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Transcranial direct current stimulation: State of the art 2008
Open accessAbstract
Effects of weak electrical currents on brain and neuronal function were first described decades ago. Recently, DC polarization of the brain was reintroduced as a noninvasive technique to alter cortical activity in humans. Beyond this, transcranial direct current stimulation (tDCS) of different cortical areas has been shown, in various studies, to result in modifications of perceptual, cognitive, and behavioral functions. Moreover, preliminary data suggest that it can induce beneficial effects in brain disorders. Brain stimulation with weak direct currents is a promising tool in human neuroscience and neurobehavioral research. To facilitate and standardize future tDCS studies, we offer this overview of the state of the art for tDCS.
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“tDCS is thought to affect neuroplasticity via modulating cellular, molecular and neurochemical mechanisms involved in use-dependent local and distant synaptic plasticity, i.e., GABA and glutamate-mediated long-term potentiation (Nitsche et al., 2008; Kim et al., 2014)”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Nitsche et al., 2008
In the citing paper
“Given that tDCS is thought to affect neuroplasticity (Nitsche et al., 2008; Kim et al., 2014),”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Nitsche et al., 2008
In the citing paper
“Transcranial Direct Current Stimulation (tDCS) has been shown to be an effective non-invasive technique for research conducted with both healthy8 and clinical subjects9 in the domain of social cognition10.”
In the citing paper
“The effects of tDCS on neuronal excitability have now been demonstrated in numerous neuroimaging and physiological studies, providing a sound neurobiological basis for its use for neuromodulation in patient populations.1,3”
From Transcranial direct current stimulation for depression: 3-week, randomised, sham-controlled trial (2012) · cites this paper as [3]
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Nitsche, M. A., & Paulus, W. (2000) · The Journal of Physiology · doi:10.1111/j.1469-7793.2000.t01-1-00633.x · Cited by 5,656 · cited 4×
“For 4 seconds of tDCS, which elicits no after-effects, a break of 10 seconds between each period of stimulation is sufficient.(13) For tDCS durations that produce short-lasting (namely, for about 10 minutes) after-effects, a 1-hour break between stimulation sessions is sufficient.”
BackgroundResultInfluentialSelf-citationSustained excitability elevations induced by transcranial DC motor cortex stimulation in humans
Nitsche, M. A., & Paulus, W. (2001) · Neurology · doi:10.1212/wnl.57.10.1899 · Cited by 2,617 · cited 1×
“For tDCS durations resulting in long-lasting after-effects (1 hour or more), an intersession interval of 48 hours to 1 week has been suggested.(14,15,43) If repetitive tDCS is performed to prolong and stabilize long-lasting after-effects, subjects are generally stimulated once a day.”
BackgroundSelf-citationNitsche, M. A., Fricke, K., Henschke, U., Schlitterlau, A., Liebetanz, D., Lang, N., Henning, S. J., Tergau, F., & Paulus, W. (2003) · The Journal of Physiology · doi:10.1113/jphysiol.2003.049916 · Cited by 1,587
Self-citationGandiga, P. C., Hummel, F. C., & Cohen, L. G. (2006) · Clinical Neurophysiology · doi:10.1016/j.clinph.2005.12.003 · Cited by 1,474 · cited 2×
“Compared with TMS, it is easier to conduct placebo stimulation-controlled studies with tDCS, because, with the exception of a slight itching sensation and sensory phenomena, including retinal phosphenes with current switching, subjects rarely experience sensations related to the treatment.(26) To reduce cutaneous sens…”
MethodSelf-citationLiebetanz, D. (2002) · Brain · doi:10.1093/brain/awf238 · Cited by 1,383
Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory
Fregni, F., Boggio, P. S., Nitsche, M., Bermpohl, F., Antal, A., Feredoes, E., Marcolin, M. A., Rigonatti, S. P., Silva, M. T. A., Paulus, W., et al. (2005) · Experimental Brain Research · doi:10.1007/s00221-005-2334-6 · Cited by 1,159 · cited 1×
“For tDCS durations resulting in long-lasting after-effects (1 hour or more), an intersession interval of 48 hours to 1 week has been suggested.(14,15,43) If repetitive tDCS is performed to prolong and stabilize long-lasting after-effects, subjects are generally stimulated once a day.”
