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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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Cites
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.”
Background
Research works printed but not linked: 1
- 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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“As research in animals has indicated that cellular changes induced directly after tDCS have fully returned to baseline levels after 48 hr (see Nitsche et al., 2008), a 2-day gap was implemented between the last stimulation session and the postsession to ensure that the temporary effects of tDCS…”
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BackgroundDosage-Dependent Effect of Dopamine D2 Receptor Activation on Motor Cortex Plasticity in Humans
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Self-citationPutative physiological mechanisms underlying tDCS analgesic effects
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Self-citationGreinacher, R., Buhôt, L., Möller, L., & Learmonth, G. (2019) · European Journal of Neuroscience · doi:10.1111/ejn.14497 · Cited by 71
“This brief stimulation period seems not to induce any substantial neuromodulatory effects (Nitsche et al., 2008) but enables the initial cutaneous sensations associated with stimulation, including tingling, itching, burning and headache (Brunoni | 3381 GREINACHER Et Al . et al., 2011; Gandiga,…”
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Self-citationNoninvasive brain stimulation in neurorehabilitation
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“On the cerebral cortex, excitation could be achieved selectively by anodal stimulation, and an inhibition by cathodal stimulation (Nitsche and Paulus 2000; Nitsche et al. 2008).”
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“…with a 5 min delay added between the onset of stimulation and the experimental tasks (duringwhich participants read the instructions again from the computer screen) to ensure tDCS effects were fully engaged at task initiation (see Nitsche& Paulus, 2000; Nitsche et al., 2008; Price et al., 2015).”
Non-invasive brain stimulation to enhance cognitive rehabilitation after stroke
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Self-citationEffects of HD‐tDCS on Resting‐State Functional Connectivity in the Prefrontal Cortex: An fNIRS Study
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Self-citationPreconditioning tDCS facilitates subsequent tDCS effect on skill acquisition in older adults
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BackgroundMethodModulating Motor Learning through Transcranial Direct-Current Stimulation: An Integrative View
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“As the static field induced by the applied current is weak, tDCS does not cause direct changes in brain activation patterns by creating neural action potentials (Nitsche et al., 2008).”
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Transcranial direct current stimulation
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“A fair sized body of published literature suggests that tDCS has positive effects on cognitive abilities and could be an alternative treatment for various brain disorders (Fregni and Pascual-Leone, 2007; Nitsche et al., 2008, 2009; Brunoni et al., 2012; Dedoncker et al., 2016).”
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Neurostimulation as a promising epilepsy therapy
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“The modulation of cortical excitability under and between the electrodes is still under debate and investigation [10, 60].”
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Design Guideline for Developing Safe Systems that Apply Electricity to the Human Body
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Reprint of: Transcranial direct current stimulation (tDCS) – Application in neuropsychology
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“In most studies, anodal tDCS enhances, while cathodal tDCS reduces cortical excitability, however, some stimulation-intensity, and duration-dependent non-linear effects of the stimulation have been described recently (Batsikadze et al., 2013; Monte–Silva et al., 2013; Nitsche et al., 2008).”
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Self-citationNoninvasive Brain Stimulation in Pediatric Attention-Deficit Hyperactivity Disorder (ADHD)
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Noninvasive Brain Stimulation and Neural Entrainment Enhance Athletic Performance—a Review
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“Improvisation during stimulation was done to maximize tDCS effects on the offline performances (Gill et al., 2015), and stimulation length was decided based on previous reports that tDCS of 10 min or longer can have lasting effects for up to 1 h (Nitsche et al., 2008).”
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“…weak direct currents that are capable of modulating cortical excitability in different areas of the human brain (Nitsche and Paulus, 2000, 2001; Nitsche et al., 2008; aPresent address: Monash Biomedical Imaging, Monash University, 770 Blackburn Road, Clayton, Melbourne, Victoria 3800,…”
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Self-citationNeuromodulatory Effects of HD-tACS/tDCS on the Prefrontal Cortex: A Resting-State fNIRS-EEG Study
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Self-citationRandomized Trial of Transcranial Direct Current Stimulation and Hearing Aids for Tinnitus Management
Shekhawat, G. S., Searchfield, G. D., & Stinear, C. M. (2013) · Neurorehabilitation and neural repair · doi:10.1177/1545968313508655 · Cited by 61
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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