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Published in: European Archives of Psychiatry and Clinical Neuroscience 1/2021

Open Access 01-02-2021 | Schizophrenia | Invited Review

Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry

Authors: Osama Elyamany, Gregor Leicht, Christoph S. Herrmann, Christoph Mulert

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 1/2021

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Abstract

Transcranial alternating current stimulation (tACS) is a unique form of non-invasive brain stimulation. Sinusoidal alternating electric currents are delivered to the scalp to affect mostly cortical neurons. tACS is supposed to modulate brain function and, in turn, cognitive processes by entraining brain oscillations and inducing long-term synaptic plasticity. Therefore, tACS has been investigated in cognitive neuroscience, but only recently, it has been also introduced in psychiatric clinical trials. This review describes current concepts and first findings of applying tACS as a potential therapeutic tool in the field of psychiatry. The current understanding of its mechanisms of action is explained, bridging cellular neuronal activity and the brain network mechanism. Revisiting the relevance of altered brain oscillations found in six major psychiatric disorders, putative targets for the management of mental disorders using tACS are discussed. A systematic literature search on PubMed was conducted to report findings of the clinical studies applying tACS in patients with psychiatric conditions. In conclusion, the initial results may support the feasibility of tACS in clinical psychiatric populations without serious adverse events. Moreover, these results showed the ability of tACS to reset disturbed brain oscillations, and thus to improve behavioural outcomes. In addition to its potential therapeutic role, the reactivity of the brain circuits to tACS could serve as a possible tool to determine the diagnosis, classification or prognosis of psychiatric disorders. Future double-blind randomised controlled trials are necessary to answer currently unresolved questions. They may aim to detect response predictors and control for various confounding factors.
Literature
7.
go back to reference Herrmann CS, Strüber D, Helfrich RF, Engel AK (2016) EEG oscillations: from correlation to causality. Int J Psychophysiol 103:12–21CrossRef Herrmann CS, Strüber D, Helfrich RF, Engel AK (2016) EEG oscillations: from correlation to causality. Int J Psychophysiol 103:12–21CrossRef
12.
go back to reference Woods AJ, Antal A, Bikson M et al (2016) A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol 127:1031–1048CrossRef Woods AJ, Antal A, Bikson M et al (2016) A technical guide to tDCS, and related non-invasive brain stimulation tools. Clin Neurophysiol 127:1031–1048CrossRef
13.
go back to reference Huang Y, Datta A, Bikson M, Parra LC (2018) ROAST: An open-source, fully-automated, realistic volumetric-approach-based simulator for TES. In: Proceedings of the annual international conference of the IEEE engineering in medicine and biology society, EMBS. Institute of Electrical and Electronics Engineers Inc, pp 3072–3075 Huang Y, Datta A, Bikson M, Parra LC (2018) ROAST: An open-source, fully-automated, realistic volumetric-approach-based simulator for TES. In: Proceedings of the annual international conference of the IEEE engineering in medicine and biology society, EMBS. Institute of Electrical and Electronics Engineers Inc, pp 3072–3075
23.
go back to reference Fröhlich F (2014) Endogenous and exogenous electric fields as modifiers of brain activity: rational design of noninvasive brain stimulation with transcranial alternating current stimulation. Dialog Clin Neurosci 16:93–102CrossRef Fröhlich F (2014) Endogenous and exogenous electric fields as modifiers of brain activity: rational design of noninvasive brain stimulation with transcranial alternating current stimulation. Dialog Clin Neurosci 16:93–102CrossRef
25.
go back to reference Spruston N (2008) Pyramidal neurons: dendritic structure and synaptic integration. Nat Rev Neurosci 9:206–221CrossRef Spruston N (2008) Pyramidal neurons: dendritic structure and synaptic integration. Nat Rev Neurosci 9:206–221CrossRef
54.
go back to reference McClintock SM, Reti IM, Carpenter LL et al (2018) Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. J Clin Psychiatry 79:35–48CrossRef McClintock SM, Reti IM, Carpenter LL et al (2018) Consensus recommendations for the clinical application of repetitive transcranial magnetic stimulation (rTMS) in the treatment of depression. J Clin Psychiatry 79:35–48CrossRef