BackgroundSelf-citationSafety aspects of transcranial direct current stimulation concerning healthy subjects and patients
Poreisz, C., Boros, K., Antal, A., & Paulus, W. (2007) · Brain Research Bulletin · doi:10.1016/j.brainresbull.2007.01.004 · Cited by 1,153 · cited 3×
“Moreover, these protocols were tested in more than 2000-3000 subjects in laboratories worldwide with no serious side effects, except for a slight itching under the electrode, and seldom-occurring headache, fatigue, and nausea.(34) It is also possible that longer-lasting protocols are safe, because stimulation of up to…”
BackgroundMethodInfluentialSelf-citationEffects of non-invasive cortical stimulation on skilled motor function in chronic stroke
Hummel, F. C. (2005) · Brain · doi:10.1093/brain/awh369 · Cited by 1,141
Self-citationNitsche, M. A., Schauenburg, A., Lang, N., Liebetanz, D., Exner, C., Paulus, W., & Tergau, F. (2003) · Journal of Cognitive Neuroscience · doi:10.1162/089892903321662994 · Cited by 1,032
Self-citationBindman, L. J., Lippold, O. C. J., & Redfearn, J. W. T. (1964) · The Journal of Physiology · doi:10.1113/jphysiol.1964.sp007425 · Cited by 969 · cited 2×
“With constant current density, increasing stimulation duration determined the occurrence and duration of after-effects in humans and animals.(3,13-15) Therefore tDCS protocols should state current strength and shape, electrode size, and stimulation duration for comparability between studies.”
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- Fregni, 2008, Cortical stimulation of the prefrontal cortex with transcranial direct current stimulation reduces cue-provoked smoking craving: a randomized, sham-controlled study, J Clin Psychiatry, 69, 32, 10.4088/JCP.v69n0105 · DOI
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BackgroundNoninvasive Brain Stimulation Techniques Can Modulate Cognitive Processing
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“Therefore, breaks in the sense of spatial or social presence and plausibility may occur (Slater, 2009; Oh et al., 2019).”
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Variable Neural Contributions to Explicit and Implicit Learning During Visuomotor Adaptation
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“11 18–23 We wished to establish the efficacy of using a patent’s response to motor cortex rTMS as a screening method for tDCS designed for home-based use and to assess the feasibility and efficacy of using home-based tDCS therapy in two groups of neuropathic pain patients (responders vs…”
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“…complex (Horvath, Carter, & Forte, 2014), anodal tDCS generally promotes depolarisation of resting membrane potentials in underlying cortical tissue (increasing rates of neuronal firing), while cathodal tDCS is understood to promote hyperpolarisation and reduce firing rates (Nitsche et al., 2008).”
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Self-citationForogh, B., Haqiqatshenas, H., Ahadi, T., Ebadi, S., Alishahi, V., & Sajadi, S. (2021) · Neurophysiologie Clinique · doi:10.1016/j.neucli.2021.03.002 · Cited by 35
Electroresponsive Hydrogels for Therapeutic Applications in the Brain
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Boosting working memory: uncovering the differential effects of tDCS and tACS
Senkowski, D., Sobirey, R., Haslacher, D., & Soekadar, S. R. (2022) · Cerebral Cortex Communications · doi:10.1093/texcom/tgac018 · Cited by 37
Multi-Scale Computational Models for Electrical Brain Stimulation
Seo, H., & Jun, S. C. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00515 · Cited by 34
“While TMS is a neurostimulation approach that activates neurons, TCS is a neuromodulatory approach that uses low current ( ∼ 2 mA) to shift the resting membrane potential (Wagner et al., 2007; Nitsche et al., 2008).”
