FITNESS

Could zapping the brain with electricity make hard effort feel easier? Trevor Ward undergoes transcranial stimulation before taking on some iconic Alpine climbs

46 | August 8, 2019 | Cycling Weekly FITNESS

n the never- The science bit need of during the next few days when ending quest for In a nutshell, tDCS targets specific our route is scheduled to include the marginal gains, one areas of the brain responsible for certain Finestre, Galibier, Izoard and Agnello WorldTour team functions and zaps them with a low mountain passes. For now, I brace myself has resorted to electrical charge — “safe enough even for something unpleasant as the last of techniques straight for young children,” says the consent the electrodes is applied. Instead, all I feel from the pages of form I’m asked to sign. By zapping the is the faintest prickling sensation that science fiction. right areas, neurons can be stimulated lasts just a few seconds (and is never felt Selected riders into states of “excitability” and improve again during the subsequent treatments). from Team Bahrain- the communication between parts of the Merida have brain and the body. If applied regularly, One Flew Over The Finestre? been having their says IRR’s promotional material, the brains zapped with electrical currents benefits can be long-term “because of in a procedure known as transcranial changes that can be made to the brain’s Idirect current stimulation (tDCS). The neural connections.” team claims the procedure has already Though brain stimulation can be traced achieved results. Domenico Pozzovivo back to the ancient Greeks — they used used it at this year’s , electric rays (fish) to treat arthritis — it where he finished seventh overall, and has only become popular in the last few at last year’s Giro, where the 35-year- decades for uses ranging from treating old equalled his best ever stroke victims and addicts to improving performance by finishing fifth. mental functions such as memory and “Normally with pro riders, all they learning. Its recent application in elite are thinking about is their weight and sport has been a natural progression in diet, but Pozzovivo and [Matej] Mohoric the quest for marginal gains. Electricity in the air wanted to know more about this type of As Dr Elisabetta Geda, the neuro- Our first day of putting tDCS to the test treatment, especially psychologist starts ominously. Geda has met us under Domenico who has currently darkening skies in the shadow of Roman a degree in sports connecting ruins in the town of Susa at the foot of the science,” says electrodes to 18km climb to the Colle delle Finestre, Bahrain-Merida various parts of featuring a final eight kilometres of business manager my head puts gravel where launched his Alex Carrera. Does it: “It’s not a spectacular solo, 80km breakaway in performance- stage 19 of last year’s Giro. use the treatment enhancing drug My fellow guinea pigs and I are being too? “No, he said he that will make fitted with our skullcaps and electrodes doesn’t trust you superhuman. when the first rumble of thunder is the machines.” It’s something shortly followed by a flash of lightning. The ‘machines’ where you’re We run to the nearest cafe with Geda cost around £9,000 changing or trailing in our wake and reassuring us Blue-sky thinking has become each, consist of a strengthening that the electric current running through ever more scientific in cycling neoprene skullcap neural our heads will not make us any more with a small connections vulnerable to a lightning strike. However, electrical unit and up to 20 electrodes in your brain to aid your training. by the time we have finished our attached to it, and belong to the Istituto Every brain is unique and will respond 20-minute session — “the optimal time delle Riabilitazion Riba (IRR) of Turin, differently. You may not ride faster, before the brain starts asking, ‘What’s Bahrain-Merida’s official sports clinic. but maybe you will be able to tolerate going on here?’” explains Geda — the The treatment is all about accessing pain better.” storm is at its peak. various parts of the brain and its neurons Geda is placing the electrodes in a It is 90 minutes before the rain eases — which sounded to me worryingly specific pattern — “montage” — to target off and we can start riding, by which time like a cross between Frankenstein and my dorsolateral prefrontal cortex, the the effects of the pre-exertion stimulation One Flew Over The Cuckoo’s Nest. But part of my brain responsible for deciding have already worn off — it normally when IRR invited me to join a group just how much I’ll tolerate the signals of lasts around an hour. Therefore, it is of guinea pigs for a week of riding and exhaustion being sent from my body. The unlikely that my eventual conquering of

neurostimulation in the Italian/French theory is that stimulating this area will the Finestre’s relentlessly steep slopes Edoardo Melchiori, Yuzuru Sunada, Endura

Alps, curiosity outweighed my doubts and increase my ability to overcome fatigue, and quagmire of rain-sodden gravel has s

before I knew it, I was on a plane to Turin. something I suspect I will be much in anything to do with the enhanced firing Photo

