Electric field and current density distribution in an anatomical head model during transcranial direct current stimulation for tinnitus treatment

Tinnitus is considered an auditory phantom percept. Recently, transcranial direct current stimulation (tDCS) has been proposed as a new approach for tinnitus treatment including, as potential targets of interest, either the temporal and temporoparietal cortex or prefrontal areas. This study investigates and compares the spatial distribution of the magnitude of the electric field and the current density in the brain tissues during tDCS of different brain targets. A numerical method was applied on a realistic human head model to calculate these field distributions in different brain structures, such as the cortex, white matter, cerebellum, hippocampus, medulla oblongata, pons, midbrain, thalamus, and hypothalamus. Moreover, the same distributions were evaluated along the auditory pathways. Results of this study show that tDCS of the left temporoparietal cortex resulted in a widespread diffuse distribution of the magnitude of the electric fields (and also of the current density) on an area of the cortex larger than the target brain region. On the contrary, tDCS of the dorsolateral prefrontal cortex resulted in a stimulation mainly concentrated on the target itself. Differences in the magnitude distribution were also found on the structures along the auditory pathways. A sensitivity analysis was also performed, varying the electrode position and the human head models. Accurate estimation of the field distribution during tDCS in different regions of the head could be valuable to better determine and predict efficacy of tDCS for tinnitus suppression.     

经颅磁刺激和经颅直流电刺激在调控大脑共情功能中的应用

共情可以帮助人们建立和谐的人际关系，更好地适应现实社会，是一种重要的社会认知功能。已有研究表明，诸多神经和精神类疾病的发生发展和复发与共情缺陷有关。非侵入性脑刺激技术（经颅磁刺激和经颅直流电刺激）可以通过调节大脑皮层兴奋性来调控个体的共情水平，缓解共情缺陷症状。针对健康群体使用该技术的现有证据显示：内侧前额叶、初级运动皮层、额下回、背外侧前额叶和颞顶交界处的活动有助于提升个体的认知共情水平，其中双侧背外侧前额叶的活动还有助于下调个体的情感共情水平，而右侧颞顶交界处的活动则可以增强自我表征从而支持个体在共情时进行自我和他人的区分。少数针对共情缺陷群体使用该技术的临床证据提示，增强左侧背外侧前额叶和内侧前额叶的活动可以分别提升精神疾病和神经退行性疾病患者的认知共情水平。未来的研究应探讨在统一的行为测量范式下针对不同刺激参数和刺激位点进行共情干预研究，通过融合其他神经生理技术进一步考察非侵入性脑刺激技术改善共情功能的作用机制，并考虑个体差异性对大脑共情功能干预效果的影响。     

经颅直流电刺激联合益生菌对脑卒中后认知功能障碍患者的作用

探讨经颅直流电刺激（tDCS）联合益生菌对脑卒中后认知功能障碍（PSCI）患者认知功能和肠道菌群的影响。

按随机数字表法将2020年6月至2021年6月我院收治的150例PSCI患者分为对照组和观察组,各75例。对照组患者给予tDCS治疗,观察组患者给予tDCS联合益生菌治疗。采用蒙特利尔认知功能评估量表（MoCA）和简易智力状态检查量表（MMSE）评估患者治疗前后的认知功能。采用荧光定量PCR法检测患者治疗前后肠道菌群数量变化。比较两组患者认知功能、肠道菌群、临床疗效以及不良反应发生情况。

治疗后,观察组患者肠道双歧杆菌和乳杆菌数量较治疗前显著升高,且双歧杆菌和乳杆菌数量显著高于对照组;而大肠埃希菌和肠球菌数量较治疗前显著降低,且大肠埃希菌和肠球菌数量显著低于对照组（均P＜0.05）。治疗后,两组患者MoCA和MMSE评分均升高,且观察组高于对照组（均P＜0.05）。观察组患者临床总有效率显著高于对照组（90.67% vs 78.67%,χ² = 12.482,P＜0.001）。对照组和观察组患者的不良反应发生情况比较差异无统计学意义（χ² = 0.150,P = 0.699）。

tDCS联合益生菌治疗能够有效改善PSCI患者的认知功能和肠道菌群状态,且不良反应少,安全系数高,值得临床推广。

     

