title: Cerebellar Transcranial Direct Current Stimulation (ctDCS): A Novel Approach to Understanding Cerebellar Function in Health and Disease.
abstract: The cerebellum is critical for both motor and cognitive control. Dysfunction of the cerebellum is a component of multiple neurological disorders. In recent years, interventions have been developed that aim to excite or inhibit the activity and function of the human cerebellum. Transcranial direct current stimulation of the cerebellum (ctDCS) promises to be a powerful tool for the modulation of cerebellar excitability. This technique has gained popularity in recent years as it can be used to investigate human cerebellar function, is easily delivered, is well tolerated, and has not shown serious adverse effects. Importantly, the ability of ctDCS to modify behavior makes it an interesting approach with a potential therapeutic role for neurological patients. Through both electrical and non-electrical effects (vascular, metabolic) ctDCS is thought to modify the activity of the cerebellum and alter the output from cerebellar nuclei. Physiological studies have shown a polarity-specific effect on the modulation of cerebellar-motor cortex connectivity, likely via cerebellar-thalamocortical pathways. Modeling studies that have assessed commonly used electrode montages have shown that the ctDCS-generated electric field reaches the human cerebellum with little diffusion to neighboring structures. The posterior and inferior parts of the cerebellum (i.e., lobules VI-VIII) seem particularly susceptible to modulation by ctDCS. Numerous studies have shown to date that ctDCS can modulate motor learning, and affect cognitive and emotional processes. Importantly, this intervention has a good safety profile; similar to when applied over cerebral areas. Thus, investigations have begun exploring ctDCS as a viable intervention for patients with neurological conditions.
authors.affiliation: Unité d'Etude du Mouvement, ULB-Erasme, Brussels, Belgium.
authors.forename: Giuliana
authors.initials: G
authors.lastname: Grimaldi
authors.affiliation: Department of Psychology, Brain, Action and Cognition Lab, University of London, Egham, Surrey, UK.
authors.forename: Georgios P
authors.initials: GP
authors.lastname: Argyropoulos
authors.affiliation: Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Bastian
authors.affiliation: Burke Medical Research Institute, Departments of Neurology and Neuroscience, Weill Medical College of Cornell University, White Plains, NY, USA.
authors.forename: Mar
authors.initials: M
authors.lastname: Cortes
authors.affiliation: Department of Psychology, Swansea University, Swansea, UK.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Davis
authors.affiliation: Burke Medical Research Institute, Departments of Neurology and Neuroscience, Weill Medical College of Cornell University, White Plains, NY, USA.
authors.forename: Dylan J
authors.initials: DJ
authors.lastname: Edwards
authors.affiliation: Department of Medical-Surgical Pathophysiology and Transplants, University of Milan, Milan, Italy Clinical Center for Neurotechnology, Neurostimulation and Movement Disorders, Fondazione IRCCS "Ca' Granda" Ospedale Maggiore di Milano, Milan, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Ferrucci
authors.affiliation: Center of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, USA.
authors.forename: Felipe
authors.initials: F
authors.lastname: Fregni
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Galea
authors.affiliation: Department of Neurology, The University of Tokyo, Tokyo, Japan.
authors.forename: Masahi
authors.initials: M
authors.lastname: Hamada
authors.affiliation: Unité d'Etude du Mouvement, ULB-Erasme, Brussels, Belgium.
authors.forename: Mario
authors.initials: M
authors.lastname: Manto
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: R Chris
authors.initials: RC
authors.lastname: Miall
authors.affiliation: Center of Neuromodulation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, USA.
authors.forename: Leon
authors.initials: L
authors.lastname: Morales-Quezada
authors.affiliation: School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Pope
authors.affiliation: Department of Medical-Surgical Pathophysiology and Transplants, University of Milan, Milan, Italy Clinical Center for Neurotechnology, Neurostimulation and Movement Disorders, Fondazione IRCCS "Ca' Granda" Ospedale Maggiore di Milano, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Priori
authors.affiliation: Institute of Neurology, University College London, London, UK.
authors.forename: John
authors.initials: J
authors.lastname: Rothwell
authors.affiliation: School of Psychology, Bangor University, Bangor, UK.
authors.forename: S Paul
authors.initials: SP
authors.lastname: Tomlinson
authors.affiliation: Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA pcelnik@jhmi.edu.
authors.forename: Pablo
authors.initials: P
authors.lastname: Celnik
mesh_terms: D000818:Animals; D002524:Cerebellar Ataxia / Q000503:physiopathology; D002531:Cerebellum / Q000502:physiology* / Q000503:physiopathology*; D006801:Humans; D009044:Motor Cortex / Q000502:physiology; D009473:Neuronal Plasticity / Q000502:physiology; D065908:Transcranial Direct Current Stimulation / Q000009:adverse effects / Q000379:methods*
keywords: cerebellum; cognitive; ctDCS; direct current stimulation; emotion; language; learning; modeling; motor; plasticity; safety; transcranial; working memory