Cycling Weekly | August 8, 2019 | 47 FITNESS

of neurons between my prefrontal and to tame their “inner chimp” and conquer primary motor cortexes. their mental demons. The next day is even worse, with only Though the science of tDCS is slowly one of us making it through the rain, wind, gaining credibility in the sporting world snow and sub-zero temperatures to the — several NBA, NFL and Major Baseball 2,642-metre summit of the Galibier. After League stars, as well as ex-WorldTour climbing the Télégraphe in drizzle and rider Andrew Talansky, use a portable, zero visibility, I’m the second last to quit headphones-style device called Halo 10km from the top when a fierce headwind Sport that retails for $399 — there are kicks up. Last man riding is Canadian Alex more lo-fi ways to tap into your potential. Hutchinson, a 63kg former elite middle “Changes in performance have been distance runner and author of Endure, a strongly correlated with changes in 2018 New York Times bestseller about perception of effort,” says Luca Angius, of “the limits of human performance”. Northumbria University’s department of sport, exercise and rehabilitation. “When Brain gains perceived effort is high, endurance The brain’s significance in endurance performance is impaired — exercise feels sports is not a new discovery. More harder. But when perception of effort is than 100 years ago, Italian scientist low, exercise feels easier and performance Angelo Mosso confirmed that cognitive is improved.” tasks could affect the body’s powers To reduce the perception of effort, of endurance. The Central Governor scientists have resorted to a variety Theory, formulated by sports scientist of cunning psychological ruses in and ultra-marathon laboratory tests. runner Tim Noakes “Endurance These have ranged in 1998, posits from the use of that your brain magically subliminal images subconsciously — cyclists shown sets limits on your doubled when 16-millisecond Brains overiding brawn body’s capabilities. videos of happy on the Col d’Izoard? And more recently, financial faces rode for elite athletes have three minutes been taught by incentives were longer than self-talk — a group of riders who used psychiatrists such those shown sad phrases such as “feeling good!” and “push as Steve Peters how offered” faces; positive through this!” in their training lasted 18 per cent longer than the control group; and financial incentives — volunteers’ endurance magically doubled in a 1986 experiment when the “fee” rose from 0.2 francs per 20 seconds to 7.8 francs. In one experiment at Northumbria University in 2012, males taking part in moderate-intensity running trials had a reduced perception of effort in the presence of a female member of staff. “These studies highlight the complexity of performance regulation and the importance of psychological factors influencing perception of effort,” says Angius, adding ominously: “They also disproved the validity of the ‘central governor’, since if any subconscious regulator existed, none of these types of manipulation should be able to increase A suitable mantra could lead to an exercise duration.” easier dispatchment of long wending climbs At the end of the next day’s ride — which thankfully sees us summit the

48 | August 8, 2019 | Cycling Weekly FITNESS

THE ETHICAL QUESTION If it works, is it fair?

Lecturer in sports ethics and integrity at Swansea University Dr John William Devine ponders whether tDCS is fair means or foul

On the face of it, tDCS is appealing because it seems to ‘unlock’ rather than ‘expand’ an athlete’s physiological capacity — removing a barrier to full potential rather than tampering with that potential. When examining whether an enhancement such as tDCS should be permitted in sport, three considerations are crucial: 1. Does the enhancement pose an unacceptable risk of harm? For example, is the electric charge that is applied to the brain during tDCS damaging to the rider’s short or long-term health? 2. Does the enhancement create unacceptable unfairness between athletes? Is tDCS so expensive that only wealthy athletes and teams can access it? 3. Does the enhancement Izoard and Agnello road from our hotel undermine some of the skills and in glorious sunshine ensures it doesn’t. capacities — the excellences — that — Geda introduces So I get up early to the sport is designed to test? This another montage, answer some work third factor is perhaps the most this one targeting a emails, unaware fundamental: the spirit of the sport. different part of our this will have a Sports communities must decide brains, the primary potentially negative which excellences should determine motor cortex, with the impact on my riding. the outcome of competition. In aim of improving our Only later do endurance cycling, the backbone of recovery process. It’s I discover that excellent performance is the ability administered at the sports scientist to endure mental discomfort, fatigue same time as we are Samuele Marcora and exhaustion while executing receiving our post- has established that complex bike-handling skills and ride massage perceived exertion making decisions under pressure. and again lasts for is increased by Riders who can overcome this 20 minutes. mental fatigue. In discomfort demonstrate virtues It’s a similar The treatment is also other words, doing of character such as fortitude and protocol to Domenico said to aid recovery a cognitive task courage. If tDCS does in fact delay the Pozzovivo’s during such as homework experience of fatigue and exhaustion, last year’s Giro and or your accounts these virtues become less decisive. this year’s Tour de Suisse and should aid immediately before riding your bike Does tDCS thereby make cycling less our sleep. We have a final big climb the will adversely affect your performance. a test of character, more a test of next day, the Colle delle Sampeyre, so Furthermore, Marcora’s experiments neuro-sensory meddling? That is a I’m hoping the treatment works. Alas, proved that cognitive tasks before question for the sport to resolve. the town clock immediately across the exercise were just as debilitating as

