Long‐term effects of transcranial direct current stimulation in the treatment of autism spectrum disorder: A randomized controlled trial
Paradee AuvichayapatKrittiya IntayotChavisa UdomchatChanyut SuphakunpinyoNiramol PatjanasoontornKeattichai KeeratitanontOrathai TunkamnerdthaiMark P. JensenAndrew HumbertNarong Auvichayapat
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Abstract Aim To compare the efficacy of 0, 5, and 20 sessions of transcranial direct current stimulation (tDCS) for reducing symptoms of autism spectrum disorder (ASD). Method Thirty‐six male children with ASD (mean age 2 years 3 months, SD 4 months, age range 1 years 6 months–2 years 11 months) were balanced and stratified by age, sex, and baseline severity of ASD, to: (1) a control group that received 20 sessions of sham tDCS; (2) a 5‐session tDCS group (5‐tDCS) that received 5 sessions of active tDCS followed by 15 sessions of sham tDCS; and (3) a 20‐session tDCS group (20‐tDCS) that received 20 sessions of active tDCS. All groups participated in the special school activity of Khon Kaen Special Education Center, Thailand. The primary outcome was autism severity as measured by the Childhood Autism Severity Scale. Results The 5‐tDCS and 20‐tDCS groups evidenced greater reductions in autism severity than the control group at days 5 and 14, and months 6 and 12. There were no significant differences in the outcome between the 5‐ and 20‐tDCS groups at any time point. Within‐group analysis showed clinically meaningful improvements starting at month 6 for the participants in the control group, and clinically meaningful improvements starting on day 5 in both active tDCS groups, all of which were maintained to month 12. Interpretation The 5‐ and 20‐session tDCS seems to reduce autism severity faster than sham tDCS. These effects maintained at least for 1 year. What this paper adds Twenty sessions of transcranial direct current stimulation (tDCS) were not superior to five sessions. Sham tDCS with a special school activity can reduce autism severity starting at 6 months after treatment. The benefits observed for 5 and 20 sessions of tDCS last for at least 12 months.Keywords:
Transcranial Direct Current Stimulation
Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that has been extensively studied. While there have been initial positive results in some clinical trials, there is still variability in tDCS results. The aim of this article is to review and discuss patents assessing novel methods to optimize the use of tDCS. A systematic review was performed using Google patents database with tDCS as the main technique, with patents filling date between 2010 and 2015. Twenty-two patents met our inclusion criteria. These patents attempt to address current tDCS limitations. Only a few of them have been investigated in clinical trials (i.e., high-definition tDCS), and indeed most of them have not been tested before in human trials. Further clinical testing is required to assess which patents are more likely to optimize the effects of tDCS. We discuss the potential optimization of tDCS based on these patents and the current experience with standard tDCS.
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Background: Transcranial direct current stimulation (tDCS) enhances treatment outcomes post-stroke. Feasibility and tolerability of high-definition (HD) tDCS (a technique that increases current focality and intensity) for consecutive weekdays as an a
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Transcranial direct current stimulation (tDCS) is a noninvasive neural control technology that has become a research hotspot. To facilitate further research of tDCS, the biosafety of 500 μA cathodal tDCS, a controversial parameter in rats was evaluated. 24 animals were randomly divided into two groups: a cathodal tDCS group (tDCS, n = 12) and control group (control, n = 12). Animals in the tDCS group received 5 consecutive days of cathodal tDCS (500 μA, 15 min, once per day) followed by a tDCS-free interval of 2 days and 5 additional days of stimulation, totally two treatments of tDCS for a total of 10 days. Computational 3D rat model was adopted to calculate the current density distributions in brain during tDCS treatment. Essential brain functions including motor function and learning and memory ability were evaluated. Additionally, to estimate the neurotoxicity of tDCS, the brain morphology, neurotransmitter levels and cerebral temperature were investigated. Our results showed that the current density inside the brain was less than 20 A/m2 during tDCS treatment in computational model. tDCS did not affect motor functions and learning and memory ability after tDCS treatment. In addition, no significant differences were found for the tDCS group in hematology, serum biochemical markers or the morphology of major organs. Moreover, tDCS treatment had no effect on the brain morphology, neural structures, neurotransmitter levels or cerebral temperature. 500 μA cathodal tDCS as performed in the present study was safe for rodents.