55.
go back to reference Barker AT, Jalinous R, Freeston IL (1985) Non-invasive magnetic stimulation of human motor cortex. Lancet 325:1106–1107CrossRef Barker AT, Jalinous R, Freeston IL (1985) Non-invasive magnetic stimulation of human motor cortex. Lancet 325:1106–1107CrossRef
60.
go back to reference Terao Y, Ugawa Y (2002) Basic mechanisms of TMS. J Clin Neurophysiol 19:322–343CrossRef Terao Y, Ugawa Y (2002) Basic mechanisms of TMS. J Clin Neurophysiol 19:322–343CrossRef
65.
go back to reference Tavakoli AV, Yun K (2017) Transcranial alternating current stimulation (tACS) mechanisms and protocols. Front Cell Neurosci 11:214CrossRef Tavakoli AV, Yun K (2017) Transcranial alternating current stimulation (tACS) mechanisms and protocols. Front Cell Neurosci 11:214CrossRef
66.
go back to reference Fröhlich F, Sellers KK, Cordle AL (2014) Targeting the neurophysiology of cognitive systems with transcranial alternating current stimulation. Expert Rev Neurother 15:145–167CrossRef Fröhlich F, Sellers KK, Cordle AL (2014) Targeting the neurophysiology of cognitive systems with transcranial alternating current stimulation. Expert Rev Neurother 15:145–167CrossRef
68.
go back to reference Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009:6 Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009:6
69.
go back to reference Uhlhaas PJ, Singer W (2010) Abnormal neural oscillations and synchrony in schizophrenia. Nat Rev Neurosci 11:100–113CrossRef Uhlhaas PJ, Singer W (2010) Abnormal neural oscillations and synchrony in schizophrenia. Nat Rev Neurosci 11:100–113CrossRef
78.
go back to reference Boutros NN, Arfken C, Galderisi S et al (2008) The status of spectral EEG abnormality as a diagnostic test for schizophrenia. Schizophr Res 99:225–237CrossRef Boutros NN, Arfken C, Galderisi S et al (2008) The status of spectral EEG abnormality as a diagnostic test for schizophrenia. Schizophr Res 99:225–237CrossRef
87.
go back to reference Uhlhaas PJ, Singer W (2013) High-frequency oscillations and the neurobiology of schizophrenia. Dialogues Clin Neurosci 15:301–313CrossRef Uhlhaas PJ, Singer W (2013) High-frequency oscillations and the neurobiology of schizophrenia. Dialogues Clin Neurosci 15:301–313CrossRef
88.
go back to reference Lisman J (2012) Excitation, inhibition, local oscillations, or large-scale loops: What causes the symptoms of schizophrenia? Curr Opin Neurobiol 22:537–544CrossRef Lisman J (2012) Excitation, inhibition, local oscillations, or large-scale loops: What causes the symptoms of schizophrenia? Curr Opin Neurobiol 22:537–544CrossRef
97.
go back to reference Hong LE, Summerfelt A, McMahon R et al (2004) Evoked gamma band synchronization and the liability for schizophrenia. Schizophrenia Res 2004:293–302CrossRef Hong LE, Summerfelt A, McMahon R et al (2004) Evoked gamma band synchronization and the liability for schizophrenia. Schizophrenia Res 2004:293–302CrossRef
101.
go back to reference Brennan AM, Harris AW, Williams LM (2013) Functional dysconnectivity in schizophrenia and its relationship to neural synchrony. Expert Rev Neurother 13:755–765CrossRef Brennan AM, Harris AW, Williams LM (2013) Functional dysconnectivity in schizophrenia and its relationship to neural synchrony. Expert Rev Neurother 13:755–765CrossRef
115.
go back to reference Phillips WA, Singer W (1997) In search of common foundations for cortical computation. Behav Brain Sci 20:657–722CrossRef Phillips WA, Singer W (1997) In search of common foundations for cortical computation. Behav Brain Sci 20:657–722CrossRef
116.
go back to reference Bertrand O, Tallon-Baudry C (2000) Oscillatory gamma activity in humans: a possible role for object representation. Int J Psychophysiol 2000:211–223CrossRef Bertrand O, Tallon-Baudry C (2000) Oscillatory gamma activity in humans: a possible role for object representation. Int J Psychophysiol 2000:211–223CrossRef
117.
go back to reference Pettersson-Yeo W, Allen P, Benetti S et al (2011) Dysconnectivity in schizophrenia: where are we now? Neurosci Biobehav Rev 35:1110–1124CrossRef Pettersson-Yeo W, Allen P, Benetti S et al (2011) Dysconnectivity in schizophrenia: where are we now? Neurosci Biobehav Rev 35:1110–1124CrossRef
118.
