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Kuo, M.-F.

Publications and source records attributed to Kuo, M.-F..

7 recordsLinked to original sources

Determining Reliable Neural Targets for enhancing Motor Sequence Learning: A preparatory study for focal tDCS

BackgroundMotor sequence learning (MSL) underlies the acquisition of everyday skilled movements, and transcranial direct current stimulation (tDCS) has shown promise for enhancing it, although reported effects vary considerably. Before such interventions can be applied and interpreted reliably, the behavioural and neural signatures of the underlying task should be shown to be robust. This study therefore characterised an fMRI-based Serial Reaction Time Task (SRTT) protocol and evaluated the consistency of its behavioural and fMRI-based neural signatures in repeated measurements to identify potential network targets for tDCS. MethodsTwenty healthy young- to middle-aged adults (10 females; mean age 24, SD 4) performed the SRTT during 3T fMRI in two sessions about one week apart, each using one of two matched, non-overlapping task versions in counterbalanced order. We examined block-wise behaviour, task-related and sequence-specific brain activation (general task activation relative to baseline and the SEQ > RND contrast), and functional connectivity using two complementary approaches: the task and temporal dynamics of seed-based connectivity (SBC) within an a priori-defined motor network (M1, SMA, PMC, putamen, and cerebellum), and whole-brain generalised psychophysiological interaction (gPPI) for the SEQ > RND contrast. ResultsReaction time decreased steadily across sequence blocks and returned toward baseline during random blocks, confirming implicit sequence learning; this pattern was consistent across both sessions and both task versions. Test-retest reliability was excellent for random-block reaction time (ICC {approx} .80 - .85), and modest for sequence blocks (ICC {approx} .29 - .53). General task activation (sequence and random performance relative to baseline) engaged the expected sensorimotor network, including the primary motor cortex (M1), premotor cortex, and SMA, with M1 more strongly engaged during sequence than random blocks. The sequence-specific contrast (SEQ > RND) additionally revealed six clusters spanning the left superior parietal cortex, bilateral supplementary and cingulate motor areas, bilateral secondary somatosensory cortex, and left ventral visual cortex together with cerebellar Crus I. The a priori defined motor network was engaged across all task phases and was anchored throughout by strong M1-SMA coupling, with overall network coupling following a non-monotonic course across the session, consistent with successive stages of resource allocation, consolidation, and automatisation. The gPPI analysis identified four sequence-specific connectivity clusters, dominated by a right-lateralised visuomotor network and a somatosensory-visual integration channel. ConclusionsTogether, these findings indicate a two-component architecture for SRTT performance: a left hemispheric cortico-striato-cerebellar network that supports performance and acquisition of the sequence, and a right hemispheric network associated with monitoring its predictable structure. Within this protocol, the SRTT produced robust and stable group-level signatures of implicit motor learning, yielding well-defined network targets for future tDCS interventions..

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Age-dependent Effects of Titrating Anodal Transcranial Direct Current Stimulation (tDCS) Intensity on Motor Sequence Learning

Optimising the currently heterogenous efficacy of transcranial direct current stimulation (tDCS) interventions for motor learning requires identifying stimulation parameters facilitating performance while accounting for age-related differences in baseline performance and mechanisms underlying neuroplasticity. We systematically explored anodal tDCS intensity effects on implicit motor sequence learning (IMSL) in young and older adults. The study utilised a randomised, double-blind, counterbalanced crossover design. Ninety-six healthy participants (48 young adults, 48 older adults) completed a serial reaction time task (SRTT) with online sham or anodal tDCS over M1 at intensities of 1, 2, and 3 mA. The next day, memory consolidation was assessed in a recall test. Both age groups demonstrated IMSL and consolidation across conditions. While 1 mA tDCS improved IMSL in young adults by reducing reaction times, higher intensities had no significant benefit compared to sham. In older adults, anodal tDCS did not affect general task performance compared to sham, but 1mA tDCS acutely impaired selective sequence learning. The results demonstrate age-dependent and non-linear dose-dependent effects of anodal tDCS on IMSL. This underscores the necessity for age-adapted protocols for experimental and clinical tDCS applications. Future research should explore neurophysiological reasons for reduced tDCS efficacy in older adults found in the present study.

