The effects of bilateral M1 anodal tDCS on corticomotor excitability and acquisition the of a bimanual videogame skill

Most activities of daily life involve some degree of coordinated, bimanual activity from the upper limbs. However, compared to single-handed movements, bimanual movements are processed, learned, and controlled from both hemispheres of the brain. Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that enhances motor learning by modulating the activity of movement-associated brain regions. While effective in simple, single-handed tasks, tDCS has shown mixed results in complex bimanual tasks. This study investigated the effects of bilateral M1 anodal tDCS (biM1 a-tDCS) on learning and cortical excitability during a customized, bimanual racing videogame task. Thirty-six right-handed adults completed three lab visits (∼48 h apart), practicing the task while receiving either biM1 a-tDCS or SHAM tDCS. Cortical excitability was measured with transcranial magnetic stimulation (TMS) and electromyography (EMG) before and after the first visit. Though all subjects demonstrated improvements over the course of the study, our analyses revealed significantly faster rates of learning on days 1 & 2, but not day 3, of practice in subjects receiving biM1 a-tDCS. Moreover, perhaps due to differences in baseline gaming experience and aptitude, this effect appeared to be stronger in female subjects. Interestingly, no significant differences in corticomotor excitability were observed between conditions. Though biM1 a-tDCS did not appear to impact corticomotor excitability, our results contribute to the growing body of evidence which seems to suggest that multifocal tDCS protocols may be superior to traditional, single-site tDCS for the enhancement of bimanual motor learning.