期刊
BRAIN STIMULATION
卷 8, 期 2, 页码 260-268出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.brs.2014.11.003
关键词
Transcranial electrical stimulation; Transcranial alternating current stimulation; Electrode montage; Photic stimulation; Physiological tremor; Entrainment; Phosphene; Current density modeling
资金
- Medical Research Council
- Rosetrees Trust
- National Institute for Health Research (NIHR) Oxford Biomedical Research Centre
- NIHR Medical Academic Clinical Fellowship
- NHS
- Department of Health
- National Institute of General Medical Sciences of the National Institutes of Health [P41GM103545]
- MRC [G0901503, MC_UU_12024/1] Funding Source: UKRI
- Medical Research Council [G0901503, MC_UU_12024/1] Funding Source: researchfish
Background: Classically, studies adopting non-invasive transcranial electrical stimulation have placed greater importance on the position of the primary stimulating electrode than the secondary reference electrode. However, recent current density modeling suggests that ascribing a neutral role to the reference electrode may prove an inappropriate oversimplification. Hypothesis: We set out to test the hypothesis that the behavioral effects of transcranial electrical stimulation are critically dependent on the position of the return (reference) electrode. Methods: We examined the effect of transcranial alternating current stimulation (sinusoidal waveform with no direct current offset at a peak-to-peak amplitude of 2000 mu A and a frequency matched to each participant's peak tremor frequency) on physiological tremor in a group of healthy volunteers (N = 12). We implemented a sham-controlled experimental protocol where the position of the stimulating electrode remained fixed, overlying primary motor cortex, whilst the position of the return electrode varied between two cephalic (fronto-orbital and contralateral primary motor cortex) and two extracephalic (ipsilateral and contralateral shoulder) locations. We additionally controlled for the role of phosphenes in influencing motor output by assessing the response of tremor to photic stimulation, through self-reported phosphene ratings. Results: Altering only the position of the return electrode had a profound behavioral effect: only the montage with extracephalic return contralateral to the primary stimulating electrode significantly entrained physiological tremor (15.9% +/- 6.1% increase in phase stability, 1 S.E.M.). Photic stimulation also entrained tremor (11.7% +/- 5.1% increase in phase stability). Furthermore, the effects of electrical stimulation are distinct from those produced from direct phosphene induction, in that the latter were only seen with the fronto-orbital montage that did not affect the tremor. Conclusion: The behavioral effects of transcranial alternating current stimulation appear to be critically dependent on the position of the reference electrode, highlighting the importance of electrode montage when designing experimental and therapeutic protocols. (C) 2015 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license.
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