• 수면정신생리
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• 제28권1호
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• pp.2-5
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• 2021

Hyperarousal or increased brain excitability is thought to play a key role in the pathophysiology of insomnia. Neuromodulation techniques are emergent complementary therapies for insomnia and can improve sleep by modulating cortical excitability. A growing body of literature support the idea that neuromodulation can be effective in improving sleep or treating insomnia. Recent evidence has revealed that neuromodulation methods can improve objective and subjective sleep measures in individuals with insomnia, although effects vary according to protocol. Different mechanisms of action might explain the relative efficacy of neuromodulation techniques on sleep outcomes. Further research testing different stimulation parameters, replicating existing protocols, and adding standardized sleep-related outcomes could provide further evidence on the clinical utility of neuromodulation techniques.

• The Journal of Korean Physical Therapy
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• 제31권5호
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• pp.328-332
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• 2019

Purpose: This study examined the effects of transcranial direct current stimulation (tDCS) on the static balance ability of patients with back pain. Methods: The subjects comprised of 30 males and females in their 20s, who were divided into two groups with and without tDCS. The balance posture ratio score was calculated to determine the changes in balance ability before and after the application of tDCS using balance equipment. A paired t-test was conducted to determine the changes over time, and an independent t-test was performed to determine the changes between the groups. The significance level was set to ${\alpha}=0.05$. Results: A significant difference in the changes in the static balance ability of CTDCSG between before and after applying tDCS was observed while the subjects' eyes were open (p<0.05). A comparison between the groups after the experiments revealed significantly increased changes in CTDCSG compared to STDCSE (p<0.05). The changes in static balance ability were not significant when the subjects' eyes were closed (p>0.05). Conclusion: The application of tDCS positively changed the static balance ability of patients with back pain. The results of this study showed that tDCS could be used as an intervention to increase the static balance ability of patients with back pain in the clinical field. The study results could be used further as foundational data for future studies on tDCS.

• 대한통합의학회지
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• 제7권3호
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• pp.33-40
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• 2019

Purpose : The purpose of this randomized controlled trial study was to examine the effect of transcranial direct current stimulation (tDCS) on cognitive function and depression in stroke patients. Methods : Thirty stroke patients were randomly divided into an experimental group (n = 15) and a control group (n = 15). The experimental group received tDCS while performing computerized cognitive rehabilitation programs, and the control group was provided with sham tDCS while operating the same programs. The 30-minute intervention was implemented five times per week for six weeks. To assess cognitive function before and after the intervention, the Neurobehavioral Cognitive Status Examination was conducted; the Beck Depression Inventory BDI was employed to assess depression. Results : The experimental group showed statistically significant increases in cognitive function and decreases in depression (p < .05 ). Comparing the amount of variation between the groups after arbitration also showed significant differences in cognitive function and depression between the two groups (p > .05). Conclusion : The application of tDCS and computerized cognitive rehabilitation programs for stroke patients may positively affect their cognitive function and depression. Therefore, tDCS used with computerized cognitive rehabilitation programs is positively applicable to the enhancement of cognitive function in stroke patients and reduction of depression.

• 한국운동역학회지
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• 제32권4호
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• pp.121-127
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• 2022

Objective: The purpose of this study was to investigate potential effects of transcranial direct current stimulation (tDCS) on bimanual force control capabilities in healthy young adults. Method: Eighteen right-handed healthy young adults (10 females and 8 males; age: 23.55 ± 3.56 yrs) participated in this crossover design study. All participants were randomly allocated to both active-tDCS and sham-tDCS conditions, respectively. While receiving 20 min of active- or sham-tDCS interventions, all participants performed bimanual isometric force control tasks at four submaximal targeted force levels (i.e., 5%, 10%, 15, and 20% of maximal voluntary contraction: MVC). To compare bimanual force control capabilities including force accuracy, variability, and regularity between active-tDCS and sham-tDCS conditions, we conducted two-way repeated measures ANOVAs (2 × 4; tDCS condition × Force levels). Results: We found no significant difference in baseline MVC between active-tDCS and sham-tDCS conditions. Moreover, our findings revealed that providing bilateral tDCS including anodal tDCS on left primary motor cortex (M1) and cathodal on right M1 while conducting bimanual force control trials significantly decreased force variability and regularity at 5%MVC. Conclusion: These findings suggest that providing bilateral tDCS on M1 areas may improve bimanual force control capabilities at a relatively low targeted force level.

• 수면정신생리
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• 제28권2호
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• pp.53-69
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• 2021

Sleep disorders, increasingly prevalent in the general population, induce impairment in daytime functioning and other clinical problems. As changes in cortical excitability have been reported as potential pathophysiological mechanisms underlying sleep disorders, multiple studies have explored clinical effects of modulating cortical excitability through non-invasive brain stimulation in treating sleep disorders. In this study, we critically reviewed clinical studies using non-invasive brain stimulation, particularly transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), for treatment of sleep disorders. Previous studies have reported inconsistent therapeutic effects of TMS and tDCS for various kinds of sleep disorders. Specifically, low-frequency repetitive TMS (rTMS) and cathodal tDCS, both of which exert an inhibitory effect on cortical excitability, have shown inconsistent therapeutic effects for insomnia. On the other hand, high-frequency rTMS and anodal tDCS, both of which facilitate cortical excitability, have improved the symptoms of hypersomnia. In studies of restless legs syndrome, high-frequency rTMS and anodal tDCS induced inconsistent therapeutic effects. Single TMS and rTMS have shown differential therapeutic effects for obstructive sleep apnea. These inconsistent findings indicate that the distinctive characteristics of each non-invasive brain stimulation method and specific pathophysiological mechanisms underlying particular sleep disorders should be considered in an integrated manner for treatment of various sleep disorders. Future studies are needed to provide optimized TMS and tDCS protocols for each sleep disorder, considering distinctive effects of non-invasive brain stimulation and pathophysiology of each sleep disorder.

