Transcutaneous Spinal Direct Current Stimulation Alters Resting-State Functional Connectivity

Transcutaneous spinal direct current stimulation (tsDCS) is a noninvasive method that can modulate spinal reflexes, sensory afferent conduction, and even pain perception. Although neurophysiological evidence suggests that tsDCS alters somatosensory and nociceptive afferent conduction to the cortex, its supraspinal effects have not yet been investigated by using functional imaging to investigate tsDCS-induced alterations in intrinsic functional connectivity (FC). Therefore, we hypothesize that tsDCS-induced changes in neurophysiological measures might also be reflected in spontaneous brain activity. We investigated tsDCS-induced changes in somatosensory cortical connectivity by using seed-to-voxel-based analyses from the bilateral primary somatosensory cortex (S1) and the thalamus in a double-blind, crossover study design. Resting state FC was measured by using blood oxygenation level-dependent, functional magnetic resonance imaging (3T Philips) before and after anodal, cathodal, and sham tsDCS (20min, 2.5mA, active electrode centered over T11 spinous process, reference electrode over left shoulder blade) in a double-blind, crossover study of 20 healthy men (24 +/- 0.7 years). As compared with sham, anodal tsDCS resulted in a decreased connectivity between the S1 and the ipsilateral posterior insula for both left and right hemispheres. Anodal tsDCS also resulted in decreased thalamic connectivity with the anterior cingulate cortex, and increased connectivity between S1 and the thalamus. Cathodal tsDCS showed increased FC between the right thalamus and both left and right posterior insulae, and decreased connectivity between the S1 seeds and the occipital cortex. Our results provide evidence of supraspinal effects of tsDCS and suggest that tsDCS may provide a noninvasive intervention that is able to target cortical sensory networks.