经颅电刺激对睡眠剥夺后双侧后扣带回皮质功能连接紊乱干预作用的初步研究

目的:探讨经颅电刺激对睡眠剥夺后双侧后扣带回皮质功能连接紊乱的干预作用。方法:研究采用自身前后对照的试验设计。16名受试者均接受2次24 h睡眠剥夺,2次睡眠剥夺间隔3周,受试者分别于第1次正常睡眠后、24 h睡眠剥夺后、经颅电刺激(真或假刺激)干预后(真、假刺激电流大小均为1 mA,电流作用时间分别为20 min、2 s,干预实验均持续20 min)及第2次经颅电刺激(假或真刺激)干预后采集静息态磁共振成像数据。以睡眠剥夺前收集静息态功能磁共振数据作为基线,选取双侧后扣带回皮质作为种子点进行全脑功能连接分析,观察睡眠剥夺前后及经颅电刺激真、假刺激后大脑的功能连接变化。结果:与正常睡眠后相比,24 h睡眠剥夺后双侧后扣带回皮质与双侧丘脑间的功能连接上升(P<0.01),与右侧楔前叶、海马旁回以及双侧岛叶间的功能下降(P<0.01)。与假刺激相比,给予真刺激后左侧后扣带回皮质与右侧楔前叶功能连接上升(P<0.01);与双侧丘脑、岛叶及右侧大脑皮质功能连接下降(P<0.01)。右侧后扣带回皮质与全脑的功能连接在双侧丘脑、右侧岛叶及大脑皮层间也存在下降(P<0....     

Noninvasive brain stimulation with transcranial magnetic or direct current stimulation (TMS/tDCS)—From insights into human memory to therapy of its dysfunction

Noninvasive stimulation of the brain by means of transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) has driven important discoveries in the field of human memory functions. Stand-alone or in combination with other brain mapping techniques noninvasive brain stimulation can assess issues such as location and timing of brain activity, connectivity and plasticity of neural circuits and functional relevance of a circumscribed brain area to a given cognitive task. In this emerging field, major advances in technology have been made in a relatively short period. New stimulation protocols and, especially, the progress in the application of tDCS have made it possible to obtain longer and much clearer inhibitory or facilitatory effects even after the stimulation has ceased. In this introductory review, we outline the basic principles, discuss technical limitations and describe how noninvasive brain stimulation can be used to study human memory functions in vivo. Though improvement of cognitive functions through noninvasive brain stimulation is promising, it still remains an exciting challenge to extend the use of TMS and tDCS from research tools in neuroscience to the treatment of neurological and psychiatric patients.     

Frequency‐dependent and montage‐based differences in phosphene perception thresholds via transcranial alternating current stimulation

It is well known that applying transcranial alternating current stimulation (tACS) to the scalp can generate artefactual visual perceptions of flashing or shimmering light known as phosphenes. The thresholds for generating these phosphenes have been used by international standards bodies to provide conservative estimates of the field strength required to interfere with human neural functioning and set safety limits accordingly. However, the precise relationship between electric currents and phosphene perception thresholds remains uncertain. The present study used tACS to systematically investigate the effects of the location and the frequency of stimulation on phosphene perception thresholds. These thresholds were obtained from 24 participants using a within‐subject design as a function of scalp stimulation sites (FPz‐Cz versus Oz‐Cz) and stimulation frequency (2–30 Hz in steps of 2 Hz). Phosphene perception thresholds were consistently lower for FPz‐Cz stimulation, and regardless of tACS location were lowest for 16 Hz stimulation. Threshold variation between participants was very small, which is meaningful when setting standards based on phosphenes. Bioelectromagnetics. 2019;40:365–374. © 2019 Bioelectromagnetics Society.     

Modulation of human visuospatial attention analysis by transcranial direct current stimulation (tDCS) in the line bisection performance

The general population shows physiologic biases in the line bisection performance for visuospatial attention, almost to the left known as pseudoneglect. Previous studies have shown that tDCS affects visuospatial attention in line bisection. This research applies tDCS over left posterior parietal cortice (P3) or right posterior parietal cortice (P4) to explore the effect on pseudoneglect. Subjects randomly were divided into five groups by stimulation distribution: (i) P3-anodal (P3A), (ii) P3-cathodal (P3C), (iii) P4-anodal (P4A), (iv) P4-cathodal (P4C), (v) sham. Participants respectively finished the post-tDCS line-bisection assignment (lines on the left/right side of the monitor (LL/LR), and lines in the center of the monitor (LC)) the same as the pre-tDCS task over the session (P3A, P3C, P4A, P4C and sham) tDCS condition. The principal findings were that P3A tDCS reduced the leftward shift in the horizontal line bisection task, as well as P4C tDCS reduced the leftward shift in LL. Sham stimulation as well as P3C and P4A stimulation didn’t have systematic improvements in the line bisection tasks. Therefore, an activation–orientation model of pseudoneglect is corroborated by these findings. Activation of intact structures in the rebalance of left and right parietal cortex might impose modulating effects on tDCS.     

