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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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“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
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“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…”
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Anodal transcranial direct current stimulation of prefrontal cortex enhances working memory
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“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…”
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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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A Direct Brain-to-Brain Interface in Humans
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“…of different quality, with the online effects observed at a narrow frequency peak, and the offline effects seen in a broader band around this peak discounting the trivial explanation that the correlated online and offline effects may simply reflect the same phenomenon measured at two time points.”
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Self-citationTranscranial direct current stimulation – update 2011
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“Traditionally, tDCS involves two electrodes placed on the scalp surface: a positively charged anode (thought to enhance excitability of underlying cortex) and a negatively charged cathode (thought to suppresses excitability of underlying cortex) (Nitsche et al. 2008).”
BackgroundCutaneous perception thresholds of electrical stimulation methods: Comparison of tDCS and tRNS
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Self-citationRetinal origin of phosphenes to transcranial alternating current stimulation
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“The waveform of the 140 Hz stimulation was sinusoidal (Moliadze et al., 2012).”
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“47,48 The ef fi cacy of these changes depends on the duration of stimulation.”
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“Transcranial direct current stimulation (tDCS) is a safe and noninvasive technique to modulate CSE in a polarity-dependent manner (Nitsche et al., 2008; Priori, Berardelli, Rona, Accornero, & Manfredi, 1998).”
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Self-citationNon-invasive brain stimulation techniques for chronic pain
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Time- but Not Sleep-Dependent Consolidation of tDCS-Enhanced Visuomotor Skills
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“However, these side effects seem to be safe, transient and could be tolerated well by most subjects (Nitsche et al., 2008; Loo et al., 2009; Miranda et al., 2009; DaSilva et al., 2011).”
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Self-citationThe Interaction With Task-induced Activity is More Important Than Polarization: A tDCS Study
Bortoletto, M., Pellicciari, M. C., Rodella, C., & Miniussi, C. (2014) · Brain stimulation · doi:10.1016/j.brs.2014.11.006 · Cited by 149
Multitarget transcranial direct current stimulation for freezing of gait in Parkinson's disease
Dagan, M., Herman, T., Harrison, R. M., Zhou, J., Giladi, N., Ruffini, G., Manor, B. D., & Hausdorff, J. M. (2018) · Movement Disorders · doi:10.1002/mds.27300 · Cited by 149
Hortensius, R., Schutter, D. J. L. G., & Harmon‐Jones, E. (2011) · Social Cognitive and Affective Neuroscience · doi:10.1093/scan/nsr012 · Cited by 148
Vitor-Costa, M., Okuno, N. M., Bortolotti, H., Bertollo, M., Boggio, P. S., Fregni, F., & Altimari, L. R. (2015) · PLoS ONE · doi:10.1371/journal.pone.0144916 · Cited by 147
Self-citationSalehinejad, M. A., Wischnewski, M., Ghanavati, E., Mosayebi-Samani, M., Kuo, M., & Nitsche, M. A. (2021) · Nature Communications · doi:10.1038/s41467-021-24885-0 · Cited by 157
Self-citationSalehinejad, M. A., Wischnewski, M., Nejati, V., Vicario, C. M., & Nitsche, M. A. (2019) · PLOS ONE · doi:10.1371/journal.pone.0215095 · Cited by 126
Self-citationDeep brain stimulation for enhancement of learning and memory
Suthana, N., & Fried, I. (2013) · NeuroImage · doi:10.1016/j.neuroimage.2013.07.066 · Cited by 144
tDCS possibly stimulates glial cells
Ruohonen, J., & Karhu, J. (2012) · Clinical Neurophysiology · doi:10.1016/j.clinph.2012.02.082 · Cited by 145
Transcranial Direct Current Stimulation in Epilepsy
San‐Juan, D., Morales-Quezada, L., Garduño, A. J. O., Alonso‐Vanegas, M., González-Aragón, M. F., Lopez, D., Gregorio, R. V., Anschel, D. J., & Fregni, F. (2015) · Brain stimulation · doi:10.1016/j.brs.2015.01.001 · Cited by 145
Self-citationBatista, E. K., Klauss, J., Fregni, F., Nitsche, M. A., & Nakamura-Palacios, E. M. (2015) · International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyv066 · Cited by 144
Self-citationIncreasing propensity to mind-wander with transcranial direct current stimulation
Axelrod, V., Rees, G. E., Michal Lavidor, B., & Bar, M. (2015) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1421435112 · Cited by 149
Dynamic modulation of intrinsic functional connectivity by transcranial direct current stimulation
Sehm, B., Schäfer, A., Kipping, J., Margulies, D. S., Conde, V., Taubert, M., Villringer, A., & Ragert, P. (2012) · Journal of Neurophysiology · doi:10.1152/jn.00606.2012 · Cited by 145
Neuromodulation techniques – From non-invasive brain stimulation to deep brain stimulation
Davidson, B., Bhattacharya, A., Sarica, C., Darmani, G., Raies, N., Chen, R. E., & Lozano, A. M. (2024) · Neurotherapeutics · doi:10.1016/j.neurot.2024.e00330 · Cited by 166
“In general, anodal tDCS increases cortical excitability through depolarization of the resting membrane potentials, and cathodal tDCS reduces cortical excitability, due to hyperpolarization of the resting membrane potential [37,38].”
