Behavioural and electrophysiological modulations induced by transcranial direct current stimulation in healthy elderly and Alzheimer's disease patients: A pilot study.

OBJECTIVE: To investigate whether anodal and cathodal transcranial direct current stimulation (tDCS) can modify cognitive performance and neural activity in healthy elderly and Alzheimer's disease (AD) patients. METHODS: Fourteen healthy elderly and twelve AD patients performed a working memory task during an electroencephalogram recording before and after receiving anodal, cathodal, and sham tDCS over the left dorsolateral prefrontal cortex. Behavioural performance, event-related potentials (P200, P300) and evoked cortical oscillations were studied as correlates of working memory. RESULTS: Anodal tDCS increased P200 and P300 amplitudes in healthy elderly. Cathodal tDCS increased P200 amplitude and frontal theta activity between 150 and 300 ms in AD patients. Improved working memory after anodal tDCS correlated with increased P300 in healthy elderly. In AD patients, slight tendencies between enhanced working memory and increased P200 after cathodal tDCS were observed. CONCLUSIONS: Functional neural modulations were promoted by anodal tDCS in healthy elderly and by cathodal tDCS in AD patients. SIGNIFICANCE: Interaction between tDCS polarity and the neural state (e.g., hyper-excitability exhibited by AD patients) suggests that appropriate tDCS parameters (in terms of tDCS polarity) to induce behavioural improvements should be chosen based on the participant's characteristics. Future studies using higher sample sizes should confirm and extend the present findings.

Age dependence of primary motor cortex plasticity induced by paired associative stimulation.

OBJECTIVE: The increase of elderly population prompted growing research for the understanding of cerebral phenomena sustaining learning abilities, with inclusion of long-term potentiation (LTP)-like plasticity phenomena. Aim of the present study was to characterize LTP-like plasticity dependence on age and gender. METHODS: A LTP-like primary motor cortex plasticity inducing a potentiation of the motor evoked potential (MEP) to focal transcranial magnetic stimulation as a consequence of a paired associative stimulation (PAS) was induced in a 50 healthy subject cohort, equally distributed for gender and age groups (25 young subjects, mean age+/-SD=29.8+/-4.5 years; elderly 61.1+/-4.1 years). RESULTS: Resting motor thresholds' excitability level increased in the elderly group, the basal MEP did not depend on gender or age. The PAS-induced primary motor cortex (M1) plastic excitability modulation was similar in young females and males, while it decreased with age in females only. CONCLUSIONS: A reduction of the PAS-induced M1 plasticity in females after menopause was documented, possibly due to an impairment of intracortical excitatory network activity. SIGNIFICANCE: A LTP-like plasticity dependence on age was found in female only, suggesting caution in interpreting behavioural studies on learning abilities in dependence on age.

Literal, fictive and metaphorical motion sentences preserve the motion component of the verb: a TMS study.

We used Transcranial Magnetic Stimulation (TMS) to assess whether reading literal, non-literal (i.e., metaphorical, idiomatic) and fictive motion sentences modulates the activity of the motor system. Sentences were divided into three segments visually presented one at a time: the noun phrase, the verb and the final part of the sentence. Single pulse-TMS was delivered at the end of the sentence over the leg motor area in the left hemisphere and motor evoked potentials (MEPs) were recorded from the right gastrocnemius and tibialis anterior muscles. MEPs were larger when participants were presented with literal, fictive and metaphorical motion sentences than with idiomatic motion or mental sentences. These results suggest that the excitability of the motor system is modulated by the motor component of the verb, which is preserved in fictive and metaphorical motion sentences.

Increased cortical plasticity in the elderly: changes in the somatosensory cortex after paired associative stimulation.

A fundamental feature of the human cortex is the capability to express plastic changes that seem to be present even during physiological aging. The paired associative stimulation (PAS) protocol is a paradigm capable of inducing neuroplastic changes, possibly by mechanisms related to spike timing-dependent associative neuronal activity, and represents a suitable tool for investigating age-dependent neuroplastic modulations of the primary somatosensory cortex (S1). To examine age dependency of S1 plasticity, the amplitude changes of median nerve somatosensory evoked potential (SEP) before and after PAS intervention were investigated in young and elderly subjects. The main finding of our study is that low-frequency medial nerve stimulation paired with transcranial magnetic stimulation over the contralateral cortex enhances S1 excitability. Moreover, the S1 long term potentiation-like plasticity changes as a function of aging, with a significant increase of N20-P25 complex in the elderly compared to young subjects. These results are congruent with the hypothesis that some elderly subjects retain a high level of plasticity in specific neuronal circuits. Such plasticity could represent a compensatory mechanism, in terms of functional reserve of somatosensory cortex, used by the aging brain to counterbalance the cortical degeneration associated with aging.