• The Journal of Korean Physical Therapy
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• 제23권1호
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• pp.77-82
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• 2011

Purpose: Recently, many studies have demonstrated that application of external stimulation can modulate cortical excitability of the human brain. We attempted to observe cortical excitability using functional magnetic resonance imaging (fMRI) during the application of transcranial direct current stimulation (tDCS) or functional electrical stimulation (FES). Methods: We recruited two healthy subjects without a history of neurological or psychiatric problems. fMRI scanning was done during? each constant anodal tDCS and FES session, and each session was repeated three times. The tDCS session consisted of three successive phases (resting phase: 60sec dummy cycle: 10sec tDCS phase: 60sec). The FES session involved stimulation of wrist extensor muscles over two successive phase (resting phase: 15sec FES phase: 15sec). Results: The average map of the tDCS and FES analyses showed that the primary sensory-motor cortex area was activated in all subjects. Conclusion: Our findings show that cortical activation can be induced by constant anodal tDCS and FES. They suggest that the above stimuli have the potential for facilitating brain plasticity and modulating neural excitability if applied as specific therapeutic interventions for brain injured patients.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.318-323
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• 2020

Objective: Reacquisition of motor functions following stroke depends on interhemispheric neural connections. The intervention highlighted in the present case is an insight for augmenting motor recovery by stimulating the lesioned area and adjacent areas governing the motor behaviour of an individual. The purpose of this study was to determine the changes in the motor and cognitive outcomes through multi target stimulation of cortical areas by application of multichannel transcranial direct current stimulation (M-tDCS) in a stroke survivor. Design: A case report. Methods: The patient was a participant of a trial registered with the clinical trial registry of India (CTRI/2020/01/022998). The patient was intervened with M-tDCS over the left primary motor cortex i.e. C3 point and left dorsolateral prefrontal cortex i.e. F3 point with 0.5-2 mA intensity for the period of 20 minutes. SaeboFlex-assisted task-oriented training, functional electrical stimulation over the lower extremity (LE) to elicit dorsiflexion at the ankle and eversion of the foot, and conventional physiotherapy rehabilitation including a tailored exercise program were performed. Outcome assessment was done using the Fugl-Meyer assessment scale (FMA) for the upper and lower extremity (UE and LE), Montreal Cognitive Assessment (MOCA), Wisconsin Gait Scale (WGS) and the Stroke Specific Quality of Life (SSQOL) measures. Assessment was taken at Day 0, 15 and 30 post intervention. Results: Improvement was observed in all the outcome measures i.e FMA (UE and LE), MOCA, SSQOL and WGS across the span of 4 weeks. Conclusions: M-tDCS induced improvement in motor functions of the UE and LE, gait parameters and cognitive functions of the patient.

• 한국정보전자통신기술학회논문지
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• 제14권5호
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• pp.403-412
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• 2021

알츠하이머병은 치매를 일으키는 원인 중 가장 높은 빈도를 차지하는 신경퇴행성 질환으로서, 아직은 증상을 개선시키는 정도의 약물적 치료가 주를 이룬다. 이러한 경구약제의 치료적 한계성 및 신약개발의 어려움에 직면하여 임상에서는 비약물적 치료에 대한 관심이 높아지고 있다. 경두개 직류전기자극(transcranial direct current stimulation, tDCS)는 낮은 강도의 직류전류를 이용한 비침습적 뇌조절술의 한 종류로서, 그 안전성에 대해서는 이미 널리 입증받은 바 있다. 본 종설에서는 알츠하이머병 쥐 모델에게 tDCS를 적용함으로써 얻을 수 있는 행동학적, 신경생리학적, 뇌조직학적 회복에 대한 객관적 근거들을 살펴봄으로써, 인간 대상 tDCS연구의 배경근거를 제시하고자 한다.

• Journal of Magnetics
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• 제19권1호
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• pp.20-27
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• 2014

This study examined the relationships between protein expression and Poly ADP ribose polymerase in brain cell death in brains damaged by thrombotic stroke and treated with the Full Wave- Cockroft Walton (FWCW) method of Transcranial Magnetic Stimulation (TMS). The two-way switching element for TMS drove a half-bridge inverter of the current resonance of direct current voltage (+) and direct current voltage (-), and the experiment was conducted by stimulating the mice with thrombotic stroke through a range of pulses. Thrombotic stroke was caused of ligation of the common carotid artery of male SD mice, and blood reperfusion was conducted five minutes later. Protein expression was examined in immune reaction cells, which reacted to an antibody to Poly ADP ribose polymerase in the cerebrum cells, and western blotting. Observations of the PARP changes after thrombotic stroke showed that the number of Poly ADP ribose polymerase reactions were significantly lower (p < 0.05) in the group treated with TMS of the FWCW than the group with thrombotic stroke 24 hours after its onset. The application of FWCW-TMS helped prevent the necrosis of nerve cells and might prevent the brain damage that occurs as a result of thrombotic stroke, and improve the function recovery and disorder of brain cells.

• 한국전문물리치료학회지
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• 제21권4호
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• pp.1-8
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• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.