Effects of transcranial magnetic stimulation on oxidative stress in experimental autoimmune encephalomyelitis

Experimental autoimmune encephalomyelitis (EAE) reproduces a multiple sclerosis (MS)-like experimental model. The main objective was to evaluate the effect of extremely low-frequency electromagnetic fields (EL-EMF) application, like a paradigm of transcranial magnetic stimulation (TMS) in the development of EAE. Rats were injected with a single dose of 150?μg of myelin oligodendrocyte glycoprotein (MOG, fragment 35–55) to produce experimental MS. To assess the effect of TMS application in EAE, the rats were treated with TMS (60?Hz and 0.7?mT) for 2?h in the morning, once a day, 5 days a week, during 3 weeks. TMS was applied to the head. The effect of TMS on EAE was evaluated as motor symptoms and, oxidative and cell damage. The data showed that MOG induced motor symptoms as tail paralysis and limb paresis/paralysis, oxidative stress and cell death similar to MS when compared with control animals. Importantly, TMS application attenuated motor symptoms, oxidative and cell damage, whereas it increased antioxidant system. Our findings suggest that: (i) MOG reproduces an experimental model of MS characterised by oxidative and cell damage; and (ii) TMS application decreases oxidative stress and cell death induced by MOG.     

Combined effects of direct current stimulation and immobilized BMP‐2 for enhancement of osteogenesis

Direct current (DC) stimulation has been used to promote bone repair and osteogenesis, but problems associated with the implanted metal electrodes may limit its application and compromise the therapeutic results. The replacement of the metal electrodes with a biodegradable conductive polymer film can potentially overcome these problems. In our work, polypyrrole/chitosan films comprising polypyrrole nanoparticles dispersed in a chitosan matrix were prepared. The polypyrrole/chitosan film meets the requirements for DC delivery, as indicated by its electrical conductivity, biodegradability, and mechanical properties. The film supports osteoblast growth to the same degree as dentine discs (a bone‐like mineralized substrate), confirming that it is non‐cytotoxic. Our results showed that optimal DC stimulation was achieved with 200 µA for 4 h per day, and under this condition, osteoblast metabolic activity on Day 7 increased by 1.8‐fold over that without DC stimulation. To further improve osteogenesis on the polypyrrole/chitosan film, bone morphogenetic protein‐2 (BMP‐2) was covalently immobilized on the film surface. Osteoblasts cultured on the BMP‐2‐functionalized polypyrrole/chitosan film and subjected to the optimal DC stimulation exhibited a significant increase in cellular metabolic activity (2.3‐fold on Day 7), ALP activity (1.7‐fold on Day 21) and mineralization (twofold on Day 21) over those cultured on polypyrrole/chitosan film without DC stimulation. Osteogenic gene expression results showed that BMP‐2 and DC stimulation by itself enhanced osteoblast differentiation, and a combination of these two factors resulted in synergistic effects on osteoblast differentiation and maturation. Biotechnol. Bioeng. 2013; 110: 1466–1475. © 2012 Wiley Periodicals, Inc.     

经颅电刺激镇痛研究的现状及展望

经颅电刺激技术是一种非侵入性神经调控方法,因其具有卓越的安全性、良好的患者依从性以及高度便携性等特点,被视为一种潜在的非药物镇痛手段。然而,目前对于经颅电刺激镇痛效果的研究结果不一致且镇痛机制尚未完全阐明。本文通过系统归纳总结3种主要的经颅电刺激技术——经颅直流电刺激、经颅交流电刺激和经颅随机噪声刺激——在镇痛领域的研究进展,评估了这些技术对短时、急性和慢性疼痛的镇痛效果,并深入剖析了其潜在的镇痛机制。同时,本文系统讨论了既往研究的局限性,并对未来研究提出了一系列切实可行的建议,如借助电场模拟技术实现个性化刺激以克服不同个体头部解剖结构差异的影响、应用多位点刺激和深部脑刺激技术来拓展刺激脑区、搭建经颅电刺激技术同步神经影像平台以制定个体特异性的刺激方案并深入揭示其镇痛机制、探索与其他治疗技术的联合应用以提高疗效等。这些建议的实施将有助于解决当前研究中存在的问题,充分发挥经颅电刺激在疼痛治疗中的临床价值,最终实现患者疼痛的缓解。     

Noninvasive brain stimulation with transcranial magnetic or direct current stimulation (TMS/tDCS)-From insights into human memory to therapy of its dysfunction

