Neurochemical Predictors of Generalized Learning Induced by Brain Stimulation and Training.

Methods of cognitive enhancement for humans are most impactful when they generalize across tasks. However, the extent to which such "transfer" is possible via interventions is widely debated. In addition, the contribution of excitatory and inhibitory processes to such transfer is unknown. Here, in a large-scale neuroimaging individual differences study with humans (both sexes), we paired multitasking training and noninvasive brain stimulation (transcranial direct current stimulation, tDCS) over multiple days and assessed performance across a range of paradigms. In addition, we varied tDCS dosage (1.0 and 2.0 mA), electrode montage (left or right prefrontal regions), and training task (multitasking vs a control task) and assessed GABA and glutamate concentrations via ultrahigh field 7T magnetic resonance spectroscopy. Generalized benefits were observed in spatial attention, indexed by visual search performance, when multitasking training was combined with 1.0 mA stimulation targeting either the left or right prefrontal cortex (PFC). This transfer effect persisted for ∼30 d post intervention. Critically, the transferred benefits associated with right prefrontal tDCS were predicted by pretraining concentrations of glutamate in the PFC. Thus, the effects of this combined stimulation and training protocol appear to be linked predominantly to excitatory brain processes.

Stimulating prefrontal cortex facilitates training transfer by increasing representational overlap.

A recent hypothesis characterizes difficulties in multitasking as being the price humans pay for our ability to generalize learning across tasks. The mitigation of these costs through training has been associated with reduced overlap of constituent task representations within frontal, parietal, and subcortical regions. Transcranial direct current stimulation, which can modulate functional brain activity, has shown promise in generalizing performance gains when combined with multitasking training. However, the relationship between combined transcranial direct current stimulation and training protocols with task-associated representational overlap in the brain remains unexplored. Here, we paired prefrontal cortex transcranial direct current stimulation with multitasking training in 178 individuals and collected functional magnetic resonance imaging data pre- and post-training. We found that 1 mA transcranial direct current stimulation applied to the prefrontal cortex paired with multitasking training enhanced training transfer to spatial attention, as assessed via a visual search task. Using machine learning to assess the overlap of neural activity related to the training task in task-relevant brain regions, we found that visual search gains were predicted by changes in classification accuracy in frontal, parietal, and cerebellar regions for participants that received left prefrontal cortex stimulation. These findings demonstrate that prefrontal cortex transcranial direct current stimulation may interact with training-related changes to task representations, facilitating the generalization of learning.

Individual Differences in Decision Strategy Relate to Neurochemical Excitability and Cortical Thickness.

The speed-accuracy trade-off (SAT), whereby faster decisions increase the likelihood of an error, reflects a cognitive strategy humans must engage in during the performance of almost all daily tasks. To date, computational modeling has implicated the latent decision variable of response caution (thresholds), the amount of evidence required for a decision to be made, in the SAT. Previous imaging has associated frontal regions, notably the left prefrontal cortex and the presupplementary motor area (pre-SMA), with the setting of such caution levels. In addition, causal brain stimulation studies, using transcranial direct current stimulation (tDCS), have indicated that while both of these regions are involved in the SAT, their role appears to be dissociable. tDCS efficacy to impact decision-making processes has previously been linked with neurochemical concentrations and cortical thickness of stimulated regions. However, to date, it is unknown whether these neurophysiological measures predict individual differences in the SAT, and brain stimulation effects on the SAT. Using ultra-high field (7T) imaging, here we report that instruction-based adjustments in caution are associated with both neurochemical excitability (the balance between GABA+ and glutamate) and cortical thickness across a range of frontal regions in both sexes. In addition, cortical thickness, but not neurochemical concentrations, was associated with the efficacy of left prefrontal and superior medial frontal cortex (SMFC) stimulation to modulate performance. Overall, our findings elucidate key neurophysiological predictors, frontal neural excitation, of individual differences in latent psychological processes and the efficacy of stimulation to modulate these.SIGNIFICANCE STATEMENT The speed-accuracy trade-off (SAT), faster decisions increase the likelihood of an error, reflects a cognitive strategy humans must engage in during most daily tasks. The SAT is often investigated by explicitly instructing participants to prioritize speed or accuracy when responding to stimuli. Using ultra-high field (7T) magnetic resonance imaging (MRI), we found that individual differences in the extent to which participants adjust their decision strategies with instruction related to neurochemical excitability (ratio of GABA+ to glutamate) and cortical thickness in the frontal cortex. Moreover, brain stimulation to the left prefrontal cortex and the superior medial frontal cortex (SMFC) modulated performance, with the efficacy specifically related to cortical thickness. This work sheds new light on the neurophysiological basis of decision strategies and brain stimulation.

Neural substrates of individual differences in learning generalization via combined brain stimulation and multitasking training.

