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Novel Brain Stimulation May Boost Creativity, Treat Depressionhttp://www.medscape.com/viewarticle/843829Application of a weak electric current to the frontal areas of the brain boosts creativity and may lead to a novel method of treating depression, a new proof-of-concept study suggests.Applying 10 Hz of stimulation via electrodes to healthy individuals, the team was able to increase alpha oscillations in the brain and improve performance on a commonly used measure of creativity.They now hope to use the findings as a springboard to improve alpha oscillations in individuals with depression and so improve symptoms.Explaining how alpha oscillations may mediate creativity, coauthor Flavio Frohlich, PhD, assistant professor at the University of North Carolina (UNC) School of Medicine, Chapel Hill, said in a release, "For a long time, people thought alpha waves represented the brain idling.""But over the past 20 years, we've developed much better insight. Our brains are not wasting energy, creating these patterns for nothing. When the brain is decoupled from the environment, it still does important things."The team believes that the stimulation may also enhance phase synchronization between the frontal regions, further boosting creativity.The research is published in the June issue of Cortex. Creativity Boost Dr Frohlich told Medscape Medical News that the overall goal of his research is to develop novel treatments for psychiatric illnesses."The approach we take is that we develop paradigms that use noninvasive brain stimulation," he said."Specifically, one of our interests is developing new treatments for mood disorders, such as major depressive disorder, and what we know from the literature is that a specific type of activity in the brain, these so-called alpha oscillations, are impaired."Because alpha oscillations, which are in the frequency band of 8 to 12 Hz, are known to be more pronounced during tasks that require a lot of creativity, the researchers enrolled 20 healthy individuals in a study with a randomized, balanced, crossover design.They applied 10 Hz or sham current to the frontal cortex through the scalp via three electrodes during two sessions.The sessions consisted of an initial 5 minutes of stimulation, followed by 25 minutes during which the participants completed the Torrance Test of Creative Thinking (TTCT), a commonly used creativity test.The results showed that compared with sham stimulation, 10 Hz of transcranial alternating current stimulation was associated with a significant 7.4% increase in performance on the creativity index of the TTCT.Furthermore, there was no improvement in performance on the TTCT when 40 Hz of stimulation was used to increase gamma wave stimulation, indicating that alpha activity in frontal brain areas is selectively involved in creativity."We've shown that we can specifically moderate alpha oscillations in terms of behavior effects, and we know that alpha oscillations are impaired with patients with depression, so a restoration of the electrical activity patterns is a highly promising approach to improve behavioral symptoms," said Dr Frohlich."Does it really work that way? We don't know. But it's a hopeful first step that those kinds of interventions can really change high-order brain function."To that end, Dr Frohlich has embarked on two clinical trials to determine whether transcranial alternating current stimulation will be of benefit to people with major depressive disorder and premenstrual dysphoric disorder.Home-Based Treatment? Commenting for Medscape Medical News, Paul E Holtzheimer, MD, associate professor of psychiatry, Dartmouth-Hitchcock Medical Center, in Lebanon, New Hampshire, described the study as "well designed" and "very interesting."But whether that "will translate into behavioral change that has clinical meaning in treating depression, we will have to wait and see."Dr Holtzheimer noted that an attractive aspect of the technique used in the study is its noninvasive nature. There are two aspects to this."One is the very low side effect profile, which is similar to other brain stimulation approaches," he said."There may be a little irritability of the skin underneath the electrodes, maybe a mild headache in some patients, but otherwise relatively low side effect burden compared to medications and other brain stimulation approaches, like, say, transcranial magnetic stimulation [TMS]," he added."Because of that decreased risk, it also opens this up to be a home-based treatment," Dr Holtzheimer added."Unlike TMS, where you have to go into the clinic or the hospital to receive this treatment, this is something similar to some of the other devices out there, that you could prescribe for patients.""They could take it home and they could use it per your directions."For Dr Holtzheimer, the current study also highlights growing awareness of the heterogeneity of depression, with potentially different pathophysiologies for different forms of the condition."Despite decades of research, we still have a very limited understanding of what are the unique and specific neurobiological abnormalities that are associated with depression," he said."It is believed by many that there are probably several types of depression and that may have some overlap biologically, but it may also have some differences.""A big push of a lot of research, including my own, is to try and identify biomarkers of specific types of depression that might be amenable to specific treatments, so as to allow more individualized treatment selection, matching specific patients to specific treatments."He added: "However, and to their credit in thinking about this as maybe a first step in a larger research program, we do know that oscillatory activity, as measured by electroencephalography…, has been shown to be abnormal in some patients with depression."Finally, Dr Holtzheimer pointed out that although the team looked at the impact of brain stimulation on creativity during the task, they did not examine whether the effect persisted after the intervention.Describing that as something that "surprised" him, Dr Holtzheimer concluded: "Again, if this going to translate into a treatment, you need to show, as they have with TMS, that you not only get a change in behavior or physiology during the stimulation but that those actually persist for some period of time beyond the stimulation."This study was funded by the National Institute of Mental Health, the Department of Psychiatry at the UNC School of Medicine, and the Swiss National Science Foundation. UNC has filed a nonprovisional patent on transcranial alternating current–related technology, with Dr Frohlich as the lead inventor. No licensing has occurred, and none of the authors are financially or otherwise benefiting from this initial filing. Cortex. 2015;67:74-82. Abstract