Noninvasive stimulation of the brain by means of transcranial magnetic stimulation (TMS) or transcranial direct current stimulation (tDCS) has driven important discoveries in the field of human memory functions. Stand-alone or in combination with other brain mapping techniques noninvasive brain stimulation can assess issues such as location and timing of brain activity, connectivity and plasticity of neural circuits and functional relevance of a circumscribed brain area to a given cognitive task. In this emerging field, major advances in technology have been made in a relatively short period. New stimulation protocols and, especially, the progress in the application of tDCS have made it possible to obtain longer and much clearer inhibitory or facilitatory effects even after the stimulation has ceased. In this introductory review, we outline the basic principles, discuss technical limitations and describe how noninvasive brain stimulation can be used to study human memory functions in vivo. Though improvement of cognitive functions through noninvasive brain stimulation is promising, it still remains an exciting challenge to extend the use of TMS and tDCS from research tools in neuroscience to the treatment of neurological and psychiatric patients.     

重复经颅磁刺激联合低剂量氟西汀对CUMS抑郁小鼠的影响*

目的:探讨重复经颅磁刺激(rTMS)联合低剂量氟西汀对慢性不可预知轻度压力(CUMS)抑郁小鼠的影响及其交互作用。方法:取42只雄性BALB/c小鼠随机分为正常对照组(Control,7只)和抑郁症模型组(Model,35只),Model组小鼠给予限制塑料管内、鼠笼倾斜、不筑巢、拥挤环境、明暗颠倒、白噪声等6种刺激,每种刺激随机且不同时出现2次,共刺激4周建立CUMS模型。随后35只Model组鼠随机分为CUMS组(8只)、氟西汀组(Fluoxetine,9只)、rTMS组(9只)和rTMS+Fluoxetine组(9只)。Fluoxetine组给予腹腔注射氟西汀5 mg/(kg·d),rTMS组给予10 Hz频率刺激,rTMS+Fluoxetine组给予腹腔注射氟西汀5 mg/(kg·d)和10 Hz频率刺激,Control和CUMS模型组给予相同体积生理盐水腹腔注射和伪刺激,各组均连续干预4周,随后进行行为学实验,最后运用析因设计方差分析方法分析Fluoxetine与rTMS的交互作用。结果:与Control组比,CUMS组小鼠强迫游泳实验中不动时间显著升高(P＜0.05),蔗糖实验中糖喜好程度、旷场实验中心运动次数和体重变化率均显著下降(P＜0.05)。与CUMS组比,rTMS组、Fluoxetine组和rTMS+Fluoxetine组抑郁症小鼠强迫游泳实验中不动时间显著降低(P＜0.01)、蔗糖实验中糖喜好程度和旷场实验中心运动次数显著升高(P＜0.05),其中rTMS+Fluoxetine组联合应用效果更显著(P＜0.05),但体重变化率仅rTMS+Fluoxetine组有变化(P＜0.05)。结论:重复经颅磁刺激和/或氟西汀均能不同程度的改善CUMS小鼠抑郁状态,其中联合应用的干预作用优于单独使用氟西汀或rTMS的效果,且有交互作用。     

Effects of direct electric current on Herpetomonas samuelpessoai: An ultrastructural study

The literature shows that the effects of direct electric currents on biological material are numerous, including bactericidal, fungicidal, parasiticidal, and anti‐tumoral, among others. Non‐pathogenic trypanosomatids, such as Herpetomonas samuelpessoai, have emerged as important models for the study of basic biological processes performed by a eukaryotic cell. The present study reports a dose‐dependent anti‐protozoan effect of direct electric treatment with both cathodic and anodic current flows on H. samuelpessoai cells. The damaging effects can be attributable to the electrolysis products generated during electric stimulation. The pH of the cell suspension was progressively augmented from 7.4 to 10.5 after the cathodic treatment. In contrast, the anodic treatment caused a pH decrease varying from 7.4 to 6.5. Transmission electron microscopy analyses revealed profound alterations in vital cellular structures (e.g., mitochondrion, kinetoplast, flagellum, flagellar pocket, nucleus, and plasma membrane) after exposure to both cathodic and anodic current flows. Specifically, cathodic current flow treatment induced the appearance of autophagic‐like structures on parasite cells, while those submitted to an anodic current flow presented marked disorganization of plasma membrane and necrotic appearance. However, parasites treated in the intermediary chamber (without contact with the electrodes) did not present significant changes in viability or morphology, and no pH variation was detected in this system. The use of H. samuelpessoai as a biological model and the direct electric current experimental approach used in our study provide important information for understanding the mechanisms involved in the cytotoxic effects of this physical agent. Bioelectromagnetics 33:334–345, 2012. © 2011 Wiley Periodicals, Inc.     

