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Online and offline effects of cerebellar transcranial direct current stimulation on motor learning in healthy older adults: a randomized double-blind sham-controlled study.

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Online and offline effects of cerebellar transcranial direct current stimulation on motor learning in healthy older adults: a randomized double-blind sham-controlled study.

Eur J Neurosci. 2017 05;45(9):1177-1185

Authors: Samaei A, Ehsani F, Zoghi M, Hafez Yosephi M, Jaberzadeh S

Abstract
The aim of this randomized double blinded sham-controlled study was to determine the effect of cerebellar anodal transcranial direct current stimulation (a-tDCS) on online and offline motor learning in healthy older individuals. Thirty participants were randomly assigned in experimental (n = 15) or sham tDCS (n = 15) groups. Participants in experimental group received 2 mA cerebellar a-tDCS for 20 min. However, the tDCS was turned off after 30 seconds in sham group. Response time (RT) and error rate (ER) in serial RT test were assessed before, during 35 minutes and 48 h after the intervention. Reduction of RT and ER following the intervention session was considered as short-term (35 min post intervention) and long-term offline learning (48 h post intervention), respectively. Online RT and ER reduction were similar in both groups (P > 0.05). RT was significantly reduced 48 hours post intervention in cerebellar a-tDCS group (P = 0.03). Moreover, RT was significantly increased after 35 minutes and 48 hours in sham tDCS group (P = 0.03, P = 0.007), which indicates a lack of short-term and long-term offline learning in older adults. A-tDCS on cerebellar region produced more short-term and long-term offline improvement in RT (P = 0.014, P = 0.01) compared to sham tDCS. In addition, online, short-term and long-term (48 h) offline error reduced in cerebellar a-tDCS as compared to sham-control group, although this reduction was not significant (P > 0.05). A deficit suggests that a direct comparison to a younger group was made. The findings suggested that cerebellar a-tDCS might be useful for improvement of offline motor learning in older individuals.

PMID: 28278354 [PubMed – indexed for MEDLINE]

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Anodal transcranial direct current stimulation over the primary motor cortex does not enhance the learning benefits of self-controlled feedback schedules.

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Anodal transcranial direct current stimulation over the primary motor cortex does not enhance the learning benefits of self-controlled feedback schedules.

Psychol Res. 2018 May;82(3):496-506

Authors: Carter MJ, Smith V, Carlsen AN, Ste-Marie DM

Abstract
A distinct learning advantage has been shown when participants control their knowledge of results (KR) scheduling during practice compared to when the same KR schedule is imposed on the learner without choice (i.e., yoked schedules). Although the learning advantages of self-controlled KR schedules are well-documented, the brain regions contributing to these advantages remain unknown. Identifying key brain regions would not only advance our theoretical understanding of the mechanisms underlying self-controlled learning advantages, but would also highlight regions that could be targeted in more applied settings to boost the already beneficial effects of self-controlled KR schedules. Here, we investigated whether applying anodal transcranial direct current stimulation (tDCS) to the primary motor cortex (M1) would enhance the typically found benefits of learning a novel motor skill with a self-controlled KR schedule. Participants practiced a spatiotemporal task in one of four groups using a factorial combination of KR schedule (self-controlled vs. yoked) and tDCS (anodal vs. sham). Testing occurred on two consecutive days with spatial and temporal accuracy measured on both days and learning was assessed using 24-h retention and transfer tests without KR. All groups improved their performance in practice and a significant effect for practicing with a self-controlled KR schedule compared to a yoked schedule was found for temporal accuracy in transfer, but a similar advantage was not evident in retention. There were no significant differences as a function of KR schedule or tDCS for spatial accuracy in retention or transfer. The lack of a significant tDCS effect suggests that M1 may not strongly contribute to self-controlled KR learning advantages; however, caution is advised with this interpretation as typical self-controlled learning benefits were not strongly replicated in the present experiment.

PMID: 28243728 [PubMed – indexed for MEDLINE]

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Effects of tDCS on motor learning and memory formation: A consensus and critical position paper.

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Effects of tDCS on motor learning and memory formation: A consensus and critical position paper.

