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  1. Article ; Online: Technique and considerations in the use of 4x1 ring high-definition transcranial direct current stimulation (HD-tDCS).

    Villamar, Mauricio F / Volz, Magdalena Sarah / Bikson, Marom / Datta, Abhishek / Dasilva, Alexandre F / Fregni, Felipe

    Journal of visualized experiments : JoVE

    2013  , Issue 77, Page(s) e50309

    Abstract: High-definition transcranial direct current stimulation (HD-tDCS) has recently been developed as a noninvasive brain stimulation approach that increases the accuracy of current delivery to the brain by using arrays of smaller "high-definition" electrodes, ...

    Abstract High-definition transcranial direct current stimulation (HD-tDCS) has recently been developed as a noninvasive brain stimulation approach that increases the accuracy of current delivery to the brain by using arrays of smaller "high-definition" electrodes, instead of the larger pad-electrodes of conventional tDCS. Targeting is achieved by energizing electrodes placed in predetermined configurations. One of these is the 4x1-ring configuration. In this approach, a center ring electrode (anode or cathode) overlying the target cortical region is surrounded by four return electrodes, which help circumscribe the area of stimulation. Delivery of 4x1-ring HD-tDCS is capable of inducing significant neurophysiological and clinical effects in both healthy subjects and patients. Furthermore, its tolerability is supported by studies using intensities as high as 2.0 milliamperes for up to twenty minutes. Even though 4x1 HD-tDCS is simple to perform, correct electrode positioning is important in order to accurately stimulate target cortical regions and exert its neuromodulatory effects. The use of electrodes and hardware that have specifically been tested for HD-tDCS is critical for safety and tolerability. Given that most published studies on 4x1 HD-tDCS have targeted the primary motor cortex (M1), particularly for pain-related outcomes, the purpose of this article is to systematically describe its use for M1 stimulation, as well as the considerations to be taken for safe and effective stimulation. However, the methods outlined here can be adapted for other HD-tDCS configurations and cortical targets.
    MeSH term(s) Electric Stimulation/instrumentation ; Electric Stimulation/methods ; Electric Stimulation Therapy/instrumentation ; Electric Stimulation Therapy/methods ; Electrodes ; Humans ; Motor Cortex/physiology
    Language English
    Publishing date 2013-07-14
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Video-Audio Media
    ZDB-ID 2259946-0
    ISSN 1940-087X ; 1940-087X
    ISSN (online) 1940-087X
    ISSN 1940-087X
    DOI 10.3791/50309
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Immediate effects of tDCS on the μ-opioid system of a chronic pain patient.

    DosSantos, Marcos Fabio / Love, Tiffany M / Martikainen, Ilkka Kristian / Nascimento, Thiago Dias / Fregni, Felipe / Cummiford, Chelsea / Deboer, Misty Dawn / Zubieta, Jon-Kar / Dasilva, Alexandre F M

    Frontiers in psychiatry

    2012  Volume 3, Page(s) 93

    Abstract: We developed a unique protocol where transcranial direct current stimulation (tDCS) of the motor cortex is performed during positron emission tomography (PET) scan using a μ-opioid receptor (μOR) selective radiotracer, [(11)C]carfentanil. This is one of ... ...

    Abstract We developed a unique protocol where transcranial direct current stimulation (tDCS) of the motor cortex is performed during positron emission tomography (PET) scan using a μ-opioid receptor (μOR) selective radiotracer, [(11)C]carfentanil. This is one of the most important central neuromechanisms associated with pain perception and regulation. We measured μOR non-displaceable binding potential (μOR BP(ND)) in a trigeminal neuropathic pain patient (TNP) without creating artifacts, or posing risks to the patient (e.g., monitoring of resistance). The active session directly improved in 36.2% the threshold for experimental cold pain in the trigeminal allodynic area, mandibular branch, but not the TNP patient's clinical pain. Interestingly, the single active tDCS application considerably decreased μORBP(ND) levels in (sub)cortical pain-matrix structures compared to sham tDCS, especially in the posterior thalamus. Suggesting that the μ-opioidergic effects of a single tDCS session are subclinical at immediate level, and repetitive sessions are necessary to revert ingrained neuroplastic changes related to the chronic pain. To our knowledge, we provide data for the first time in vivo that there is possibly an instant increase of endogenous μ-opioid release during acute motor cortex neuromodulation with tDCS.
    Language English
    Publishing date 2012-11-02
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2564218-2
    ISSN 1664-0640 ; 1664-0640
    ISSN (online) 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2012.00093
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: tDCS-induced analgesia and electrical fields in pain-related neural networks in chronic migraine.

    Dasilva, Alexandre F / Mendonca, Mariana E / Zaghi, Soroush / Lopes, Mariana / Dossantos, Marcos Fabio / Spierings, Egilius L / Bajwa, Zahid / Datta, Abhishek / Bikson, Marom / Fregni, Felipe

    Headache

    2012  Volume 52, Issue 8, Page(s) 1283–1295

    Abstract: Objective: We investigated in a sham-controlled trial the analgesic effects of a 4-week treatment of transcranial direct current stimulation (tDCS) over the primary motor cortex in chronic migraine. In addition, using a high-resolution tDCS ... ...

    Abstract Objective: We investigated in a sham-controlled trial the analgesic effects of a 4-week treatment of transcranial direct current stimulation (tDCS) over the primary motor cortex in chronic migraine. In addition, using a high-resolution tDCS computational model, we analyzed the current flow (electric field) through brain regions associated with pain perception and modulation.
    Methods: Thirteen patients with chronic migraine were randomized to receive 10 sessions of active or sham tDCS for 20 minutes with 2 mA over 4 weeks. Data were collected during baseline, treatment and follow-up. For the tDCS computational analysis, we adapted a high-resolution individualized model incorporating accurate segmentation of cortical and subcortical structures of interest.
    Results: There was a significant interaction term (time vs group) for the main outcome (pain intensity) and for the length of migraine episodes (ANOVA, P < .05 for both analyses). Post-hoc analysis showed a significant improvement in the follow-up period for the active tDCS group only. Our computational modeling studies predicted electric current flow in multiple cortical and subcortical regions associated with migraine pathophysiology. Significant electric fields were generated, not only in targeted cortical regions but also in the insula, cingulate cortex, thalamus, and brainstem regions.
    Conclusions: Our findings give preliminary evidence that patients with chronic migraine have a positive, but delayed, response to anodal tDCS of the primary motor cortex. These effects may be related to electrical currents induced in pain-related cortical and subcortical regions.
    MeSH term(s) Adolescent ; Adult ; Analgesia/methods ; Electric Stimulation Therapy/methods ; Female ; Humans ; Male ; Middle Aged ; Migraine Disorders/physiopathology ; Migraine Disorders/therapy ; Motor Cortex/physiopathology ; Nerve Net/physiopathology ; Pain/physiopathology ; Pain Management ; Pain Measurement ; Pain Perception/physiology ; Single-Blind Method ; Treatment Outcome
    Language English
    Publishing date 2012-04-18
    Publishing country United States
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 410130-3
    ISSN 1526-4610 ; 0017-8748
    ISSN (online) 1526-4610
    ISSN 0017-8748
    DOI 10.1111/j.1526-4610.2012.02141.x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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