A pervasive limitation in cognition is reflected by the performance costs we experience when attempting to undertake two tasks simultaneously. While training can overcome these multitasking costs, the more elusive objective of training interventions is to induce persistent gains that transfer across tasks. Combined brain stimulation and cognitive training protocols have been employed to improve a range of psychological processes and facilitate such transfer, with consistent gains demonstrated in multitasking and decision-making. Neural activity in frontal, parietal, and subcortical regions has been implicated in multitasking training gains, but how the brain supports training transfer is poorly understood. To investigate this, we combined transcranial direct current stimulation of the prefrontal cortex and multitasking training, with functional magnetic resonance imaging in 178 participants. We observed transfer to a visual search task, following 1 mA left or right prefrontal cortex transcranial direct current stimulation and multitasking training. These gains persisted for 1-month post-training. Notably, improvements in visual search performance for the right hemisphere stimulation group were associated with activity changes in the right hemisphere dorsolateral prefrontal cortex, intraparietal sulcus, and cerebellum. Thus, functional dynamics in these task-general regions determine how individuals respond to paired stimulation and training, resulting in enhanced performance on an untrained task.

On the relationship between GABA+ and glutamate across the brain.

Equilibrium between excitation and inhibition (E/I balance) is key to healthy brain function. Conversely, disruption of normal E/I balance has been implicated in a range of central neurological pathologies. Magnetic resonance spectroscopy (MRS) provides a non-invasive means of quantifying in vivo concentrations of excitatory and inhibitory neurotransmitters, which could be used as diagnostic biomarkers. Using the ratio of excitatory and inhibitory neurotransmitters as an index of E/I balance is common practice in MRS work, but recent studies have shown inconsistent evidence for the validity of this proxy. This is underscored by the fact that different measures are often used in calculating E/I balance such as glutamate and Glx (glutamate and glutamine). Here we used a large MRS dataset obtained at ultra-high field (7 T) measured from 193 healthy young adults and focused on two brain regions - prefrontal and occipital cortex - to resolve this inconsistency. We find evidence that there is an inter-individual common ratio between GABA+ (γ-aminobutyric acid and macromolecules) and Glx in the occipital, but not prefrontal cortex. We further replicate the prefrontal result in a legacy dataset (n = 78) measured at high-field (3 T) strength. By contrast, with ultra-high field MRS data, we find extreme evidence that there is a common ratio between GABA+ and glutamate in both prefrontal and occipital cortices, which cannot be explained by participant demographics, signal quality, fractional tissue volume, or other metabolite concentrations. These results are consistent with previous electrophysiological and theoretical work supporting E/I balance. Our findings indicate that MRS-detected GABA+ and glutamate (but not Glx), are a reliable measure of E/I balance .

The influence of tDCS intensity on decision-making training and transfer outcomes.

Transcranial direct current stimulation (tDCS) has been shown to improve single- and dual-task performance in healthy participants and enhance transferable training gains following multiple sessions of combined stimulation and task practice. However, it has yet to be determined what the optimal stimulation dose is for facilitating such outcomes. We aimed to test the effects of different tDCS intensities, with a commonly used electrode montage, on performance outcomes in a multisession single/dual-task training and transfer protocol. In a preregistered study, 123 participants, who were pseudorandomized across four groups, each completed six sessions (pre- and posttraining sessions and four combined tDCS and training sessions) and received 20 min of prefrontal anodal tDCS at 0.7, 1.0, or 2.0 mA or 15-s sham stimulation. Response time and accuracy were assessed in trained and untrained tasks. The 1.0-mA group showed substantial improvements in single-task reaction time and dual-task accuracy, with additional evidence for improvements in dual-task reaction times, relative to sham performance. This group also showed near transfer to the single-task component of an untrained multitasking paradigm. The 0.7- and 2.0-mA intensities varied in which performance measures they improved on the trained task, but in sum, the effects were less robust than for the 1.0-mA group, and there was no evidence for the transfer of performance. Our study highlights that training performance gains are augmented by tDCS, but their magnitude and nature are not uniform across stimulation intensity.NEW & NOTEWORTHY Using techniques such as transcranial direct current stimulation to modulate cognitive performance is an alluring endeavor. However, the optimal parameters to augment performance are unknown. Here, in a preregistered study with a large sample (123 subjects), three different stimulation dosages (0.7, 1.0, and 2.0 mA) were applied during multitasking training. Different cognitive training performance outcomes occurred across the dosage conditions, with only one of the doses (1.0 mA) leading to training transfer.

The efficacy of transcranial direct current stimulation to prefrontal areas is related to underlying cortical morphology.