go back to reference Li S, Hu N, Zhang W et al (2019) Dysconnectivity of multiple brain networks in schizophrenia: a meta-analysis of resting-state functional connectivity. Front Psychiatry 10:482CrossRef Li S, Hu N, Zhang W et al (2019) Dysconnectivity of multiple brain networks in schizophrenia: a meta-analysis of resting-state functional connectivity. Front Psychiatry 10:482CrossRef
119.
go back to reference Stephan KE, Friston KJ, Frith CD (2009) Dysconnection in Schizophrenia: from abnormal synaptic plasticity to failures of self-monitoring. Schizophr Bull 35:509–527CrossRef Stephan KE, Friston KJ, Frith CD (2009) Dysconnection in Schizophrenia: from abnormal synaptic plasticity to failures of self-monitoring. Schizophr Bull 35:509–527CrossRef
123.
go back to reference Steinmann S, Leicht G, Mulert C (2019) The interhemispheric miscommunication theory of auditory verbal hallucinations in schizophrenia. Int J Psychophysiol 145:83–90CrossRef Steinmann S, Leicht G, Mulert C (2019) The interhemispheric miscommunication theory of auditory verbal hallucinations in schizophrenia. Int J Psychophysiol 145:83–90CrossRef
132.
go back to reference Fingelkurts AAA, Fingelkurts AAA (2015) Altered structure of dynamic electroencephalogram oscillatory pattern in major depression. Biol Psychiatry 77:1050–1060CrossRef Fingelkurts AAA, Fingelkurts AAA (2015) Altered structure of dynamic electroencephalogram oscillatory pattern in major depression. Biol Psychiatry 77:1050–1060CrossRef
141.
go back to reference Breitenstein B, Scheuer S, Holsboer F (2014) Are there meaningful biomarkers of treatment response for depression? Drug Discov. Today 19:539–561 Breitenstein B, Scheuer S, Holsboer F (2014) Are there meaningful biomarkers of treatment response for depression? Drug Discov. Today 19:539–561
184.
go back to reference Lima IMM, Peckham AD, Johnson SL (2018) Cognitive deficits in bipolar disorders: implications for emotion. Clin Psychol Rev 59:126–136CrossRef Lima IMM, Peckham AD, Johnson SL (2018) Cognitive deficits in bipolar disorders: implications for emotion. Clin Psychol Rev 59:126–136CrossRef
191.
go back to reference Babiloni C, Lizio R, Marzano N et al (2016) Brain neural synchronization and functional coupling in Alzheimer’s disease as revealed by resting state EEG rhythms. Int J Psychophysiol 103:88–102CrossRef Babiloni C, Lizio R, Marzano N et al (2016) Brain neural synchronization and functional coupling in Alzheimer’s disease as revealed by resting state EEG rhythms. Int J Psychophysiol 103:88–102CrossRef
196.
go back to reference Reddy M (2012) Non-compliance in pharmacotherapy. Indian J Psychol Med 34:107–109CrossRef Reddy M (2012) Non-compliance in pharmacotherapy. Indian J Psychol Med 34:107–109CrossRef
197.
go back to reference Mago R (2016) Adverse effects of psychotropic medications: a call to action. Psychiatr Clin N Am 39:361–373CrossRef Mago R (2016) Adverse effects of psychotropic medications: a call to action. Psychiatr Clin N Am 39:361–373CrossRef
204.
go back to reference Thut G, Bergmann TO, Fröhlich F et al (2017) Guiding transcranial brain stimulation by EEG/MEG to interact with ongoing brain activity and associated functions: a position paper. Clin Neurophysiol 128:843–857CrossRef Thut G, Bergmann TO, Fröhlich F et al (2017) Guiding transcranial brain stimulation by EEG/MEG to interact with ongoing brain activity and associated functions: a position paper. Clin Neurophysiol 128:843–857CrossRef
222.
go back to reference Karabanov AN, Saturnino GB, Thielscher A, Siebner HR (2019) Can transcranial electrical stimulation localize brain function? Front Psychol 10:213CrossRef Karabanov AN, Saturnino GB, Thielscher A, Siebner HR (2019) Can transcranial electrical stimulation localize brain function? Front Psychol 10:213CrossRef
224.
go back to reference Guleyupoglu B, Schestatsky P, Edwards D et al (2013) Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations. J Neurosci Methods 219:297–311CrossRef Guleyupoglu B, Schestatsky P, Edwards D et al (2013) Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations. J Neurosci Methods 219:297–311CrossRef
Metadata
Title
Transcranial alternating current stimulation (tACS): from basic mechanisms towards first applications in psychiatry
Authors
Osama Elyamany
Gregor Leicht
Christoph S. Herrmann
Christoph Mulert
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
European Archives of Psychiatry and Clinical Neuroscience / Issue 1/2021
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI
https://doi.org/10.1007/s00406-020-01209-9

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