Enhancing cognition and memory via mobile brain stimulation

正常老龄化个体的认知障碍强烈影响着越来越多的英国人口的生活质量。那些从健康年龄过渡到不健康年龄的人，比如阿尔茨海默病，发现自己处于高危阶梯的顶端，最近超过心脏病和中风，成为头号死因。安全、非侵入性电刺激与认知训练相结合的最新进展显示，作为减缓健康和非健康老龄化人口认知衰退的一种手段，前景广阔。事实上，早期干预可以极大地降低医疗保健成本，同时提高正常老龄化和开始患上痴呆症的人的生活质量和独立性。我们提议的项目将调查“在线”和“离线”大脑刺激对工作记忆和长期记忆的有益影响，这是人类认知的两个关键支柱。首先，我们将使用同步脑刺激与认知训练(在线刺激)相结合的方法来系统地增强参与者的工作记忆能力。认知训练是一种非药物干预形式，有助于在健康衰老期间保持认知功能。其次，我们将在自然睡眠中使用大脑刺激(离线刺激)，努力放大标志着健康睡眠的特定大脑节奏(例如，“慢波”或“睡眠纺锤”)。除了改善恢复性睡眠质量，一个关键的目标是改善长期记忆，众所周知，长期记忆受益于睡眠，在健康老龄化和患有神经退行性疾病的患者中都显示出急剧下降。工作记忆和长期记忆变化都需要大脑可塑性，即大脑经历功能和结构变化以适应新需求的能力。经颅电流刺激(TCS)是一种非侵入性、安全和易于使用的技术，被认为可以改变皮质的兴奋性，进而使大脑可塑性。然而，认知训练和睡眠干预通常都需要在实验室环境中进行多次实验。这不仅对参与者的灵活性和机动性提出了很高的要求(这对老年人来说尤其令人担忧)，而且不熟悉的实验室环境给睡眠带来了额外的压力，从而使实验室睡眠干预特别具有挑战性。我们提议的项目的核心是与NeuroElectrics(NE)的合作，NeuroElectrics(NE)是一家生产刺激和治疗大脑的设备的领先公司。至关重要的是，NE已经创建了远程医疗无线平台，将多通道TCS与脑电波记录结合在一起。因此，我们将处于独特的位置，可以在参与者舒适的家中远程应用大脑刺激。事实上，NE产品已被用于帮助患者在慢性疼痛和中风康复等病理疾病中恢复大脑健康。在过去的两年里，夏皮罗教授一直与NE保持着成功的合作(致力于认知技能和需求培训(Cogisant)工具包的工作)，该公司热衷于进一步支持我们将TCS应用于认知训练和睡眠改善的努力。在他们的博士任期内，成功的候选人将首先在我们伯明翰大学睡眠和认知实验室的健康志愿者中使用TCS进行认知培训和睡眠，建立大脑刺激对工作记忆和长期记忆的有益影响。在第二阶段，将对刺激方案进行调整，以适用于患者群体和家庭环境中的健康志愿者

Cognitive impairment in normally ageing individuals strongly impacts the quality of life in an increasingly large percentage of the UK population. Those who transition from healthy to unhealthy ageing, such as Alzheimer's disease, have found themselves at the top of the at-risk ladder, recently overtaking heart disease and stroke as the number one cause of death. Recent advances in safe, non-invasive electrical stimulation combined with cognitive training show tremendous promise as a means of slowing cognitive decline in both healthy and non-healthy ageing populations. Indeed, early intervention can dramatically reduce health care costs while at the same time improving quality of life and independence of people normally ageing and those starting to acquire dementia.Our proposed project will investigate the beneficial effects of 'online' and 'offline' brain stimulation on working memory and long-term memory, two key pillars of human cognition. First, we will use simultaneous brain stimulation in combination with cognitive training ('online' stimulation) to systematically enhance working memory capacity in participants. Cognitive training is a form of non-pharmaceutical intervention, useful to preserve cognitive function during healthy aging. Second, we will employ brain stimulation during natural sleep ('offline' stimulation) in an effort to amplify particular brain rhythms hallmarking healthy sleep (e.g., 'slow waves' or 'sleep spindles'). Beyond improving restorative sleep quality, a key goal is to improve long-term memory, known to benefit from sleep and showing a dramatic decline both in healthy ageing and in patients suffering from neurodegenerative diseases.Both working memory and long-term memory changes require brain plasticity, i.e., the ability of the brain to undergo functional and structural changes to adapt to new needs. Transcranial Current Stimulation (tCS) is a non-invasive, safe and easily administered technique that is believed to modify cortical excitability, in turn enabling brain plasticity. However, cognitive training and sleep interventions both typically require multiple experimental sessions in laboratory environments. Not only does this put high demands participants' flexibility and mobility (which is a particular concern for the elderly), but unfamiliar laboratory environments put extra strains on efforts to sleep, thereby rendering laboratory sleep interventions particularly challenging.At the core of our proposed project is a collaboration with Neuroelectrics (NE), a leading company that produces devices to stimulate and treat the brain. Critically, NE has created 'telemedicine' wireless platforms, which combine multichannel tCS with recording of brain waves. Thus, we will be in the unique position to apply brain stimulation remotely in the comfort of participants' homes. Indeed, NE products have been used to help patients recovering their brain health in pathologies such as chronic pain and stroke rehabilitation. Prof. Shapiro has maintained a successful collaboration with NE for the last two years (working on the Cognitive Skills and Needs Training (COGNISANT) toolkit), and the company is keen on further supporting our efforts to apply tCS for cognitive training and sleep improvement.Over the tenure of their PhD, the successful candidate will first employ tCS during cognitive training and sleep in healthy volunteers in our sleep and cognition laboratories at the University of Birmingham, establishing the beneficial effect of brain stimulation on working memory and long-term memory. In phase 2, the stimulation protocols will be adapted for translation to patient groups and healthy volunteers in their home environments