People with Disorders of Consciousness
Barbara A. Wilson, Jill Winegardner, Caroline M. van Heugten, Tamara Ownsworth in Neuropsychological Rehabilitation, 2017
Lately, interest in electrical brain stimulation to improve the patient's state has increased. Deep brain stimulation of the thalamus in one MCS patient allowed him to recover the ability to functionally communicate and use objects by increasing thalamo-cortical connectivity (Schiff et al., 2007). The results of this study are very promising, yet a big limitation is that it is invasive and not without risk (i.e. infection and haemorrhage). A non-invasive technique is transcranial direct current stimulation (tDCS), which establishes a stable current between two electrodes (anode and cathode) that can be placed on the scalp. Some MCS patients showed behavioural improvements after a single session as well as repetitive sessions of anodal tDCS on the dorsolateral prefrontal cortex, whereas UWS patients did not show any improvement (see Figure 10.2A) (Thibaut et al., 2014; Angelakis et al., 2014). MCS responders showed more grey matter preservation and residual metabolic activity in the stimulated brain region, in the precuneus and in the thalamus, compared to non-responders (see Figure 10.2B) (Thibaut et al., 2015c). Repetitive TMS has also been used to stimulate brains of DOC patients. In two single case reports, MCS patients improved clinically after TMS on the motor cortex (Manganotti et al., 2013; Piccione et al., 2011). Similar to tDCS, UWS patients do not seem to clinically improve after repetitive TMS (Cincotta et al., 2015).
Electrical Brain Stimulation to Treat Neurological Disorders
Bahman Zohuri, Patrick J. McDaniel in Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
One serious argument against this NIBS approach to neurological treatment is that we are changing the frequency spectrum only temporarily, and long-term characteristics have not yet been resolved. We know that there are neurochemical effects that accompany the changing frequency spectrum,61 and the result of the electrical and chemical change can lead to retained brain network changes, called plasticity, that result in a remembered functional process. We hypothesize that the electrical brain stimulation can train the brain to continue operating in the desired manner and that this memory effect is an adjunct of the individual motivation. We are proposing the use of electrical brain stimulation as a “brain builder” dependent on the motivation of the patient.
Home Use of tDCS
L. Syd M Johnson, Karen S. Rommelfanger in The Routledge Handbook of Neuroethics, 2017
There are several possible explanations for why the home use of tDCS has not undergone broad adoption by the general population. Perhaps only a small subset of individuals is sufficiently motivated to experiment with electrical brain stimulation devices that have not undergone review by regulatory authorities. As with any novel technology, home users may represent a group of “early adopters,” and it is possible that there has not been enough time (or technological refinement) for tDCS to gain mainstream acceptance. Indeed, one study of the comments on online articles related to tDCS found that although public misunderstanding of the technology has diminished in the years following the release of the Foc.us device, there is still a significant degree of confusion surrounding tDCS (Cabrera and Reiner, 2015). In line with such thinking, people may be skeptical of either the efficacy or safety involved in home use of tDCS. It is also worth observing that while DIY movements themselves do not generally spread to the mainstream public, the commercialization of DIY techniques into consumer-friendly devices often results in greater public uptake. For example, though the quantified self movement began in mid-2008 (Swan, 2009), the commercialization of self-tracking tools (such as Fitbit and other wearable devices) has brought these technologies to the general population.
Transcranial direct current stimulation (tDCS) effects on upper limb motor function in stroke: an overview review of the systematic reviews
Published in Brain Injury, 2023
Jaya Shanker Tedla, Devika Rani Sangadala, Ravi Shankar Reddy, Kumar Gular, Venkata Nagaraj Kakaraparthi, Faisal Asiri
Over the past century, technological advancements and their incorporation into health sciences have led to the development of safe, well-controlled, and effective stimulation devices (10). Currently, these stimulation devices are categorized as invasive, deep brain stimulation, and noninvasive, such as magnetic or electrical brain stimulation. Noninvasive brain stimulation methods have the advantage of minimizing the risk of infection that is associated with invasive brain stimulation (10). Noninvasive brain stimulation approaches include repetitive transcranial magnetic stimulation (rTMS), transcranial alternating current stimulation, transcranial pulsed ultrasound, and transcranial direct current stimulation (tDCS) (11). Among these, rTMS and tDCS have considerable evidence supporting their use for rehabilitating patients after stroke (12).
Developing a framework for utilizing adjunct rehabilitation therapies in motor recovery of upper extremity post stroke
Published in Topics in Stroke Rehabilitation, 2023
Robert Teasell, Amanda McIntyre, Ricardo Viana, Emma A. Bateman, Manuel Murie-Fernandez, Shannon Janzen, Marcus Saikaley
These “priming” or stimulating treatments include three subcategories Internal Brain-Stimulating Therapies include activation through the intact hemisphere (i.e. Action Observation and Mental Practice), mentally rehearsing the motor task (i.e. Mirror therapy and Bilateral Arm Training), and adding cognitive elements to improve motor recovery (i.e. Virtual Reality and Music Therapy).Repetitive Magnetic or Electrical Brain Stimulation include Repetitive Transcranial Magnetic Stimulation, Transcranial Direct Current Stimulation, and Theta-Burst Stimulation.Pharmacological and Biological Treatments include Central Nervous System (CNS) stimulants and Anti-Depressants.
Mark Twain’s phrenological experiment: Three renditions of his “small test”
Published in Journal of the History of the Neurosciences, 2020
Stanley Finger
The zeitgeist was clearly changing when Twain took it upon himself to walk into Lorenzo Fowler’s emporium on what might have been a sunny or perhaps a foggy or rainy day in London. Forward-looking physicians (e.g., Paul Broca in France) and experimentalists (e.g., Gustav Fritsch and Eduard Hitzig in Prussia; David Ferrier in England) were now busily assessing patients with brain damage and studying animals subjected to lesions or electrical brain stimulation (Finger 1994, 2000; Young 1970). These new pioneers of the brain rejected craniology yet, in accordance with what Gall was the first to claim publicly, they were now confirming that specialized parts of the cerebral cortex are, in fact, associated with different functions, such as speech and voluntary movements. Also consistent with what the phrenologists had long been claiming, their research was showing that our most noble faculties (e.g., speech, controlled attention, higher ideation) are dependent on cortical territories in the front of the brain.
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