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Transcranial direct current stimulation (tDCS) is a non-invasive neuromodulation technique proposed as an alternative or complementary treatment for several neuropsychiatric diseases. The biological effects of tDCS are not fully understood, which is in part explained due to the difficulty in obtaining human brain tissue. This protocol describes a tDCS mouse model that uses a chronically implanted electrode allowing the study of the long-lasting biological effects of tDCS. In this experimental model, tDCS changes the cortical gene expression and offers a prominent contribution to the understanding of the rationale for its therapeutic use.
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We investigated the effect of anodal transcranial direct current stimulation (tDCS) over the right dorsolateral prefrontal cortex (rDLPFC) on the sensitive decision making of female team sports referees. Twenty-four female referees voluntarily participated in this randomized, double-blind, crossover, and sham-controlled study. In three different sessions, participants received either anodal (a-tDCS; anode (+) over F4, cathode (-) over the supraorbital region (SO)), cathodal (c-tDCS; -F4/+SO), or sham tDCS (sh-tDCS) in a randomized and counterbalanced order. a-tDCS and c-tDCS were applied with 2 mA for 20 min. In sh-tDCS, the current was turned off after 30 s. Before and after tDCS, participants performed the computerized Iowa Gambling Task (IGT) and Go/No Go impulsivity (IMP) tests. Only a-tDCS improved IGT and IMP scores from pre to post. The delta (Δ = post-pre) analysis showed a significantly higher ΔIGT in a-tDCS compared to c-tDCS (p = 0.02). The ΔIMP was also significantly higher in a-tDCS compared to sh-tDCS (p = 0.01). Finally, the reaction time decreased significantly more in a-tDCS (p = 0.02) and sh-tDCS (p = 0.03) than in c-tDCS. The results suggest that the a-tDCS improved factors related to sensitive decision making in female team sports referees. a-tDCS might be used as an ergogenic aid to enhance decision performance in female team sports referees.
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Background : Endogenous analgesic systems in the brain modulate pain perception. Offset analgesia (OA) describes the large decrease in perceived pain in response to a minor decrease in applied painful thermal stimulus. Here non-invasive brain stimulation (NIBS) of the cerebellum is used to probe OA. Methods : An OA protocol individualized to heat pain threshold (HPT) was applied via TSA-II (Medoc, Israel). Heat was ramped to HPT, with a transient temperature increase of HPT+1°C. NIBS interventions were applied prior to OA in 46 participants within a sham controlled repeated measures design. Cathodal cerebellar transcranial direct current stimulation (tDCS) and high-definition (4X1) transcranial direct current stimulation (HD-tDCS) were applied in separate experimental sessions to examine whether diffuse (tDCS) or focal (HD-tDCS) stimulation differentially modulates OA. Results : OA induced hypoanalgesia was robust, with 90% of responses showing a substantial drop in perceived pain (δVAS) following the 1°C fall in temperature, with an average VAS decrease of 38 in response to the 1°C fall in temperature. Cathodal cerebellar HD-tDCS enhances the analgesic impact of OA on four OA parameters (OA latency, VAS minimum, VAS mean and VAS 2nd max) relative to pre-stimulation. Conventional tDCS modulates two OA metrics relative to pre-stimulation (OA duration, VAS 2nd max) with an increase in OA duration following sham tDCS. Conclusion : There is a differential influence of conventional and high-definition cerebellar NIBS on OA. This is suggestive of cerebellar modulation of OA and highlights the importance of electrode montage in delineating the influence of the cerebellum in pain processing.
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