Applying a weak electrical current to the cortex can have effects on a range of behaviours. Techniques such as transcranial direct current stimulation (tDCS) have been widely used in both research and clinical settings. However, there is significant variability across individuals in terms of their responsiveness to stimulation, which poses practical challenges to the application of tDCS, but also provides a unique opportunity to study the link between the brain and behaviour. Here, we assessed the role of individual differences in cortical morphology - specifically in prefrontal cortical regions of interest - for determining the influence of tDCS on decision-making performance. Specifically, we employed magnetic resonance imaging (MRI) and a previously replicated paradigm in which we modulated learning in a simple decision-making task by applying tDCS to the left prefrontal cortex in human subjects of both sexes. Cortical thickness of the left (but not right) prefrontal cortex accounted for almost 35% of the variance in stimulation efficacy across subjects. This is the first demonstration that variations in cortical architecture are associated with reliable differences in the effects of tDCS on cognition. Our findings have important implications for predicting the likely efficacy of different non-invasive brain stimulation treatments on a case by case basis.

tDCS augments decision-making efficiency in an intensity dependent manner: A training study.

The application of transcranial direct current stimulation (tDCS) to the prefrontal cortex has the potential to improve performance more than cognitive training alone. Such stimulation-induced performance enhancements can generalize beyond trained tasks, leading to benefits for untrained tasks/processes. We have shown evidence that stimulation intensity has non-linear effects on augmenting cognitive training outcomes. However, it is currently unclear how stimulation intensity augments cognitive processing to impact training and transfer effects. Here, we applied decision-making modelling via the linear ballistic accumulator framework to understand what aspects of cognitive processes underlying speeded single-/dual-task decision-making performance change with tDCS intensity. One hundred and twenty-three participants were split into four groups: sham, 0.7 mA, 1.0 mA and 2.0 mA stimulation intensities. Participants completed four training sessions whilst tDCS was delivered. The 0.7 mA & 1.0 mA intensities provided the greatest benefit for performance (increased decision-making efficiency as measured by drift rates) on the trained task - more than sham or 2.0 mA stimulation. The latent decision components integrated both accuracy and reaction times to estimate performance more broadly. We see an inverted u-shaped function of stimulation intensity and cognitive performance in the trained-on task, where either no stimulation or too much stimulation is sub-optimal for performance. By contrast, 1.0 mA and 2.0 mA intensities led to increased drift rates in an untrained (transfer) single task. In sum, tDCS intensity non-linearly modulates cognitive processes related to decision-making efficiency.

Dissociable effects of tDCS polarity on latent decision processes are associated with individual differences in neurochemical concentrations and cortical morphology.

Applying a weak electrical current to the cortex has the potential to modulate neural functioning and behaviour. The most common stimulation technique, transcranial direct current stimulation (tDCS), has been used for causal investigations of brain and cognitive functioning, and to treat psychiatric conditions such as depression. However, the efficacy of tDCS in modulating behaviour varies across individuals. Moreover, despite being associated with different neural effects, the two polarities of electrical stimulation - anodal and cathodal - can result in similar behavioural outcomes. Here we employed a previously replicated behavioural paradigm that has been associated with polarity non-specific disruption of training effects in a simple decision-making task. We then used the linear ballistic accumulator model to quantify latent components of the decision-making task. In addition, magnetic resonance imaging measures were acquired prior to tDCS sessions to quantify cortical morphology and local neurochemical concentrations. Both anodal and cathodal stimulation disrupted learning-related task improvement relative to sham (placebo) stimulation, but the two polarities of stimulation had distinct effects on latent task components. Whereas anodal stimulation tended to affect decision thresholds for the behavioural task, cathodal stimulation altered evidence accumulation rates. Moreover, performance variability with anodal stimulation was related to cortical thickness of the inferior frontal gyrus, whereas performance variability with cathodal stimulation was related to cortical thickness in the inferior precentral sulcus, as well as to prefrontal neurochemical excitability. Our findings demonstrate that both cortical morphology and local neurochemical balance are important determinants of individual differences in behavioural responses to electrical brain stimulation.

Accounting for individual differences in the response to tDCS with baseline levels of neurochemical excitability.

There is now considerable evidence that applying a small electrical current to the cerebral cortex can have wide ranging effects on cognition and performance, and may provide substantial benefit as a treatment for conditions such as depression. However, there is variability across subjects in the extent to which stimulation modulates behaviour, providing a challenge for the development of applications. Here, we employed an individual differences approach to test if baseline concentrations of the neurochemicals GABA and glutamate are associated with an individual's response to transcranial direct current stimulation (tDCS). Using a previously replicated response selection training paradigm, we applied tDCS to the left prefrontal cortex part-way through the learning of a six-alternative-forced-choice task. Across three sessions, subjects received anodal, cathodal, or sham stimulation. Pre-tDCS baseline measures of GABA and glutamate, acquired using magnetic resonance spectroscopy (MRS), correlated with the extent to which stimulation modulated behaviour. Specifically, relative concentrations of GABA and glutamate (used as an index of neurochemical excitability) in the prefrontal cortex were associated with the degree to which active stimulation disrupted response selection training. This work represents an important step forward in developing models to predict stimulation efficacy, and provides a unique insight into how trait-based properties of the targeted cortex interact with stimulation.