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。     

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。     

右侧背外侧前额叶在视觉工作记忆中的因果性作用

以往的影像学研究表明右侧背外侧前额叶皮层(DLPFC)在视觉工作记忆中发挥重要作用, 然而缺乏因果性的证据。本研究旨在考察右侧DLPFC的激活与视觉工作记忆容量的因果关系, 并探讨这一关系受到记忆负荷的调节及其神经机制。被试接受经颅直流电刺激之后完成视觉工作记忆变化检测任务, 根据被试在虚假刺激情况下从负荷4到负荷6任务记忆容量的增量将被试分为低记忆增长潜力组(简称低潜力组)和高记忆增长潜力组(简称高潜力组), 结果发现正性电刺激右侧DLPFC相对于虚假电刺激显著提升了高潜力组被试在低记忆负荷(负荷4)下的记忆容量及其对应的提取阶段的脑电指标SPCN成分。表明右侧DLPFC在视觉工作记忆的提取阶段发挥重要的因果性作用; 正性经颅直流电刺激右侧DLPFC可使工作记忆容量高潜力被试获得更多的脑活动增益, 并导致更好的行为提升效果。     

基于非侵入性脑刺激的认知增强：方法、伦理和应用

作为人类追求卓越的方式之一,基于非侵入性脑刺激的认知增强成为众多学科和公众关注的问题。首先阐述了非侵入性脑刺激的两种主要技术手段(经颅磁刺激和经颅直流刺激)的技术原理及其在提升健康个体认知功能上的应用,并分析了这两种技术可能带来的安全、自主选择、公平等伦理问题,最后总结了该认知增强技术在体育和军事等两个具体领域的应用。未来可进一步提高技术手段的深部脑区刺激能力及该增强技术的持续和真实效果。     

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。     

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。     

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。     

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。     

经颅直流电刺激对健康大学生反应抑制的影响

拟观察经颅直流电刺激作用于右侧背外侧前额叶皮层前后,被试在停止信号任务中的行为变化。实验共入组34名正常大学生,被试前后两次随机接受真刺激和伪刺激,两次刺激间隔7天,每个被试在接受刺激前后均完成停止信号任务,并在每次实验前后完成Stroop色词任务、词语流畅性、数字广度任务。结果发现真刺激作用于右侧背外侧前额叶皮层后停止信号反应时显著减小,但伪刺激条件下没有该趋势。本实验证明了作用于右侧背外侧前额叶皮层的经颅直流电刺激可以调节反应抑制能力,右侧背外侧前额叶皮层是反应抑制的重要脑区。     

Neuromodulation as a cognitive enhancement strategy in healthy older adults: promises and pitfalls

Increases in life expectancy have been followed by an upsurge of age-associated cognitive decline. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) have risen as promising approaches to prevent or delay such cognitive decline. However, consensus has not yet been reached about their efficacy in improving cognitive functioning in healthy older adults. Here we review the effects of TMS and tDCS on cognitive abilities in healthy older adults. Despite considerable variability in the targeted cognitive domains, design features and outcomes, the results generally show an enhancement or uniform benefit across studies. Most studies employed tDCS, suggesting that this technique is particularly well-suited for cognitive enhancement. Further work is required to determine the viability of these techniques as tools for long-term cognitive improvement. Importantly, the combination of TMS/tDCS with other cognitive enhancement strategies may be a promising strategy to alleviate the cognitive decline associated with the healthy aging process.     

Effects of 1 mA and 2 mA transcranial direct current stimulation on working memory performance in healthy participants

Anodal transcranial current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to enhance working memory (WM) in neuropsychiatric patients. In healthy populations, however, tDCS obtains inconclusive results, mostly due to heterogeneous study and stimulation protocols. Here, we approached these issues by investigating effects of tDCS intensity on simultaneous WM performance with three cognitive loads by directly comparing findings of two double-blind, cross-over, sham-controlled experiments. TDCS was administrated to the left DLPFC at intensity of 1 mA (Experiment 1) or 2 mA (Experiment 2), while participants completed a verbal n-back paradigm (1-, 2-, 3-back). Analysis showed no overall effects of tDCS on WM, but a significant interaction with cognitive load. The present study suggests that cognitive load rather than tDCS intensity could be a decisive factor for effects on WM. Moreover, it emphasizes the need of thorough investigation on study parameters to develop more efficient stimulation protocols.     

Does transcranial direct current stimulation during writing alleviate upper limb freezing in people with Parkinson’s disease? A pilot study

Transcranial direct current stimulation (tDCS) over the primary motor cortex (M1) can boost motor performance in Parkinson’s disease (PD) when it is applied at rest. However, the potential supplementary therapeutic effect of the concurrent application of tDCS during the training of motor tasks is largely unknown. The present study examined the effects of tDCS on upper limb motor blocks during a freezing-provoking writing task (the funnel task) requiring up- and down-stroke movements at alternating amplitudes. Ten PD patients and 10 age-matched controls underwent two sessions of writing combined with 20 min of anodal or sham tDCS on the left M1 in a randomized cross-over design. The primary outcome was the number of upper limb freezing episodes during five trials of the funnel task on a touch-sensitive tablet. PD patients showed a significant reduction in freezing episodes during tDCS compared to sham. No effects of tDCS were found for the amplitude, variability and speed of the strokes outside the freezing episodes. However, patients who reported freezing episodes in daily life (N = 6) showed a beneficial effect of tDCS on stroke characteristics. These results indicate a subgroup-dependent variability in response to non-invasive brain stimulation applied during the performance of motor tasks in PD. This warrants future studies to examine tDCS as an adjuvant tool for training programs aimed to reduce motor deficits related to freezing.     

Transcranial direct current stimulation versus intermittent theta-burst stimulation for the improvement of working memory performance

Non-invasive brain stimulation (NIBS) techniques have been increasingly used over the dorsolateral prefrontal cortex (DLPFC) to enhance working memory (WM) performance. Notwithstanding, NIBS protocols have shown either small or inconclusive cognitive effects on healthy and neuropsychiatric samples. Therefore, we assessed working memory performance and safety of transcranial direct current stimulation (tDCS), intermittent theta-burst stimulation (iTBS), and both therapies combined vs placebo over the neuronavigated left DLPFC of healthy participants. Twenty-four subjects were included to randomly undergo four sessions of NIBS, once a week: tDCS alone, iTBS alone, combined interventions and placebo. The 2-back task and an adverse effect scale were applied after each NIBS session. Results revealed a significantly faster response for iTBS (b= -21.49, p= 0.04), but not for tDCS and for the interaction tDCS vs. iTBS (b= 13.67, p= 0.26 and b= 40.5, p= 0.20, respectively). No changes were observed for accuracy and no serious adverse effects were found among protocols. Although tolerable, an absence of synergistic effects for the combined protocol was seen. Nonetheless, future trials accessing different outcomes for the combined protocols, as well as studies investigating iTBS over the left DLPFC for cognition and exploring sources of variability for tDCS are encouraged.