Clin Neurophysiol. 2017 Apr;128(4):589-603

Authors: Buch ER, Santarnecchi E, Antal A, Born J, Celnik PA, Classen J, Gerloff C, Hallett M, Hummel FC, Nitsche MA, Pascual-Leone A, Paulus WJ, Reis J, Robertson EM, Rothwell JC, Sandrini M, Schambra HM, Wassermann EM, Ziemann U, Cohen LG

Abstract
Motor skills are required for activities of daily living. Transcranial direct current stimulation (tDCS) applied in association with motor skill learning has been investigated as a tool for enhancing training effects in health and disease. Here, we review the published literature investigating whether tDCS can facilitate the acquisition, retention or adaptation of motor skills. Work in multiple laboratories is underway to develop a mechanistic understanding of tDCS effects on different forms of learning and to optimize stimulation protocols. Efforts are required to improve reproducibility and standardization. Overall, reproducibility remains to be fully tested, effect sizes with present techniques vary over a wide range, and the basis of observed inter-individual variability in tDCS effects is incompletely understood. It is recommended that future studies explicitly state in the Methods the exploratory (hypothesis-generating) or hypothesis-driven (confirmatory) nature of the experimental designs. General research practices could be improved with prospective pre-registration of hypothesis-based investigations, more emphasis on the detailed description of methods (including all pertinent details to enable future modeling of induced current and experimental replication), and use of post-publication open data repositories. A checklist is proposed for reporting tDCS investigations in a way that can improve efforts to assess reproducibility.

PMID: 28231477 [PubMed – indexed for MEDLINE]

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Anodal Transcranial Direct Current Stimulation Does Not Facilitate Dynamic Balance Task Learning in Healthy Old Adults.

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Anodal Transcranial Direct Current Stimulation Does Not Facilitate Dynamic Balance Task Learning in Healthy Old Adults.

Front Hum Neurosci. 2017;11:16

Authors: Kaminski E, Hoff M, Rjosk V, Steele CJ, Gundlach C, Sehm B, Villringer A, Ragert P

Abstract
Older adults frequently experience a decrease in balance control that leads to increased numbers of falls, injuries and hospitalization. Therefore, evaluating older adults’ ability to maintain balance and examining new approaches to counteract age-related decline in balance control is of great importance for fall prevention and healthy aging. Non-invasive brain stimulation techniques such as transcranial direct current stimulation (tDCS) have been shown to beneficially influence motor behavior and motor learning. In the present study, we investigated the influence of tDCS applied over the leg area of the primary motor cortex (M1) on balance task learning of healthy elderly in a dynamic balance task (DBT). In total, 30 older adults were enrolled in a cross-sectional, randomized design including two consecutive DBT training sessions. Only during the first DBT session, either 20 min of anodal tDCS (a-tDCS) or sham tDCS (s-tDCS) were applied and learning improvement was compared between the two groups. Our data showed that both groups successfully learned to perform the DBT on both training sessions. Interestingly, between-group analyses revealed no difference between the a-tDCS and the s-tDCS group regarding their level of task learning. These results indicate that the concurrent application of tDCS over M1 leg area did not elicit DBT learning enhancement in our study cohort. However, a regression analysis revealed that DBT performance can be predicted by the kinematic profile of the movement, a finding that may provide new insights for individualized approaches of treating balance and gait disorders.

PMID: 28197085 [PubMed]

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A single session of prefrontal cortex transcranial direct current stimulation does not modulate implicit task sequence learning and consolidation.

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A single session of prefrontal cortex transcranial direct current stimulation does not modulate implicit task sequence learning and consolidation.

Brain Stimul. 2017 May – Jun;10(3):567-575

Authors: Savic B, Müri R, Meier B

Abstract
BACKGROUND: Transcranial direct current stimulation (tDCS) is assumed to affect cortical excitability and dependent on the specific stimulation conditions either to increase or decrease learning.
OBJECTIVE: The purpose of this study was to modulate implicit task sequence learning with tDCS.
METHODS: As cortico-striatal loops are critically involved in implicit task sequence learning, tDCS was applied above the dorsolateral prefrontal cortex (DLPFC). In Experiment 1, anodal, cathodal, or sham tDCS was applied before the start of the sequence learning task. In Experiment 2, stimulation was applied during the sequence learning task. Consolidation of learning was assessed after 24 h.
RESULTS: The results of both experiments showed that implicit task sequence learning occurred consistently but it was not modulated by different tDCS conditions. Similarly, consolidation measured after a 24 h-interval including sleep was also not affected by stimulation.
CONCLUSIONS: These results indicate that a single session of DLPFC tDCS is not sufficient to modulate implicit task sequence learning. This study adds to the accumulating evidence that tDCS may not be as effective as originally thought.

