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RISS 인기검색어
- 검색키워드
- 저자 : Marom Bikson (검색결과 3 건)
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Giuseppina Pilloni,Leigh E. Charvet,Marom Bikson,Nikhil Palekar,Min-Jeong Kim 대한신경과학회 2022 Journal of Clinical Neurology Vol.18 No.4
Transcranial direct current stimulation (tDCS) is a safe and well-tolerated noninvasive method for stimulating the brain that is rapidly developing into a treatment method for various neurological and psychiatric conditions. In particular, there is growing evidence of a therapeutic role for tDCS in ameliorating or delaying the cognitive decline in Alzheimer’s disease (AD). We provide a brief overview of the current development and application status of tDCS as a nonpharmacological therapeutic method for AD and mild cognitive impairment (MCI), summarize the levels of evidence, and identify the improvements needed for clinical applications. We also suggest future directions for large-scale controlled clinical trials of tDCS in AD and MCI, and emphasize the necessity of identifying the mechanistic targets to facilitate clinical applications.
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Adaptive current tDCS up to 4 mA
Khadka, Niranjan,Borges, Helen,Paneri, Bhaskar,Kaufman, Trynia,Nassis, Electra,Zannou, Adantchede L.,Shin, Yungjae,Choi, Hyeongseob,Kim, Seonghoon,Lee, Kiwon,Bikson, Marom Elsevier 2020 Brain stimulation Vol.13 No.1
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Higher tDCS current may putatively enhance efficacy, with tolerability the perceived limiting factor.</P> <P><B>Objective</B></P> <P>We designed and validated electrodes and an adaptive controller to provide tDCS up to 4 mA, while managing tolerability. The adaptive 4 mA controller included incremental ramp up, impedance-based current limits, and a Relax-mode where current is transiently decreased. Relax-mode was automatically activated by self-report VAS-pain score >5 and in some conditions by a Relax-button available to participants.</P> <P><B>Methods</B></P> <P>In a parallel-group participant-blind design with 50 healthy subjects, we used specialized electrodes to administer 3 daily session of tDCS for 11 min, with a lexical decision task as a distractor, in 5 study conditions: adaptive 4 mA, adaptive 4 mA with Relax-button, adaptive 4 mA with historical-Relax-button, 2 mA, and sham. A tablet-based stimulator with a participant interface regularly queried VAS pain score and also limited current based on impedance and tolerability. An Abort-button provided in all conditions stopped stimulation. In the adaptive 4 mA with Relax-button and adaptive 4 mA with historical-Relax-button conditions, participants could trigger a Relax-mode ad libitum, in the latter case with incrementally longer current reductions. Primary outcome was the average current delivered during each session, VAS pain score, and adverse event questionnaires. Current delivered was analyzed either excluding or including dropouts who activated Abort (scored as 0 current).</P> <P><B>Results</B></P> <P>There were two dropouts each in the adaptive 4 mA and sham conditions. Resistance based current attenuation was rarely activated, with few automatic VAS pain score triggered relax-modes. In conditions with Relax-button option, there were significant activations often irrespective of VAS pain score. Including dropouts, current across conditions were significantly different from each other with maximum current delivered during adaptive 4 mA with Relax-button. Excluding dropouts, maximum current was delivered with adaptive 4 mA. VAS pain score and adverse events for the sham was only significantly lower than the adaptive 4 mA with Relax-button and adaptive 4 mA with historical-Relax-button. There was no difference in VAS pain score or adverse events between 2 mA and adaptive 4 mA.</P> <P><B>Conclusions</B></P> <P>Provided specific electrodes and controllers, adaptive 4 mA tDCS is tolerated and effectively blinded, with acceptability likely higher in a clinical population and absence of regular querying. Indeed, presenting participants with overt controls increases rumination on sensation.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Designed and validated an adaptive controller with electrode to maximize tDCS upto 4 mA while maintaining tolerability. </LI> <LI> Conditions with overt subject controls increase rumination on sensation, decreasing tolerability. </LI> <LI> No difference in VAS or adverse events among 2 mA, adaptive 4 mA, and sham. </LI> <LI> Adaptive 4 mA tDCS is relatively tolerated with specific electrodes and controller. </LI> </UL> </P>
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Huh, Yeowool,Jung, Dahee,Seo, Taeyoon,Sun, Sukkyu,Kim, Su Hyun,Rhim, Hyewhon,Chung, Sooyoung,Kim, Chong-Hyun,Kwon, Youngwoo,Bikson, Marom,Chung, Yong-an,Kim, Jeansok J.,Cho, Jeiwon Elsevier 2018 Brain stimulation Vol.11 No.5
<P><B>Abstract</B></P> <P><B>Background</B></P> <P>The bursting pattern of thalamocortical (TC) pathway dampens nociception. Whether brain stimulation mimicking endogenous patterns can engage similar sensory gating processes in the cortex and reduce nociceptive behaviors remains uninvestigated.</P> <P><B>Objective</B></P> <P>We investigated the role of cortical parvalbumin expressing (PV) interneurons within the TC circuit in gating nociception and their selective response to TC burst patterns. We then tested if transcranial magnetic stimulation (TMS) patterned on endogenous nociceptive TC bursting modulate nociceptive behaviors.</P> <P><B>Methods</B></P> <P>The switching of TC neurons between tonic (single spike) and burst (high frequency spikes) firing modes may be a critical component in modulating nociceptive signals. Deep brain electrical stimulation of TC neurons and immunohistochemistry were used to examine the differential influence of each firing mode on cortical PV interneuron activity. Optogenetic stimulation of cortical PV interneurons assessed a direct role in nociceptive modulation. A new TMS protocol mimicking thalamic burst firing patterns, contrasted with conventional continuous and intermittent theta burst protocols, tested if TMS patterned on endogenous TC activity reduces nociceptive behaviors in mice.</P> <P><B>Results</B></P> <P>Immunohistochemical evidence confirmed that burst, but not tonic, deep brain stimulation of TC neurons increased the activity of PV interneurons in the cortex. Both optogenetic activation of PV interneurons and TMS protocol mimicking thalamic burst reduced nociceptive behaviors.</P> <P><B>Conclusions</B></P> <P>Our findings suggest that burst firing of TC neurons recruits PV interneurons in the cortex to reduce nociceptive behaviors and that neuromodulation mimicking thalamic burst firing may be useful for modulating nociception.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Electrical stimulation mimicking thalamic bursts activate cortical PV interneurons. </LI> <LI> Selective optical activation of PV interneurons reduces nociceptive behaviors. </LI> <LI> TMS mimicking ‘Thalamic burst’ reduces nociceptive behaviors in mice. </LI> </UL> </P>
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