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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
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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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“[13] [14]), but only a few reported the number of responders.”
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Self-citationBrain stimulation enables the solution of an inherently difficult problem
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“…densities that do not directly lead to increases in neural spike rate but instead are thought to modulate population neuronal excitability (Coslett, Hamilton, Nitsche, & Paulus, 2011; Nitsche et al., 2008; Wagner, Valero-Cabre, & Pascual-Leone, 2007; Zaghi, Acar, Hultgren, Boggio, & Fregni, 2010).”
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“The E=field distributions are dependent on the gradient coil design and these E-fields as well as the resultant current densities can be evaluated through computation simulations and knowledge of tissue conductivity distributions (Nyenhuis et al., 1997).”
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Self-citationImproved multitasking following prefrontal tDCS
Filmer, H. L., Mattingley, J. B., & Dux, P. E. (2013) · Cortex · doi:10.1016/j.cortex.2013.08.015 · Cited by 100
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“…the development of the voltaic pile (Hellwag & Jacobi, 1802) its long-lasting after effects only became clear when it became possible to measure them objectively by comparing TMS-evoked motor-evoked potentials (MEPs) before and after tDCS (Nitsche & Paulus, 2000; overview in Nitsche et al. 2008).”
BackgroundSelf-citationThe effect of transcranial direct current stimulation of the motor cortex on exercise-induced pain
Angius, L., Hopker, J., Marcora, S., & Mauger, A. R. (2015) · European Journal of Applied Physiology · doi:10.1007/s00421-015-3212-y · Cited by 100
“…study, it is generally accepted that sensitivity to somatosensory inputs is reduced after cathodal tDCS administration to the motor and somatosensory cortex, probably because of the alteration of the resting membrane potential in the targeted area (Nitsche et al. 2008; Schestatsky et al. 2013).”
BackgroundElmer, S., Burkard, M., Renz, B., Meyer, M. E., & Jäncke, L. (2009) · Behavioral and Brain Functions · doi:10.1186/1744-9081-5-29 · Cited by 100
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“To ensure stable stimulation effects according to Nitsche et al. (2008), each participant received 5 min of tDCS before he started with the Flanker task (Figure 1D).”
MethodWeinberger, A. B., Green, A. E., & Chrysikou, E. G. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00246 · Cited by 100
“…current to the cortex through surface electrodes positioned on the scalp to modulate the excitability of neurons within a region of interest (Nitsche et al., 2008; Stagg and Nitsche, 2011). tDCS studies may use anodal stimulation (generally intended to increase regional cortical…”
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Visual memory improved by non-invasive brain stimulation
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Astroglia in Alzheimer’s Disease
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“This has been shown to be a reliable and effective sham-procedure to simulate the sensations observed at the beginning of active stimulation without modifying cortical excitability [11, 33, 34].”
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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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