is able to maintain performance on specific subtasks in which they selected as high importance while other subtasks experience a decrement. The objective of this study was to evaluate the effects of transcranial direct current stimulation (tDCS) applied to the left dorsolateral prefrontal cortex (ldLPFC) on information processing capabilities to improve individual and overall multitasking performance while performing the multi-attribute task battery (MATB). Two groups of 8 participants each received either 2 mA of anodal or sham tDCS while performing MATB. In addition, eye tracking was implemented to record eye movement patterns. In doing so, we were able to determine how much time the operator allocated to each of the subtasks within MATB and how their task priorities changed as workload demands increased. The findings provided evidence that 2 mA of anodal tDCS during MATB significantly improved overall information throughput compared to the sham group. With respect to the individual subtasks, communication and system monitoring displayed the greatest enhancement with anodal tDCS. Our data suggests that tDCS could be a useful tool to enhance information processing capabilities during a multitasking paradigm resulting in improved processing capabilities and information throughput.     

Does Transcranial Direct Current Stimulation Affect the Learning of a Fine Sequential Hand Motor Skill with Motor Imagery?

Learning a fine sequential hand motor skill, like playing the piano or learning to type, improves not only due to physical practice, but also due to motor imagery. Previous studies revealed that transcranial direct current stimulation (tDCS) and motor imagery independently affect motor learning. In the present study, we investigated whether tDCS combined with motor imagery above the primary motor cortex influences sequence-specific learning. Four groups of participants were involved: an anodal, cathodal, sham stimulation, and a control group (without stimulation). A modified discrete sequence production (DSP) task was employed: the Go/NoGo DSP task. After a sequence of spatial cues, a response sequence had to be either executed, imagined, or withheld. This task allows to estimate both non-specific learning and sequence-specific learning effects by comparing the execution of unfamiliar sequences, familiar imagined, familiar withheld, and familiar executed sequences in a test phase. Results showed that the effects of anodal tDCS were already developing during the practice phase, while no effects of tDCS on sequence-specific learning were visible during the test phase. Results clearly showed that motor imagery itself influences sequence learning, but we also revealed that tDCS does not increase the influence of motor imagery on sequence learning.     

Cathodal transcranial direct current stimulation of the right Wernicke's area improves comprehension in subacute stroke patients

Previous studies have shown the appearance of right-sided language-related brain activity in right-handed patients after a stroke. Non-invasive brain stimulation such as transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) have been shown to modulate excitability in the brain. Moreover, rTMS and tDCS have been found to improve naming in non-fluent post-stroke aphasic patients. Here, we investigated the effect of tDCS on the comprehension of aphasic patients with subacute stroke. We hypothesized that tDCS applied to the left superior temporal gyrus (Wernicke’s area) or the right Wernicke’s area might be associated with recovery of comprehension ability in aphasic patients with subacute stroke. Participants included right-handed subacute stroke patients with global aphasia due to ischemic infarct of the left M1 or M2 middle cerebral artery. Patients were randomly divided into three groups: patients who received anodal tDCS applied to the left superior temporal gyrus, patients who received cathodal tDCS applied to the right superior temporal gyrus, and patients who received sham tDCS. All patients received conventional speech and language therapy during each period of tDCS application. The Korean-Western Aphasia Battery (K-WAB) was used to assess all patients before and after tDCS sessions. After intervention, all patients had significant improvements in aphasia quotients, spontaneous speech, and auditory verbal comprehension. However, auditory verbal comprehension improved significantly more in patients treated with a cathode, as compared to patients in the other groups. These results are consistent with the role of Wernicke’s area in language comprehension and the therapeutic effect that cathodal tDCS has on aphasia patients with subacute stroke, suggesting that tDCS may be an adjuvant treatment approach for aphasia rehabilitation therapy in patients in an early stage of stroke.     