MethodUsing Brain Technologies in Practice
Bertollo, M., Doppelmayr, M. M., & Robazza, C. (2020) · Wiley eBooks · doi:10.1002/9781119568124.ch32 · Cited by 35
Zheng, Y., Liu, C. W., Chan, D. X. H., Ong, D., Ker, J., Ng, W. H., & Wan, K. R. (2023) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2023.05.003 · Cited by 37
Excitability changes in the visual cortex quantified with signal detection analysis
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RetractedSandars, M., Cloutman, L. L., & Woollams, A. M. (2015) · Neural Plasticity · doi:10.1155/2016/8428256 · Cited by 34
“tDCS is considered safe when administered in accordance with the established conventions and, unlike TMS, it is not associated with an increased seizure risk [65, 66, 83–85].”
Hasan, A., Aborowa, R., Nitsche, M. A., Marshall, L., Schmitt, A., Gruber, O., Falkai, P., & Wobrock, T. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0298-7 · Cited by 35
Self-citationCurrent and emerging strategies for treatment of childhood dystonia
Bertucco, M., & Sanger, T. D. (2014) · Journal of Hand Therapy · doi:10.1016/j.jht.2014.11.002 · Cited by 34
Strube, W., Nitsche, M. A., Wobrock, T., Bunse, T., Rein, B., Herrmann, M., Schmitt, A., Nieratschker, V., Witt, S. H., Rietschel, M., et al. (2015) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyu040 · Cited by 35
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Gögler, N., Willacker, L., Funk, J., Strube, W., Langgartner, S., Napiórkowski, N., Hasan, A., & Finke, K. (2016) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-016-0761-y · Cited by 36
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“This finding is consistent with previous studies highlighting the neuromodulatory effects of a-tDCS on superficial neuronal assemblies closest to the anode (Nitsche et al. , 2008).”
BackgroundResultDisruption of cortical synaptic homeostasis in individuals with chronic low back pain
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“…of time usually on the order of minutes. tDCS delivers a weak polarizing electrical current to the cortex through a pair of electrodes, and brain excitability can be increased via anodal stimulation or decreased via cathodal stimulation depending 2008; Paulus, 2011; Polania, Nitsche, & Ruff, 2018).”
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Neural correlates of visual aesthetic appreciation: insights from non-invasive brain stimulation
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Stimulating aged brains with transcranial direct current stimulation: Opportunities and challenges
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Ghasemian-Shirvan, E., Mosayebi-Samani, M., Farnad, L., Kuo, M.-F., Meesen, R. L. J., & Nitsche, M. A. (2022) · Brain Stimulation · doi:10.1016/j.brs.2022.01.011 · Cited by 34
Self-citation
Metadata
- Authors
- Nitsche, M. A., Cohen, L. G., Wassermann, E. M., Priori, A., Lang, N., Antal, A., Paulus, W., Hummel, F., Boggio, P. S., Fregni, F., & Pascual-Leone, A.
- Affiliations
- University of Göttingen (DE)
- National Institutes of Health (US)
- University of Milan (IT)
- Christian-Albrechts-Universität zu Kiel (DE)
- Universität Hamburg (DE)
- Universidade Presbiteriana Mackenzie (BR)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Nitsche, Michael A.
- ORCID
- Venue
- Brain Stimulation
- Publisher
- Elsevier BV
- Published
- 2008-07
- Volume
- 1
- Issue
- 3
- Pages
- 206-223
- ISSN
- 1876-4754 (ISSN-L)
- 1935-861X
- OpenAlex
- W2162932719
- Cited by
- 3,057
- References
- 122
- Citations by year
- 2026: 110 · 2025: 166 · 2024: 152 · 2023: 175 · 2022: 168 · 2021: 218 · 2020: 233 · 2019: 298 · 2018: 239 · 2017: 208 · 2016: 234 · 2015: 227 · 2014: 181 · 2013: 172 · 2012: 113
- FWCI
- 4.64
- Type
- journal article
- Language
- en
- Open access
- green
- doaj.org
- Licence
- Locations
- Brain stimulation (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Topics
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Electroconvulsive Therapy Studies
- Keywords
- transcranial direct current stimulation, non-invasive brain stimulation, cortical excitability, behavioral effects, brain disorders
- MeSH terms
- Animals, Cerebral Cortex, Transcutaneous Electric Nerve Stimulation, Humans, Research Design, Transcranial Magnetic Stimulation
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