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      Long-Term Enhancement of Brain Function and Cognition Using Cognitive Training and Brain Stimulation

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          Summary

          Noninvasive brain stimulation has shown considerable promise for enhancing cognitive functions by the long-term manipulation of neuroplasticity [ 1–3]. However, the observation of such improvements has been focused at the behavioral level, and enhancements largely restricted to the performance of basic tasks. Here, we investigate whether transcranial random noise stimulation (TRNS) can improve learning and subsequent performance on complex arithmetic tasks. TRNS of the bilateral dorsolateral prefrontal cortex (DLPFC), a key area in arithmetic [ 4, 5], was uniquely coupled with near-infrared spectroscopy (NIRS) to measure online hemodynamic responses within the prefrontal cortex. Five consecutive days of TRNS-accompanied cognitive training enhanced the speed of both calculation- and memory-recall-based arithmetic learning. These behavioral improvements were associated with defined hemodynamic responses consistent with more efficient neurovascular coupling within the left DLPFC. Testing 6 months after training revealed long-lasting behavioral and physiological modifications in the stimulated group relative to sham controls for trained and nontrained calculation material. These results demonstrate that, depending on the learning regime, TRNS can induce long-term enhancement of cognitive and brain functions. Such findings have significant implications for basic and translational neuroscience, highlighting TRNS as a viable approach to enhancing learning and high-level cognition by the long-term modulation of neuroplasticity.

          Highlights

          • Subjects received TRNS of the bilateral DLPFC while undergoing arithmetic training

          • TRNS was uniquely coupled with NIRS, an optical brain imaging technique

          • TRNS elicited short- and long-term improvements in trained and untrained material

          • Hemodynamic responses suggested enhanced neurovascular coupling efficiency

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          Most cited references27

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          Is 2+2=4? Meta-analyses of brain areas needed for numbers and calculations.

          Most of us use numbers daily for counting, estimating quantities or formal mathematics, yet despite their importance our understanding of the brain correlates of these processes is still evolving. A neurofunctional model of mental arithmetic, proposed more than a decade ago, stimulated a substantial body of research in this area. Using quantitative meta-analyses of fMRI studies we identified brain regions concordant among studies that used number and calculation tasks. These tasks elicited activity in a set of common regions such as the inferior parietal lobule; however, the regions in which they differed were most notable, such as distinct areas of prefrontal cortices for specific arithmetic operations. Given the current knowledge, we propose an updated topographical brain atlas of mental arithmetic with improved interpretative power. Copyright © 2010 Elsevier Inc. All rights reserved.
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            Interpretation of near-infrared spectroscopy signals: a study with a newly developed perfused rat brain model.

            Using a newly developed perfused rat brain model, we examined direct effects of each change in cerebral blood flow (CBF) and oxygen metabolic rate on cerebral hemoglobin oxygenation to interpret near-infrared spectroscopy signals. Changes in CBF and total hemoglobin (tHb) were in parallel, although tHb showed no change when changes in CBF were small (< or =10%). Increasing CBF caused an increase in oxygenated hemoglobin (HbO(2)) and a decrease in deoxygenated hemoglobin (deoxy-Hb). Decreasing CBF was accompanied by a decrease in HbO(2), whereas changes in direction of deoxy-Hb were various. Cerebral blood congestion caused increases in HbO(2), deoxy-Hb, and tHb. Administration of pentylenetetrazole without increasing the flow rate caused increases in HbO(2) and tHb with a decrease in deoxy-Hb. There were no significant differences in venous oxygen saturation before vs. during seizure. These results suggest that, in activation studies with near-infrared spectroscopy, HbO(2) is the most sensitive indicator of changes in CBF, and the direction of changes in deoxy-Hb is determined by the degree of changes in venous blood oxygenation and volume.
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              Increasing human brain excitability by transcranial high-frequency random noise stimulation.

              For >20 years, noninvasive transcranial stimulation techniques like repetitive transcranial magnetic stimulation (rTMS) and direct current stimulation (tDCS) have been used to induce neuroplastic-like effects in the human cortex, leading to the activity-dependent modification of synaptic transmission. Here, we introduce a novel method of electrical stimulation: transcranial random noise stimulation (tRNS), whereby a random electrical oscillation spectrum is applied over the motor cortex. tRNS induces consistent excitability increases lasting 60 min after stimulation. These effects have been observed in 80 subjects through both physiological measures and behavioral tasks. Higher frequencies (100-640 Hz) appear to be responsible for generating this excitability increase, an effect that may be attributed to the repeated opening of Na(+) channels. In terms of efficacy tRNS appears to possess at least the same therapeutic potential as rTMS/tDCS in diseases such as depression, while furthermore avoiding the constraint of current flow direction sensitivity characteristic of tDCS.
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                Author and article information

                Contributors
                Journal
                Curr Biol
                Curr. Biol
                Current Biology
                Cell Press
                0960-9822
                1879-0445
                03 June 2013
                03 June 2013
                : 23
                : 11
                : 987-992
                Affiliations
                [1 ]Department of Experimental Psychology, University of Oxford, Oxford, OX1 3UD, UK
                [2 ]Department of Medical Physics and Bioengineering, University College London, London, WC1E 6BT, UK
                [3 ]Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
                Author notes
                [* ]Corresponding author roi.cohenkadosh@ 123456psy.ox.ac.uk
                Article
                CURBIO10303
                10.1016/j.cub.2013.04.045
                3675670
                23684971
                7789a49a-e9c0-4885-8d30-8bc878dbe0c1
                © 2013 ELL & Excerpta Medica.

                This document may be redistributed and reused, subject to certain conditions.

                History
                : 5 February 2013
                : 22 March 2013
                : 15 April 2013
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                Life sciences
                Life sciences

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