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Sleep stage-specific effects of 0.75 Hz phase-synchronized rTMS and tACS on delta frequency activity during sleep

Slow oscillatory activity during non-rapid-eye-movement (NREM) sleep plays a crucial role in both physical health and cognitive functions. Enhancing slow oscillatory activity during sleep has the potential to benefit these domains, yet an optimal stimulation protocol has not been established. This study aimed to investigate whether repetitive transcranial magnetic stimulation (rTMS), synchronized with the trough phase of 0.75 Hz transcranial alternating current stimulation (tACS) can modulate EEG activity in the delta frequency range during sleep and enhance cognitive functions. Healthy adults participated in a within-subject, counterbalanced study design comparing real and sham stimulation conditions. Combined rTMS and tACS was applied over the bilateral prefrontal cortex before sleep. We evaluated (1) power spectral density and functional connectivity within the delta frequency range during resting state and sleep, (2) retention of declarative memory learned before sleep, and (3) sleep parameters including spindle activity, sleep stage ratios, sleep onset latency and sleep efficiency. The combined rTMS and tACS protocol significantly increased delta oscillatory activity during the N3 sleep stage compared to sham. Functional connectivity, as measured by global efficiency, was enhanced during the N2 sleep stage. However, the stimulation did not improve declarative memory retention, spindle activity or other sleep parameters. These findings demonstrate the potential of combined rTMS and tACS as a non-invasive method to enhance delta oscillatory activity during sleep. While the stimulation did not improve memory performance, its ability to modulate delta activity during sleep suggests potential clinical applications for addressing pathological alterations in slow wave activity during sleep. State of SignificanceSlow oscillatory activity during non-rapid eye movement (NREM) sleep is relevant for declarative memory consolidation and overall sleep quality. However, noninvasive brain-stimulation methods to selectively modulate these oscillations remain elusive. In this study, we show that pre-sleep application of repetitive transcranial magnetic stimulation (rTMS) synchronized to the trough of 0.75 Hz transcranial alternating current stimulation (tACS) significantly enhances delta oscillatory activity during N3 sleep and increases global functional connectivity during N2 sleep in healthy humans without sleep disturbances without altering sleep structure. Our findings indicate that rTMS synchronized to the trough of the tACS exerts sleep-stage-specific effects on delta oscillatory activity. This stimulation protocol represents a promising approach for restoring pathological slow-wave activity during sleep in clinical populations.

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Phase-synchronized 40 Hz transcranial electric and magnetic stimulation boosts gamma oscillations and working memory

Gamma oscillations play a crucial role in core cognitive functions such as memory processes. Enhancing gamma oscillatory activity, which is reduced in Alzheimers Disease, may have therapeutic potential, but effective interventions remain to be determined. Previous studies have shown that phase-synchronized electric and magnetic stimulation boosts brain oscillatory activities at theta, alpha, and delta frequency bands in different ways. The high-frequency gamma frequency band remains to be investigated. This study applies novel noninvasive brain stimulation techniques, namely phase-locked 40-Hz intermittent theta-burst stimulation (iTBS) and transcranial alternating current stimulation (tACS), and explores gamma oscillation changes in the brain. Thirty healthy young participants randomly underwent 40-Hz tACS (1), 40-Hz iTBS (2), two combined interventions (phase-locked iTBS to tACS peak sine wave or tACS trough sine wave) (3-4), and a sham condition (5). The target regions were the left and right dorsolateral prefrontal cortex and were stimulated by simultaneous tACS and iTBS. Gamma oscillatory activities (for 2 hours after intervention) were monitored following each intervention. Our results show that all stimulation protocols enhanced 40-Hz oscillatory power. The iTBS-tACS Peak shows the most significant and stable increase in gamma oscillatory activities (up to 2 hours), followed by 40-Hz tACS and 40-Hz iTBS. 40-Hz tACS and 40-Hz iTBS had the strongest acute effects (up to 30 min) on induced gamma oscillations, while 40-Hz tACS most consistently induced gamma oscillations for up to 2 hours in overall resting EEG data. Phase-synchronizing iTBS with tACS at 40 Hz and the 40 Hz tACS alone targeting the dorsolateral prefrontal cortex, may be a viable approach for inducing and stabilizing gamma oscillatory activity, particularly in conditions where endogenous gamma oscillatory is attenuated, such as Alzheimers Disease. Registration IDs:101017716 (CORDIS - European Union-funded project)

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Transferability of cathodal tDCS effects from the primary motor to the dorsolateral prefrontal cortex: a multimodal TMS-EEG study