Augmenting Visual Search Performance With Transcranial Direct Current Stimulation (tDCS)

Military personnel endure rigorous and demanding man-hours designated to monitoring and locating targets in tasks such as cyber defense and Unmanned Aerial Vehicle (UAV) operators. These tasks are monotonous and repetitive, which can result in vigilance decrement. The objective of the study was to implement a form of noninvasive brain stimulation known as transcranial DC stimulation (tDCS) over the left frontal eye field (LFEF) region of the scalp to improve cognitive performance. The participants received anodal and cathodal stimulation of 2 mA for 30 min as well as placebo stimulation on 3 separate days while performing the task. The findings suggest that anodal and cathodal stimulation significantly improves detection accuracy. Also, a correlation was detected between percent of eye closure (PERCLOS) and blinking frequency in relation to stimulation condition. Our data suggest that tDCS over the LFEF would be a beneficial countermeasure to mitigate the vigilance decrement and improve visual search performance.     

Testing the involvement of the prefrontal cortex in lucid dreaming: A tDCS study

Recent studies suggest that lucid dreaming (awareness of dreaming while dreaming) might be associated with increased brain activity over frontal regions during rapid eye movement (REM) sleep. By applying transcranial direct current stimulation (tDCS), we aimed to manipulate the activation of the dorsolateral prefrontal cortex (DLPFC) during REM sleep to increase dream lucidity. Nineteen participants spent three consecutive nights in a sleep laboratory. On the second and third nights they randomly received either 1 mA tDCS for 10 min or sham stimulation during each REM period starting with the second one. According to the participants’ self-ratings, tDCS over the DLPFC during REM sleep increased lucidity in dreams. The effects, however, were not strong and found only in frequent lucid dreamers. While this indicates some preliminary support for the involvement of the DLPFC in lucid dreaming, further research, controlling for indirect effects of stimulation and including other brain regions, is needed.     

经颅直流电刺激技术在增强健康个体认知功能中的应用及其影响因素

经颅直流电刺激作为一种无创脑刺激技术,已在临床治疗及康复领域有广泛应用。随着研究的深入和人类对于自身认知需求的提高,近年来也有研究者开始尝试使用该技术增强健康个体的认知功能。本文从感知觉、注意、记忆、学习和复杂任务五个方面对目前经颅直流电刺激技术在健康个体认知增强领域的研究现状进行梳理和总结,讨论了机制和影响因素,以及未来面临的问题和挑战。     

Working memory improvement with non-invasive brain stimulation of the dorsolateral prefrontal cortex: A systematic review and meta-analysis

Recent studies have used non-invasive brain stimulation (NIBS) techniques, such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS), to increase dorsolateral prefrontal cortex (DLPFC) activity and, consequently, working memory (WM) performance. However, such experiments have yielded mixed results, possibly due to small sample sizes and heterogeneity of outcomes. Therefore, our aim was to perform a systematic review and meta-analyses on NIBS studies assessing the n-back task, which is a reliable index for WM. From the first data available to February 2013, we looked for sham-controlled, randomized studies that used NIBS over the DLPFC using the n-back task in PubMed/MEDLINE and other databases. Twelve studies (describing 33 experiments) matched our eligibility criteria. Active vs. sham NIBS was significantly associated with faster response times (RTs), higher percentage of correct responses and lower percentage of error responses. However, meta-regressions showed that tDCS (vs. rTMS) presented only an improvement in RT, and not in accuracy. This could have occurred in part because almost all tDCS studies employed a crossover design, possibly due to the reliable tDCS blinding. Study design was also associated with no improvement in correct responses in the active vs. sham groups. To conclude, rTMS of the DLPFC significantly improved all measures of WM performance whereas tDCS significantly improved RT, but not the percentage of correct and error responses. Mechanistic insights on the role of DLPFC in WM are further discussed, as well as how NIBS techniques could be used in neuropsychiatric samples presenting WM deficits, such as major depression, dementia and schizophrenia.