Bilateral frontal transcranial direct current stimulation: Failure to replicate classic findings in healthy subjects

OBJECTIVE There has been no modern effort to replicate, further characterize, or quantify the dramatic effects on affect described in controlled studies from the 1960s using bilateral frontal electrodes with an extra-cephalic reference in a mixed group composed primarily of mildly depressed individuals. We performed a comprehensive, quantitative assessment of the effects of bifrontal TDCS on emotion in 21 healthy subjects. METHODS In a double-blind crossover study, we administered tests of emotional state, affect, emotional decision-making, arousal, and psychomotor functions during sham, anodal, and cathodal TDCS. RESULTS We found no systematic effects on any measure, despite two subjects who had pronounced mood effects in the predicted direction. There were no adverse events. CONCLUSIONS In line with some other studies, we found no consistent effects of bifrontal TDCS on measures of emotional function of psychomotor performance. SIGNIFICANCE These results demonstrate the safety of bilateral anterior frontal TDCS with an extra-cephalic reference, but raise questions about its effectiveness as a modulator of mood and emotional cognition, at least in healthy subjects.

[1]  A. Priori,et al.  Transcranial direct current stimulation improves recognition memory in Alzheimer disease , 2008, Neurology.

[2]  O. Lippold,et al.  Mental Changes Resulting from the Passage of Small Direct Currents Through the Human Brain , 1964, British Journal of Psychiatry.

[3]  D. Tranel,et al.  Acquired Personality Disturbances Associated With Bilateral Damage to the Ventromedial Prefrontal Region , 2000, Developmental neuropsychology.

[4]  Á. Pascual-Leone,et al.  A randomized, double-blind clinical trial on the efficacy of cortical direct current stimulation for the treatment of major depression. , 2008, The international journal of neuropsychopharmacology.

[5]  D. Purpura,et al.  INTRACELLULAR ACTIVITIES AND EVOKED POTENTIAL CHANGES DURING POLARIZATION OF MOTOR CORTEX. , 1965, Journal of neurophysiology.

[6]  A. Damasio,et al.  Individuals with sociopathic behavior caused by frontal damage fail to respond autonomically to social stimuli , 1990, Behavioural Brain Research.

[7]  S. Sato,et al.  Safety and cognitive effect of frontal DC brain polarization in healthy individuals , 2005, Neurology.

[8]  P. Lang,et al.  International Affective Picture System (IAPS): Instruction Manual and Affective Ratings (Tech. Rep. No. A-4) , 1999 .

[9]  Á. Pascual-Leone,et al.  Cortical stimulation of the prefrontal cortex with transcranial direct current stimulation reduces cue-provoked smoking craving: a randomized, sham-controlled study. , 2008, The Journal of clinical psychiatry.

[10]  Steven Mark Miller,et al.  The use of tDCS and CVS as methods of non-invasive brain stimulation , 2007, Brain Research Reviews.

[11]  L. Cohen,et al.  Transcranial DC stimulation (tDCS): A tool for double-blind sham-controlled clinical studies in brain stimulation , 2006, Clinical Neurophysiology.

[12]  Á. Pascual-Leone,et al.  Transcranial direct current stimulation of the prefrontal cortex modulates the desire for specific foods , 2008, Appetite.

[13]  Á. Pascual-Leone,et al.  Lateralized effect of rapid-rate transcranial magnetic stimulation of the prefrontal cortex on mood , 1996, Neurology.

[14]  Á. Pascual-Leone,et al.  Behavioral / Systems / Cognitive Activation of Prefrontal Cortex by Transcranial Direct Current Stimulation Reduces Appetite for Risk during Ambiguous Decision Making , 2007 .

[15]  M. Nitsche,et al.  Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation , 2000, The Journal of physiology.

[16]  J. C. Ramsay,et al.  Treatment of Depression with Low Voltage Direct Current , 1966, Southern medical journal.

[17]  R. Adolphs,et al.  Damage to the prefrontal cortex increases utilitarian moral judgements , 2007, Nature.

[18]  Sergio P. Rigonatti,et al.  Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory , 2005, Experimental Brain Research.

[19]  A. Lozano,et al.  Deep Brain Stimulation for Treatment-Resistant Depression , 2005, Neuron.

[20]  Á. Pascual-Leone,et al.  Technology Insight: noninvasive brain stimulation in neurology—perspectives on the therapeutic potential of rTMS and tDCS , 2007, Nature Clinical Practice Neurology.

[21]  O. Lippold,et al.  A Controlled Trial of the Therapeutic Effects of Polarization of the Brain in Depressive Illness , 1964, British Journal of Psychiatry.

[22]  M. Carney,et al.  Polarization in Depression , 1970, British Journal of Psychiatry.

[23]  Walter Paulus,et al.  Facilitation of probabilistic classification learning by transcranial direct current stimulation of the prefrontal cortex in the human , 2004, Neuropsychologia.

[24]  Sergio P. Rigonatti,et al.  Repeated sessions of noninvasive brain DC stimulation is associated with motor function improvement in stroke patients. , 2007, Restorative neurology and neuroscience.

[25]  Á. Pascual-Leone,et al.  Diminishing Risk-Taking Behavior by Modulating Activity in the Prefrontal Cortex: A Direct Current Stimulation Study , 2007, The Journal of Neuroscience.

[26]  L. Merabet,et al.  Prefrontal cortex modulation using transcranial DC stimulation reduces alcohol craving: a double-blind, sham-controlled study. , 2008, Drug and alcohol dependence.

[27]  Sergio P. Rigonatti,et al.  Treatment of major depression with transcranial direct current stimulation. , 2006, Bipolar disorders.

[28]  A. Damasio,et al.  Deciding Advantageously Before Knowing the Advantageous Strategy , 1997, Science.

[29]  M. Lorr,et al.  Manual for the Profile of Mood States , 1971 .

[30]  M. Herjanic,et al.  Clinical Report on a New Therapeutic Technique: Polarization , 1967, Canadian Psychiatric Association journal.

[31]  M Hallett,et al.  Changes in mood and hormone levels after rapid-rate transcranial magnetic stimulation (rTMS) of the prefrontal cortex. , 1996, The Journal of neuropsychiatry and clinical neurosciences.

[32]  L J Sheffield,et al.  The Effects of Polarization on Normal Subjects , 1968, British Journal of Psychiatry.