BackgroundFatigue in Multiple Sclerosis: Neural Correlates and the Role of Non-Invasive Brain Stimulation
Chalah, M. A., Riachi, N. J., Ahdab, R., Créange, A., Lefaucheur, J., & Ayache, S. S. (2015) · Frontiers in Cellular Neuroscience · doi:10.3389/fncel.2015.00460 · Cited by 146
“Moreover, tDCS appears to be an NIBS technique with a good safety profile, easy implementation, good patients’ tolerance and little or no adverse effects (Poreisz et al., 2007; Nitsche et al., 2008; Brunoni et al., 2012).”
BackgroundFood Addiction: Implications for the Diagnosis and Treatment of Overeating
Adams, R. C., Sedgmond, J., Maizey, L., Chambers, C., & Lawrence, N. (2019) · Nutrients · doi:10.3390/nu11092086 · Cited by 158
Oliveira, J. F., Zanão, T. A., Valiengo, L., Lotufo, P. A., Benseñor, I. M., Fregni, F., & Brunoni, A. R. (2013) · Neuroscience Letters · doi:10.1016/j.neulet.2013.01.023 · Cited by 138
Self-citationCreativity comes in waves: an EEG-focused exploration of the creative brain
Stevens, C. E., & Zabelina, D. L. (2019) · Current Opinion in Behavioral Sciences · doi:10.1016/j.cobeha.2019.02.003 · Cited by 149
Bennabi, D., Nicolier, M., Monnin, J., Tio, G., Pazart, L., Vandel, P., & Haffen, É. (2014) · Clinical Neurophysiology · doi:10.1016/j.clinph.2014.09.026 · Cited by 135
Controversy: Noninvasive and invasive cortical stimulation show efficacy in treating stroke patients
Hummel, F. C., Celnik, P. A., Pascual-Leone, A., Fregni, F., Byblow, W. D., Buetefisch, C. M., Rothwell, J. C., Cohen, L. G., & Gerloff, C. P. (2008) · Brain stimulation · doi:10.1016/j.brs.2008.09.003 · Cited by 140
Self-citationCan tDCS enhance treatment of aphasia after stroke?
Holland, R., & Crinion, J. (2011) · Aphasiology · doi:10.1080/02687038.2011.616925 · Cited by 135
Prefrontal tDCS Decreases Pain in Patients with Multiple Sclerosis
Ayache, S. S., Palm, U., Chalah, M. A., Al-ani, T., Brignol, A., Abdellaoui, M., Dimitri, D., Sorel, M., Créange, A., & Lefaucheur, J. (2016) · Frontiers in Neuroscience · doi:10.3389/fnins.2016.00147 · Cited by 140
“All participants were well instructed about the protocol and voluntarily gave their written informed consent prior to inclusion.”
BackgroundElectrode Positioning and Montage in Transcranial Direct Current Stimulation
DaSilva, A. F. M., Volz, M. S., Bikson, M., & Fregni, F. (2011) · Journal of Visualized Experiments · doi:10.3791/2744-v · Cited by 137
Self-citationGuerra, A., Pogosyan, A. H., Nowak, M. A., Tan, H., Ferreri, F., Lazzaro, V. D., & Brown, P. (2016) · Cerebral Cortex · doi:10.1093/cercor/bhw245 · Cited by 144
“Anodal (positive) current causes depolarization of the resting membrane potentials of local neurons, which increases neuronal excitability and allows for more spontaneous cell firing (Nitsche et al. 2008).”
BackgroundEnhancing verbal episodic memory in older and young subjects after non-invasive brain stimulation
Manenti, R., Brambilla, M., Petesi, M., Ferrari, C., & Cotelli, M. (2013) · Frontiers in Aging Neuroscience · doi:10.3389/fnagi.2013.00049 · Cited by 145
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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