Electric field simulations of transcranial direct current stimulation in children with perinatal stroke.

Introduction: Perinatal stroke (PS) is a focal vascular brain injury and the leading cause of hemiparetic cerebral palsy. Motor impairments last a lifetime but treatments are limited. Transcranial direct-current stimulation (tDCS) may enhance motor learning in adults but tDCS effects on motor learning are less studied in children.

Electroencephalography correlates of transcranial direct-current stimulation enhanced surgical skill learning: A replication and extension study.

Transcranial direct-current stimulation (tDCS), an increasingly applied form of non-invasive brain stimulation, can augment the acquisition of motor skills. Motor learning investigations of tDCS are limited to simple skills, where mechanisms are increasingly understood. Investigations of meaningful, complex motor skills possessed by humans, such as surgical skills, are limited.

Longitudinal Assessment of Cortical Excitability in Children and Adolescents With Mild Traumatic Brain Injury and Persistent Post-concussive Symptoms.

Symptoms following a mild traumatic brain injury (mTBI) usually resolve quickly but may persist past 3 months in up to 15% of children. Mechanisms of mTBI recovery are poorly understood, but may involve alterations in cortical neurophysiology. Transcranial Magnetic Stimulation (TMS) can non-invasively investigate such mechanisms, but the time course of neurophysiological changes in mTBI are unknown.

Repetitive Transcranial Magnetic Stimulation in Youth With Treatment Resistant Major Depression.

Major depressive disorder (MDD) is common in youth and treatment options are limited. We evaluated the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in adolescents and transitional aged youth with treatment resistant MDD. Thirty-two outpatients with moderate to severe, treatment-resistant MDD, aged 13-21 years underwent a three-week, open-label, single center trial of rTMS (ClinicalTrials.

Effects of High-Definition and Conventional Transcranial Direct-Current Stimulation on Motor Learning in Children.

Transcranial direct current stimulation (tDCS) can improve motor learning in children. High-definition approaches (HD-tDCS) have not been examined in children. We hypothesized that primary motor cortex HD-tDCS would enhance motor learning but be inferior to tDCS in children.

Intervention-Induced Motor Cortex Plasticity in Hemiparetic Children With Perinatal Stroke.

Background: Clinical trials are suggesting efficacy of intensive therapy combined with brain stimulation to improve hand function in hemiparetic children with perinatal stroke. However, individual variability exists and the underlying neuroplasticity mechanisms are unknown. Exploring primary motor cortex (M1) neurophysiology, and how it changes with such interventions, may provide valuable biomarkers for advancing personalized neurorehabilitation.

Modeling Transcranial Direct-Current Stimulation-Induced Electric Fields in Children and Adults.

Transcranial direct-current stimulation (tDCS) is a form of non-invasive brain stimulation that induces electric fields in neuronal tissue, modulating cortical excitability. Therapeutic applications of tDCS are rapidly expanding, and are being investigated in pediatrics for various clinical conditions. Anatomical variations are among a host of factors that influence the effects of tDCS, and pronounced anatomical differences between children and adults suggest that induced electric fields may be substantially different across development.

Interhemispheric motor interactions in hemiparetic children with perinatal stroke: Clinical correlates and effects of neuromodulation therapy.

Objective: Brain stimulation and constraint therapy may enhance function after perinatal stroke but mechanisms are unknown. We characterized interhemispheric interactions (IHI) in hemiparetic children and explored their relationship to motor function and neuromodulation.

Methods: Forty-five hemiparetic perinatal stroke subjects aged 6-19 years completed a clinical trial of repetitive-transcranial magnetic stimulation (rTMS) and constraint therapy.

Changes in spectroscopic biomarkers after transcranial direct current stimulation in children with perinatal stroke.

Background: Perinatal stroke causes lifelong motor disability, affecting independence and quality of life. Non-invasive neuromodulation interventions such as transcranial direct current stimulation (tDCS) combined with intensive therapy may improve motor function in adult stroke hemiparesis but is under-explored in children. Measuring cortical metabolites with proton magnetic resonance spectroscopy (MRS) can inform cortical neurobiology in perinatal stroke but how these change with neuromodulation is yet to be explored.

Effects of Transcranial Direct-Current Stimulation on Neurosurgical Skill Acquisition: A Randomized Controlled Trial.

Background: Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery require extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure the acquisition of skill proficiency.

Early Intensive Leg Training to Enhance Walking in Children With Perinatal Stroke: Protocol for a Randomized Controlled Trial.

Background: Development of motor pathways is modulated by activity in these pathways, when they are maturing (ie, critical period). Perinatal stroke injures motor pathways, including the corticospinal tracts, reducing their activity and impairing motor function. Current intervention for the lower limb emphasizes passive approaches (stretching, braces, botulinum toxin injections).

Developmental profile of motor cortex transcallosal inhibition in children and adolescents.

Transcallosal fibers facilitate interhemispheric networks involved in motor tasks. Despite their clinical relevance, interhemispheric motor control systems have not been completely defined in the developing brain. The objective of this study was to examine the developmental profile of transcallosal inhibition in healthy children and adolescents.

Transcranial direct current stimulation for children with perinatal stroke and hemiparesis.

Objective: To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy.

Methods: This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI-classified unilateral perinatal stroke, age of 6 to 18 years, and disabling hemiparesis.

Cortical excitability after pediatric mild traumatic brain injury.

Introduction: Mild traumatic brain injury (mTBI) outcomes are variable, and 10-15% may suffer from prolonged symptoms beyond 3 months that impair the child's return to normal activities. Neurophysiological mechanisms of mTBI are incompletely understood, particularly in children, but alterations in cortical excitability have been proposed to underlie post-concussion syndrome. Improved understanding is required to advance interventions and improve outcomes.

Contralesional Corticomotor Neurophysiology in Hemiparetic Children With Perinatal Stroke.

Background: Perinatal stroke causes most hemiparetic cerebral palsy. Ipsilateral connections from nonlesioned hemisphere to affected hand are common. The nonlesioned primary motor cortex (M1) determines function and is a potential therapeutic target but its neurophysiology is poorly understood.

Transcranial Direct-Current Stimulation Can Enhance Motor Learning in Children.

This study aims to determine the effects of transcranial direct-current stimulation (tDCS) on motor learning in healthy school-aged children. Safety, tolerability, and translation of effects to untrained tasks were also explored. We recruited 24 right-handed children for a randomized, sham-controlled, double-blinded trial to receive: right primary motor cortex (M1) 1 mA anodal (1A-tDCS), left M1 1 mA cathodal (1C-tDCS), left M1 2 mA cathodal tDCS (2C-tDCS), or sham tDCS over 3 consecutive days of motor task practice.