Cycling Weekly | August 8, 2019 | 49 FITNESS

physical tasks — a 90-minute mental task “Continuing to improve had the exact same effect on a group of your physiological capacity cyclists’ performance as doing 100 drop through your regular training jumps from a height of 40cm. is still the most effective Marcora, now the director of research way. Everything you’ve been at the University of Kent’s school of sport doing so far, keep doing it, it and exercise science, says the brain can all has an effect.” be trained to resist mental fatigue, and Thankfully there are a Dr Geda maps out electrode locations is currently using his research to help couple of tricks with proven ultra-distance cyclists be more resistant benefits. “Two other things to sleep deprivation. He has encouraging can help. First, caffeine. This has an effect self-talk, which aren’t considered words for the rest of us who’d merely on the brain and reduces perception of doping — whereas tDCS may be in like to be able to complete that race or effort. Secondly, use some psychological the future!” sportive a little faster. techniques such as motivational self- Isn’t there a risk in ignoring what “When you stop because you feel talk, imagery and goal-setting. Learn you perceive to be close-to-your-limit there’s nothing left in the tank, the reality how to deal with negative thoughts by exertions? “In all the studies we’ve done, is that there is quite a lot of reserve,” he replacing them with motivational, simple whether using tDCS, caffeine or self-talk, says. “If you cycle at 300 watts for as statements. You can convince yourself no negative effects have been reported. long as you can, the reality is that from a it’s not so bad.” Perceived effort is measured on the Borg neuro-muscular perspective you are able And what does Marcora make of tDCS? Scale from six to 20, and by using these to do much more than that. We reach a “Personally, I prefer the caffeine and techniques we are changing perceptions perceptual limit, but by just one point. there are things you It’s not like a big can do to tap into your “It’s not a big change, but change from hard physiological capacity effort to light, it’s just a little more.” enough to significantly improve enough to improve Sadly, there is no your performance in a magic bullet. your performance” significant way.”

Riding to the limit, and beyond, in the high Alps

50 | August 8, 2019 | Cycling Weekly FITNESS

Mind over mountain PRO RIDERS ON t DCS During the 15km climb up to the Colle delle Sempeyre’s 2,284m summit, I am ‘Brain stimulation trying to decipher the signals from my body. I’ve learned about parts of my brain boosted my Giro’ I never previously knew even existed and am trying to see if I can put this Bahrain-Merida’s Domenico knowledge to good use, and distinguish Pozzovivo is known among his between my real and perceived suffering. friends as ‘Dr Pozzovivo’ because of But I’ve dropped off the back of the his studies in economics and sports group and the support van is hovering science. During the 2018 Giro, he behind me, tempting me with its air- was given tDCS treatment during conditioned seats. I have no way of his massage after every stage — knowing if my neurons are firing more except one. effectively or not, so resort to some “He didn’t have time and the next self-incentivising imagery that mainly day he lost his podium position on consists of a large glass of foaming beer, a the GC,” says the team’s business hearty meal and home comforts. manager Alex Carrera. But in the end it’s the poor maths of But 35-year-old Pozzovivo the Italian Highways department that eventually equalled his best ever saves me. I arrive at the summit three Grand Tour performance, finishing kilometres earlier than I had expected fifth overall, and credits his success (the sign at the bottom had said 18km to to the brain stimulation, saying: go) and this lifts my spirits more than any “Given that time is short after amount of electric currents zapping my stages during the Giro, we used it various cortexes. during my massages and it’s indeed fkflk‘Dr Pozzovivo’ lf flkf lf lfk fklf is a kf tDCS klf f advocate At the end of the day, we receive our had its benefits; I truly noticed an final session of tDCS — again aimed at effect. The protocols that we used improving our recovery — though I can’t on me have been focused on enhancing physical fitness is not important, but be sure whether it’s the electrodes or the the quality of sleep and stimulating somehow secondary to the serenity you fine wine that eventually sends me to the parts of my brain that command can reach with your mind, especially in sleep that night. relaxation. After some of the very hard events where you feel under pressure. Back home in the UK, I read stages of the Giro, it’s a struggle to “I decided to start using tDCS Hutchinson’s book Endure. It includes a even find the ability to be able to relax because I believe in science and think chapter about brain stimulation in which the muscles, so we experimented with sport is a very good field of application. two elite US cyclists race each other various protocols and I have to say that Also, Dr Elisabetta Geda is renowned after receiving tDCS. Surveying all the for me my quality of sleep improved.” in her field and I’m very interested in electronic gadgetry around them, one of Vittoria Bussi is the current women’s her research. them says: “You can do all this s**t, but Hour record holder — she recorded “I have been using it exclusively it all comes down to two guys on a bike 48.007km in Aguascalientes, Mexico, before races to enhance my trying to beat each other.” last September. She was also runner- performance. We don’t have any Hutchinson concludes: “Brain up in the 2018 Italian national TT scientific data yet but I can say for stimulation may or may not turn out to be championships, and is a doctor in pure sure that it changes the perception an effective way of accessing your hidden mathematics. Bussi of fatigue. reserves, but… when it comes down to started using tDCS at “My next goal is Bussi: seeking serenity two guys on a bike, maybe that’s the real the start of this year. the Chrono Kristin secret weapon: believing that you have “I’ve always Armstrong, a another gear.” believed the brain prestigious UCI race is as important as in the US. I plan to use Cycling Weekly was hosted by your legs and can tDCS during training Neurofire Cycling, a collaboration say that my best before leaving for the between the IRR clinic and cycling performances are US, then use it a couple tour operator Tourissimo. For more often due of times out there and information about their tours to a good state of finally immediately including tDCS treatment, visit mind. I’m not saying before the race.” neurofirecycling.com.

Cycling Weekly | August 8, 2019 | 51