Effects of Transcranial Direct Current Stimulation (tDCS) on Pain Distress Tolerance: A Preliminary Study.

OBJECTIVE: Pain remains a critical medical challenge. Current treatments target nociception without addressing affective symptoms. Medically intractable pain is sometimes treated with cingulotomy or deep brain stimulation to increase tolerance of pain-related distress. Transcranial direct current stimulation (tDCS) may noninvasively modulate cortical areas related to sensation and pain representations. The present study aimed to test the hypothesis that cathodal ("inhibitory") stimulation targeting left dorsal anterior cingulate cortex (dACC) would increase tolerance to distress from acute painful stimuli vs anodal stimulation. METHODS: Forty healthy volunteers received both anodal and cathodal stimulation. During stimulation, we measured pain distress tolerance with three tasks: pressure algometer, cold pressor, and breath holding. We measured pain intensity with a visual-analog scale before and after each task. RESULTS: Mixed ANOVA revealed that mean cold pressor tolerance tended to be higher with cathodal vs anodal stimulation (P = 0.055) for participants self-completing the task. Pressure algometer (P = 0.81) and breath holding tolerance (P = 0.19) did not significantly differ. The pressure algometer exhibited a statistically significant order effect irrespective of stimulation polarity (all P < 0.008). Pain intensity ratings increased acutely after cold pressor and pressure algometer tasks (both P < 0.01), but not after breath holding (P = 0.099). Cold pressor pain ratings tended to rise less after cathodal vs anodal tDCS (P = 0.072). CONCLUSIONS: Although our primary results were nonsignificant, there is a preliminary suggestion that cathodal tDCS targeting left dACC may increase pain distress tolerance to cold pressor. Pressure algometer results are consistent with task-related sensitization. Future studies are needed to refine this novel approach for pain neuromodulation.

Brain activation during the Stroop task in adolescents with severe substance and conduct problems: A pilot study.

BACKGROUND: Although many neuroimaging studies have examined changes in brain function in adults with substance use disorders, far fewer have examined adolescents. This study investigated patterns of brain activation in adolescents with severe substance and conduct problems (SCP) compared to controls. METHODS: Functional magnetic resonance imaging (fMRI) at 1.5Tesla assessed brain activation in 12 adolescent males with SCP, ranging in age from 14 to 18, and 12 controls similar in age, gender, and neighborhood while performing the attentionally demanding Stroop task. RESULTS: Even though the adolescents with SCP performed as well as the controls, they activated a more extensive set of brain structures for incongruent (e.g., "red" in blue ink) versus congruent (e.g. "red" in red ink) trials. These regions included parahippocampal regions bilaterally, posterior regions involved in language-related processing, right-sided medial prefrontal areas, and subcortical regions including the thalamus and caudate. CONCLUSION: These preliminary results suggest that the neural mechanisms of attentional control in youth with SCP differ from youth without such problems. This difficulty may prevent SCP youth from ignoring salient but distracting information in the environment, such as drug-related information.

Functional dissociation of attentional selection within PFC: response and non-response related aspects of attentional selection as ascertained by fMRI.

In this experiment using a color-word Stroop task, we explored whether different regions of prefrontal cortex bias selection of response-related processes as compared with non-response-related processes. To manipulate demands at the level of response selection, we varied the degree of overlap between stimulus-response mappings in a manual Stroop task. To vary demands at a non-response level, we compared activation for incongruent trials (e.g. the word 'purple' in blue ink) that contain two color representations, one in the word and one in the ink color, to neutral trials (e.g. the word 'drawer' in blue ink), which contain only one color representation, that in the ink color. These manipulations had differential effects within prefrontal cortex. Both a region of right inferior frontal cortex and caudal regions of the cingulate were sensitive to the selection demands at the response-level and insensitive to demands at the non-response level. In contrast, a more anterior region of left dorsolateral prefrontal cortex was sensitive to the number of color representations (i.e. incongruent versus neutral trials), but not to the overlap in stimulus-response mappings. Therefore, this study indicates a functional differentiation for implementing attentional control within prefrontal cortex.

Common and distinct neural substrates of attentional control in an integrated Simon and spatial Stroop task as assessed by event-related fMRI.

The purpose of this experiment was to directly examine the neural mechanisms of attentional control involved in the Simon task as compared to a spatial Stroop task using event-related fMRI. The Simon effect typically refers to the interference people experience when there is a stimulus-response conflict. The Stroop effect refers to the interference people experience when two attributes of the same stimulus conflict with each other. Although previous imaging studies have compared the brain activation for each of these tasks performed separately, none had done so in an integrated task that incorporates both types of interference, as was done in the current experiment. Both tasks activated brain regions that serve as a source of attentional control (dorsolateral prefrontal cortex) and posterior regions that are sites of attentional control (the visual processing stream-middle occipital and inferior temporal cortices). In addition, there were also specific brain regions activated to a significantly greater degree by one task and/or only by a single task. The brain regions significantly more activated by the Simon task were those sensitive to detection of response conflict, response selection, and planning (anterior cingulate cortex, supplementary motor areas, and precuneus), and visuospatial-motor association areas. In contrast, the regions significantly more activated by the Stroop task were those involved in biasing the processing toward the task-relevant attribute (inferior parietal cortex). These findings suggest that the interference effects of these two tasks are caused by different types of conflict (stimulus-response conflict for the Simon effect and stimulus-stimulus conflict for the Stroop effect) but both invoke similar sources of top-down modulation.