Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial
The Effects of Anodal Transcranial Direct Current Stimulation on the Walking Performance of Chronic Hemiplegic Patients.
To evaluate the effect of a single session of tDCS over the primary motor cortex of the lower limb (M1-LL) vs. placebo on the walking performance in chronic hemiplegic patients. ⋯ The authors reported no conflict of interest.
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The methodology used for the application of repetitive transcranial magnetic stimulation (TMS) is such that it may induce a placebo effect. Respectively, adverse events (AEs) can occur when using a placebo, a phenomenon called nocebo. The primary aim of our meta-analysis is to establish the nocebo phenomena during TMS. Safety and tolerability of TMS were also studied. ⋯ TMS is a safe and well-tolerated intervention. Nocebo phenomena do occur during TMS treatment and should be acknowledged during clinical trial design and daily clinical practice.
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Hemispatial neglect is a frequent condition usually following nondominant hemispheric brain injury. It strongly affects rehabilitation strategies and everyday life activities. It is associated with behavioral and cognitive disability with a strong impact on patient's life. ⋯ Noninvasive brain stimulation and neuromuscular vibration are promising therapeutic neuromodulatory approaches for neglect. Further randomized-controlled studies are needed to corroborate their effectiveness as separate and combined techniques.
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Aging is associated with a decline in cognitive and motor performances, which are a part of geriatric syndromes. Since aging is associated with morphological changes in the cerebellum and cerebellar morphology is a good predictor of cognitive and motor performances, so the study of cerebellar role in age-related decline in performance is necessary. Cerebellar transcranial direct current stimulation (ctDCS) has been proposed to study and facilitate the cerebellar function. However, lobule-specific dosing has not been investigated in healthy aging. This is important because the same electrode montage across different individuals for ctDCS (called the "one-size-fits-all" approach) can lead to inter-individual differences in the lobule-specific dosing of the electric field (EF). These differences can be due to the inter-individual variability and age-related changes in the cerebellar structure. To investigate such lobule-specific dosing differences in healthy aging, we modeled the lobular EF distribution across groups of 18 to 89 years for a commonly used "one-size-fits-all" ctDCS montage. ⋯ We found that cerebellar shrinkage and increasing thickness of the highly conductive CSF during healthy aging can lead to the dispersion of the current away from the lobules underlying the active electrode. We concluded that an individualized ctDCS approach for dosimetry is critical when ctDCS is used as an adjuvant treatment for active aging to address age-related lobule-specific cerebellar geriatric syndromes effectively. Future work is necessary to investigate age-related effects of lobule-specific ctDCS on the large-scale cognitive and motor networks using functional neuroimaging that is expected due to the cerebellum's extensive reciprocal connectivity with the cerebral cortex.
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Rodent models are fundamental in unraveling cellular and molecular mechanisms of transcranial magnetic stimulation (TMS)-induced effects on the brain. However, proper translation of human TMS protocols to animal models have been restricted by the lack of rodent-specific focal TMS coils. ⋯ Computer simulations motivated the design of a smaller rodent-specific TMS coil, but came short in explaining the capability of a larger commercial human coil to induce unilateral MEPs in vivo. Lateralized TMS, as demonstrated for both TMS coils, corroborates their use in translational rodent studies, to elucidate mechanisms of action of therapeutic TMS protocols.