Transcranial Direct Current Stimulation (tDCS) Can Alter Cortical Excitability of the Lower Extremity in Healthy Participants: A Review and Methodological Study

Overview

Journal Front Neurol Neurosci Res

Date 2020 Dec 4

PMID 33274350

Authors

John Tyler Floyd

Chad Lairamore

Mark Kevin Garrision

Adam J Woods

Jacqueline L Rainey

Thomas Kiser

Prasad R Padala

Mark Mennemeier

Affiliations

Soon will be listed here.

Abstract

Objective: Transcranial direct current stimulation (tDCS) has been used to alter cortical excitability of the lower extremity (LE) and to influence performance on LE tasks like ankle tracking accuracy; but no study, to our knowledge, ever reported a significant change in cortical excitability relative to sham-tDCS. Additionally, because several different electrode montages were used in previous studies, it is difficult to know how stimulation should be applied to achieve this effect. Our objective was to determine whether active-tDCS alters cortical excitability of the LE and ankle tracking accuracy relative to sham-tDCS in healthy participants. The efficacy of two electrode montages and two conductance mediums were compared.

Methods: A triple-blind, fully randomized, within-subjects study was conducted with healthy participants (N=18, 24.2 (6.6) years). Cortical recruitment curves and measures of ankle tracking accuracy for the dominant lower extremity were obtained before and after participants received active-tDCS at 2 milliamps for 20 minutes using montage-medium combinations of M-SO:Saline, M-SO:Gel, C1-C2:Saline, and C1-C2:Gel and a sham-tDCS condition (M1-SO: Saline).

Results: The motor evoked potential maximum of the recruitment curve was significantly lower for active than sham-tDCS, but only for the M-SO:Saline combination. No other significant differences in the recruitment curve parameters or in ankle tracking were found.

Conclusions: This is the first study to our knowledge to demonstrate a significant difference in cortical excitability of the LE between active and sham-tDCS conditions. Given the order in which the experimental procedures occurred, the result is consistent with the concept of a homeostatic plasticity response.

References

Batsikadze G, Moliadze V, Paulus W, Kuo M, Nitsche M . Partially non-linear stimulation intensity-dependent effects of direct current stimulation on motor cortex excitability in humans. J Physiol. 2013; 591(7):1987-2000. PMC: 3624864. DOI: 10.1113/jphysiol.2012.249730. View

Karabanov A, Ziemann U, Hamada M, George M, Quartarone A, Classen J . Consensus Paper: Probing Homeostatic Plasticity of Human Cortex With Non-invasive Transcranial Brain Stimulation. Brain Stimul. 2015; 8(3):442-54. DOI: 10.1016/j.brs.2015.01.404. View

Lang N, Siebner H, Ernst D, Nitsche M, Paulus W, Lemon R . Preconditioning with transcranial direct current stimulation sensitizes the motor cortex to rapid-rate transcranial magnetic stimulation and controls the direction of after-effects. Biol Psychiatry. 2004; 56(9):634-9. DOI: 10.1016/j.biopsych.2004.07.017. View

Nitsche M, Paulus W . Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000; 527 Pt 3:633-9. PMC: 2270099. DOI: 10.1111/j.1469-7793.2000.t01-1-00633.x. View

Tahtis V, Kaski D, Seemungal B . The effect of single session bi-cephalic transcranial direct current stimulation on gait performance in sub-acute stroke: A pilot study. Restor Neurol Neurosci. 2014; 32(4):527-32. DOI: 10.3233/RNN-140393. View

Roche N, Lackmy A, Achache V, Bussel B, Katz R . Effects of anodal transcranial direct current stimulation over the leg motor area on lumbar spinal network excitability in healthy subjects. J Physiol. 2011; 589(Pt 11):2813-26. PMC: 3112557. DOI: 10.1113/jphysiol.2011.205161. View

Yamaguchi T, Fujiwara T, Tsai Y, Tang S, Kawakami M, Mizuno K . The effects of anodal transcranial direct current stimulation and patterned electrical stimulation on spinal inhibitory interneurons and motor function in patients with spinal cord injury. Exp Brain Res. 2016; 234(6):1469-78. PMC: 4851690. DOI: 10.1007/s00221-016-4561-4. View