Neurophysiological effects of transcranial direct current stimulation (tDCS) have been extensively studied over the primary motor cortex (M1). Much less is however known about its effects over non-motor areas, such as the prefrontal cortex (PFC), which is the neuronal foundation for many high-level cognitive functions and involved in neuropsychiatric disorders. In this study, we, therefore, explored the transferability of cathodal tDCS effects over M1 to the PFC. Eighteen healthy human participants (11 males and 8 females) were involved in eight randomized sessions, in which four cathodal tDCS dosages, low, medium, and high, as well as sham stimulation, were applied over the M1 and PFC. After-effects of tDCS were evaluated via transcranial magnetic stimulation (TMS)-electroencephalography (EEG), and TMS-elicited motor evoked potentials (MEP), for the outcome parameters TMS-evoked potentials (TEP), TMS-evoked oscillations, and MEP amplitude alterations. TEPs were studied both at the regional and global scalp levels. The results indicate a regional dosage-dependent nonlinear neurophysiological effect of M1 tDCS, which is not one-to-one transferable to PFC tDCS. Low and high dosages of M1 tDCS reduced early positive TEP peaks (P30, P60), and MEP amplitudes, while an enhancement was observed for medium dosage M1 tDCS (P30 and MEP amplitudes). In contrast, prefrontal low, medium and high dosage tDCS uniformly reduced the early positive TEP peak amplitudes. Furthermore, for both cortical areas, regional tDCS-induced modulatory effects were not observed for late TEP peaks, nor TMS-evoked oscillations. However, at the global scalp level, widespread effects of tDCS were observed for both, TMS-evoked potentials and oscillations. This study provides the first direct physiological comparison of tDCS effects applied over different brain areas and therefore delivers crucial information for future tDCS applications. SIGNIFICANCE STATEMENTModulatory effects of tDCS over the M1 were largely taken as a template so far for the use of this intervention over non-motor regions. However, the neurophysiological effects of tDCS over non-motor regions, such as the prefrontal cortex (PFC), have been much less explored. In the current study, we, using concurrent transcranial magnetic stimulation- electroencephalography, systematically explored the transferability of cathodal tDCS effects on cortical excitability from M1 to the PFC. The results indicate a dosage-dependent nonlinear neurophysiological effect of motor cortex tDCS, which is not one-to-one transferable to prefrontal tDCS. This study provides the first direct physiological comparison of tDCS effects applied over different brain areas, which will further consolidate the rationale for the extension of tDCS applications at both, basic and clinical levels.

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Cognitive functions and respective parameters of human brain physiology are chronotype-dependent

Circadian rhythms have natural relative variations among humans known as chronotype. Chronotype or being a morning or evening person, has a specific physiological, behavioural, and also genetic manifestation. Whether and how chronotype modulates human brain physiology and cognition is, however, not well understood. Here we examine how cortical excitability, neuroplasticity, and cognition are associated with chronotype in early and late chronotype individuals. We monitor motor cortical excitability, brain stimulation-induced neuroplasticity, and examine motor learning and cognitive functions at circadian-preferred and non-preferred times of day in 32 individuals. Motor learning and cognitive performance (working memory, and attention) along with their electrophysiological components are significantly enhanced at the circadian-preferred, compared to the non-preferred time. This outperformance is associated with enhanced cortical excitability (prominent cortical facilitation, diminished cortical inhibition), and long-term potentiation/depression-like plasticity. Our data show convergent findings of chronotype can modulate human brain functions from basic physiological mechanisms to behaviour and higher cognitive functions.

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Sleep-dependent upscaled excitability and saturated neuroplasticity in the human brain: From brain physiology to cognition

Sleep strongly affects synaptic strength, making it critical for cognition, especially learning, and memory formation. Whether and how sleep deprivation modulates human brain physiology and cognition is not well understood. Here we examined how overnight sleep deprivation vs sufficient sleep affects (a) cortical excitability, as measured by transcranial magnetic stimulation (TMS), (b) inducibility of LTP-and-LTD-like plasticity via transcranial direct current stimulation (tDCS), and (c) learning, memory and attention. The results suggest that sleep deprivation upscales cortical excitability due to enhanced glutamate-related cortical facilitation and decreased and/or reversed GABAergic cortical inhibition. Furthermore, tDCS-induced LTP-like plasticity abolishes while LTD-like plasticity converts to excitatory LTP-like plasticity under sleep deprivation. This is associated with increased EEG theta activity, which is related to sleep pressure. Finally, we show that learning and memory formation, behavioral counterparts of plasticity, and working memory and attention, which rely on cortical excitability, are impaired during sleep deprivation. Our data suggest that upscaled brain excitability, and altered plasticity, due to sleep deprivation, are associated with impaired cognitive performance.

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