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Influence of neurovascular mechanisms on response to tDCS: an exploratory study

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Abstract

The beneficial effects of transcranial direct current stimulation (tDCS) for stroke rehabilitation are limited by the variability in changes in corticomotor excitability (CME) after tDCS. Neuronal activity is closely related to cerebral blood flow; however, the cerebral hemodynamics of neuromodulation in relation to neural effects have been less explored. In this study, we examined the effects of tDCS on cerebral blood velocity (CBv) in chronic stroke survivors using transcranial Doppler (TCD) ultrasound in relation to changes in CME and described the neurovascular characteristics of tDCS responders. Middle cerebral artery (MCA) CBv, cerebrovascular resistance (CVRi) and other cerebral hemodynamics-related variables were continuously measured before and after 15 min of 1 mA anodal tDCS to the lesioned lower limb M1. tDCS did not modulate CBv in the whole group and upon TMS-based stratification of responders and non-responders. However, at baseline, responders demonstrated lower CME levels, lower CBv and higher CVRi as compared to non-responders. These results indicate a possible difference in baseline CME and CBv in tDCS responders that may influence their response to neuromodulation. Future trials with a large sample size and repeated baseline measurements may help validate these findings and establish a relationship between neuromodulation and neurovascular mechanisms in stroke.

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Data accessibility

Deidentified data that support the findings of this study will be available on reasonable request from the corresponding author (S.M.) after completion of secondary analyses.

Abbreviations

CME:

Corticomotor excitability

CBF:

Cerebral blood flow

CBv:

Cerebral blood velocity

MBv:

Mean blood velocity

CVRi:

Cerebrovascular resistance index

PI:

Pulsatility index

Et-CO2 :

End-tidal carbon dioxide

tDCS:

Transcranial direct current stimulation

TMS:

Transcranial magnetic stimulation

MCA:

Middle cerebral artery

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Acknowledgements

We would like to thank the members of Brain Plasticity Lab. This work was partly supported by a grant funded by the National Institute of Health (NIH) R01HD075777 (SM).

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Authors and Affiliations

  1. Graduate Program in Rehabilitation Science, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Pooja C. Iyer

  2. Brain Plasticity Laboratory, Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, 1919 West Taylor Street, Chicago, IL, 60612, USA

    Sangeetha Madhavan

  3. Department of Physiology and Anatomy, University of North Texas Health Science Center, Fort Worth, TX, USA

    Alexander Rosenberg

  4. Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA

    Alexander Rosenberg & Tracy Baynard

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  1. Pooja C. Iyer
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Iyer, P.C., Rosenberg, A., Baynard, T. et al. Influence of neurovascular mechanisms on response to tDCS: an exploratory study. Exp Brain Res 237, 2829–2840 (2019). https://doi.org/10.1007/s00221-019-05626-8

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