PMID: 28089321 [PubMed – indexed for MEDLINE]

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Modulating Motor Learning through Transcranial Direct-Current Stimulation: An Integrative View.

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Modulating Motor Learning through Transcranial Direct-Current Stimulation: An Integrative View.

Front Psychol. 2016;7:1981

Authors: Ammann C, Spampinato D, Márquez-Ruiz J

Abstract
Motor learning consists of the ability to improve motor actions through practice playing a major role in the acquisition of skills required for high-performance sports or motor function recovery after brain lesions. During the last decades, it has been reported that transcranial direct-current stimulation (tDCS), consisting in applying weak direct current through the scalp, is able of inducing polarity-specific changes in the excitability of cortical neurons. This low-cost, painless and well-tolerated portable technique has found a wide-spread use in the motor learning domain where it has been successfully applied to enhance motor learning in healthy individuals and for motor recovery after brain lesion as well as in pathological states associated to motor deficits. The main objective of this mini-review is to offer an integrative view about the potential use of tDCS for human motor learning modulation. Furthermore, we introduce the basic mechanisms underlying immediate and long-term effects associated to tDCS along with important considerations about its limitations and progression in recent years.

PMID: 28066300 [PubMed]

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Differential effects of bihemispheric and unihemispheric transcranial direct current stimulation in young and elderly adults in verbal learning.

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Differential effects of bihemispheric and unihemispheric transcranial direct current stimulation in young and elderly adults in verbal learning.

Behav Brain Res. 2017 03 15;321:170-175

Authors: Fiori V, Nitsche M, Iasevoli L, Cucuzza G, Caltagirone C, Marangolo P

Abstract
For the past few years, the potential of transcranial direct current stimulation (tDCS) for the treatment of several pathologies has been investigated. In the language domain, several studies, in healthy and brain-damaged populations, have already shown that tDCS is effective in enhancing naming, repetition and semantic word generation. In those studies, different tDCS electrode configurations have been tested, however, a direct comparison between different montages in verbal learning has never been conducted. In this study, we aimed to explore the impact of bihemispheric and unihemispheric tDCS on verbal learning task performance in two groups (young vs. elderly). Fifteen healthy volunteers participated per group. Each participant received three stimulation conditions: unihemispheric anodal tDCS over the left temporal area, bihemispheric tDCS over the left (anodal) and right (cathodal) temporal areas and a sham condition. During active stimulation, tDCS (20min, 2mA) was applied while each participant learned twenty pseudowords (arbitrarily assigned to corresponding pictures). No significant differences were found between the three conditions for the young group with regard to accuracy and vocal reaction times. In contrast, in the elderly group, real stimulation improved performance compared to sham but bihemispheric tDCS was more efficient than unilateral stimulation. These results suggest that bihemispheric stimulation is more effective in improving language learning but this effect is age-dependent. The hypothesis is advanced that cortical changes in the course of aging might differentially impact on tDCS efficacy on behavioral performance. These data may also have implications for treatment of stroke patients with language impairment.

PMID: 28062255 [PubMed – indexed for MEDLINE]

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Cerebellar tDCS Does Not Enhance Performance in an Implicit Categorization Learning Task.

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Cerebellar tDCS Does Not Enhance Performance in an Implicit Categorization Learning Task.