Nonnekes J, Arrogi A, Munneke M, van Asseldonk E, Oude Nijhuis L, Geurts A . Subcortical structures in humans can be facilitated by transcranial direct current stimulation. PLoS One. 2014; 9(9):e107731. PMC: 4169471. DOI: 10.1371/journal.pone.0107731. View

Dutta A, Chugh S, Banerjee A, Dutta A . Point-of-care-testing of standing posture with Wii balance board and Microsoft Kinect during transcranial direct current stimulation: a feasibility study. NeuroRehabilitation. 2014; 34(4):789-98. DOI: 10.3233/NRE-141077. View

10.

Kaski D, Quadir S, Patel M, Yousif N, Bronstein A . Enhanced locomotor adaptation aftereffect in the "broken escalator" phenomenon using anodal tDCS. J Neurophysiol. 2012; 107(9):2493-505. PMC: 3362242. DOI: 10.1152/jn.00223.2011. View

11.

Dutta A, Paulus W, Nitsche M . Facilitating myoelectric-control with transcranial direct current stimulation: a preliminary study in healthy humans. J Neuroeng Rehabil. 2014; 11:13. PMC: 3931480. DOI: 10.1186/1743-0003-11-13. View

12.

Sohn M, Jee S, Kim Y . Effect of transcranial direct current stimulation on postural stability and lower extremity strength in hemiplegic stroke patients. Ann Rehabil Med. 2014; 37(6):759-65. PMC: 3895515. DOI: 10.5535/arm.2013.37.6.759. View

13.

Bastani A, Jaberzadeh S . Does anodal transcranial direct current stimulation enhance excitability of the motor cortex and motor function in healthy individuals and subjects with stroke: a systematic review and meta-analysis. Clin Neurophysiol. 2011; 123(4):644-57. DOI: 10.1016/j.clinph.2011.08.029. View

14.

Craig C, Doumas M . Anodal Transcranial Direct Current Stimulation Shows Minimal, Measure-Specific Effects on Dynamic Postural Control in Young and Older Adults: A Double Blind, Sham-Controlled Study. PLoS One. 2017; 12(1):e0170331. PMC: 5242524. DOI: 10.1371/journal.pone.0170331. View

15.

Bienenstock E, Cooper L, Munro P . Theory for the development of neuron selectivity: orientation specificity and binocular interaction in visual cortex. J Neurosci. 1982; 2(1):32-48. PMC: 6564292. View

16.

von Papen M, Fisse M, Sarfeld A, Fink G, Nowak D . The effects of 1 Hz rTMS preconditioned by tDCS on gait kinematics in Parkinson's disease. J Neural Transm (Vienna). 2014; 121(7):743-54. DOI: 10.1007/s00702-014-1178-2. View

17.

Devanathan D, Madhavan S . Effects of anodal tDCS of the lower limb M1 on ankle reaction time in young adults. Exp Brain Res. 2015; 234(2):377-85. PMC: 5015891. DOI: 10.1007/s00221-015-4470-y. View

18.

Madhavan S, Stinear J . Focal and bi-directional modulation of lower limb motor cortex using anodal transcranial direct current stimulation. Brain Stimul. 2010; 3(1):42. PMC: 2818023. DOI: 10.1016/j.brs.2009.06.005. View

19.

Angius L, Pageaux B, Hopker J, Marcora S, Mauger A . Transcranial direct current stimulation improves isometric time to exhaustion of the knee extensors. Neuroscience. 2016; 339:363-375. DOI: 10.1016/j.neuroscience.2016.10.028. View

20.

Vitor-Costa M, Okuno N, Bortolotti H, Bertollo M, Boggio P, Fregni F . Improving Cycling Performance: Transcranial Direct Current Stimulation Increases Time to Exhaustion in Cycling. PLoS One. 2015; 10(12):e0144916. PMC: 4687680. DOI: 10.1371/journal.pone.0144916. View