The diagnostic value of miRNA-141 in prostate cancer: a systematic review and meta-analysis

MiR-141 has gradually demonstrated its value in the diagnosis of prostate cancer. However, the diagnostic parameters applied in previous studies were different. This systematic review was conducted to explore the diagnostic value of miR-141 in prostate cancer. A comprehensive search of related literature in PubMed, Medline, the Cochrane Library and Embase databases was performed. Seven studies were included which assessed the diagnostic value of miR-141 in patients with prostate cancer up to October 31, 2019. Meta-disc version 1.4 and STATA software version 12.0 were used to analyze the data. The pooled sensitivity and specificity were 0.70 (95% CI 0.64~0.75) and 0.73 (95% CI 0.64~0.80), respectively. The positive likelihood ratio (PLR) was 2.88 (95% CI 1.40~5.93), and negative likelihood ratio (NLR) was 0.38 (95% CI 0.20~0.71). The pooled diagnostic odds ratio (DOR) of miR-141 for prostate cancer was observed to be 9.94 (95% CI: 2.55~38.80). The summary area under the receiver operating characteristic (ROC) curve was 0.83 (95% CI: 0.79~0.86). The results of meta-regression suggested that heterogeneity was mainly derived from patient age. The Fagan nomogram results showed a significant increase when correlating miR-141 with the diagnosis of prostate cancer. This meta-analysis suggests that miR-141 has a high diagnostic value for prostate cancer. In future, large-scale prospective studies will be done to verify and evaluate this result.     

Circulating visfatin levels and cancers risk: A systematic review and meta-analysis

Visfatin levels have been reported to be abnormal in many types of cancers. However, epidemiological studies yielded inconsistent results. Therefore, a meta-analysis was performed to assess the association between circulating visfatin levels and cancer risk. A systematic search was conducted for relevant studies in health-related electronic databases up to March 2018. Data related to standard mean difference (SMD) and overall odds ratio (ORS) were collected and analyzed. Summary SMD and pooled OR with 95% CIs were calculated using a random-effect model. Funnel plot and Egger's linear regression test were conducted to examine the risk of publication bias. A total of 27 studies with 2,693 cases and 3,040 healthy controls were included in meta-analysis for pooling SMD analysis. The results of the meta-analysis showed a significant higher visfatin levels in patients with various cancers than in controls, with a pooled SMD of 0.88, 95% CI = 0.56–1.20, p = 0.000. In subgroup, metaregression, Galbraith plot, and sensitivity analysis showed no substantial difference among all the analyzed factors. Data from 14 studies were also used for pooling ORs analysis. Metaresults revealed that high visfatin levels were associated with cancer risk (OR = 1.24, 95% CI: 1.14–1.34, p = 0.000). No evidence of publication bias was observed for pooling ORs and SMD analysis. This meta-analysis indicated a significant association between high circulating visfatin levels and increased risk of various cancers. Visfatin may represent a potential biomarker for early detection of cancers who may benefit from preventive treatment.Note.     

跨颅电刺激对大鼠抑郁症的治疗作用

目的：探讨跨颅电刺激对大鼠抑郁症的治疗作用。方法：跨颅电刺激抑郁症大鼠左侧前额叶皮层,敞箱实验测定大鼠行为学变化,荧光法测定单胺类递质含量的变化。结果：跨颅直流电和低频脉冲电刺激后,大鼠敞箱实验中垂直和水平运动得分均较模型组显著升高（P〈0.05）;且大鼠左侧前额叶皮层和海马5-HT、NE含量较模型组显著升高（P〈0.05）,而前额叶皮层DA含量无显著变化（P〉0.05）。结论：直流电和低频脉冲电跨颅刺激左侧前额叶皮层,对抑郁症均有显著治疗作用。     

经颅磁刺激参数与结构要件的影响分析

为了进一步探索经颅磁刺激工作机理并改进或研制出新的经颅磁刺激激励源.本文从经颅磁刺激的原理推导出了磁场、感应电流及激励源原理电路电流的表达式,利用大脑-线圈和大脑-线圈-铁芯两种经颅磁刺激模型分析影响因素与头模型各组织的磁场和感应电流分布.对比分析表明电流的性质,线圈半径,线圈激励特性与铁芯对感应电流分布与电磁场分布有着本质的影响.对经颅磁刺激参数及结构要件的研究与分析可用于指导刺激线圈参数及激励源电路参数的设置,以及探索新的激励源制作.