Front Psychol. 2017;8:476

Authors: Verhage MC, Avila EO, Frens MA, Donchin O, van der Geest JN

Abstract
Background: Transcranial Direct Current Stimulation (tDCS) is a form of non-invasive electrical stimulation that changes neuronal excitability in a polarity and site-specific manner. In cognitive tasks related to prefrontal and cerebellar learning, cortical tDCS arguably facilitates learning, but the few studies investigating cerebellar tDCS, however, are inconsistent. Objective: We investigate the effect of cerebellar tDCS on performance of an implicit categorization learning task. Methods: Forty participants performed a computerized version of an implicit categorization learning task where squares had to be sorted into two categories, according to an unknown but fixed rule that integrated both the size and luminance of the square. Participants did one round of categorization to familiarize themselves with the task and to provide a baseline of performance. After that, 20 participants received anodal tDCS (20 min, 1.5 mA) over the right cerebellum, and 19 participants received sham stimulation and simultaneously started a second session of the categorization task using a new rule. Continue Reading →

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Single-Session Anodal tDCS with Small-Size Stimulating Electrodes Over Frontoparietal Superficial Sites Does Not Affect Motor Sequence Learning.

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Single-Session Anodal tDCS with Small-Size Stimulating Electrodes Over Frontoparietal Superficial Sites Does Not Affect Motor Sequence Learning.

Front Hum Neurosci. 2017;11:153

Authors: Hashemirad F, Fitzgerald PB, Zoghi M, Jaberzadeh S

Abstract
Due to the potential of anodal transcranial direct current stimulation (a-tDCS) for enhancement of fine sequenced movements and increasing interest in achieving high level of fine movements in the trained and untrained hands especially at initial stage of learning, we designed this study to investigate whether the application of single-session a-tDCS with small-size stimulating electrodes over FPN sites, such as dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1) or posterior parietal cortex (PPC) could enhance sequence learning with the trained hand and these effects are transferred into the untrained hand or not. A total of 51 right-handed healthy participants were randomly assigned to one of the four stimulation groups: a-tDCS of left M1, DLPFC, PPC, or sham. Stimulation was applied for 20 min during a sequential visual isometric pinch task (SVIPT). Eight blocks of training using SVIPT were completed with the right hand during stimulation. Two blocks of sequence training with each hand were performed by participants as assessment blocks at three time points: baseline, 15 min and one day following the intervention. Behavioral outcomes including movement time, error rate and skill were assessed in all assessment blocks across three time points. We also measured corticospinal excitability, short-interval intracortical inhibition, and intracortical facilitation using single- and paired-pulse transcranial magnetic stimulation. The results indicated that the behavioral outcomes were significantly improved with the right trained hand, but this learning effect was not modulated by a-tDCS with small-size stimulating electrodes over the FPN. Transfer of learning into the untrained hand was observed in all four groups for movement time but not for the error rate or skill. Our results suggest that sequential learning in SVIPT and its transfer into the untrained hand were not sensitive to a single-session a-tDCS with small-size stimulating electrodes over left M1, DLPFC or PPC in young healthy participants.

PMID: 28420970 [PubMed]

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The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke.

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The effect of transcranial direct current stimulation on motor sequence learning and upper limb function after stroke.

Clin Neurophysiol. 2017 07;128(7):1389-1398

Authors: Fleming MK, Rothwell JC, Sztriha L, Teo JT, Newham DJ

Abstract
OBJECTIVE: To assess the impact of electrode arrangement on the efficacy of tDCS in stroke survivors and determine whether changes in transcallosal inhibition (TCI) underlie improvements.
METHODS: 24 stroke survivors (3-124months post-stroke) with upper limb impairment participated. They received blinded tDCS during a motor sequence learning task, requiring the paretic arm to direct a cursor to illuminating targets on a monitor. Four tDCS conditions were studied (crossover); anodal to ipsilesional M1, cathodal to contralesional M1, bihemispheric, sham. The Jebsen Taylor hand function test (JTT) was assessed pre- and post-stimulation and TCI assessed as the ipsilateral silent period (iSP) duration using transcranial magnetic stimulation.
RESULTS: The time to react to target illumination reduced with learning of the movement sequence, irrespective of tDCS condition (p>0.1). JTT performance improved after unilateral tDCS (anodal or cathodal) compared with sham (p<0.05), but not after bihemispheric (p>0.1). There was no effect of tDCS on change in iSP duration (p>0.1).
CONCLUSIONS: Unilateral tDCS is effective for improving JTT performance, but not motor sequence learning.
SIGNIFICANCE: This has implications for the design of future clinical trials.

PMID: 28410884 [PubMed – indexed for MEDLINE]

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